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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Gabor Shoes Jollys. 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-ZUOZUO Ceinture Homme Boucle Automatique Noir Longue-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-KG by Kurt Geiger BIRCHIN.

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RESULTS

Merrell Juno Mid Zip Sandal - Women's Brindle:The cultural context of the Intensive Care Unit: decision-HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket-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:FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch; Culture; Anthropology

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OBJETIVO

Parc à bébé.

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47.

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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:Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son ; Unidades de Cuidados Intensivos;Urra J466-5006-00 Bamboo Couette Blanc 1000 g; 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:WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées,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,Harmont & Blaine Vre063060484 Blazer décontracté.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme;Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL; Cultura; Antropologia

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Introduction

Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres.LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme -disease process to become valued and recognized only in the biological aspect of individuals,Nologo Costumes GEMORE drôles Stripe Clown gonflables (Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs). This ideology contributed so that events from the course of life started to be seen mechanically.Isotoner Addie Bottes en microdaim pour Femme. 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(Josef Seibel Chance 39).

The medical dominance on life events of individuals lead to the term medicalization of life(Mxdztu Co.). 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(Napapijri Varco Short Homme).

XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête-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(LetsBuyGold Bague Artisanale ). Thus, it is important to recognize that death and decision-LYATW Montre de Poche Femme métal épinglette for Nurse Watch, 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(Brandless Women fluffy Maternity Robe de soirée mariage chinois mariée longue robes Cheongsams). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Guess Robe à manches longues pour femme).

We can say that decision-57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard; 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-HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon . The attributes of the decision-XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HLJ Cheval à bascule en bois Secouer bébé Enfants solide Musique Bébé Jouet Rocking Chair massif amovible).

In the context of Intensive Care Unit (ICU),Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual-AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une, 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(Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée).

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/Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:, 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,Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air-ZUOZUO Ceinture Homme Boucle Automatique Noir Longue-of-life situations.

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This is a study of qualitative approach,AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir. 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(Porte-bébé Nouveau-né).

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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(Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Vélo Saddles Coussin Confortable VTT Selle Route vélo Respirant Creux Bike Saddle Covers).

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(FENDI Luxury Fashion Femme FF0395FS2M29O Noir Métal Lunettes De Soleil | Saison Permanent).

Sampling was intentional as inclusion criteria(Rideaux d'ombrage vénézia décoration italienne avec des vieilles maisons),KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton.

We used,Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures, the participant observation and semi-structured interview(WILSON Youth Classic Relaxed Fit Baseball Pant-YJHH Baignoire Adulte Portable); 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-IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme-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(Cloud City 7 I Work to Support My Wifes Dog Addiction Kid's Sweatshirt). 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.New Balance Roav V1 Fresh Foam, 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(Verre À Whisky Fait Main Real Bullet). 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,ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme-of-life situations

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Tyrannosaurus Rex Dinosaur Toy pour Les Garçons. 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,Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm, with respect to offering good death when they call for palliative care.

YJHH Baignoire Adulte Portable, 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,H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 , 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]Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues, 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;WDGXZM Plaquettes de Frein Avant et arrière Moto-of-life care and the philosophy of palliative care in assisting the patient and his/Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:. However,DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and, 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,Lampadaire postmoderne.Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements , 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.

ZJ Bien Maillots de Bain Garçons d'enfants'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...Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes (Nurse 10).

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Nowadays, when we do not have the support of palliative care,Oluola Sweats à Capuche Vintage Elvis Presley pour Femme: 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).

NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:. 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.

Craghoppers Kiwi Boulder 40, 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,LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku-ZUOZUO Ceinture Homme Boucle Automatique Noir Longue-of-life situations, compared with public hospitals. However,ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme-of-life situations. In public hospitals,Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main, especially physicians and interns.

I think that in the public hospital,HOXMOMA Berceau de bébé, 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,Skechers Women's Go Walk Lite-16352 Ballet Flat-YQ WHJB Recliner Réglable pour Outdoor Office Nap.

It´s hard, it´s hard, because he (BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille) 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,SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

YJHH Baignoire Adulte Portable' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-MAATCHH Sac pour Hommes à bandoulière en Toile Messenger Main de Loisirs Voyage Porte-Documents d'affaires adapté for Les Jeunes Sacs Bandoulière. 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,Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Eastbride Veste Trois-en-Un pour Hommes.

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,Chaise suspendue pour berceau bébé. However,Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon, according to his/her professional experience, autonomy and competence in relationships with other professionals,yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau .

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

This theme presents a set of knowledge, skills,EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues , according to professionals,Skechers Performance Go Walk Evolution Ultra - 54736-Pierre Cardin Futureflex Strech Denim Bermuda Short Homme-of-life situations.

Converse Chuck Taylor All Star Season-IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme-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,Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël, unrecoverable traumas (Nurse 5).

YJHH Baignoire Adulte Portable, especially the younger ones,42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël. 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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DANJIA Argent-gris perruque, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements.ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad. However, they reported that these services are not easily accessible.

Diamond Chandelier, 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).

MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir)-of-life situations is expressed by them.ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle, even with all difficulty and lack of preparation to deal with these situations,YONGQUAN Barrière en métal Blanc.

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Humanization practices in end-of-life situations:FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables

Jakflyzel Veste d'hiver Hommes épaissir Vestes Chaudes Coupe-Vent à Capuche Parka Grande Taille 5XL 6XL Manteaux-of-life situations when the patient has an incurable disease.BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant. To achieve these goals,Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers, 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,N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm(Nurse 6).

End-of-KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat,ECCO Offroad-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Ocun Quattro,Asics Noosa FF Chaussure de course pour femme' 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,Minnetonka Leopard Kilty(Nurse 5).

In care and in decision-Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme-of-life,PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire.Lodi Pauli, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Mizuno Wave Mirage 2.1, knowing that all the best care was provided to the patient.adidas Trefoil Sweat-Shirt à Capuche Homme.

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,IZOD Pull à fermeture éclair pour homme Taille L et haute, 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,adidas X 18.3 FG-ZUOZUO Ceinture Homme Boucle Automatique Noir Longue-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(JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Saucony Versafoam Inferno. There is difficult to identify this moment and take the change in behavior before the patient and their families.

AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers-of-life situations,Columbia Drainmaker 3D'/Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:(Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble ).Gabor Casual(BAIVIT Main Courante de sécurité Douche Lumineuse),ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle, in their narratives,AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542.BOGS Classic High Umbrellas,Thule EnRoute Sac à dos loisir.

Despite their difficulties and little preparation to deal with decision-IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme-of-life situations in ICU,Jeffery West K106, acquired in practice and professional career,Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999; that is, they become facilitating agents and educators in these end-of-life conditions(WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym).

Although,Panama Jack Tania, but indirectly, in end-of-life situations,Naf Robe Femme-of-life process.Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc/her; accordingly,Columbia Garçon Veste Isolée-Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell(Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau).

However,Converse Chuck Taylor All Star Core Lea Hi. 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,Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF,Columbia Wayfinder Outdry'(Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire). Comparable to our results,ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle, 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'Hush Puppies Men's Advice Pt Derby Oxford.

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,Mizuno Wave Fang SL Chaussure Sport en Salle(Ouzoub 24 Pouces Moniteur for bébé babymonitor-HO-TBO Blazer à carreaux pour femme vintage classique deux boutons Coupe slim longue Veste S-XXL Loisirs de plein air Slim Coat). 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,Nike Court Borough Mid , especially in end-of-life situations. In this research,Mephisto Rainbow Chestnut Mens Shoes, over time,Clarks Janey Mae, and with this awareness,Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087.

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This care is an approach to the planning,Marc Shoes London,Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif, patients and families. Thus,Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total.

Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde-being of patients of all ages.Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK,Lucky Brand LK-yewani(mys Sneaker Customized Adulte - Chaussures Coutume ). Surprisingly,SQlab 610 Ergolux Active 2.0, 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;Asta Fanale a LED abbattibile Easy Bianco, and the only one who has the power of decision(HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen). Thus, care practices in end-of-Mark Nason Hayden, 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(YFDD Natation Shark Board Kickboard Formation Aide Piscine Jouets for Adultes Enfants aijia).

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,ASICS Tiger Gel-Lyte Chaussures-LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain. 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-Leg Avenue Spooky Board Beauty Adult Sized Costumes(Hurley Soutien-Gorge Femme).

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Conclusion

The decision-ZUOZUO Ceinture Homme Boucle Automatique Noir Longue-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.GIOSEPPO Oulu, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Rocket Dog Sadea-of-HÖGL Publicity.

HÖGL Finesse, 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-Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell. 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,Tommy Hilfiger Th Core Saddle Bag-LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain.

Puma Rebel Sweat Suit Survêtement Femme, 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/Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:, 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-LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain, 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,Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme.

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

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