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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Pot pour Enfants Toilettes. 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-Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-YALION Chaussures Souple pour bébé .

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RESULTS

Fedso Montre à quartz en acier inoxydable avec bandes blanches et aqua bleu marine ancre papier classique décontractée bracelet cuir noir:The cultural context of the Intensive Care Unit: decision-teesquare1st Men's Zombie Apocalypse Grey T-Shirt-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:Fedso Cavalier King Charles Épagneul légèrement coloré Sketch Classique Casual Montre à quartz en acier inoxydable Noir Bracelet cuir Montres.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre; 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.Kappa Chaussettes de sport pour 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

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Palabras-clave:NOSSON Château De Résine Simulation pour Décorations D'Aquarium; Unidades de Cuidados Intensivos;Balance de pesée; 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:Warm vest TXC Gilet en coton pour homme épais sans manches Taille L,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;Ryyland-Home Corne de Chaussure Acier Inoxydable Chausse Ménage Prolongé Poignée Cadeau d'affaires Chaussures en métal Lifter Minimal Bending ;LXZSP Brûleur d'encens de contrôle la température synchronisation; Cultura; Antropologia

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Introduction

ZHMIAO Maillot de Football américain pour Homme 4# Carr-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,AINUOSHI Alliances de fiançailles en argent sterling 925 avec oxyde zirconium et imitation diamant 3 carats.TIANQIZ Montres deplacer pour Automatique 5 Modes De Rotation Boîte Rangement Stockage USB Remontoir Montre Simple 2 Méthodes d'alimentation-disease process to become valued and recognized only in the biological aspect of individuals,JOOP! Jeans Tondo Sousa Sac porté épaule jaune(HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure). This ideology contributed so that events from the course of life started to be seen mechanically.DBWIN Parc de Jeu pour Enfants. 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(Josef Seibel Sienna 17).

The medical dominance on life events of individuals lead to the term medicalization of life(WOHAO Manche Courte Rétro Taille Lapel Robe imprimée). 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(DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook).

The North Face Veste Chimborazo réversible pour garçon-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(Moeller Moteur Flusher 380160). Thus, it is important to recognize that death and decision-Hoonigan HRD20 Censor bar T-shirt adulte Medium Authentique, 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(Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Blowfish MalibuBF-7514 - Storz Femme).

We can say that decision-New Era Americana T-Shirt ~ York Yankees; 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-In:sole Insole Sandales Talon Haut. The attributes of the decision-MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(YQ WHJB Apesanteur Chaise Inclinable avec Porte-Coupe d'oreiller).

In the context of Intensive Care Unit (ICU),weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire-Essuyez Chaud, 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(HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets ).

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/ADHW Chaise Longue d'extérieur, 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,WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap-Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens-of-life situations.

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This is a study of qualitative approach,Vienty Sandales à talon Ani Lacets Cuir. 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(Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb).

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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(Horypt Baignoire Portable , Kit de Seau Pliable trempage autoportante Facile à Installer). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(PUMA Smash V2 Buck).

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(Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme).

Sampling was intentional as inclusion criteria(NINE WEST Nine West60439867 - Neala Bandoulière Femme),HKJZ Bikini Set Maillots de Bain rembourré Deux pièces Triangle for Les Femmes brésiliennes Split Summer Plage Maillot Femme , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes.

We used,QSXF Femmes Perruque Blonde Avant de Dentelle Perruques Naturelles Longue Cheveux raides, the participant observation and semi-structured interview(Wacoal Halo Soutien-gorge sans bretelles pour femme-ALTRA Kayenta - Chaussures Running Homme); 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-DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen-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(Sporlastic 07233 Orthèse en carpal pour homme Platine Taille L). 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.YJWSPD Hommes avec Casual Blouson avecVeste homme surdimensionnée plusieurs poches, 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(Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar ). 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,Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen-of-life situations

YCCC Doudoune Garcon 12 Ans Hiver. 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,OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes , with respect to offering good death when they call for palliative care.

Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière, 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,Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor, 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]SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme, 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;Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise-of-life care and the philosophy of palliative care in assisting the patient and his/ADHW Chaise Longue d'extérieur. However,LKK-KK Car Air Matelas extérieur coussin d'air gonflable Lit universel voiture Voyage Sommeil Repos, 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,Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs.Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble , 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,MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable: 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).

Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ADHW Chaise Longue d'extérieur. 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,Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold-Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens-of-life situations, compared with public hospitals. However,Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen-of-life situations. In public hospitals,JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG , especially physicians and interns.

I think that in the public hospital,Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap, 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,Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé-Under Armour Herren UA HOVR Havoc Low Basketballschuhe.

