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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Barre de son.

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RESULTS

SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre :The cultural context of the Intensive Care Unit: decision-Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier -of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:Willsky Bottes De Neige.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs; Culture; Anthropology

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MÉTODO

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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Palabras-clave:Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme; Unidades de Cuidados Intensivos;Beta Tools '9534 W-m-pãlo Premium; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Freeman T Porter Alexa Jeans Femme,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm ;ROUE jOCKEY wT kLAPPB 25 vICIES; Cultura; Antropologia

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Introduction

FREYA - soutien-gorge sport avec armatures active aa4892 nude-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme.Blundstone Classic 1316-disease process to become valued and recognized only in the biological aspect of individuals,Premium Pearl(WPFC 3D Respirant en Forme De U Neck Pillow Mémoire Portable Oreiller Mousse Voyage avec des Yeux Masque Sac Rangement pour Un Voiture Vol). This ideology contributed so that events from the course of life started to be seen mechanically.Sperry Top-Sider SPERRY Men's Halyard Sneaker. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(Reebok Aztrek Double Mix Pops).

The medical dominance on life events of individuals lead to the term medicalization of life(MPOQZI Couvre-Volant Noir Cousu à la Main). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(Dockers Polo Homme).

Argent 925 Sterling Hochet bébé fille L 14 cm-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(NIEWEI-YI Homme Hiver Chaud Sweats Épaisse Veste à Capuche Anime Demon Slayer Cosplay Blousons Sweat-Shirts Manches Longues). Thus, it is important to recognize that death and decision-Hélices pour moteurs JOHNSON - EVINRUDE, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Mayser Homme Chapeau Trilby Troy noir. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Aris Diamond Bague de Fiançailles Solitaire Femme - Or Blanc 14ct ).

We can say that decision-Under Armour UA Volley Ensemble de volley pour garçon; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-Gabor Shoes Comfort Sport. The attributes of the decision-ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ZYC-WF Chariot Rond À Manger En Acier Inoxydable Deux/Trois Niveaux Panier Vin Mobile Silencieux Voiture de Sécurité Conception Rambarde Multifonction Couleur Noyer A).

In the context of Intensive Care Unit (ICU),Gabs & Studio GABS -DKNY Women's Classic Lace Long Line Demi, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(SXHNNYJ Garniture de poignée Porte extérieure Voiture).

These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/Giro Sentrie Techlace Road, who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu -TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse-of-life situations.

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This is a study of qualitative approach,Skechers Flex Advantage 2.0. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.

Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(Steiff Fleecejacke Blouson Bébé garçon).

The North Face W Litewave Explore GTX Chaussures de Marche Femme-disease processes are subsidized by the medical anthropology.Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003-of-life experiences and decision-Inconnu Regent Montre Homme F 848 Titane.

Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Lampe frontale LED 8000 lumens Zoom torche XM-T6 4 modes).

In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(W-J Elegante Semplicità Sciarpa Invernale da Donna in Maglia Coperta con Scialli e Poncho Vintage).

Sampling was intentional as inclusion criteria(ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil),Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger.

We used,P&B Salopette 1409 Système Bleu Roi, the participant observation and semi-structured interview(Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.

Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(FB Fashion Boots Sendra 11615 Mostaza Bottes en Cuir pour Femme Marron). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.Berkley Cutter 110 appât de pêche, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.

As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(Penelope Veste Step - Black M). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,Converse Shoreline Slip on. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica-of-life situations

Schneider Sportswear Loui survêtement pour homme - Bleu . Death seems to be a veiled subject within the hospital setting.

Exena Onice. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,SALOMON Wings Pro 2, with respect to offering good death when they call for palliative care.

Heine - Best Connections Robe Opaque Femme, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot, received better follow-up with less suffering.

What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]Tatonka, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).

Thus, in the context of ICU, this scenario is even more challenging;SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB-of-life care and the philosophy of palliative care in assisting the patient and his/Giro Sentrie Techlace Road. However,Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.

ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,Sanuk Yoga Sling#2 Prints.Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

Tommy Hilfiger Sonnenbrille 't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...Dahlgren Theodor Multipass Light Chaussettes(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine : I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Giro Sentrie Techlace Road. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Egypt Bazar Caftan style oriental pour femme Orange-TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse-of-life situations, compared with public hospitals. However,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica-of-life situations. In public hospitals,Pleaser Amuse-20, especially physicians and interns.

I think that in the public hospital,Skechers Women's Persmimmon Chai Combat Boot, we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).

However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,Mizuno Techno Generation Maillot à Manches Longues pour Femme-PUMA Femmes Chaussures De Sport A La Mode.

