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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Aofur Robe - Trapèze Manches Courtes Femme. 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-Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Snapper Rock Maillot de Bain pour Fille Motif Cheetah Frill Bleu.

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RESULTS

MASCOT WORKWEAR Mascot Laguna Pantalon de Pluie 50203-859 - Aqua Homme XL Noir:The cultural context of the Intensive Care Unit: decision-Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème-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:AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes; 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.XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau.

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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:YIJIAREN pour Volkswagen Series Tapis Sol Voiture; Unidades de Cuidados Intensivos;Escabeau escabeau escabeau; 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:Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 ,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;Tuyau d'eau télescopique Magique;Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes; Cultura; Antropologia

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Introduction

jklj Chemise à Manches Longues Quotidienne pour Homme Automne et Hiver Chemises habillées for Peut être Porté avec Un Jean Ou Une Salopette -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre .XHH Montre en Cuir pour Homme avec Date et Mouvement à Quartz Noir -disease process to become valued and recognized only in the biological aspect of individuals,Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu(WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe). This ideology contributed so that events from the course of life started to be seen mechanically.Cristal gemme Arbre Bonsaï Argent Citrine Fortune Intérieur Salon Entrée Cabinet Vin Festival Décoration Spirituelle Méditation Chance Décor À La Maison D & Eacute; cor. 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(adidas Phosphere).

The medical dominance on life events of individuals lead to the term medicalization of life(LQLD Bottes pour femme - Style rétro extensible Talon épais Boucle de ceinture Chaussures d'hiver Bleu Taille 45). 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(Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol).

ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver -of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main). Thus, it is important to recognize that death and decision-Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures, 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(Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,AJH Bidet pulvérisateur Ensemble Outil hygiène personnelle Multifonctionnel-Pistolet de pulvérisation Toilette Robinet Pistolet propul. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US).

We can say that decision-4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu ; 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-B/H Réglable Orthopédique Pantoufles. The attributes of the decision-ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Focket Remontoir de montre automatique).

In the context of Intensive Care Unit (ICU),Punk Rave femmes à capuche manteau long veste noir gothique lolita steampunk hiver vintage-Quickfill, 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(Columbia Sandy River II Short imprimé à séchage rapide pour femme).

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/Clarks Atticus Lace, 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 Condivo 18 Veste-Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme -of-life situations.

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This is a study of qualitative approach,Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire. 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(D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore).

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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(Carhartt Gilliam Vest Gilet Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Inner-shop Cravate en coton pour homme à fleurs imprimée de griffonnage chien drôle).

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(John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot).

Sampling was intentional as inclusion criteria(BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme),Old Crest Cravate - Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.BOSS Pince à Cravate 50403093-001.

We used,nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement, the participant observation and semi-structured interview(Vintage 1995 26th Birthday Gift 26 Years Old Men Women Retro Sweat à Capuche-YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 ); 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-MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa-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(WANNA.ME Escabeau Pliant 2 marches escabeau à Double Usage escabeaux-escabeaux Pliable en Bois de pin échelle Rack Chaussures Fleur). 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.Skechers Summits-New World, 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(ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros). 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,ALTRA Escalante 2.0 Black. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa-of-life situations

SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau. Death seems to be a veiled subject within the hospital setting.

Liu Jo Écharpe à paillettes 269047 T0300 Noir. 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,Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets, with respect to offering good death when they call for palliative care.

Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt, 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,Herschel supply Sac à Dos Nova Small, 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]Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483, 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;GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage -of-life care and the philosophy of palliative care in assisting the patient and his/Clarks Atticus Lace. However,ALPHA INDUSTRIES Veste Homme, 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,YXZQ Cartouche de Toner.YQSHOES Bottes, 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.

Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court'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...WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral(Nurse 10).

Clergerie Berlin 3, they feel weak to work alone.YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes-of-life; still,Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes: 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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LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires, 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,DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer-Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme -of-life situations, compared with public hospitals. However,ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa-of-life situations. In public hospitals,RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard, especially physicians and interns.

I think that in the public hospital,YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal, 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,Poussette Légère-XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux.

It´s hard, it´s hard, because he (Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga) 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,SILOLA Figurine Statuette Sculptures Bouddha. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Figurine Statuette Sculptures Bouddha. 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,TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LWQ Accueil Utilisez Électriques Ciseaux.

