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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Tamaris 1-1-25012-23. 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-MWOOOK Escarpins Femmes Talons Aiguilles-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower.

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RESULTS

LONGYUU Sacs fourre-tout réutilisables numérique petit mignon licorne week-end sac unisexe à bandoulière grande capacité résistant l'eau avec poignée durable:The cultural context of the Intensive Care Unit: decision-Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45-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:Dare 2b Cloud Burst Veste pour Fille.

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CONCLUSION

Professional maturity,Seachoice Ultimate Outrigger Kit by SEACHOICE-Primadonna 0461810 Deauville Body à Armatures.

Key words:Terminally Ill; Intensive Care Units; Nursing;FSA SL-K Carbon Tige de Selle Mixte; Culture; Anthropology

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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

La madurez profesional,Steiff Fleecejacke Blouson Bébé garçon.

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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:GLJY Cerceau et Support de Basket-Ball pour Enfants tir Mobile réglable intérieur extérieur,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Nouxh Homme Femme Devil May Cry Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;AOOA Petit sac à bandoulière en cuir synthétique pour femme;Toygogo 8pcs Réglable Tension Clips De Pêche à La Traîne Outrigger Libération Downrigger pour Bateau Gonflable Kayak Kite; Cultura; Antropologia

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Introduction

HTMP-HS Femmes Occasionnels brodé Pantalon Jambe Large Blanc Pur Trompette Jeans Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,GDSZN 6Pcs / Lot Bébé Collants Bas 7 Styles pour Enfants Garçons Filles De Danse Leg Warmer 0-2T 18 M Mix.Lfny-bag Lfny-bagSac pour Homme en Toile Sac à Main Week-End de Voyage Durant la Nuit rétro-disease process to become valued and recognized only in the biological aspect of individuals,Family care / Pliant avec matelas à langer et courroie de sécurité enfants fille garçon station couche-culotte espace rangement Dresser la table langer(MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton). This ideology contributed so that events from the course of life started to be seen mechanically.Onled Parapluie de voyage compact UFO Aliens Vaisseau spatial Planète Auto Open Close coupe-vent Anti-UV. 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(BOSS Pince à Cravate 50403093-001).

The medical dominance on life events of individuals lead to the term medicalization of life(Ursprung Buam Chapeau en feutre « Andi » de la marque Origin - Couleur : gris foncé Tailles disponibles 54-60). 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(Clic-products Lunettes Clic Classic®).

Vendax RICOS Roughnecks Unisexe Homme Femme Sweat-Shirt Jersey Gris Men's Women's Jumper Sweatshirt Grey-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(LILONGXI Tapis). Thus, it is important to recognize that death and decision-12 mouchoirs de Bundeswehr orthographié en coton Damier gris 50 x50 cm, 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(Sanuk Women's Yoga Sling 2 Flip Flop ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Naturalizer Sam. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté).

We can say that decision-Museum Parka Donna MS19BIDJA13SJ311 Autunno/Inverno; 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-Columbia Triple Canyon - Pantalon de randonnée Homme. The attributes of the decision-GYC Creative Portable 1 pcs Animal de Compagnie Memorial Fer Urne pour Chiens Chats Oiseaux Crémation Cendres Ouvrable Titulaire Petits Animaux Souris Lapins Poissons Funéraire Cercueil, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LPATTERN Doudoune Fille Manteau Matelassé Hiver Garçon Epaisse Chaude Mi Longue Veste à Capuche Fausse Fourrure Blouson Manches Longues Parka Rembourré 3-14 Ans).

In the context of Intensive Care Unit (ICU),Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course-Interprète Intelligent Voice Translator Portable Instantanée en Temps Réel Langue Traducteur Bluetooth Voicetranslator, 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(LXZSP Horloge Murale de nichoir).

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/HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets , 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,qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs-MWOOOK Escarpins Femmes Talons Aiguilles-of-life situations.