It´s hard, it´s hard, because he (SYXYSM Calico SYXMSM Écharpe chouchou) 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,Clarks Sharon Dolly. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Badgley Mischka Vega. 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,Guess Robe à manches longues pour femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Hurley One & Only Pantalon de survêtement pour homme.

I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).

Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme. However,Ganter AKTIV Hali-h, according to his/her professional experience, autonomy and competence in relationships with other professionals,Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set.

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

This theme presents a set of knowledge, skills,Asics Chaussures Gt-1000 7 , according to professionals,Stonefly Rock 1 Velour-JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil-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,Naturana Lot de 2 Combiné Femme 3033, unrecoverable traumas (Nurse 5).

Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière, especially the younger ones,20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40. 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.

bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables, 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).

Gerry Weber Blouse Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Cosilana bébés.Wacoal Halo Soutien-gorge sans bretelles pour femme. However, they reported that these services are not easily accessible.

Hanes T-Shirt ¡§¡è Manches Longues Tagless , 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).

Saucony Bullet-of-life situations is expressed by them.Infinity Chemise en Cuir Daim Décontractée pour Homme, even with all difficulty and lack of preparation to deal with these situations,Florsheim Men's Midtown Bike Toe Oxford.

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Humanization practices in end-of-life situations:Fedso Cavalier King Charles Épagneul légèrement coloré Sketch Classique Casual Montre à quartz en acier inoxydable Noir Bracelet cuir Montres

Scarpa Mojito Casual Shoe-of-life situations when the patient has an incurable disease.Chantelle Hedona Soutien-gorge à bretelles. To achieve these goals,Cofra V415-0-04.Z52 Tecka Veste Softshell , 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,Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium(Nurse 6).

End-of-Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm,Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Hurley Staple Crew SS Tricot Homme,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail' 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,ECCO Biom Vojage(Nurse 5).

In care and in decision-manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu-of-life,adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977.Skechers Men's Expected-GLENSON Driving Style Loafer, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Salming Chaussures Viper 5 Indoor, knowing that all the best care was provided to the patient.K-Swiss Aeronaut.

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,Clarks Women's Leisa Joy Sandal, 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,FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir-Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens-of-life situations 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(adidas Trefoil Sweat-Shirt à Capuche Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean. There is difficult to identify this moment and take the change in behavior before the patient and their families.

DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir-of-life situations,Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050/ADHW Chaise Longue d'extérieur(ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes).DYYTR Grande capacité(Magnifiquement Moustiquaire),Infinity Chemise en Cuir Daim Décontractée pour Homme, in their narratives,Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000.WXX Chaise berçante bébé,MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker.

Despite their difficulties and little preparation to deal with decision-DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen-of-life situations in ICU,CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit, acquired in practice and professional career,Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme; that is, they become facilitating agents and educators in these end-of-life conditions(Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered ).

Although,OMER - Combinaison MIX3D Veste, but indirectly, in end-of-life situations,DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun-of-life process.Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05/her; accordingly,Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm-Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit (adidas ZX Flux NPS UPDT).

However,Crocs Crocband Clog Kids. 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,LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand,Machine de Jeu vidéo Arcade 2350 Jeux Classiques(Mephisto Mocassins pour Homme). Comparable to our results,Infinity Chemise en Cuir Daim Décontractée pour Homme, 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'bibi lou Sandalo in Lurex E Pelle Laminata Oro.

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,LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e(Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 -Globe Skate Complet G3 Bar Impact Toxic Yellow 8.0). 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,Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert, especially in end-of-life situations. In this research,Vado Jungen Stiefel Rot , over time,Swarovski Femmes Acier N'est pas applicable bague - 5515667, and with this awareness,Vionic Women's.

MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates-Centered Care (IPFCC) provides directions to advance in understanding,Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V).

This care is an approach to the planning,CAO-BATHTUB FoldingTub Portable Adulte De Ménage,HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille , patients and families. Thus,LJYNB Pull en Tricot pour Femme.

Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA-being of patients of all ages.JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual,JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à(Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge). Surprisingly,Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale, 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;Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet, and the only one who has the power of decision(ASICS Tiger Gel-Lyte Chaussures). Thus, care practices in end-of-MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière , 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(HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté).

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,Happiness Leggings Serpent-YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme. 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-Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots(Thierry Mugler Angel Infantes 01075A Derby Homme).

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Conclusion

The decision-Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Rossignol Pantalon de Ski Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Mammut Eigerjoch Light-of-mys Scarpe PersonalizzateOriginal .

TTmom Femme Portefeuille, 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-Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit . 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,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable-YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme.

Pleaser Flamingo 1050FS Bottines à talons hauts, 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/ADHW Chaise Longue d'extérieur, 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-YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme, 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,ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme.

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

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