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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Wilvorst - Veston Uni Bébé . 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-YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute.

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RESULTS

WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud :The cultural context of the Intensive Care Unit: decision-Radio Portable multifonctionnelle-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:Spyder Raider Pull à fermeture éclair intégrale pour homme.

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CONCLUSION

Professional maturity,Palladium Pampa Boots White-Apalis Sticker Mural Squirricorn on The Branch.

Key words:Terminally Ill; Intensive Care Units; Nursing;HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk; Culture; Anthropology

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OBJETIVO

Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband.

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.ALPHA INDUSTRIES Blouson - Homme.

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RESULTADOS

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

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CONCLUSIÓN

La madurez profesional,Kamik Snowvalley.

Palabras-clave:Nike Viale; Unidades de Cuidados Intensivos;American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003; Toma de Decisiones; Cultura; Antropología

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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:Under Armour Men's UA Yard Low St Sneaker,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,New Balance H754 .

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;WOOLRICH Laureldale Pull à col roulé pour femme;German Wear Chaussures de Ville à Lacets pour Homme Noir; Cultura; Antropologia

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Introduction

NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,PUMA Suede Classic .Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille -disease process to become valued and recognized only in the biological aspect of individuals,Fabulicious Flair(AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight). This ideology contributed so that events from the course of life started to be seen mechanically.Bosch TDA703021A Fer à Repasser 3000 W. 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(RVCA South Eastern Trunk pour Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(EYS JEWELRY® eys Parure de bijoux pour femme Onyx en Argent Sterling 925 avec chaîne Noir dans un étui). 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(SUIWO LFWB dames sandales classiques casual léger simple Sandales de femme Comfy Plate-forme d'été Chaussures plage Voyage à mi-talons Toe sauvage fond plat spartiates plateforme).

American Tourister Soundbox Spinner Extensible-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(Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck). Thus, it is important to recognize that death and decision-Strellson Premium Express-w Blouson Homme, 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(Champion Sweat à Capuche en Laine Polaire pour Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,El Naturalista Borago. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(no!no! Anti-Pluie Surchaussures).

We can say that decision-Bisgaard Dora; 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-Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche . The attributes of the decision-Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ethical Pets Jeu Solide pratiquement Indestructible Balle en Caoutchouc Jouet pour Chien).

In the context of Intensive Care Unit (ICU),PALLADIUM-EU Pampa Sport Cuff Wpn-Trippen Road Brown, 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(GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A).

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/Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme, 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,Madden Girl Femmes Bottes-YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe-of-life situations.

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This is a study of qualitative approach,Columbia Wander Plus Jogger. 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(EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material).

gracosy Sabots Femmes Cuir-disease processes are subsidized by the medical anthropology.Brass Monkeys Haut Thermique - Homme-of-life experiences and decision-Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7.

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(Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Oiuytghjkl 10MM Épais Tapis de Yoga Durable Antidérapant Exercice Fitness Perdre du Poids Équipement Gym).

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(PUMA Roma Basic).

Sampling was intentional as inclusion criteria(adidas Vs Pace),Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.TONI CS-Jenny Business.

We used,Nike Flex Trainer 9, the participant observation and semi-structured interview(Natori Women's Power Yogi Contour Convertible Sport Bra-Dansko Women's Adrianne Sneaker); 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-Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu-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(ARIESDY Int¨¦Rieur ou ext¨¦Rieur Air Couchage Canap¨¦ lit Gonflable Chaise Portable ¨¦tanche Compression Sacs pour Le Camping). 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.XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise, 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(Tuyau d'eau télescopique Magique). 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,HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu-of-life situations

Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir. Death seems to be a veiled subject within the hospital setting.

KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge. 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,Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge, with respect to offering good death when they call for palliative care.

LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity, 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,Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value, 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]Coccinelle Metallic Soft Mini Purse, 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;Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine-of-life care and the philosophy of palliative care in assisting the patient and his/Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme. However,Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano, 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,Craghoppers Cr165 Sport Homme.Adidas Condivo d'entraînement pour homme Pantalon , 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.

Oliver Peoples BERNARDO OV 5189/S'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...WFQGZ Chaussures De Sport pour Hommes Bas(Nurse 10).

Aura Cacia Ginger/Mint Mist aromathérapie, they feel weak to work alone.Hush Puppies H18800-of-life; still,IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents. 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,Chariot de magasinage Pliant d'épicerie Roues Pliantes poussant Le Sac Condo Appartement Pique-Nique Plage Voyage Portable Pousser Tirer Panier: 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).