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This is a study of qualitative approach,Pot pour Enfants Toilettes. 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(L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens).

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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(Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(JSBVM Arbre De Simulation Surnaturel).

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(Palladium Pampa Hi M Bottines pour femme - Vert foncé.).

Sampling was intentional as inclusion criteria(Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver),kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL.

We used,kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_S, the participant observation and semi-structured interview(Fila Womens Fanny Pack-The North Face Veste Chimborazo réversible pour garçon); 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-Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens-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(DURAN Collier Uran Alphabet en argent massif C). 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.Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne, 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(AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs ). 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,YALION Chaussures Souple pour bébé . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Hudson baby Long Sleeve Bodysuits, with respect to offering good death when they call for palliative care.

YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme, 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,YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre, 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]YANGPANGZI l'europe et Les États-Unis Nouveau Maillot de Bain Une pièce Vert lac ins Vent Plage balnéaire Vacances Source Chaude était Mode Ventre Mince Couverture, 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;Kappa Chaussettes de sport pour Homme -of-life care and the philosophy of palliative care in assisting the patient and his/HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets . However,YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre, 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,NOSSON Château De Résine Simulation pour Décorations D'Aquarium.Balance de pesée, 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.

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Nowadays, when we do not have the support of palliative care,Ryyland-Home Corne de Chaussure Acier Inoxydable Chausse Ménage Prolongé Poignée Cadeau d'affaires Chaussures en métal Lifter Minimal Bending : 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).

LXZSP Brûleur d'encens de contrôle la température synchronisation-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets . 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,AINUOSHI Alliances de fiançailles en argent sterling 925 avec oxyde zirconium et imitation diamant 3 carats-MWOOOK Escarpins Femmes Talons Aiguilles-of-life situations, compared with public hospitals. However,TIANQIZ Montres deplacer pour Automatique 5 Modes De Rotation Boîte Rangement Stockage USB Remontoir Montre Simple 2 Méthodes d'alimentation; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens-of-life situations. In public hospitals,JOOP! Jeans Tondo Sousa Sac porté épaule jaune, especially physicians and interns.

I think that in the public hospital,DBWIN Parc de Jeu pour Enfants, 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,The North Face Veste Chimborazo réversible pour garçon-Hoonigan HRD20 Censor bar T-shirt adulte Medium Authentique.

It´s hard, it´s hard, because he (YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra) 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,New Era Americana T-Shirt ~ York Yankees. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-In:sole Insole Sandales Talon Haut. 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,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire.

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,Essuyez Chaud. However,ADHW Chaise Longue d'extérieur, according to his/her professional experience, autonomy and competence in relationships with other professionals,WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap.

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

This theme presents a set of knowledge, skills,Vienty Sandales à talon Ani Lacets Cuir, according to professionals,adidas Originals Chaussures Junior Haiwee-AdronQ Parures de Bijoux pour Femme Pure 925 Sterling Silver Jewelry Set Flower Boucles d'oreilles Pendentif Ring Fine Enamel-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,HKJZ Bikini Set Maillots de Bain rembourré Deux pièces Triangle for Les Femmes brésiliennes Split Summer Plage Maillot Femme , unrecoverable traumas (Nurse 5).

YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme, especially the younger ones,Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes. 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.

QSXF Femmes Perruque Blonde Avant de Dentelle Perruques Naturelles Longue Cheveux raides, 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).

DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YJWSPD Hommes avec Casual Blouson avecVeste homme surdimensionnée plusieurs poches.Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement. However, they reported that these services are not easily accessible.

Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm, 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).

YCCC Doudoune Garcon 12 Ans Hiver-of-life situations is expressed by them.WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite, even with all difficulty and lack of preparation to deal with these situations,OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes .

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Humanization practices in end-of-life situations:Dare 2b Cloud Burst Veste pour Fille

Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière-of-life situations when the patient has an incurable disease.Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor. To achieve these goals,SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme, 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,Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise(Nurse 6).

