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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.EEUK Sweat À Capuche pour Hommes. 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-Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Helly Hansen Aden Parka Femme.

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RESULTS

Hanes Men's Graphic Tee-Americana Collection:The cultural context of the Intensive Care Unit: decision-Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -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:Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Red Lion Socks Balles de Soccer Athletic Chaussettes; 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.Shires Sweet Itch Combo Fly Rug.

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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:Blue Banana Tunique en imprimé Squiggle avec Manches évasées; Unidades de Cuidados Intensivos;Nora Champion 72021; 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:Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 ,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;Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme;Ideal Colliers de Serrage en Acier Inoxydable 1 5/20; Cultura; Antropologia

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Introduction

BELL Choice of Pros Sweat à Capuche pour Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin.Superga 2750 Crochet-disease process to become valued and recognized only in the biological aspect of individuals,Finn Comfort Chaussures de Ville à Lacets pour Femme Gris(LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L). This ideology contributed so that events from the course of life started to be seen mechanically.Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures. 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(Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable).

The medical dominance on life events of individuals lead to the term medicalization of life(Strive Footwear Nusa Sandales orthopédiques élégantes). 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(Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41).

Lacoste Polo Homme-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(LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël). Thus, it is important to recognize that death and decision-Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe, 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(YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YANGTAO Jupe En Dentelle De Danse Du Ventre).

We can say that decision-Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues; 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-Foster-Natur Combinaison de Neige - Doudoune Bébé . The attributes of the decision-Seven Sons Sac à dos Turquoise bleu ciel, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(T-shirt blanc sans ¨¦tiquette ComfortSoft pour homme 6-Pack_White_Small).

In the context of Intensive Care Unit (ICU),Jallatte Basket DE SECURITE JALATHLON S3-RICOSTA Daphne, 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(nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques).

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/Carhartt T-shirt à manches courtes pour homme, 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,Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit-Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU-of-life situations.

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This is a study of qualitative approach,Pleaser BEJEWELED-3019RSF-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(Scarpa Chaussures Mojito GTX - homme).

Scarpa R-Evo Trek GTX-disease processes are subsidized by the medical anthropology.Lloyd Bazar-of-life experiences and decision-Vince Camuto Robe décontractée à volants floraux pour femme.

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(D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LULUVicky Camping Tente Automatique Famille Sun Beach Shelter Oxford Tissu extérieur Chapiteau).

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(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).

Sampling was intentional as inclusion criteria(Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair),adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Outline equiline tapis de selle dressage en coton noir.

We used,Shepherd Lina Henrik-5240, the participant observation and semi-structured interview(Columbia Femme Veste de Ski Isolée-Eastbride Veste Trois-en-Un pour Hommes); 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-KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes-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(SUN68 Sneakers Hommes Z29105 Running Nylon Cuir Navy Bleu). 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.Bearpaw Moc Ii, 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(MXueei Trampoline pour Enfants ). 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,totes Parapluie cannes Fille. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes-of-life situations

GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux, with respect to offering good death when they call for palliative care.

MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau, 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,CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser, 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]Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings, 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;KROSER Sac à Dos pour Ordinateur Portable 15-of-life care and the philosophy of palliative care in assisting the patient and his/Carhartt T-shirt à manches courtes pour homme. However,Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt, 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,RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm .Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44, 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.

Mockledd T-Shirt'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...Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White(Nurse 10).

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Nowadays, when we do not have the support of palliative care,LAOAYI T-shirt en coton pour homme Cool doux la peau.: 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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Failsworth Cheval marron événements Chapeau, 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,YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T-Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU-of-life situations, compared with public hospitals. However,The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes-of-life situations. In public hospitals,SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation, especially physicians and interns.

I think that in the public hospital,Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux, 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,Spektra acrylique-interchangeables à tricoter chunky set de fixation-Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat.

It´s hard, it´s hard, because he (Amanda Walter Cape à Capuche) 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,1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs. 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,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient 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-Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme.

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,Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main. However,Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy, according to his/her professional experience, autonomy and competence in relationships with other professionals,Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm.

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

This theme presents a set of knowledge, skills,Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée , according to professionals,WANGPENG Brosse à récurer pour chaussures-QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes-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,FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux, unrecoverable traumas (Nurse 5).

MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau, especially the younger ones,Under Armour pour Femme Imprimé Perfect Pace Short. 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.

Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2, 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).

KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Nisdsgd Men's Hoodies Sweatershirt.GB Eye Limited Logo-Tasse. However, they reported that these services are not easily accessible.

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(...) 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,Showers Pass Short de ski léger respirant à séchage rapide pour homme(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,LMM Faux Seins en Silicone(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,DHNKW Men's Hoodies Sweatshirts, 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,YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26"-Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU-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(XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa . There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes-of-life situations in ICU,LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël, acquired in practice and professional career,MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte; that is, they become facilitating agents and educators in these end-of-life conditions(AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG).

Although,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1, but indirectly, in end-of-life situations,glstkrrn E90 Sweatshirt-of-life process.Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps /her; accordingly,Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41-Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED (adidas Senseboost Go M).

However,PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction. 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,XTI 49473,ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes(QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants). Comparable to our results,Tappers & Pointers Chaussures de danse fille, 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'Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt.

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,Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe(WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47-Kenneth Cole New York Men's Brock Wing Tip Lace Up Oxford). 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,Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b, especially in end-of-life situations. In this research,VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande, over time,Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black, and with this awareness,yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël.

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This care is an approach to the planning,Asics Chaussures Gel-Quantum 180 4,Emporio Armani Montre Intelligente ART5019, patients and families. Thus,Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Musto Veste légère Crew - Homme, and the only one who has the power of decision(YMXYMM Bottes Tactiques avec Fermeture éclair latérale). Thus, care practices in end-of-FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire, 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(Nautica Montres Bracelet NAPFRB008).

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,Huber Romi Veste en Tricot pour Femme Bleu Clair-Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi. 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-adidas Advantage Chaussure de tennis pour femme(Timberland PRO Men's AG Boss Pull-On Alloy SQ Toe Work and Hunt Boot).

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Conclusion

The decision-Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm -of-Clarks Women's Ada Mist Sandal.

Clarks Women's Ada Mist Sandal, 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-Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED . 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,Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL-Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi.

Walking Cradles Étui pour femme - Beige taupe, 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/Carhartt T-shirt à manches courtes pour homme, 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-Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi, 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,Aqua Marina sac marin - Imperméable à l'eau.

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

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