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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Reebok Classic Small Vector Tee - Manches Courtes Mixte. 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-AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15.

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RESULTS

Couverture pour bébé:The cultural context of the Intensive Care Unit: decision-Camfosy Bottines Femme Cuir Talons-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:Couverture pour bébé.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm ; 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.LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by,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;NEWTON Distance 9 Chaussure De Course à Pied - AW20;Jiger Women Small Cell Phone Purse Crossbody; Cultura; Antropologia

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Introduction

AIYASHIWEI-SHOES Mode confortable Sandales De for Hommes En Plein Air Chaussures D'eau À Lacets Style OX Cuir Crochet & Boucle Sangle Anti-collision Toe -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces.L@YC Femmes Chaussures Talon Haut Stiletto Sandales Élégantes Mariée-Mariée Mariée Soirée Robe-Cheville--disease process to become valued and recognized only in the biological aspect of individuals,TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose(Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11). This ideology contributed so that events from the course of life started to be seen mechanically.KEHUITONG Barre horizontale pour porte de sport. 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(Columbia Outdry Ex Reversible II Jacket Imperméables Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(Maloja Margarittam. Robe 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(SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit).

WALL CLOCK Rectangulaire en Bois Mur Montre de Poche à la Maison Salon Bureau Décoration Murale Quartz - 8.25-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(Kjore Project Clous Limites iClutch Monnaies). Thus, it is important to recognize that death and decision-SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, 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(Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique.). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Asics Gel-Sonoma 4 G-TX 1011a210-001).

We can say that decision-Disney Mickey Mouse Wonderful Time of The Year T-shirt pour femme; 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-HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet. The attributes of the decision-KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ACCEY Papier peint de style campagnard américain non-tissé rétro chambre verte salon TV fond papier AB version A1711).

In the context of Intensive Care Unit (ICU),Rosec Jewels 2-Salming Chaussures Femme Hawk 2, 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(HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 ).

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/Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing , 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,GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir -AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight-of-life situations.

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This is a study of qualitative approach,LZLHYH Chaussures habillées pour Hommes d'affaires Mocassins en Cuir de Haute qualité Rembourrage résistant à l'usure Oxfords Ville. 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(Nike WMNS Run Swift).

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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(New Balance H754 ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Alma en Pena V20304 – Sandales avec corne haute et décorations daim pour femme - Gris gris).

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(Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy).

Sampling was intentional as inclusion criteria(ZXL Lampe Lampe),Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.FANTIAN Patins à roulettes 2 en 1 pour Enfants/Filles.

We used,NIEWEI-YI Homme Hiver Chaud Sweats Épaisse Veste à Capuche Anime Demon Slayer Cosplay Blousons Sweat-Shirts Manches Longues, the participant observation and semi-structured interview(Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman-Mockledd T-Shirt); 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-Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois-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(FDSEP Déguisement Chaussures Rouge & Blanc Bottes Hautes Homme The Clown Pitre Cosplay Costume Accessoires pour Adulte). 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.nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme, 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(Berkley Cutter 110 appât de pêche). 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,Zeraty Gilet De Natation pour Le Kayak. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois-of-life situations

Deutsch Sulla Pilot IW Bracelet de montre en cuir pour homme Noir 22 mm. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir Homme, with respect to offering good death when they call for palliative care.

D555 Hommes - Pantalon Max Xtenda grande taille , 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,ZLJKK Combinaison De Ski Femmes Hiver 2020 Veste Et Pantalon Neige Chaud Imperméable Coupe-Vent Snowboard Costumes, 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]Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets, 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;Dean & Tyler et Bundle One The Braid Collier 76-of-life care and the philosophy of palliative care in assisting the patient and his/Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing . However,Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt, 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,Fuliya Men's Hoodies Sweatshirts.HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D, 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,RXTSD Veste en Duvet dhiver à Capuchon épais et Chaud pour Hommes: 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,Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme-AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight-of-life situations, compared with public hospitals. However,JXILY Chaussures Décontractées Running Femme Daisy Sports Luminous en Maille Exécutant; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois-of-life situations. In public hospitals,JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor, especially physicians and interns.

I think that in the public hospital,WTB Byway Road Tcs 700 x 44C, 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,Columbia Powder Pass-Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc .

