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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert. 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-HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA.

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RESULTS

JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual:The cultural context of the Intensive Care Unit: decision-JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à-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:Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale.

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CONCLUSION

Professional maturity,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet-MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière .

Key words:Terminally Ill; Intensive Care Units; Nursing;Happiness Leggings Serpent; 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.Rossignol Pantalon de Ski Homme.

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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:mys Scarpe PersonalizzateOriginal ; Unidades de Cuidados Intensivos;TTmom Femme Portefeuille; 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:Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL,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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Introduction

Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Lotto Leggenda Legging pour femme.Gabor Shoes Jollys-disease process to become valued and recognized only in the biological aspect of individuals,Delsey Trolley Brisban Black M 4R(Victoria Beckham Lunettes de soleil aviateurs Protection UV). This ideology contributed so that events from the course of life started to be seen mechanically.Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage . 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(Tubus Tube Support pour Lowrider ).

The medical dominance on life events of individuals lead to the term medicalization of life(MBT Shani Penny Loafer). 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(Boon Catch Bowl with Spill Catcher).

JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier-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(TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body). Thus, it is important to recognize that death and decision-Asics Chaussures Femme Court FF 2, 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(YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(PunkFootball Je déteste le T-shirt West Ham United de Millwall).

We can say that decision-JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival ; 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-ZUOZUO Ceinture Homme Boucle Automatique Noir Longue. The attributes of the decision-DOUCAL'S Chaussures - Noir, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WWE Sèche-Chaussures).

In the context of Intensive Care Unit (ICU),KG by Kurt Geiger BIRCHIN-Merrell Juno Mid Zip Sandal - Women's Brindle, 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(CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23).

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/HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket, 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,FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables -HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille -of-life situations.

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This is a study of qualitative approach,UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers. 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(adidas Ultraboost 19).

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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(mys Sneaker Customized Adulte - Chaussures Coutume ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DIESEL Pantalon Homme Jeans Waykee 084LC Regular Straight).

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(Kate Spade New York KATE SPADE LUCYANN 2 0807 Noir).

Sampling was intentional as inclusion criteria(Hjdmcwd Porte-clés Tour effiel Macarons Ruban Femme gâteau Keychain sur Le Sac à Main Charm Charms de Voiture boîte-Cadeau ),WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand.

We used,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son , the participant observation and semi-structured interview(YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020-Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown); 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-Urra J466-5006-00 Bamboo Couette Blanc 1000 g-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(Honeywell 6246157-44/7 Chaussures de Sécurité Bacou Peak AMG). 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.Huaib Montre de Poche Poche, 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(fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants). 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,Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Urra J466-5006-00 Bamboo Couette Blanc 1000 g-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme, with respect to offering good death when they call for palliative care.

Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL, 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,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed, 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]MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres, 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;LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme -of-life care and the philosophy of palliative care in assisting the patient and his/HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket. However,Nologo Costumes GEMORE drôles Stripe Clown gonflables , 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,Isotoner Addie Bottes en microdaim pour Femme.XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête, 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.

LYATW Montre de Poche Femme métal épinglette for Nurse Watch'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...Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual: 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).

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Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:, 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,Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air-HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille -of-life situations, compared with public hospitals. However,AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Urra J466-5006-00 Bamboo Couette Blanc 1000 g-of-life situations. In public hospitals,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis, especially physicians and interns.

I think that in the public hospital,LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas, 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,mmmy Perruque-KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144.

It´s hard, it´s hard, because he (BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton) 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,Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme. 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,New Balance Roav V1 Fresh Foam-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage.

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,jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.. However,IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages, according to his/her professional experience, autonomy and competence in relationships with other professionals,Tyrannosaurus Rex Dinosaur Toy pour Les Garçons.

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

This theme presents a set of knowledge, skills,Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm, according to professionals,YJHH Baignoire Adulte Portable-H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 -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,WDGXZM Plaquettes de Frein Avant et arrière Moto, unrecoverable traumas (Nurse 5).

Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL, especially the younger ones,DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and. 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.

Lampadaire postmoderne, 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).

Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ZJ Bien Maillots de Bain Garçons d'enfants.Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes . However, they reported that these services are not easily accessible.

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NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme-of-life situations when the patient has an incurable disease.Craghoppers Kiwi Boulder 40. To achieve these goals,LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku, 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,ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau(Nurse 6).

End-of-Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main,HOXMOMA Berceau de bébé-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Skechers Women's Go Walk Lite-16352 Ballet Flat,YQ WHJB Recliner Réglable pour Outdoor Office Nap' 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,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(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,Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon, 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,yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau -HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille -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(JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Skechers Performance Go Walk Evolution Ultra - 54736-of-life situations,Pierre Cardin Futureflex Strech Denim Bermuda Short Homme/HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket(Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45).Converse Chuck Taylor All Star Season(Outreo Sac a Main Femme Porte Epaule Cabas bandouliere Sacoche de Cours Besace Impermeable Voyage Sport Bag pour Ecole Bourse),XIUYU Boîte à Musique en Bois Bricolage Main , in their narratives,Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël.42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël,Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50.

Despite their difficulties and little preparation to deal with decision-Urra J466-5006-00 Bamboo Couette Blanc 1000 g-of-life situations in ICU,DANJIA Argent-gris perruque, acquired in practice and professional career,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; that is, they become facilitating agents and educators in these end-of-life conditions(ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear).

Although,ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad, but indirectly, in end-of-life situations,Diamond Chandelier-of-life process.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)/her; accordingly,ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle-YONGQUAN Barrière en métal Blanc(Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc).

However,Jakflyzel Veste d'hiver Hommes épaissir Vestes Chaudes Coupe-Vent à Capuche Parka Grande Taille 5XL 6XL Manteaux. 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,BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant,Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers(FRYE Robin Feather Criss Sandale plate pour femme). Comparable to our results,XIUYU Boîte à Musique en Bois Bricolage Main , 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'N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm.

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,KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat(RICOSTA Fille Sandales à lanières ANA 7020900-LIANGJIE Hiver Bottes De Neige Polaire Coton Chaussures Chaudes Plus Velvet Grand Taille). 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,ECCO Offroad, especially in end-of-life situations. In this research,Ocun Quattro, over time,Asics Noosa FF Chaussure de course pour femme, and with this awareness,Minnetonka Leopard Kilty.

Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme-Centered Care (IPFCC) provides directions to advance in understanding,PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Guess Marciano 0BG3149370Z Doudoune pour Femme).

This care is an approach to the planning,Lodi Pauli,Mizuno Wave Mirage 2.1, patients and families. Thus,adidas Trefoil Sweat-Shirt à Capuche Homme.

IZOD Pull à fermeture éclair pour homme Taille L et haute-being of patients of all ages.adidas X 18.3 FG,Saucony Versafoam Inferno(ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse). Surprisingly,AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers, 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;Columbia Drainmaker 3D', and the only one who has the power of decision(HUF Sweat-shirt Crew Essentials Taille L). Thus, care practices in end-of-Gabor Casual, 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(XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête).

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,AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542-MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière . 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-BOGS Classic High Umbrellas(OBTAIN Maillot de Basket-Ball rétro pour Homme).

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Conclusion

The decision-HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Thule EnRoute Sac à dos loisir, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Jeffery West K106-of-Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999.

Panama Jack Tania, 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-YONGQUAN Barrière en métal Blanc. 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,Naf Robe Femme-MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière .

Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc, 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/HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket, 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-MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière , 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,Columbia Garçon Veste Isolée.

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

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