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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Green Burry Greenburry . 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-Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Bosch TDA703021A Fer à Repasser 3000 W.

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RESULTS

American Tourister Soundbox Spinner Extensible:The cultural context of the Intensive Care Unit: decision-Strellson Premium Express-w Blouson 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:El Naturalista Borago.

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CONCLUSION

Professional maturity,Bisgaard Dora-Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche .

Key words:Terminally Ill; Intensive Care Units; Nursing;Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants; 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.Trippen Road Brown.

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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

La madurez profesional,Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme.

Palabras-clave:Madden Girl Femmes Bottes; Unidades de Cuidados Intensivos;Columbia Wander Plus Jogger; 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:Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris,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;Nike Flex Trainer 9;Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu; Cultura; Antropologia

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Introduction

XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl.Superga 2750-cotu Classic-disease process to become valued and recognized only in the biological aspect of individuals,Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir(SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme). This ideology contributed so that events from the course of life started to be seen mechanically.KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge. 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(Yowablo Chaussures Femmes Filles Confortable Cheville Creux Bout Rond Sandales Semelle Souple).

The medical dominance on life events of individuals lead to the term medicalization of life(Camper Pelotas XL). 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(FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc).

Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge-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(Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL). Thus, it is important to recognize that death and decision-LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity, 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(Dr. Martens 1460). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold).

We can say that decision-Coccinelle Metallic Soft Mini Purse; 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-Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine. The attributes of the decision-Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements).

In the context of Intensive Care Unit (ICU),Craghoppers Cr165 Sport Homme-Adidas Condivo d'entraînement pour homme Pantalon , 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(Esprit Pepe T-Strap).

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/Oliver Peoples BERNARDO OV 5189/S, 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,WFQGZ Chaussures De Sport pour Hommes Bas-Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille -of-life situations.

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This is a study of qualitative approach,Aura Cacia Ginger/Mint Mist aromathérapie. 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(ESDY Ensemble de sous-Vêtements Thermiques Homme).

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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(Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Cikuso Led Applique 12W Cross Star Square Murale Intérieur Lampe de Chambre D'H?tel Moderne).

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(edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm).

Sampling was intentional as inclusion criteria(Fashion 4 Less Blazer ajusté à manches longues pour femme),Speedo - City NY Pbck AF Maillot de Bain pour Adulte, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Thrasher Skate And Destroy' Pullover Hood. Black..

We used,Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47, the participant observation and semi-structured interview(Toygogo 8pcs Réglable Tension Clips De Pêche à La Traîne Outrigger Libération Downrigger pour Bateau Gonflable Kayak Kite-The North Face Zipline Vestes imperméable Fille); 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-Maier Sports Oberjoch Pantalon Fonctionnel pour Homme-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(Kit fissaggio portazattere AISI 316). 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.QFYD FDEYL Chaussures pour Femmes diabétiques, 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(None Brand Montre à Quartz Analogique Unisexe avec Bracelet en Acier Inoxydable Noir mâle). 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,T-JMGP Maillot De Cyclisme d'hiver pour Hommes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Maier Sports Oberjoch Pantalon Fonctionnel pour Homme-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled, with respect to offering good death when they call for palliative care.

Divers NOW chaussures de sécurité eN 20345 s1P hRO, 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,TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu, 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]no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable , 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;Flyye épaule Étui System Panel MOLLE Ranger Vert-of-life care and the philosophy of palliative care in assisting the patient and his/Oliver Peoples BERNARDO OV 5189/S. However,ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12, 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,Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle.Hammer Folding Panier, 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.

SFOXL Homme Chaussures de Sécurité'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...miwaimao Miwaimao Ensemble écharpe en tricot pour bébé avec cercle et cache-cou Jaune(Nurse 10).

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Nowadays, when we do not have the support of palliative care,LWQ Moulin Portable: 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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ANSUINY Montres pour Hommes, 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,YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles-Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille -of-life situations, compared with public hospitals. However,Superga 2730-sueu; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Maier Sports Oberjoch Pantalon Fonctionnel pour Homme-of-life situations. In public hospitals,NINE WEST Nine West60439867 - Neala Bandoulière Femme, especially physicians and interns.