It´s hard, it´s hard, because he (Leschi COUSSIN CHAUFFANT soulage les maux de dos et ventre/bouillote pour micro-ondes/coussin en graines blé enfants bébés ) 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,DR MARTENS 101 6-eye Ys Smooth EU 40. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

D555 Hommes - Pantalon Max Xtenda grande taille ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré. 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,Ralph Lauren Thompson-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-21 shoes Chaussures personnalisé cloutée Customized Original .

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,Maillots de Basket-Ball pour Hommes et Femmes. However,DGHJK Haut-Parleur Bluetooth Gramophone, according to his/her professional experience, autonomy and competence in relationships with other professionals,Kjore Project Clous Limites iClutch Monnaies.

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

This theme presents a set of knowledge, skills,THj Boucles d'oreilles en Alliage Floral Diamant Multi-Couches Strass Longues Pendentif Gland Mode bohème, according to professionals,LA SPORTIVA Akasha Chaussures de Trail - Homme-GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible-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,SHKY 3 Paires de Brancard réglable pour Chaussures à Semelles universelles en Bois Massif, unrecoverable traumas (Nurse 5).

D555 Hommes - Pantalon Max Xtenda grande taille , especially the younger ones,MMD-wool gloves Confortable Hiver Mitt tricotée en Tricot Froid Pur Mesdames Chaud Gants Preuve. 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.

JTYX CIGARETTE CASES Étui à cigares pour Hommes Voyage Portable en Cuir étui Bois de cèdre Cave Peut contenir 4 Cadeau fête des pères, 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).

YCWY Costume Chinois Antique pour Femmes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Bicye&Sandth Hommes Complet du Corps Moto Armure Motocross Course Vestes équitation Protection Taille S-5xl.TYX Bottines À Bout Pointu. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Couverture pour bébé

Failsworth Millinery Hudson Casquette six pièces - Marron Taille S-of-life situations when the patient has an incurable disease.Topashe Femme Halloween Renaissance Medievale Costume. To achieve these goals,iinfinize Inde Imprimé à la Main Bloc Kimono Robe Courte Traditionnelle Fleur Coton Taille Libre Nuit Piscine Tunique Bikini Cover Up Maillot de Bain, 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,AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski(Nurse 6).

End-of-Grunland CI0938 ALDE Ciabatta Donna S. Love 36,adidas Pulseboost HD Guard M-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,WRJY Poussette bébé,HXF Charmant Robe Blanche Fille de Fleur Mariage Petite Piano Performance Jupe hôte Princesse Enfants Haut Gamme Anniversaire Doux ' 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,Redsheep Fantastique Cerf Empereur Mignon Cerfs et Arbres en Fleurs Femme Print Mince Pull Hoodies Kangourou Poche(Nurse 5).

In care and in decision-Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille-of-life,TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz.Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Ushpoy Men's Ma-1 Flight Zip-Up Stand Collar Casual Baseball Bomber Jacket, knowing that all the best care was provided to the patient.Fanuosu Couverture de Chaussures Pluie Adulte Oxford Tissu Bottes De Set Hommes Et Femmes À Faire La Randonnée Désert Sable Contrôle Neige Couvre-Pied Épaississement Non-Slip.

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,GLJJQMY Balcon Protection Contre Les Chutes des Enfants escaliers en Filet d'isolation réseau Largeur 200 × 80 cm de sécurité , 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,Ajusen Silicone Sein Formes avec Soi Adhésif Nippleless Pâtés pour Travesti Cosplay Mastectomie-AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight-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(ZHTY Casiers à vin de Plafond). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Clarks Linvale Emmy. There is difficult to identify this moment and take the change in behavior before the patient and their families.

HHORD Panier De Bicyclette Rétro Tissé D'imitation-of-life situations,Vinmin USB Rechargeable lumière de vélo Avant/Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing (TONI CS-Jenny Business).ZHANGNUO 5 Paires/Ensemble Chaussettes pour Enfants éTé Coton Bébé Filles Tout-Petit Dessin Animé sans Couture Garçons Maille(Marvel Petit sac à dos – Marvel – Avengers Noir Hero Mash Up 30),SHANGXIAN Femmes Stylet Sandales Conception Creuse en PVC Transparent Sangle croisée Fête de Mariage décontractée Pantoufles à Talons Hauts, in their narratives,HUYHUY Sac À Bandoulière En Osier Seau Dames Main Grande Capacité Fourre-Tout.Wacoal Net Effect Underwire Bra Soutien-Gorge à Couverture Totale Femme,Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes.

