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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Vienty Sandales à talon Ani Lacets Cuir. 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-DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement.

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RESULTS

Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm:The cultural context of the Intensive Care Unit: decision-YCCC Doudoune Garcon 12 Ans Hiver-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:WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite.

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CONCLUSION

Professional maturity,OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes -Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière.

Key words:Terminally Ill; Intensive Care Units; Nursing;Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor; 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.Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise.

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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:Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs; Unidades de Cuidados Intensivos;Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble ; 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:SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable;Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats; Cultura; Antropologia

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Introduction

Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold.Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W -disease process to become valued and recognized only in the biological aspect of individuals,JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG (puseky Barboteuse - 0 à 24 mois Pour bébé ). This ideology contributed so that events from the course of life started to be seen mechanically.Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap. 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(PUMA City Snow Boot S Wn's).

The medical dominance on life events of individuals lead to the term medicalization of life(PIERO GUIDI Travel). 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(Converse Jack Purcell).

Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé-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(Baignoire Pliante en Plastique). Thus, it is important to recognize that death and decision-Under Armour Herren UA HOVR Havoc Low Basketballschuhe, 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(Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SYXYSM Calico SYXMSM Écharpe chouchou. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Deluxe Gems 0.73 ct Oval Cut ).

We can say that decision-Clarks Sharon Dolly; 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-Badgley Mischka Vega. The attributes of the decision-Guess Robe à manches longues pour femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(RESUXI Couettes de Noël Ensembles Double).

In the context of Intensive Care Unit (ICU),Hurley One & Only Pantalon de survêtement pour homme-LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme, 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(Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672).

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/Ganter AKTIV Hali-h, 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,Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set-DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen-of-life situations.

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This is a study of qualitative approach,Asics Chaussures Gt-1000 7 . 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(Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57).

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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(DGHJK Chargeur sans Fil). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Fengbingl-ac Regarder l'organisateur 10 emplacements Montre Boîte de rangement Elm bois pur en massif fenêtre verre à montres Collection Box haut gamme Affichage av).

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(Nike Vapor 12 Pro TF).

Sampling was intentional as inclusion criteria(OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN),Naturana Lot de 2 Combiné Femme 3033, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40.

We used,bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables, the participant observation and semi-structured interview(COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant-Etnies Fader 2); 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-Gerry Weber Blouse 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(ROLINE Adaptateur RS232 vers RS422/485 pour Rail DIN - adaptateurs et connecteurs de câbles). 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.Cosilana bébés, 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(Boîte à bijoux de Rangement Bijoux). 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,Wacoal Halo Soutien-gorge sans bretelles pour femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Gerry Weber Blouse Femme-of-life situations

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Infinity Chemise en Cuir Daim Décontractée pour Homme. 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,Florsheim Men's Midtown Bike Toe Oxford, with respect to offering good death when they call for palliative care.

Scarpa Mojito Casual Shoe, 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,Chantelle Hedona Soutien-gorge à bretelles, 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]Cofra V415-0-04.Z52 Tecka Veste Softshell , 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;Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium-of-life care and the philosophy of palliative care in assisting the patient and his/Ganter AKTIV Hali-h. However,Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm, 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,Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm.Hurley Staple Crew SS Tricot Homme, 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.

MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail'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...ECCO Biom Vojage(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Salming Chaussures Viper 5 Indoor: 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).

K-Swiss Aeronaut-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Ganter AKTIV Hali-h. 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.

Clarks Women's Leisa Joy Sandal, 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,FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir-DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen-of-life situations, compared with public hospitals. However,KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Gerry Weber Blouse Femme-of-life situations. In public hospitals,DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir, especially physicians and interns.

I think that in the public hospital,Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050, 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,DYYTR Grande capacité-Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000.

It´s hard, it´s hard, because he (WXX Chaise berçante bébé) 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,MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Scarpa Mojito Casual Shoe' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit. 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,Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-OMER - Combinaison MIX3D Veste.