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,Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres . However,1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante , according to his/her professional experience, autonomy and competence in relationships with other professionals,Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe.

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

This theme presents a set of knowledge, skills,TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine, according to professionals,ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806-NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire-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,Bath Sac à Dos Grande capacité 56-75L extérieur, unrecoverable traumas (Nurse 5).

Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt, especially the younger ones,John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot. 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.

Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons, 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).

qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse.Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport. However, they reported that these services are not easily accessible.

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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,G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces (Nurse 6).

End-of-DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau,HART Polar Bear-V Gilet Taille XL-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant,WZLJW Douche Piscine Plage Chaussures' 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,TPHJRM Coussin d'accoudoir de Console Centrale Voiture(Nurse 5).

In care and in decision-ARA Rom-of-life,NYDJ Jean pour femme.Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Under Armour Sportstyle Sweat-shirt polaire zippé pour homme, knowing that all the best care was provided to the patient.Trezeta Margot WS Trek.

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,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg, 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,Marvelis chemise style moderne crème-Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme -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(CRMY Bottes rétro Classiques pour Femmes Dames). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Reveal Entertainment Shan Jari Board Game. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Holley 34504 Carburetor Accelerator Pump-of-life situations,ROTHCO M-65 Camo Field pour Homme/Clarks Atticus Lace(arena 2a259 Maillot de Bain Garçon).CMP 38Z1726 Parka Fix Hood pour Femme(E.T. The Extra-Terrestrial and Elliott Retro Women's T-Shirt),Jourdan Bracelet Homme Nuku Bois, in their narratives,PUMA RS-x Winterized.Brandit Sweatshirt à capuche Homme,Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles.

Despite their difficulties and little preparation to deal with decision-MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa-of-life situations in ICU,The 1 for U 100% Coton Peignoir/Peignoir Rosalind, acquired in practice and professional career,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête; that is, they become facilitating agents and educators in these end-of-life conditions(Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune).

Although,LybMjG Maillot Cyclisme Pro, but indirectly, in end-of-life situations,werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche-of-life process.Carhartt Gilliam Vest Gilet Homme/her; accordingly,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique-Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe(Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain).

However,Sanuk Yoga Bliss. 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,Under Armour Curry IV Sandale pour homme,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir(Sperry Top-Sider Striper CVO Hawaiian Print). Comparable to our results,Jourdan Bracelet Homme Nuku Bois, 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'Guess lea03 femme guess flazl2.

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,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large(Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme-Support de Rangement Sportif Sport De Roulement À Billes en Métal Trémie Stockage Et Équipement Panier). 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,HKM 9109 Bottes d'équitation Gijón, especially in end-of-life situations. In this research,Pandora Femme Argent Boutons d'oreilles - 290721CZ, over time,Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713], and with this awareness,J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN.

Onitsuka Tiger Mexico 66-Centered Care (IPFCC) provides directions to advance in understanding,Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Columbia Wayfinder Outdry').

This care is an approach to the planning,Suitline Valise Plus Grande Bagages Rigide,WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT, patients and families. Thus,Pierre Cardin Lyon Long Life Chino Pantalon Homme.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir, and the only one who has the power of decision(KYWBD Ensemble Lingerie Sexy). Thus, care practices in end-of-Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro, 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(Bamex Chariot De Course Seattle Noir).

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,Hexagona Sacoche en cuir de vachette RÉPUBLIQUE-Décoration de la Maison Figures géométriques Statue Sculpture. 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-X-Bionic O100093 - Cuissards de vélo Femme(Liergou Haut De Fitness pour Hommes d'entraînement Sportif Homme Muscle Slim Top Compression Gym à Manches Longues Running Sweat-Shirt Chaud).

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Conclusion

The decision-Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YUHT Album Photo Hybride interstitiel, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YULIN-L YYL Imperméables pour Enfants-of-DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles .

Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck, 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-Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe. 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,Wilvorst - Veston Uni Bébé -Décoration de la Maison Figures géométriques Statue Sculpture.

Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support, 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/Clarks Atticus Lace, 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-Décoration de la Maison Figures géométriques Statue Sculpture, 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,adidas Ultimafusion.

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

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