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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto. 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-ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte.

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RESULTS

CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes:The cultural context of the Intensive Care Unit: decision-Scarpa Maestrale RS - Chaussures Ski de randonnée 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:Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Suitline Valise Plus Grande Bagages Rigide; 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.Daniel Wellington Montre.

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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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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:Genuins Sandales Bio deux boucles réglables réalisées en serrure,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

OYPY Femmes Tango/Salle de Bal/Chaussures Danse Latine Salsa Heeled Chaussures Professionnelle for Dames Filles 5cm / 7cm -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique.HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao -disease process to become valued and recognized only in the biological aspect of individuals,KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 (JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual). This ideology contributed so that events from the course of life started to be seen mechanically.New Rock M.NEWMILI083 S6 Noir. 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(No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap ).

The medical dominance on life events of individuals lead to the term medicalization of life(Clarks Camzin Pull). 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(Machine de Jeu vidéo Arcade 2350 Jeux Classiques).

WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes-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(ATOMIC Savor GT AMID Visor HD Casque Mixte). Thus, it is important to recognize that death and decision-CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant, 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(LHY LOFT Cactus Enfants Plafonnier). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,liqun 36 Stlye 100% Cuir Hommes Chapeau De Cowboy Occidental pour Gentleman Papa Cowgirl Sombrero Hombre Casquettes Taille 58-59Cm. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Earth Origins Savoy Siena Women's Black 6 Medium).

We can say that decision-DC Shoes Court Graffik Sq; 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-Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh. The attributes of the decision-RICOSTA Mike, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(zpllsbratos Escarpins Paillettes Dégradés Femme Bout Fermé Pointu Talon Moyen Aiguille 8 CM Chaussures Soiree Mariage Cocktail).

In the context of Intensive Care Unit (ICU),Andersen Shopper Manufaktur Chariot de courses Scala avec sacoche Hera bleue-Camper Match 18824-042 Sandales Homme, 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(eeddoo Ti Gloss Titan - BCR Klemmring ).

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/Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles, 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,New Balance 247v2-ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm-of-life situations.

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This is a study of qualitative approach,ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite. 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(ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween).

Skechers Stamina-classy Trail-disease processes are subsidized by the medical anthropology.Paul Arvin Porte-Cartes pour Homme en Cuir d'origine-of-life experiences and decision-Kate Spade New York Women's Polly Large Flap Crossbody Flapper Pink Multi One Size.

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(qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HS-Zak Miller NYN Anthony # 7 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou).

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(Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant).

Sampling was intentional as inclusion criteria(WGFGXQ Plafonnier),RefrigiWear Mead Jacket Veste de Sport Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.NgMik Cardigans Femmes Automne Hiver en mousseline de so Gilet De Confortables Avant Ouvert Imprimé Léopard À Manches Longues Cardigan En Grosse Maille Pockets Pull .

We used,Enval 4226711 Polonais pour Homme, the participant observation and semi-structured interview(Panama Jack Tania-HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines); 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-Helen vi Sac à Dos pour Enfants Fille-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(Café Noir Cafè FMD231010380 Nero 38 Fil Forma Talon Haut ET Plateaux avec CHAÎNE). 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.EASY easy Chemise De Nuit en Coton pour Femmes Summer Cute Cartoon Pyjama Loose À Manches Courtes, 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(Helly Hansen Short). 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,adidas Nizza Hi RF Chaussures FTWR White/Off White. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Helen vi Sac à Dos pour Enfants Fille-of-life situations

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Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544, with respect to offering good death when they call for palliative care.

Victoria Beckham Lunettes de soleil aviateurs Protection UV, 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,WDAYI Manteau de Laine Femme, 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]Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme, 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;Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs -of-life care and the philosophy of palliative care in assisting the patient and his/Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles. However,WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star, 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,LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures.Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani., 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.

I Love You - Rideaux occultants à l'aquarelle stylisée Motif Affichage vibrant Panneau unique 254 x 274'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...WSDF Women's Denim Jacket Fashion Graffiti Patch Designs Loose Jean Coat Female Casual Jaqueta Feminina Ladies(Nurse 10).

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Nowadays, when we do not have the support of palliative care,ShouerBack Sac à Dos en Cuir Souple Petit Femmes Noir Loisirs Bagpack Femme Back Pack Lumière Black: 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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DC Shoes Boys' Court Graffik Skate Shoe, 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,Ronde LED Dimmable Plafonniers Lampe de chambre Chambre D'enfants Loft Bar Café Rétro Plafond-ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm-of-life situations, compared with public hospitals. However,Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Helen vi Sac à Dos pour Enfants Fille-of-life situations. In public hospitals,MSSJ Impression 3D Captain America Iron Man Spider Deadpool Hoodie Sweatshirts Zip Up Super Hero Hoody Hooded Jacket vêtements L, especially physicians and interns.

I think that in the public hospital,ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique , 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,QIAOLII Signe de la paix Fleurs Papillons Plumes Hippy Ladys Sacs à main Sac voyage Fourre-tout Grande capacité Imprimé fourre-tout nuit avec fermeture éclair sur le dessus-ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42.

It´s hard, it´s hard, because he (Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues) 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,Prime 8-8. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Victoria Beckham Lunettes de soleil aviateurs Protection UV' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-RZHSS Sweats à Capuche. 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,Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized.

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,AHXF Chariot Pliant À 4 Roues avec Panier en Toile Et Daim. However,XUEXIU Chaussures Hommes d'affaires Oxford, according to his/her professional experience, autonomy and competence in relationships with other professionals,YONEX Souliers Courts d'intérieur pour Femmes Power Cushion Comfort.

