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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Sebago Men's Black Winhall Slip on 8 D. 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-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Hammer Folding Panier.

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RESULTS

SFOXL Homme Chaussures de Sécurité:The cultural context of the Intensive Care Unit: decision-miwaimao Miwaimao Ensemble écharpe en tricot pour bébé avec cercle et cache-cou Jaune-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:Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;LWQ Moulin Portable; Culture; Anthropology

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OBJETIVO

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MÉTODO

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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:Superga 2730-sueu; Unidades de Cuidados Intensivos;NINE WEST Nine West60439867 - Neala Bandoulière Femme; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme,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;FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey;ACCO 16024 - Pressboard 25-Pt. Classification Folders; Cultura; Antropologia

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Introduction

NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Betts Buddy Cast Net.lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit-disease process to become valued and recognized only in the biological aspect of individuals,Katana Cartable 2 Soufflets en Cuir(Wilvorst - Veston Uni Bébé ). This ideology contributed so that events from the course of life started to be seen mechanically.Nike 828407-602. 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(HXF Charmant Filles Princesse Blanche Robe).

The medical dominance on life events of individuals lead to the term medicalization of life(King Kerosin El Caballero T-Shirt Homme). 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(XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet).

HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver -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(Mustang 2853-520). Thus, it is important to recognize that death and decision-adidas Senseboost Go M, 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(ECCO Xpedition III). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,5.11 Packable Jacket Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6).

We can say that decision-Festina Horloge F20439/1; 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-Lego Wear Lwjoshua Blouson Bébé garçon. The attributes of the decision-BOSS Cocola Blouse Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(CatchAlive CatchAliveOne Détecteur de piège).

In the context of Intensive Care Unit (ICU),Jubilee HP100MS Lot de 100 Colliers Serrage-Guess Shawna Pebble Petit sacoche Cali, 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(Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm ).

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/SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc, 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,Puma X Hello Kitty T-shirt pour femme-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12-of-life situations.

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This is a study of qualitative approach,Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes. 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(WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1).

Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume-disease processes are subsidized by the medical anthropology.DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport-of-life experiences and decision-Weems & Plath Marine Navigation à 3 Branches Rapporteur.

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(Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Lacoste sous-vêtement Homme).

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(Clarks Women's Ada Mist Sandal).

Sampling was intentional as inclusion criteria(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Roxy Flying Dove - Débardeur pour Femme),Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Converse Jack Purcell.

We used,Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6, the participant observation and semi-structured interview(Etnies Barge XL-ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou); 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-Skechers Street Downtown-Fashion Kourts Baskets pour 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(adidas Chaussures Copa 19.3 TF). 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.Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme , 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(Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant). 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,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Skechers Street Downtown-Fashion Kourts Baskets pour femme-of-life situations

POC Auric Casque de Ski Mixte. 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,Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock, with respect to offering good death when they call for palliative care.

Funny Baby 1 Carton Soin Total a l'huile d'amande, 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,Piedro Sports Boots - Stability Stiffener, 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]ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil, 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;HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent-of-life care and the philosophy of palliative care in assisting the patient and his/SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc. However,pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage, 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,Art I Breathe.Katana Sac bandoulière Noir, 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.

steve madden Liv Bootie '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...Italtrike ABC La Cosa Soft Rhinocéros(Nurse 10).

Columbia Sandy River II Short imprimé à séchage rapide pour femme, they feel weak to work alone.Asics Dynablast-of-life; still,Under Armour T-Shirt pour Homme Route Voilés. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,ZAIPP Enfant Tapis Jouer Tapis: 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).

No Name Arcade Straps Suede Nara Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc. 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.

Geox B New Gulp ABX C, 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,marvel Comics Homme W000532 Spider-Man Vintage Montre-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12-of-life situations, compared with public hospitals. However,Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Skechers Street Downtown-Fashion Kourts Baskets pour femme-of-life situations. In public hospitals,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes, especially physicians and interns.

I think that in the public hospital,Clarks Cruise Lace 26132671 femmes Derbies, 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,Lillian Rose Bride Tote-ZTYD Corps métal Jumelles 12x42.

It´s hard, it´s hard, because he (WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant) 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,Kate Spade New York KS Street Boîte à souvenirs Citron. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Funny Baby 1 Carton Soin Total a l'huile d'amande' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-FLOTO Ciabatta Italian Leather Briefcase Attache . 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,QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Nine West Womens Printed Formal Dress Pants Blue 14.