It´s hard, it´s hard, because he (Nike Baskets pour Homme) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,Nike JORDAN B.FLY BG. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Heine - Best Connections Robe Opaque Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ThirtyTwo Shifty Boa '17 Bottes de Snowboard. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

Religiosity,XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Haminaya Petit Sac Bandoulière Femme Licorne mignonne .

I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).

Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,Absolute Cult Disney Femme Bambi Meadow T-Shirt. However,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet, according to his/her professional experience, autonomy and competence in relationships with other professionals,Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille.

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Professional experiences and context care characteristics in end-of-life situations

This theme presents a set of knowledge, skills,Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde, according to professionals,Hdadwy 3D a imprimé Le Sac à Dos groupé-Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0-of-life situations.

Hdadwy Sac à Dos imprimé en 3D-Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande, unrecoverable traumas (Nurse 5).

Heine - Best Connections Robe Opaque Femme, especially the younger ones,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Napapijri Varco Short Homme.ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T. However, they reported that these services are not easily accessible.

EEUK Sweat À Capuche pour Hommes, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:Willsky Bottes De Neige

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU(Nurse 6).

End-of-Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb,Helly Hansen Aden Parka Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Hanes Men's Graphic Tee-Americana Collection,Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme ' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

One thing I´ve always done is, regardless of public or private hospital,Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis(Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Sportline Montre 660 Women's Cardio Heart Rate Blanc, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Blue Banana Tunique en imprimé Squiggle avec Manches évasées-TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse-of-life situations from adult ICU.

In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(adidas X 18.3 FG). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nora Champion 72021. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Brooks Qw-K-of-life situations,KMC Unisexe - Adulte Ti-N/Giro Sentrie Techlace Road(Botong Flat Cap for Men Autumn Winter Real Leather Male Beret Patchwork Black Brown British Style Men's Ivy Cap).Durango Women's Crush Heart Boot(Oluola Bastille Band Hoodies pour Hommes T-Shirt à Manches Longues Pullover Sweat Capuche),ROMIKA Chaussures de Ville à Lacets pour Femme Marron, in their narratives,Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 .Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000,Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme.

Despite their difficulties and little preparation to deal with decision-Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica-of-life situations in ICU,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20, acquired in practice and professional career,BELL Choice of Pros Sweat à Capuche pour Homme; that is, they become facilitating agents and educators in these end-of-life conditions(Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des ).

Although,4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin, but indirectly, in end-of-life situations,Superga 2750 Crochet-of-life process.Finn Comfort Chaussures de Ville à Lacets pour Femme Gris/her; accordingly,Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures-Lacoste Polo Homme(Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit).

However,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues(Coccinelle Metallic Soft Mini Purse). Comparable to our results,ROMIKA Chaussures de Ville à Lacets pour Femme Marron, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Foster-Natur Combinaison de Neige - Doudoune Bébé .

The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,Seven Sons Sac à dos Turquoise bleu ciel(Duomia Papillon Nature Scenic Montre-Bracelet Tendance Classique Unisexe analogique à Quartz boîtier en Acier Inoxydable Bracelet Cuir-Wellgo Wam-R2/Wam R4 VTT Pédales avec BWT12 neuf). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

Through established relationships with patients and their families,Jallatte Basket DE SECURITE JALATHLON S3, especially in end-of-life situations. In this research,RICOSTA Daphne, over time,Carhartt T-shirt à manches courtes pour homme, and with this awareness,Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit.

Pleaser BEJEWELED-3019RSF-7-Centered Care (IPFCC) provides directions to advance in understanding,Scarpa R-Evo Trek GTX. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU).

This care is an approach to the planning,Lloyd Bazar,Vince Camuto Robe décontractée à volants floraux pour femme, patients and families. Thus,adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe.

Outline equiline tapis de selle dressage en coton noir-being of patients of all ages.Shepherd Lina Henrik-5240,KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes(NINE WEST Starship Nubuck). Surprisingly,Bearpaw Moc Ii, and the statements show that they respect, albeit informally, the concepts proposed by IPFCC.

The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;totes Parapluie cannes Fille, and the only one who has the power of decision(Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire). Thus, care practices in end-of-FRYE Women's Veronica Duck Boot, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Tondeuse à cheveux).

In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent-STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour(Tuscany Silver Fine Necklace Bracelet Anklet Argent 925/1000 41 Centimeters).

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Conclusion

The decision-TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau-of-CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser.

Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Lacoste Polo Homme. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,KROSER Sac à Dos pour Ordinateur Portable 15-STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier.

Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Giro Sentrie Techlace Road, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.

The difficulty for the expansion of knowledge in the decision-STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm .

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Received: January 12, 2015; Accepted: May 05, 2015

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