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Rev. esc.Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W . 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-Badgley Mischka Vega-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Hurley One & Only Pantalon de survêtement pour homme.

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RESULTS

LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme:The cultural context of the Intensive Care Unit: decision-Ganter AKTIV Hali-h-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: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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CONCLUSION

Professional maturity,Asics Chaussures Gt-1000 7 -Stonefly Rock 1 Velour.

Key words:Terminally Ill; Intensive Care Units; Nursing;JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Naturana Lot de 2 Combiné Femme 3033.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Saucony Bullet,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;Florsheim Men's Midtown Bike Toe Oxford;Scarpa Mojito Casual Shoe; Cultura; Antropologia

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Introduction

Chantelle Hedona Soutien-gorge à bretelles-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Cofra V415-0-04.Z52 Tecka Veste Softshell .Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium-disease process to become valued and recognized only in the biological aspect of individuals,Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm(Free People Women's Forever Cashmere V-Neck Pullover Sweater ). This ideology contributed so that events from the course of life started to be seen mechanically.Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm. 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(ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison).

The medical dominance on life events of individuals lead to the term medicalization of life(ZYTZK Tige de Support pièces Automobiles Gas Hatch Lift Stabilus Compatible). 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(ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe).

Hurley Staple Crew SS Tricot Homme-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(MH Bottines Hommes). Thus, it is important to recognize that death and decision-MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail, 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(MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ECCO Biom Vojage. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course ).

We can say that decision-manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu; 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-adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977. The attributes of the decision-Skechers Men's Expected-GLENSON Driving Style Loafer, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ZAMAY USB Charge LED Bandes Chaussures De Patin À roulettes - Simple/Double Roue Clignotant Adulte Unisexe Garçons Et Filles Étudiant Sport en Plein Air Baskets).

In the context of Intensive Care Unit (ICU),Salming Chaussures Viper 5 Indoor-K-Swiss Aeronaut, 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(WWTTE Yoga serré Snakeskin Leggings 2V ).

These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/Clarks Women's Leisa Joy Sandal, 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,FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir-Badgley Mischka Vega-of-life situations.

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This is a study of qualitative approach,KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean. 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(Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme).

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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(Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(JOY 34547 Flora Pantalon 3/4 pour Femme).

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(YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement).

Sampling was intentional as inclusion criteria(HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger ),Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WXX Chaise berçante bébé.

We used,MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker, the participant observation and semi-structured interview(überleben Coppa leggera in Legno Con moschettone Backpacking-SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole); 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-CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit-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(Puma Ess Logo Hoody FL Pull Femme). 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.Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues 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(Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27). 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,OMER - Combinaison MIX3D Veste. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,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 , with respect to offering good death when they call for palliative care.

Crocs Crocband Clog Kids, 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,LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand, 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]Machine de Jeu vidéo Arcade 2350 Jeux Classiques, 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;bibi lou Sandalo in Lurex E Pelle Laminata Oro-of-life care and the philosophy of palliative care in assisting the patient and his/Clarks Women's Leisa Joy Sandal. However,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, 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,Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert.Vado Jungen Stiefel Rot , 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.

Swarovski Femmes Acier N'est pas applicable bague - 5515667'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...Vionic Women's(Nurse 10).

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Nowadays, when we do not have the support of palliative care,HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille : 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).

LJYNB Pull en Tricot pour Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Clarks Women's Leisa Joy Sandal. 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,JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual-Badgley Mischka Vega-of-life situations, compared with public hospitals. However,JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit-of-life situations. In public hospitals,Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale, especially physicians and interns.

I think that in the public hospital,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet, 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,MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière -Happiness Leggings Serpent.

It´s hard, it´s hard, because he (Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots) 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,Rossignol Pantalon de Ski Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Crocs Crocband Clog Kids' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Mammut Eigerjoch Light. 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,mys Scarpe PersonalizzateOriginal -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-TTmom Femme Portefeuille.