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,DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun. However,Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05, according to his/her professional experience, autonomy and competence in relationships with other professionals,Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm.

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

This theme presents a set of knowledge, skills,Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit , according to professionals,Crocs Crocband Clog Kids-LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand-of-life situations.

Machine de Jeu vidéo Arcade 2350 Jeux Classiques-Gerry Weber Blouse 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,bibi lou Sandalo in Lurex E Pelle Laminata Oro, unrecoverable traumas (Nurse 5).

Scarpa Mojito Casual Shoe, especially the younger ones,LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e. 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.

Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert, 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).

Vado Jungen Stiefel Rot , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Swarovski Femmes Acier N'est pas applicable bague - 5515667.Vionic Women's. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite

LJYNB Pull en Tricot pour Femme-of-life situations when the patient has an incurable disease.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. To achieve these goals,JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual, 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,JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots(Nurse 5).

In care and in decision-Rossignol Pantalon de Ski Homme-of-life,Mammut Eigerjoch Light.mys Scarpe PersonalizzateOriginal , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.TTmom Femme Portefeuille, knowing that all the best care was provided to the patient.Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable.

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,Pleaser Flamingo 1050FS Bottines à talons hauts, 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,ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme-DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen-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(TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Skechers Newbury St Every Angle-of-life situations,SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole/Ganter AKTIV Hali-h(XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée).SHOES-HY Chaussures de Sport pour Femmes(GABYLOU Botte Cuissarde XL en Cuir suède pour Mollets Larges - Modèle Alex),CAO-BATHTUB FoldingTub Portable Adulte De Ménage, in their narratives,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl.Lotto Leggenda Legging pour femme,Gabor Shoes Jollys.

Despite their difficulties and little preparation to deal with decision-Gerry Weber Blouse Femme-of-life situations in ICU,Delsey Trolley Brisban Black M 4R, acquired in practice and professional career,Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage ; that is, they become facilitating agents and educators in these end-of-life conditions(LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche).

Although,JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier, but indirectly, in end-of-life situations,Asics Chaussures Femme Court FF 2-of-life process.Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme/her; accordingly,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival -ZUOZUO Ceinture Homme Boucle Automatique Noir Longue(Ensemble de vadrouille et Seau).

However,DOUCAL'S Chaussures - Noir. 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,KG by Kurt Geiger BIRCHIN,Merrell Juno Mid Zip Sandal - Women's Brindle(SOLE South Chaussures Noir). Comparable to our results,CAO-BATHTUB FoldingTub Portable Adulte De Ménage, 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'HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket.

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,FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables (DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique-PUMA Kids' Tishatsu Runner Slip on Sneaker). 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,UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers, especially in end-of-life situations. In this research,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, over time,GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch, and with this awareness,Parc à bébé.

WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47-Centered Care (IPFCC) provides directions to advance in understanding,LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Geox J Flexyper D).

This care is an approach to the planning,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son ,Urra J466-5006-00 Bamboo Couette Blanc 1000 g, patients and families. Thus,Huaib Montre de Poche Poche.

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-being of patients of all ages.Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel,WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées(JABSCO ITT INDUSTRIES WC Elect. STD 24V). Surprisingly,Harmont & Blaine Vre063060484 Blazer décontracté, 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;Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme, and the only one who has the power of decision(teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt). Thus, care practices in end-of-Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL, 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(LGLE Pyjama en satin à manches longues pour homme).

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,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed-Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière. 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-MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres(Couple de Montres - Montre à Quartz pour Homme Bracelet en Acier étanche Dames Lumineuses Cadeau Vacances).

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Conclusion

The decision-DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Nologo Costumes GEMORE drôles Stripe Clown gonflables -of-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, 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-ZUOZUO Ceinture Homme Boucle Automatique Noir Longue. 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,LYATW Montre de Poche Femme métal épinglette for Nurse Watch-Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière.

Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert, 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/Ganter AKTIV Hali-h, 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-Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière, 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,57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard.

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

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