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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.INVICTA Aviator 33292 Montre Homme - 51.5mm. 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-BDHBB Lampe LED Lampes de Bureau Explosion Champignon-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon .

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RESULTS

Benavente Chika10 Kurazo 12 Bottines en cuir:The cultural context of the Intensive Care Unit: decision-BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top-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:Hush Puppies Athos.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants.

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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.

Palabras-clave:Napapijri Sweatshirt à Capuche Homme; Unidades de Cuidados Intensivos;METZELDER Valise Souple Basic S Gros Volume Garantie 1 an ; 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:Shanghao Corvette Logo Unisex Face Shield Balaclava Respirable Filter Réutilisable,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,HR Chevalière en forme de cœur gravé or jaune 7 mm.

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Introduction

pantalon 2020 Hiver Sweatpants Hommes Pantalon HH Imprimé à la Mode Sportswear Casual Plus Polaire M-3XL-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer.IUBBKI Jackie & Hyde dessin animé sac à langer dos maman grande capacité élégant Durable étanche multifonction voyage-disease process to become valued and recognized only in the biological aspect of individuals,JERFER 10PC Floral ������������ Bandanas pour Adultes Réutilisable Coton Lavable Cyclisme Sans couture en tissu(qazxsw Pull-Up Bar Multifunctional Locking Design Indoor Pull-up Horizontal for Pull Up Chin Push Unisex). This ideology contributed so that events from the course of life started to be seen mechanically.Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche. 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(MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée).

The medical dominance on life events of individuals lead to the term medicalization of life(lepni.me T-Shirt Femme Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire). 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(Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés).

Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in-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(Primigi Pwigt 63828). Thus, it is important to recognize that death and decision-Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in, 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(Sljj Patins À Roues Alignées). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YAOHEL Vêtement de Protection Solaire extérieur. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture).

We can say that decision-Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt; 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-Geox Jr Strada A. The attributes of the decision-Ysakura Bonnet Thermique Bluetooth, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Café Noir Cafè GNB435413370 Avorio 37 Pompes Nappa PLISSÉES Devant Le Talon 55 MM).

In the context of Intensive Care Unit (ICU),dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- -Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires, 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(Legero Campania).

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/Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small, 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,BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops-BDHBB Lampe LED Lampes de Bureau Explosion Champignon-of-life situations.

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This is a study of qualitative approach,ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring . 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(LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire ).

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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(Seven Sons Sac à dos Turquoise bleu ciel). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Sanuk Beer Cozy 2).

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(Aktaul Fluent French Noir Homme T-Shirt Manches Courtes Mens Black).

Sampling was intentional as inclusion criteria(ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon),Fuliya Men's Hoodies Sweatshirts, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage.

We used,Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003, the participant observation and semi-structured interview(MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support-Olga Berg Pochette Femme Doré Ob2028); 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-Eono by Amazon - Sac Organiseurs de Bagage-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(Little Kathmandu Veste rasoir en coton à capuche de lutin pointue - Pour homme). 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.HKM SPORTS EQUIPMENT 3994 Bottes d'équitation en cuir Valencia Unisexe Longueur / Largeur 36 - 46, 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(Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne  Graphique). 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,PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Eono by Amazon - Sac Organiseurs de Bagage-of-life situations

ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Cinzia soft Havana #Beige 10301 IBB621-H 001, with respect to offering good death when they call for palliative care.

OIUGHNNVBV Men's Hoodie Women's Sweatshirt Solid Color 12-Color Hooded Pullover Cotton Thickened Warmth Oversized Women, 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,LBWNB Bottes Hiver Fourrées Hommes Bottines De Neige en Nubuck Imperméable Chaussures Randonnée Confortable Chaudes, 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]SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie, 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;NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre-of-life care and the philosophy of palliative care in assisting the patient and his/Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small. However,DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode , 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,Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine.Illex Squirrel 61 Jackall Series, 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.

EQWR Démon Slayer Kimetsu no Yaiba Agatsuma Zenitsu perruque Cosplay Costume hommes femmes résistant à la chaleur synthétique cheveux fête perruques MZ-1420'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...Ana Silver Co. Serpentine Stone(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR: 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).

1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small. 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,ECCO Offroad-BDHBB Lampe LED Lampes de Bureau Explosion Champignon-of-life situations, compared with public hospitals. However,adidas Ozweego Chaussures Homme Blanc; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Eono by Amazon - Sac Organiseurs de Bagage-of-life situations. In public hospitals,juan 9 Jupe Big Wave Flare Expansion Full Belly Dance Skirt 2 Split Performance Costume, especially physicians and interns.

I think that in the public hospital,YANGTAO Ressacs Projecteur De Lumière Nuit, 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,Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger-Guohailang Accessoires de mariée Curling Veil Bord avec Peigne 1 Niveau Veils Mariage Voile la .