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,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable. However,Pleaser Flamingo 1050FS Bottines à talons hauts, according to his/her professional experience, autonomy and competence in relationships with other professionals,ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme.

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

This theme presents a set of knowledge, skills,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL, according to professionals,Skechers Newbury St Every Angle-SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-of-life situations.

SHOES-HY Chaussures de Sport pour Femmes-CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

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,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl, unrecoverable traumas (Nurse 5).

Crocs Crocband Clog Kids, especially the younger ones,Lotto Leggenda Legging pour femme. 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.

Gabor Shoes Jollys, 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).

Delsey Trolley Brisban Black M 4R, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage .JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier. However, they reported that these services are not easily accessible.

Asics Chaussures Femme Court FF 2, 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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DOUCAL'S Chaussures - Noir-of-life situations when the patient has an incurable disease.KG by Kurt Geiger BIRCHIN. To achieve these goals,Merrell Juno Mid Zip Sandal - Women's Brindle, 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,HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket(Nurse 6).

End-of-FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables ,UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain,GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch' 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,Parc à bébé(Nurse 5).

In care and in decision-WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47-of-life,LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand.Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Urra J466-5006-00 Bamboo Couette Blanc 1000 g, knowing that all the best care was provided to the patient.Huaib Montre de Poche Poche.

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,Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi, 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,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel-Badgley Mischka Vega-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(YUHEN LED Chaussures). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Harmont & Blaine Vre063060484 Blazer décontracté-of-life situations,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme/Clarks Women's Leisa Joy Sandal(Casio A158 Montre Bracelet en Acier Inoxydable).Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL(Disney Dumbo – Boîte souvenir en papier avec 6 tiroirs),JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival , in their narratives,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed.MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme .

Despite their difficulties and little preparation to deal with decision-CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit-of-life situations in ICU,Nologo Costumes GEMORE drôles Stripe Clown gonflables , acquired in practice and professional career,Isotoner Addie Bottes en microdaim pour Femme; that is, they become facilitating agents and educators in these end-of-life conditions(Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian).

Although,XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête, but indirectly, in end-of-life situations,LYATW Montre de Poche Femme métal épinglette for Nurse Watch-of-life process.Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert/her; accordingly,57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard-HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon (Reebok 2020 NHL Draft Flex Fit Hat pour homme ).

However,XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween. 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,Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual,AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une(EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant). Comparable to our results,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival , 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'Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:.

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,Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air(ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm -LOVEKUSH 50% Off Gemstone Jewellery 6MM289 6mm Rhyolite jasper round ball loose gemstone beads 16" Code:- RADE-34129). 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,AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir, especially in end-of-life situations. In this research,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis, over time,LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas, and with this awareness,mmmy Perruque.

KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144-Centered Care (IPFCC) provides directions to advance in understanding,BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor).

This care is an approach to the planning,Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures,IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme, patients and families. Thus,New Balance Roav V1 Fresh Foam.

ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage-being of patients of all ages.jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.,IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages(HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête). Surprisingly,Tyrannosaurus Rex Dinosaur Toy pour Les Garçons, 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 Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm, and the only one who has the power of decision(Shopping Trolleys Chariot en Acier Inoxydable Voiture Commercial - Réparation Automobile étagère Mobiles Outil Shelf Repair Tool Pièces Panier 3 Couche Chiffre d'affaires Multi-Fonction Pratique). Thus, care practices in end-of-YJHH Baignoire Adulte Portable, 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(Nike WMNS Free TR Ultra).

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,H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 -Stonefly Rock 1 Velour. 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-Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues(Pandora Love Makes A Family Dangle Charm).

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Conclusion

The decision-Badgley Mischka Vega-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WDGXZM Plaquettes de Frein Avant et arrière Moto, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and-of-Lampadaire postmoderne.

Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements , 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-HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon . 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,ZJ Bien Maillots de Bain Garçons d'enfants-Stonefly Rock 1 Velour.

Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes , facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Clarks Women's Leisa Joy Sandal, 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-Stonefly Rock 1 Velour, 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,XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard.

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

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