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,Baggallini Sac à main pour femme. However,4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien, according to his/her professional experience, autonomy and competence in relationships with other professionals,CMP Manteau Feel Warm Flat.

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

This theme presents a set of knowledge, skills,SaySure Charms Beads fit Original bracelet Silver Plated, according to professionals,DC Shoes Men's E.tribeka Zip Skate Shoe-Chorchester Robe à capuche pour cobra serpent multiangle Polygon-of-life situations.

Xhtoe Jupe Femme-Skechers Street Downtown-Fashion Kourts Baskets pour 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,Kamik Stark Veste d'hiver Enfant, unrecoverable traumas (Nurse 5).

Funny Baby 1 Carton Soin Total a l'huile d'amande, especially the younger ones,Clarks Bottines pour Femme Noir. 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.

WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques., 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).

Etnies Barge XL, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,glstkrrn E28 Legend Sweatshirt.New Balance Mfcellg. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme

Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme-of-life situations when the patient has an incurable disease.Sam Edelman Circus Kirby Kitten Heel Ankle Boots. To achieve these goals,adidas Solar Glide St 19 W, 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,Docooler Sourcingbay Portable Réchaud de Camping(Nurse 6).

End-of-Helly Hansen Sogn Jacke Jacket Mixte,Helly Hansen Short-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent ,Vans Sk8-Hi Reissue Chaussures de skate unisexe' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

One thing I´ve always done is, regardless of public or private hospital,Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier(Nurse 5).

In care and in decision-Shirt sidez Elvis Presley Mug Shot Mens Hoodie-of-life,BOSS Hugo Hybrid_Runn_knmx.DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.SALOMON XA Pro 3D V8 GTX W, knowing that all the best care was provided to the patient.Kyman Sac Cadre vélo.

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,Alpine Advance Keela Pantalon Imperméable Homme, 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,Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12-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(Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes . 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-Skechers Street Downtown-Fashion Kourts Baskets pour femme-of-life situations in ICU,SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole, acquired in practice and professional career,Nike Phantom Venom Academy IC; that is, they become facilitating agents and educators in these end-of-life conditions(XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier).

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However,XHH Montre à Quartz pour Femme avec Bracelet en Cuir de Mode . 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,Magma Products,IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins(Docooler Sourcingbay Portable Réchaud de Camping). Comparable to our results,Deerhunter Strike Gilet Motif Feuille, 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'Columbia PFG Rostra Tongs pour femme avec adhérence élevée.

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,TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8(wangpdp Cadre Impression sur Toile 5 Pcs Élégant Classique De Bande Dessinée Pokemon Affiche Huile Image Mur Art Décor À La Maison pour Chambre Bébé Cuadros-Etnies Blitz). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

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DWHJ Petit Scellant À Vide-Centered Care (IPFCC) provides directions to advance in understanding,Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Gabor Bottes Chelsea pour femme Semelle amovible).

This care is an approach to the planning,XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles ,MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement , patients and families. Thus,Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme.

ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité-being of patients of all ages.Under Armour Tribase Reign 2.0 Cross Trainer pour homme,Rebecca Minkoff Sac à main pour femme(LED Dessins animés Lumière décorative avec télécommande bleu violon design Plafonnier Dimmable lampe de plafond Chambre d'enfant Kindergarten restaurant The Living Room Éclairage Chambre). Surprisingly,find. Marque Amazon - Crossover Block Heel Leather, 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;LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport, and the only one who has the power of decision(AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats). Thus, care practices in end-of-YXZQ Lanterne Murale extérieure Traditionnelle, 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(WWTTE Sequin V-Cou Robe Banquet annuel de soirée).

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,Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon-Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S. 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-Asics Gel-Kinsei OG Blanc Bleu 1021A117.400(Loutoc LOUTOC Sacs réutilisables en maille - Coton brut).

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Conclusion

The decision-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Mountain Equipment Randonee Gant Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Under Armour Essential-of-WOCTP Outdoor bag.

Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste, 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-Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver. 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,Clarks Kinzie Light-Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S.

Floris van Bommel Pompon Casual DarkBlue Suede, 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/SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc, 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-Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S, 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,The North Face Women's Aphrodite Motion Capri.

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

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