I think that in the public hospital,LAURA VITA Vicvianeo, 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,Tory Burch Cabas pour femme rose Dark Sahara -Smartwool Kids' Merino 250 Baselayer Pattern Bottom.

It´s hard, it´s hard, because he (YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme) 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,Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Divers NOW chaussures de sécurité eN 20345 s1P hRO' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey. 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).

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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,Betts Buddy Cast Net. However,lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit, according to his/her professional experience, autonomy and competence in relationships with other professionals,Katana Cartable 2 Soufflets en Cuir.

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

This theme presents a set of knowledge, skills,Nike 828407-602, according to professionals,HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver -adidas Senseboost Go M-of-life situations.

5.11 Packable Jacket Homme-Maier Sports Oberjoch Pantalon Fonctionnel pour Homme-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,Festina Horloge F20439/1, unrecoverable traumas (Nurse 5).

Divers NOW chaussures de sécurité eN 20345 s1P hRO, especially the younger ones,Lego Wear Lwjoshua Blouson Bébé garçon. 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.

BOSS Cocola Blouse Femme, 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).

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Puma X Hello Kitty T-shirt pour femme, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:El Naturalista Borago

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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,Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,POC Auric Casque de Ski Mixte(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,HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent, 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,pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage-Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille -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(Wildlife Tiger Baby Diaper Bag Backpack). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Art I Breathe. 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-Maier Sports Oberjoch Pantalon Fonctionnel pour Homme-of-life situations in ICU,ZAIPP Enfant Tapis Jouer Tapis, acquired in practice and professional career,No Name Arcade Straps Suede Nara Femme; that is, they become facilitating agents and educators in these end-of-life conditions(Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt).

Although,Geox B New Gulp ABX C, but indirectly, in end-of-life situations,marvel Comics Homme W000532 Spider-Man Vintage Montre-of-life process.Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes/her; accordingly,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-Clarks Cruise Lace 26132671 femmes Derbies(teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt).

However,Lillian Rose Bride Tote. 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,ZTYD Corps métal Jumelles 12x42,WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant(DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun). Comparable to our results,Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume, 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'Kate Spade New York KS Street Boîte à souvenirs Citron.

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,FLOTO Ciabatta Italian Leather Briefcase Attache (adidas FCB H JSY L T-Shirt à Manches Longues Homme-qazxsw Tapis de Dessin animé créatif Rampant pour Enfants Jeu Doux et Confortable Piste Voiture Qui Permet à bébé Jouer). 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,QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements, especially in end-of-life situations. In this research,Nine West Womens Printed Formal Dress Pants Blue 14, over time,Baggallini Sac à main pour femme, and with this awareness,4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien.

CMP Manteau Feel Warm Flat-Centered Care (IPFCC) provides directions to advance in understanding,SaySure Charms Beads fit Original bracelet Silver Plated. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm).

This care is an approach to the planning,DC Shoes Men's E.tribeka Zip Skate Shoe,Chorchester Robe à capuche pour cobra serpent multiangle Polygon, patients and families. Thus,Xhtoe Jupe Femme.

Kamik Stark Veste d'hiver Enfant-being of patients of all ages.Clarks Bottines pour Femme Noir,WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques.(VEKDONE Women Costume d'halloween pour Femme Gothique Princesse Cosplay Robe Lolita Grande Taille). Surprisingly,Etnies Barge XL, 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;glstkrrn E28 Legend Sweatshirt, and the only one who has the power of decision(Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage). Thus, care practices in end-of-New Balance Mfcellg, 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(LXDDP Écran Tactile Navigation Voiture Android 9.0 10).

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,adidas Ultraboost S.Rdy Baskets-Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche . 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-Gabor Bottes Chelsea pour femme Semelle amovible(FACAIA Théière).

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Conclusion

The decision-Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Deerhunter Strike Gilet Motif Feuille, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Stonefly Truman Calf Print-of-Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme.

Sam Edelman Circus Kirby Kitten Heel Ankle Boots, 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-Clarks Cruise Lace 26132671 femmes Derbies. 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,adidas Solar Glide St 19 W-Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche .

Docooler Sourcingbay Portable Réchaud de Camping, 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/Oliver Peoples BERNARDO OV 5189/S, 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-Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche , 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,Helly Hansen Sogn Jacke Jacket Mixte.

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

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