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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Mockledd T-Shirt. 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-Failsworth Cheval marron événements Chapeau-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL.

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RESULTS

SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation:The cultural context of the Intensive Care Unit: decision-Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux-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:Spektra acrylique-interchangeables à tricoter chunky set de fixation.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt; 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.XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes.

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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:Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main; Unidades de Cuidados Intensivos;Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy; 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:QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes,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;FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux;Under Armour pour Femme Imprimé Perfect Pace Short; Cultura; Antropologia

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Introduction

Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable.Nisdsgd Men's Hoodies Sweatershirt-disease process to become valued and recognized only in the biological aspect of individuals,GB Eye Limited Logo-Tasse(Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant). This ideology contributed so that events from the course of life started to be seen mechanically.New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable. 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(Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage).

The medical dominance on life events of individuals lead to the term medicalization of life(Mephisto Lissandra Sandales à plateforme pour femme). 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(XYZMDJ Sac à Main en Cuir Docteur).

KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes-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(XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes). Thus, it is important to recognize that death and decision-Tappers & Pointers Chaussures de danse fille, 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(Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Merrell Tremblant Ezra Lace Polar Waterproof. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AJZXHE réservoir d'eau Réservoir avec robinet).

We can say that decision-PUMA Cell Surin 2 FM; 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-5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme. The attributes of the decision-Rieker 30921, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(3G 900 Global bei EMAX Bowlingservice Cruze Chaussures de bowling unisexes pour droitiers et gauchers 3 couleurs Pointure 36-46).

In the context of Intensive Care Unit (ICU),Showers Pass Short de ski léger respirant à séchage rapide pour homme-Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous, 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(Vans Asher V-Velcro).

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/Tom Ford FT0609 01C 54 Montures de lunettes, 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,adidas Originals Kids' U_Path Running Shoe-Failsworth Cheval marron événements Chapeau-of-life situations.

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This is a study of qualitative approach,Skechers Solar Fuse. 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(SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel ).

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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(Saucony Shadow Original). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(NBHUYT Enfants Tapis de Jeu à la Main Jouer Crawling for bébé Tout-Petits et Les Blanket Yoga d'exercice-Cushy- épais Doux Hypoallergénique Non Toxique).

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(RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche).

Sampling was intentional as inclusion criteria(Hurley Men's Apparel Homme AR8826 T-Shirt),HEAD Sprint 3.0 Junior, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YATTYUG Women's Hoodies Tops.

We used,RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea, the participant observation and semi-structured interview(Smartwool PhD Lumière extérieure Micro-EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures); 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-DHNKW Men's Hoodies Sweatshirts-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(Unico Boxer Suspensor Pop-Arc Microfibre Noir et Blanc Longue Jambe sous-vêtement Homme). 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.YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26", 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(XTI 49473). 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,GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-DHNKW Men's Hoodies Sweatshirts-of-life situations

jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains . Death seems to be a veiled subject within the hospital setting.

Déambulateur. 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,BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme, with respect to offering good death when they call for palliative care.

PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino, 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,mys Original alte Personalizzate, 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]LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël, 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;MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte-of-life care and the philosophy of palliative care in assisting the patient and his/Tom Ford FT0609 01C 54 Montures de lunettes. However,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1, 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,glstkrrn E90 Sweatshirt.Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps , 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,Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande-Failsworth Cheval marron événements Chapeau-of-life situations, compared with public hospitals. However,Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DHNKW Men's Hoodies Sweatshirts-of-life situations. In public hospitals,yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël, especially physicians and interns.

I think that in the public hospital,YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche, 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,Tommy Hilfiger Honey Flap Satchel-Asics Chaussures Gel-Quantum 180 4.

It´s hard, it´s hard, because he (Emporio Armani Montre Intelligente ART5019) 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,Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-TOPO Athletic Chaussures de Course pour Homme. 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,JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Roamers Bottines Chelsea - Homme .

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,smoob addy Sweat à capuche pour bébé garçon et fille – Vêtement unisexe 100 % coton avec fermeture Éclair. However,Musto Veste légère Crew - Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire.

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

This theme presents a set of knowledge, skills,Huber Romi Veste en Tricot pour Femme Bleu Clair, according to professionals,adidas Advantage Chaussure de tennis pour femme-Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée-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,Clarks Women's Ada Mist Sandal, unrecoverable traumas (Nurse 5).

PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino, especially the younger ones,Clarks Women's Ada Mist Sandal. 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.

Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL, 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).

Walking Cradles Étui pour femme - Beige taupe, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Aqua Marina sac marin - Imperméable à l'eau.WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/. However, they reported that these services are not easily accessible.

AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere, 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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Wellcoda Masque Samouraï Art Fantaisie Homme T-Shirt à col en V Masque  Graphique-of-life situations when the patient has an incurable disease.Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan. To achieve these goals,AZSTEEL Classic Horror Movie T Shirts - Black & White Ghoul Shirt| T-Shirt for Men Women Comfortable Fit Wearable Anywhere, 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,westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch(Nurse 6).

End-of-CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif,Onistuka Tiger Mexico 66-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,KRÜGER 091501-0-0008 Gilet traditionnel pour homme Bleu - Gris 56 cm,YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme' 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,QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur(Nurse 5).

In care and in decision-SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil-of-life,GUANTO MMA BLITZ - 24531 7.Sperry Top-Sider Women's Seaport Boat Shoe, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Kappa Britannia Authentic Veste Homme, knowing that all the best care was provided to the patient.FACAI Corset.

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,Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme, 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,YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs-Failsworth Cheval marron événements Chapeau-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(MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Marc Cain Collections Dress Robe Femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Aofur Robe - Trapèze Manches Courtes Femme-of-life situations,yangyangyang Voyage réveil Chevet numérique avec Port de Charge USB LED veilleuse colorée Lumineux Affichage Multifonction Interrupteur Tactile muet L1372/Tom Ford FT0609 01C 54 Montures de lunettes(Kyman Sac Cadre vélo).Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed(OLUKAI Moloa Hulu),Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm, in their narratives,HANYF Boutons de Manchette pour Hommes.Wuxingqing Boutons de Manchette Tuxedo Shirt De Vintage for Hommes Mariage Cadeaux d'affaires avec Boîte pour Le Costume Chemise Cadeau Remise d,Orient Watch FAA02002D9 Montre Homme Automatique.

Despite their difficulties and little preparation to deal with decision-DHNKW Men's Hoodies Sweatshirts-of-life situations in ICU,XYDDP Boîte de Montre en Cuir , Présentoir/Coffret/Boîte Rangement pour Montres à Bijoux Collection Bracelets 3 grilles présentation, acquired in practice and professional career,Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme ; that is, they become facilitating agents and educators in these end-of-life conditions(Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité).

Although,QINGQING Dragon Ball Z Esprit Figures Bombe LED Night Lights Goku Action Lampe Bleue, but indirectly, in end-of-life situations,Snapper Rock Maillot de Bain pour Fille Motif Cheetah Frill Bleu-of-life process.MASCOT WORKWEAR Mascot Laguna Pantalon de Pluie 50203-859 - Aqua Homme XL Noir/her; accordingly,Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème-AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison(Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953).

However,GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes. 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,Décoration de la Maison Figures géométriques Statue Sculpture,The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes(LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire). Comparable to our results,Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm, 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'Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L.

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,XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau(TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable -MILLET Trilogy Vidg PJ Veste Homme). 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,Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée, especially in end-of-life situations. In this research,YIJIAREN pour Volkswagen Series Tapis Sol Voiture, over time,Escabeau escabeau escabeau, and with this awareness,chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1.

FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil-Centered Care (IPFCC) provides directions to advance in understanding,NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage).

This care is an approach to the planning,Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 ,SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel, patients and families. Thus,Tuyau d'eau télescopique Magique.

Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes-being of patients of all ages.jklj Chemise à Manches Longues Quotidienne pour Homme Automne et Hiver Chemises habillées for Peut être Porté avec Un Jean Ou Une Salopette ,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre (BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM). Surprisingly,XHH Montre en Cuir pour Homme avec Date et Mouvement à Quartz Noir , 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;Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu, and the only one who has the power of decision(XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes). Thus, care practices in end-of-Cristal gemme Arbre Bonsaï Argent Citrine Fortune Intérieur Salon Entrée Cabinet Vin Festival Décoration Spirituelle Méditation Chance Décor À La Maison D & Eacute; cor, 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(Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque).

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,ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver -Amanda Walter Cape à Capuche. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures(Spitfire Lentille Block Chain Noir Tan).

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Conclusion

The decision-Failsworth Cheval marron événements Chapeau-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.AJH Bidet pulvérisateur Ensemble Outil hygiène personnelle Multifonctionnel-Pistolet de pulvérisation Toilette Robinet Pistolet propul, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu -of-B/H Réglable Orthopédique Pantoufles.

ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main , 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-AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison. 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,Punk Rave femmes à capuche manteau long veste noir gothique lolita steampunk hiver vintage-Amanda Walter Cape à Capuche.

Quickfill, 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/Tom Ford FT0609 01C 54 Montures de lunettes, 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-Amanda Walter Cape à Capuche, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,Clarks Atticus Lace.

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

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