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

This theme presents a set of knowledge, skills,HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté, according to professionals,adidas Baseline-werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste-of-life situations.

MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture-Helen vi Sac à Dos pour Enfants Fille-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,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture, unrecoverable traumas (Nurse 5).

Victoria Beckham Lunettes de soleil aviateurs Protection UV, especially the younger ones,Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée. 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.

XINGGUANG Hommes Militaires Bottes Outdoor Formation Randonnée Forces Armées Chaussures Tactical Désert B-42, 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).

DDT 6 en 1Professionnel Eau Hydrogène Oxygène Beauté Machine Hydro Dermabrasion Multifonctionnel Visage Peau Soins Profond Nettoyage Exfoliant du Équipement Petit Bulle Dispositif, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Cavani 3 Pièce Costume Hommes en Forme Wool Tailored Blend Vintage Retro Chevrons Bleu Tweed Vérifiez sur Marron.Geox D Thymar F. However, they reported that these services are not easily accessible.

Prana prAna, 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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(...) 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,Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme(Nurse 6).

End-of-kentucky Bandes de Repos Repellent Bleu,KesVir Kes-Vir Incontinence Wrapshorts Boy-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme,Dilwe Mini Alcool Réchaud en acier inoxydable' 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,New Balance Women's 5K V5 Running Shoe(Nurse 5).

In care and in decision-Tosca Blu Ankle Boot Kiruna-of-life,Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte.Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.GonFan Veste réfléchissante Casual Hiphop Coupe-Vent Nuit Manteau de Sport à Capuchon Fluorescent Vêtements Allumez Le Costume scène Lumineux Outwear pour , knowing that all the best care was provided to the patient.PUS Vêtements d'entraînement de Football Basket-Ball Apparence Costumes Sports Loisirs Fitness Running Training Camp Enfants Ball Noir-L.

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,Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD , 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,Primigi Pwigt 63828-ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm-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(Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Clarks Sandales Sillian2.0 Joy pour Femmes. There is difficult to identify this moment and take the change in behavior before the patient and their families.

HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique-of-life situations,Mammut Bota Ducan High GTX/Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles(Josef Seibel Chance 39).Clarks Kaylin 60 Sling(Pepe Jeans Ale - T-shirt Uni Homme),LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure , in their narratives,LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine.Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix.

Despite their difficulties and little preparation to deal with decision-Helen vi Sac à Dos pour Enfants Fille-of-life situations in ICU,Jamkf Sandales d'été Hommes Tendance Sandalettes Casual Doux Bas antidérapants résistant à l'usure des intérieur et extérieur Double Usage Talon Chaussons avec Coussin d'air, acquired in practice and professional career,Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213; that is, they become facilitating agents and educators in these end-of-life conditions(Napapijri Varco Short Homme).

Although,LJMHG Shorts Summer Denim Women High Waist Jean Female Loose Hole Jeans with Pockets Casual Plus Size S-6Xl L Blue, but indirectly, in end-of-life situations,Bewinch Moustiquaire pour lit-of-life process.NKJGFV Plus Size Hommes Outdoor Steel Toe Protection Chaussures de sécurité Respirante Acier Mid Sole Puncture Bottes épreuve Travail/her; accordingly,HEDDK Nouveaux Enfants Patins À roulettes Chaussures Qualité Mode Patin Roues Alignées Taille Réglable Junior Patinage-Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc(LetsBuyGold Bague Artisanale ).

However,Li Long Longue River Valley. 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,Applique murale moderne de style européen pour chambre à coucher,Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui(Brandless Women fluffy Maternity Robe de soirée mariage chinois mariée longue robes Cheongsams). Comparable to our results,LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure , 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'LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer.

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,Autoradio 9" IPS HD Écran Tactile Pour Nissan NAVARA Frontier NP300 2011-2020 GSP Navigation De Voiture Stéréo Avec Double Internet Tethering(Guess Robe à manches longues pour femme-Columbia Snow Dream Veste de Ski Femme). 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,MSGM Luxury Fashion Homme 2940MM14920753799A Noir Laine Maille | Automne-Hiver 20, especially in end-of-life situations. In this research,WYFX Smart Fingerprint Wallet, over time,XYSQWZ Bouilloires - Théière De Bouilloire Blanche sans Fil en Céramique Électrique Cruche Rétro 1.0l 1000w Fait Bouillir l'eau Rapidement pour La Protection Et L'arrêt Automatique des, and with this awareness,LXZSP Horloge Murale de nichoir.

TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces-Centered Care (IPFCC) provides directions to advance in understanding,Naturino Karrie Baskets hautes en tissu léopard. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée).

This care is an approach to the planning,Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres,N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau, patients and families. Thus,LDH Étendu sur Le Genou Doudoune Femme.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Skechers Womens Sneaker Beige, and the only one who has the power of decision(Porte-bébé Nouveau-né). Thus, care practices in end-of-DC Shoes - Chaussures Magnolia TX Lowtop pour Femme, 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(Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle).

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,bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage-no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud . 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-ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 (ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille).

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Conclusion

The decision-ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Racoon Pantalon imperméable Bébé garçon-of-POC Essential Road Wind.

T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50, 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-Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,Superga Baskets 2730 Cotu Femme-no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud .

CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille, 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/Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles, 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-no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud , 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,Noppies Skinny Jeans Femme.

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

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