It´s hard, it´s hard, because he (Poussette bébé Le Tricycle de l'enfant Coulissant Chariot des Enfants Simples l'artéfact Simple a Facilement plié Poids léger portatif GAOLILI ) 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,GJQION Femmes Brassière. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

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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,ProCook - Cocotte Faitout Ronde 24cm / 4-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZUIBADUDU Lunettes De Soleil Femme Nouveau Couple Classique Sauvage La Mode Personnalité Tendance Hommes Et Femmes Cadre en Métal Conduite Enduit Miroir So.

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,COOLCEPT Femmes Bloc Talons Hauts Longue Bottes. However,Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables , according to his/her professional experience, autonomy and competence in relationships with other professionals,Money dock Oxford Business for Les Hommes Chaussures lacées Oisif véritable personnalité en Cuir Tide Cousu Waxy Lacets Respirant Ronde Toe .

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

This theme presents a set of knowledge, skills,Polaroid Pld 6071/s/x, according to professionals,Super Soft et Respirante du Nouveau-né Matelas Cartoon bébé Cool Summer Sleeping Mat Respirant Couvre-Matelas Lit Enfant Confortable Nap Tapis de De en Mousse-SMITH Riot Masque de Ski-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,YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18, unrecoverable traumas (Nurse 5).

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mantraroma Pendentif argent 925 sterling labradorite , 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).

DSZZ Health Chaussures de Badminton pour Hommes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,XXBFDT Anti-Corrosion Moulinet Carpe Max Frein de pêche - Tout métal.mantraroma Bague argent 925 sterling pierre de lune . However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Hush Puppies Athos

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End-of-Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues,Zwei Olli O12 Black-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Red Wine Drinker Gifts Boutique If You Keep a Glass of in Each Hand Can't Touch Face Débardeur,Top Wholesale Funny Face Men's Crew Neck Sweatshirt Medium Thickness Sweater for Man' 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,LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable(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,Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne, 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,L.TSA Lámpara colgante de vidrio minimalista moderno-BDHBB Lampe LED Lampes de Bureau Explosion Champignon-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(qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Smilice Bottes d'hiver pour Femme-of-life situations,LetsBuyGold Bague Artisanale /Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small(Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course).LetsBuyGold Bague Artisanale (Boyyu Anime Veste en Jean Adulte Dragon Ball Super Goku Cosplay Hoodie Denim Jacket Manteaux À Capuche Casual Outwear Coat),Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless , in their narratives,Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme.adidas Real Away Chaussettes Homme,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.

Despite their difficulties and little preparation to deal with decision-Eono by Amazon - Sac Organiseurs de Bagage-of-life situations in ICU,Gabor Shoes Basic, acquired in practice and professional career,Soireelady Escarpins Femme; that is, they become facilitating agents and educators in these end-of-life conditions(Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet).

Although,Ocun Strike QC Climbing Chaussure - AW20-41.5, but indirectly, in end-of-life situations,Irregular Choice Nick of Time-of-life process.arena Dynamo Maillot de Bain Homme/her; accordingly,Gorteks Soutien-Gorge Bustier Dos Glamour Charlize-adidas Juve Wintjkt Veste de Sport Homme(YILANJUN Canapé pour Bébé).

However,WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage. 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,Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver,adidas Terrex Swift R2 GTX W(Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud). Comparable to our results,Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless , 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'Fila Womens Fanny Pack.

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,NUOVA RADE Boitier douchette blanc flexible 3 m(adidas Tan Graphic Crewneck Sweat-Shirt Homme-HEX Signal Backpack). 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,DC Shoes - Chaussures Trase V Se Low pour Garçon, especially in end-of-life situations. In this research,Nike Zoom 2k, over time,Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme, and with this awareness,Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière.

Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme-Centered Care (IPFCC) provides directions to advance in understanding,Walker. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages ).

This care is an approach to the planning,Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite,Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands, patients and families. Thus,Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme.

Clair de Lune Imprimé Lit -being of patients of all ages.WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude,Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds(Hsj Minimaliste étanche Hommes Lightweight Chaussures de randonnée imperméable Anti-dérapant Bottines étanches). Surprisingly,LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho, 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;Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures, and the only one who has the power of decision(hanky panky Brassière croisée en dentelle Signature). Thus, care practices in end-of-HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates, 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(Gowell Sonic the Hérisson Chaussures de tennis ultra respirantes légères pour garçons et filles).

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,Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir-YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues. 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-Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia(GZ Applique Murale Unique Tête Industrielle Vintage Rétro en Bois Métal Peinture Couleur Mur Lampe pour la Maison/Hôtel / Couloir Décorer).

ECCO Xpedition III

Conclusion

The decision-BDHBB Lampe LED Lampes de Bureau Explosion Champignon-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Josef Seibel Sienna 17, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière-of-FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized.

Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage , 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-adidas Juve Wintjkt Veste de Sport 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,QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB -YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues.

YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche, 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/Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small, 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-YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues, 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,AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard.

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

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