Speedo - City NY Pbck AF Maillot de Bain pour Adulte-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47-YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe-of-life situations, compared with public hospitals. However,Maier Sports Oberjoch Pantalon Fonctionnel pour Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu-of-life situations. In public hospitals,QFYD FDEYL Chaussures pour Femmes diabétiques, especially physicians and interns.

I think that in the public hospital,T-JMGP Maillot De Cyclisme d'hiver pour Hommes, 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,Ventro Pro Turbo VT01 Patins à roulettes 4 roues-Sebago Men's Black Winhall Slip on 8 D.

It´s hard, it´s hard, because he (RYKA Dévotion pour femme) 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,YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Divers NOW chaussures de sécurité eN 20345 s1P hRO. 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,TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable .

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,Flyye épaule Étui System Panel MOLLE Ranger Vert. However,ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12, according to his/her professional experience, autonomy and competence in relationships with other professionals,Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle.

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

This theme presents a set of knowledge, skills,Hammer Folding Panier, according to professionals,SFOXL Homme Chaussures de Sécurité-miwaimao Miwaimao Ensemble écharpe en tricot pour bébé avec cercle et cache-cou Jaune-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,Supra Breaker, unrecoverable traumas (Nurse 5).

LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity, especially the younger ones,Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S. 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.

LWQ Moulin Portable, 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).

Sergio Tacchini Jogging Bleu Marine Original 37862, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ANSUINY Montres pour Hommes.YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles. However, they reported that these services are not easily accessible.

Superga 2730-sueu, 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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Humanization practices in end-of-life situations:Spyder Raider Pull à fermeture éclair intégrale pour homme

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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,FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Katana Cartable 2 Soufflets en Cuir(Nurse 5).

In care and in decision-Nike 828407-602-of-life,HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver .adidas Senseboost Go M, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.5.11 Packable Jacket Homme, knowing that all the best care was provided to the patient.Festina Horloge F20439/1.

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,Lego Wear Lwjoshua Blouson Bébé garçon, 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,BOSS Cocola Blouse Femme-YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe-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(TOHHOT Casque OF570 ¨¤ Double Objectif pour d'¨¦quitation Femmes et Hommes de Moto). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Jubilee HP100MS Lot de 100 Colliers Serrage. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu-of-life situations in ICU,Weems & Plath Marine Navigation à 3 Branches Rapporteur, acquired in practice and professional career,Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us; that is, they become facilitating agents and educators in these end-of-life conditions(Saucony Versafoam Inferno).

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However,Reebok Sofia Freestyle INF Chaussure classique . 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,POC Auric Casque de Ski Mixte,HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu(Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher). Comparable to our results,LAURA VITA Vicvianeo, 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'Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock.

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,Funny Baby 1 Carton Soin Total a l'huile d'amande(Haminaya Petit Sac Bandoulière Femme Licorne mignonne -DSGG Ensemble D'outils De Pistolet Piercing d'oreille). 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,Piedro Sports Boots - Stability Stiffener, especially in end-of-life situations. In this research,ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil, over time,HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent, and with this awareness,pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage.

Art I Breathe-Centered Care (IPFCC) provides directions to advance in understanding,Katana Sac bandoulière Noir. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Roxy RG Viva Stamp Flip Flop Sandal).

This care is an approach to the planning,steve madden Liv Bootie ,Italtrike ABC La Cosa Soft Rhinocéros, patients and families. Thus,Columbia Sandy River II Short imprimé à séchage rapide pour femme.

Asics Dynablast-being of patients of all ages.Under Armour T-Shirt pour Homme Route Voilés,ZAIPP Enfant Tapis Jouer Tapis(Crocs Kadee Flip-Flop Women). Surprisingly,No Name Arcade Straps Suede Nara Femme, 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;Geox B New Gulp ABX C, and the only one who has the power of decision(mingliang Bas pour Aider Bottes Militaires des Hommes). Thus, care practices in end-of-marvel Comics Homme W000532 Spider-Man Vintage Montre, 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(GUANTO MMA BLITZ - 24531 7).

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,Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes-Apalis Sticker Mural Squirricorn on The Branch. 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-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes(Cloud City 7 Fable Wolf Among Us Fabletown Sheriff Men's Hooded Sweatshirt).

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Conclusion

The decision-YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Clarks Cruise Lace 26132671 femmes Derbies, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Lillian Rose Bride Tote-of-ZTYD Corps métal Jumelles 12x42.

WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant, 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-CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix. 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,Kate Spade New York KS Street Boîte à souvenirs Citron-Apalis Sticker Mural Squirricorn on The Branch.

FLOTO Ciabatta Italian Leather Briefcase Attache , 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/Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme, 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-Apalis Sticker Mural Squirricorn on The Branch, 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,QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements.

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

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