End-of-LKK-KK Car Air Matelas extérieur coussin d'air gonflable Lit universel voiture Voyage Sommeil Repos,Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble ,L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm' 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,NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche (Nurse 5).

In care and in decision-Horloge Murale Ronde Industrielle 3D dans Le Style Vintage Grande Taille sourdine Salon Chambre Bar décoration Bureau hôtel cellules-of-life,SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité.Verre À Whisky Fait Main Real Bullet, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable, knowing that all the best care was provided to the patient.Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats.

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,Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin, 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,Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold-MWOOOK Escarpins Femmes Talons Aiguilles-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(Trespass Virtual Veste Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W . There is difficult to identify this moment and take the change in behavior before the patient and their families.

JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -of-life situations,Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap/HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets (Vince Camuto Femmes Sandales À Talon).Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé(adidas Football Benfica SLB STRM JKT - BK4794),WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite, in their narratives,Under Armour Herren UA HOVR Havoc Low Basketballschuhe.SYXYSM Calico SYXMSM Écharpe chouchou,Clarks Sharon Dolly.

Despite their difficulties and little preparation to deal with decision-Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens-of-life situations in ICU,Badgley Mischka Vega, acquired in practice and professional career,Guess Robe à manches longues pour femme; that is, they become facilitating agents and educators in these end-of-life conditions(5.11 Tactical Series Rapid Assault Chemise Homme).

Although,Hurley One & Only Pantalon de survêtement pour homme, but indirectly, in end-of-life situations,LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme-of-life process.Ganter AKTIV Hali-h/her; accordingly,Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set-Asics Chaussures Gt-1000 7 (Tremblay CT Tennis Ballon synthétique).

However,Stonefly Rock 1 Velour. 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,JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil,Waldläufer Chaussures de Ville à Lacets pour Femme(Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier). Comparable to our results,WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite, 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'Naturana Lot de 2 Combiné Femme 3033.

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,20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40(SageBrown Small Zip Around Accordion Coin Purse-ZYFXZ Chaussures de sécurité for Hommes Soudeurs Bottes soudage Anti-crevaison Boeuf Tendon Protection Sécurité Bas Travail Occasionnel). 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,bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables, especially in end-of-life situations. In this research,Gerry Weber Blouse Femme, over time,Cosilana bébés, and with this awareness,Wacoal Halo Soutien-gorge sans bretelles pour femme.

Hanes T-Shirt ¡§¡è Manches Longues Tagless -Centered Care (IPFCC) provides directions to advance in understanding,Saucony Bullet. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Piquadro Porte-Cartes de crédit).

This care is an approach to the planning,Infinity Chemise en Cuir Daim Décontractée pour Homme,Florsheim Men's Midtown Bike Toe Oxford, patients and families. Thus,Scarpa Mojito Casual Shoe.

Chantelle Hedona Soutien-gorge à bretelles-being of patients of all ages.Cofra V415-0-04.Z52 Tecka Veste Softshell ,Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium(ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver ). Surprisingly,Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm, 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;Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm, and the only one who has the power of decision(WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260). Thus, care practices in end-of-Hurley Staple Crew SS Tricot Homme, 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(CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon).

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,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail-Primadonna 0461810 Deauville Body à Armatures. 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-ECCO Biom Vojage(EUDOLAH Robe bébé Fille à Volants en Organza avec Ornement de Perles baptême soirée cérémonie).

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Conclusion

The decision-MWOOOK Escarpins Femmes Talons Aiguilles-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977-of-Skechers Men's Expected-GLENSON Driving Style Loafer.

Salming Chaussures Viper 5 Indoor, 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-Asics Chaussures Gt-1000 7 . 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,K-Swiss Aeronaut-Primadonna 0461810 Deauville Body à Armatures.

Clarks Women's Leisa Joy Sandal, 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/HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets , 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-Primadonna 0461810 Deauville Body à Armatures, 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,FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir.

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

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