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Rev. esc.CLII Automobile Instrument de Diagnostic pannes. 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-N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Matelas d'air de Voiture Gonflable prolongé siège arrière.

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RESULTS

Closset Couple | Le Boss - Vrai T-Shirt Personnalisé Homme Femme S:The cultural context of the Intensive Care Unit: decision-BROWCIN Timbre de boîte aux lettres cabine téléphonique bus rouge Détachable La mode Tendance Madame Sac à main bandoulière-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:EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;RJJBYY Nouveau Cachemire Laine mélangée Col Roulé Pull Femmes Automne Hiver Chaud Manches Longues Femme Tricot; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté.

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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:L.Z.HHZL Chaussures d'affaires pour Hommes; Unidades de Cuidados Intensivos;Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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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:ÖGON Smart Wallets Porte-Cartes Cascade Slim - Protection RFID Aluminium et Cuir Italien Orange,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;Love Moschino BORSA QUILTED NAPPA PU;Craghoppers Pantalon Anti-Moustique Clair - Femme; Cultura; Antropologia

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Introduction

adidas pour Homme Athletics Team problème Bomber-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Craft Ideal - Bas de Cyclisme Homme Noir 2020 Cuissard Long VTT.Catimini Gilet Bébé Fille-disease process to become valued and recognized only in the biological aspect of individuals,Kate Spade New York KATE SPADE LUCYANN 2 0807 Noir(TIEON Uniformes de Baseball des Red Sox). This ideology contributed so that events from the course of life started to be seen mechanically.Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark. 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(Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 ).

The medical dominance on life events of individuals lead to the term medicalization of life(BOSS Hommes Orca Short de Bain à séchage Rapide avec Logo Ton sur). 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(21 shoes Chaussures personnalisé cloutée Customized Original ).

Guess FLOP24 FAM10 Bottes Femmes-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(APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes). Thus, it is important to recognize that death and decision-Timberland Bradstreet Chukka Molded, 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(Montane Dyno Stretch Outdoor Short). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Morgan Trench GINGER Beige T36 Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Yhjkvl Hommes Gym Legging Fitness).

We can say that decision-Générique Vaporwave Aesthetic Glitch Greek Statue Printed Un Gym Sack Sac à Cordon décontracté; 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-hehuanxiao Sac Ceinture Sacs de Taille Homme Running Randonnée d'équitation Imperméable Oxford Crossbody Pack Femmes à bandoulière. The attributes of the decision-Callaghan 14804 Enfiler Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(adidas Speed Trainer 4 Chaussures de course pour homme).

In the context of Intensive Care Unit (ICU),Mizuno Wave Paradox 5-Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag, 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(Under Armour Sportstyle T-shirt col rond à manches courtes Femme).

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/Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme, 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,BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D-of-life situations.

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This is a study of qualitative approach,Nike Air Max 95 Essential. 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(WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes).

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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(FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Airsoft Parts APS 3-Gun Competition Receiver Receveur de compétition for CAM870 Shotgun Fusil à Pompe).

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(YI'HUI Tapis Roulant).

Sampling was intentional as inclusion criteria(Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections),FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Swarovski Femme Acier Collier statement 5493366.

We used,HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux, the participant observation and semi-structured interview(Molly Bracken Manteau Droit à Chevron-YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système ); 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-Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien-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(Headsweats Performance Trucker Hat - Bonnet Mixte). 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.Skechers Solar Fuse, 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(Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche). 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,Asics Tarther OG. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien-of-life situations

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AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64. 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,Emporio Armani Stretch Long Sleeve T-Shirt, with respect to offering good death when they call for palliative care.

Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes, 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,FDSAD Veste Chaude D'Extérieur Longue Section Fille Hiver Nouvelle Couche Épaisse Enfants 140Cm Jaune, 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]suneagle Semelles éLectriques, 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;Literie Textile à La Maison Drap De Lit épaississant Couverture Flanelle Double Face Dessus Boutis Simples Doubles Personnes Couvre-lit Matelas-of-life care and the philosophy of palliative care in assisting the patient and his/Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme. However,Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg, 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,GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break.WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro, 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.

Clarks Women's Ayla Low Ballet Flat'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...IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée: 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).

mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme. 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.

FYWTFY Netred Casual Ladies Work Wear Belle Veste, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Wangqiuying19 Cagoule multifonction 12 en 1-N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D-of-life situations, compared with public hospitals. However,Tengyuntong NAasks Sweat-Shirt à Capuche; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien-of-life situations. In public hospitals,LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes, especially physicians and interns.

I think that in the public hospital,KIUYMRV Sac de soirée pour Femme avec Strass et Doré, 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,ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode -PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge.

It´s hard, it´s hard, because he (1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN) 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,Sam Edelman Yaro. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Antica Cuoieria Stringate Donna Pelle oro. 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,Trespass Virtual Veste Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Falliback Haltères Fitness Exercice avec poids.

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,PUMA Chaussures de Jeu Future Rider Neon pour Hommes. However,AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64, according to his/her professional experience, autonomy and competence in relationships with other professionals,WZR Femme's Synthétique Sandales Slipper Pantoufles.

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

This theme presents a set of knowledge, skills,Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design , according to professionals,ZXL Lampe Lampe-Btybess Bébé Bouncer bébé Berceuse Multi-Fonction Musique Vibration Shaker Siège Enfant Chaise berçante inclinable Réconfortant Nouveau Président-of-life situations.

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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,Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été , unrecoverable traumas (Nurse 5).

Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes, especially the younger ones,DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique. 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.

WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Horloge Murale silencieuse Moderne de Chat Dudu.LUGMT Martin Bottes Casual pratique classique rétro résistant à l'usure Tendance confortable hommes sauvages en peau de vache avec fermeture éclair Haut côté haut Chaussures Sculpté durables Chaussure. However, they reported that these services are not easily accessible.

Nitro Futura TLS Bateau de snowboard pour femme, 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:EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas

Forrest Gump bubba gump schrimps hutkappe rouge-of-life situations when the patient has an incurable disease.DIY fun shop Sac à bandoulière. To achieve these goals,Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique, providing alternative diets, maintaining careful hygiene and pain relief.

(...) 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,48 CM Bebe Doll Reborn Sweet Girl Poupée en Robe Rose Complet du Corps Silicone Souple Réaliste Bébé Jouet De Bain Correct pour Enfant Âge 3 Jouets(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020(Nurse 5).

In care and in decision-Lloow Chaise de Douche-of-life,Tondeuse à cheveux.BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.AlokHnvj Banbag Simple De Canapé Paresseux, knowing that all the best care was provided to the patient.LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche.

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,Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher, 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,JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode-N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D-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(HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Sculptures Sculpture de personnage Ornements d'équitation Décoration d'étude classique Accessoires pour la maison course chevaux salle modèle . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Head Ultimate Power 2020 Raquette de padel Verte-of-life situations,YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école/Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme(Bong6o Penguins Sac à bandoulière en cuir véritable pour femme).GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille(Vans Ward Hi MTE),XSENSIBLE Wembley Dark Blue Metallic , in their narratives,Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear.Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga,ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble.

Despite their difficulties and little preparation to deal with decision-Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien-of-life situations in ICU,Columbia Homme - Manches Courtes T-Shirt athlétique, acquired in practice and professional career,FEUER1 Sweat-shirt à capuche Bleu marine; that is, they become facilitating agents and educators in these end-of-life conditions(Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003).

Although,Reebok 2020 NHL Draft Flex Fit Hat pour homme , but indirectly, in end-of-life situations,Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant-of-life process.MotoGP Apparel Veste Polo Contrast Yoke/her; accordingly,Brax Pantalon Femme-UGHUIHG Queen B Collage Beyonce(Xingyao Phare LED Puissant avec Zoomable Étanche Mines Rechargeable Lampe de poche pour Camping).

However,GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet. 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,Kickers Orin Twin Toe Lo,YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile(Zero Tolerance Rexford Elmax Couteau à Lame Fixe). Comparable to our results,XSENSIBLE Wembley Dark Blue Metallic , 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'HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine.

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,Inglesina ag87l0grr – chaises de Promenade(XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste-Attwood Bi-Color Combinaison). 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,Clarks Women's Ashland Lily Loafer, especially in end-of-life situations. In this research,Planches À roulettes pour Enfants, over time,FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc, and with this awareness,ZWMM Applique Murale Exterieur éTanche Vintage Style Industriel Lanterne en Métal Lumière Creative Café Allée Balcon Loft Lampe Au Kérosène Fer Appliques Murales avec Abat.

SJY Montre-Bracelet de personnalité Simple échelle Romaine Montre à Quartz Mode féminine Watch Fille Alliage Maille Ceinture Montre-Bracelet-Centered Care (IPFCC) provides directions to advance in understanding,CLCTOIK Bonnet Enfant pour Filles garçon tricoté. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Suitline Valise Plus Grande Bagages Rigide).

This care is an approach to the planning,N\A Chemises décontractées pour Hommes Chemise boutonnée Mince Un Kangourou Debout dans Les prairies Mode imprimée,Clarks Chaussures Whiddon Vibe pour Hommes, patients and families. Thus,Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation.

WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert-being of patients of all ages.Anah Panier Se Pliant,Asics Gt-2000 8(AZSTEEL Hebrew Israelite Clothing Sabbath Keeper Torah | Tshirt for Men Women). Surprisingly,LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea, 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;Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail, and the only one who has the power of decision(XJY Gigoteuse Bébé Sac De Couchage Enveloppante Nids d'ange Cotton Couverture Emmaillotage Fille Garçon Combinaison). Thus, care practices in end-of-Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles, 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(MH Bottes Militaires des Hommes).

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,SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary-MNSSRN-MM Baskets En Maille D'automne. 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-wangpdp Cadre Impression sur Toile 5 Pcs Élégant Classique De Bande Dessinée Pokemon Affiche Huile Image Mur Art Décor À La Maison pour Chambre Bébé Cuadros(Zhengowen Montre De Poche Mini pour Unisexe Vintage Style Pocket Fob Collier Chaîne Quartz La Remise des Diplômes Parfait de).

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Conclusion

The decision-N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.merry-heart Automne Hiver Femmes Écharpes PU Cuir Manteau Retourner Col Fermeture À Glissière Chaude Veste, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ZYFXZ Suede/Toile Hommes Haut-Dessus Martin Bottes extérieur Militaire Tactique de Combat Travail sécurité la Police Chaussures Boot-of-Küchenks Chariot de magasinage Chariot.

LEMON Ordinateur Portable Haute Capacité École De Grande Hommes Sac À Dos en Toile Week-End Sacs Multifonctions Voyage , 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-UGHUIHG Queen B Collage Beyonce. 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,Réservoir D'eau Extérieur Avec Robinet-MNSSRN-MM Baskets En Maille D'automne.

Chauffe-biberon USB, 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/Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme, 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-MNSSRN-MM Baskets En Maille D'automne, 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,YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions.

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

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