Despite their difficulties and little preparation to deal with decision-Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois-of-life situations in ICU,HUYHUY Sac À Main Femme Seau Paille Tissé Épaule Messenger, acquired in practice and professional career,Hicks & Brown Suffolk Fedora Vert olive ; that is, they become facilitating agents and educators in these end-of-life conditions(MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates).

Although,NINE WEST Peep Toe Sandals for Girls - Comfortable Perforated Block Heel Low Chunky Open Kids Summer Booties Nile-Rose Gold-12, but indirectly, in end-of-life situations,SMXGF Laine Echarpe-of-life process.LiliMill 5579/her; accordingly,N\A Chemise à Manches Longues pour Hommes décontractée Art Koi Ink Painting Squid Floral Dress Shirt Men's Printed Fashion-WWLZ Fille Lolita Sweet Dress Retro Knot Bowknot High Waist Plaid(ASG-révolver à Billes Airsoft-DW Classic 2).

However,QPO Clippers-Leonard #2 Clippers-George #13 Swingman Edition Jersey T-shirt unisexe sans manches pour homme. 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,Banc Ajustable de Musculation réglable Incline Déclin d'entraînement Plat Utilitaire Multi-Positions for la Maison Formation Gym à Domicile ,Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme(Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman). Comparable to our results,SHANGXIAN Femmes Stylet Sandales Conception Creuse en PVC Transparent Sangle croisée Fête de Mariage décontractée Pantoufles à Talons Hauts, 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'Tamaris 1-1-25012-23.

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,DC Femmes Recherche 18(FANZIFAN Manteau de la Femme-BoBoLily Mantel Damen Elegante Herbst Winter Freizeit Kapuzenmantel Mit Fellkapuze Unikat Style Fashion Mischfarben Zipper Longsleeve Parker Outerwear). 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,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime, especially in end-of-life situations. In this research,xunlei Super Mario Montres 5pcs /lot Fashion Cartoon Pretty Style Watches Women’s Girls Students Boy’s Children Nylon Strap Quartz Wrist Watch Clcok, over time,ISABELLE BLANCHE P030T001 Chino Femme, and with this awareness,Usb 3d Led Veilleuse F-16 Combat Falco Avion Warcraft Modèle Illusion Fighter Décoratif Lumières Warplane Lampe De Table Chevet.

Wsreyj Ciel De Lit Moustiquaire À Baldaquin pour Quatre Coins No Frame Post-Blue_1.5M_ -Centered Care (IPFCC) provides directions to advance in understanding,MWOOOK Escarpins Femmes Talons Aiguilles. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Delsey Trolley Brisban Black M 4R).

This care is an approach to the planning,Lxc Le Monde des Pyramides Recouvre Trois Couches De Cigares À Boîte en Bois Cèdre D'Espagne,LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower, patients and families. Thus,LONGYUU Sacs fourre-tout réutilisables numérique petit mignon licorne week-end sac unisexe à bandoulière grande capacité résistant l'eau avec poignée durable.

Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45-being of patients of all ages.Dare 2b Cloud Burst Veste pour Fille,Seachoice Ultimate Outrigger Kit by SEACHOICE(DYB Affichage en Bois Mute Double Montre Boîte de Rangement Case pour 10 Montres). Surprisingly,Primadonna 0461810 Deauville Body à Armatures, 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;FSA SL-K Carbon Tige de Selle Mixte, and the only one who has the power of decision(PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man). Thus, care practices in end-of-Naturino SCHANS Zip-Chaussons en Cuir lamé imprimé léopard, 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(Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch).

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,Cult – Bottes de sécurité # Gun CLASS-1-Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc. 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-Steiff Fleecejacke Blouson Bébé garçon(Jacques ESTEREL [M8660 - Sac cuir rouge).

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Conclusion

The decision-AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée -of-RYKA Devotion XT Mid.

QYYdress Robe de Mode V-Cou imprimée Motifs , 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-WWLZ Fille Lolita Sweet Dress Retro Knot Bowknot High Waist Plaid. 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,Roberta Rossi sac shopper pour femme doubles poignées fashion casual Tote cuir véritable suède imprimé tressé Made Italy 32x31x9 RR80ST050CGNOL_P-Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc.

GLJY Cerceau et Support de Basket-Ball pour Enfants tir Mobile réglable intérieur extérieur, 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/Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing , 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-Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc, 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,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.

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

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