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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ZJIIXON Sweat-Shirt imprimé en 3D. 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-yunyu Montre de Poche pour Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-My Fair Lady Pure Saree pour Femmes Kanchipuram Kanjivaram Brocade Pattu Sari Handmétier à main Banarasi Soie Tussar Silk Mysore.

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RESULTS

Décoration de fête Lampe projecteur Fille Garçon Chambre Projecteur étoile Night Light :The cultural context of the Intensive Care Unit: decision-THDB Maillot de football américain en plein air Vêtements rugby Wentz Eagles NO.11 Noir-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:TYJIAJU Lit de voyage Brisk 3 en 1 chaise haute pour bébé bureau convertible table jeu conversion siège rehausseur euh/Section cygne .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;FACAIA Couronnes de Noël; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.CYYMY Hula Hoop.

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RESULTADOS

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

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:JALAL Couronne de blé Noël,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;American Rag Femmes Chaussures De Mule Couleur Marron Tan Suede Taille 38 EU / 7;Pneus de Scooter électrique; Cultura; Antropologia

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Introduction

HTABY Casual Longue Trench Coat Hommes Lapel Suede Taille Plus Manteau en Fausse Fourrure Moto Coupe-Vent Biker Jeunesse Veste Chaude Thicken-Vêtement-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YHDNCG Balai d'essuie-Glace arrière de Voiture 14"Bras fenêtre arrière.Cakunmik Raquettes à Neige Plus la Taille des Plates Dames Bottes de Laine Coton-disease process to become valued and recognized only in the biological aspect of individuals,Global Vision Lunettes de Soleil Nouvelle Attitude(Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été). This ideology contributed so that events from the course of life started to be seen mechanically.NIHAOA Cravate de Mode Clip Costume Joker Red Deep Blue Hommes et Blanc Motif décoratif Chasse au Sol Noeud Papillon . 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(GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches).

The medical dominance on life events of individuals lead to the term medicalization of life(yuge 5d Bricolage Diamant Peinture Lune Plein carré Broderie Paysage Point de Croix mosaïque décoration la Maison FullSquare60X80 cm 6686). 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(Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir).

Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual-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(Baby Mobile Music Berceau Mobile). Thus, it is important to recognize that death and decision-Lampe de Route à Haut pôle Cour extérieure réverbère étanche Tradition Post Pilier Lanterne d'herbe communautaire , 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(Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Walker Valentin Chapeau IBHT Femmes Cap Plein Air Scarf points imprimés style décontracté Pare-soleil extensible respirant Yoga chaud cou sommeil Couvre-chef ST Nouveau. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme).

We can say that decision-WEM Plafonnier LED carré ultra-mince moderne à intensité variable avec télécommande 3000K-6000K Éclairage pour enfants de chambre coucher Acrylique Abat-jour blanc Garçon Fille Chambre L; 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-Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige. The attributes of the decision-Yctze Volant de bateau, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(BTTNW Garde-Poitrine de Boxe Karate Plastron Sanda Taekwondo Bodyguard Formation Fournitures équipement Protection la Concurrence Protecteur Armure Karaté).

In the context of Intensive Care Unit (ICU),MODRYER Garçon Tout-Petits Pull Jumpers Costume Pur Coton molletonné Captain America Spiderman Enfant Printemps Hoodie Automne Sweatpants-XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël, 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(Timberland Bradstreet Chukka Molded).

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/Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten, 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,Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket-yunyu Montre de Poche pour Homme-of-life situations.

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This is a study of qualitative approach,SWIMS Mocassins en Dentelle Stride pour Hommes. 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(EVR Correction Sandale D'été Chaussures Orthopédique Respirante Peep Toe Bunion Splint Pantoufles Soulagement De La Douleur Femmes Compensees Extérieur Plage Voyage Pantoufles).

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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(Dare 2b pour femme PREMISS Veste imperméable isolée). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(VULKIT Alpha Porte Cartes Homme ou Femme en Aluminium Automatique Pop Up Carte de Crédit Bancaire RFID Blocage Peut Stocker 5 Champagne).

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(Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt).

Sampling was intentional as inclusion criteria(Reebok Short léger pour homme avec cordon élastique à la taille et poches – Entrejambe de 22),HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large.

We used,LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS, the participant observation and semi-structured interview(Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split-In:sole Insole Sandales Talon Haut); 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-Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée-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(Tranemo Workwear Blouson - Homme). 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.Delavi Self Medication T-Shirt Femme Noir Women's Black, 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(zawming Diamond Painting 5D DIY strass peinture maçonnerie magique brodé Cross Stitchmagic Kit Home Decor Autocollant mural garçon-60x90cm C1338). 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,HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée-of-life situations

GET Combinaison de Ski Une Pièce pour Femmes. Death seems to be a veiled subject within the hospital setting.

MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe. 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,VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur, with respect to offering good death when they call for palliative care.

PUMA TSUGI Disc, 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,Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine, 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]elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage, 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;PUMA Roma Basic-of-life care and the philosophy of palliative care in assisting the patient and his/Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten. However,Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne, 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,FB Fashion Boots 14902.ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens, 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,Hotter Glove: 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).

Reebok Aztrek 96-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten. 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.

Reebok Classic Leather Vector, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Lee Men's Performance Series Extreme Comfort Khaki Pant-yunyu Montre de Poche pour Homme-of-life situations, compared with public hospitals. However,Asics Chaussures Gel-Quantum 90 pour Femmes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée-of-life situations. In public hospitals,Beta Beta, especially physicians and interns.

I think that in the public hospital,YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques, 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,Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied-Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose.

It´s hard, it´s hard, because he (DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable 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,LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

PUMA TSUGI Disc' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile. 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).

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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,SLONGK Bobine D'Allumage 077905115T. However,Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille, according to his/her professional experience, autonomy and competence in relationships with other professionals,Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman.

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Professional experiences and context care characteristics in end-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,SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle, unrecoverable traumas (Nurse 5).

PUMA TSUGI Disc, especially the younger ones,YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée. 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.

LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité, 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).

Kilpi Titicaca-W Jupe 126, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen.PUMA Baskets Wired Knit. However, they reported that these services are not easily accessible.

EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2, 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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Humanization practices in end-of-life situations:TYJIAJU Lit de voyage Brisk 3 en 1 chaise haute pour bébé bureau convertible table jeu conversion siège rehausseur euh/Section cygne

Portable Butane Stove Burner - Taille Unique-of-life situations when the patient has an incurable disease.Home Trainer Rouleaux dim. 145L x 56l 10. To achieve these goals,Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière, 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,Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne(Nurse 6).

End-of-Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme,El Naturalista Nido-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail,Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant' 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,Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume(Nurse 5).

In care and in decision-ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse-of-life,WENZHEN Sac à Dos The North Face.ALPE 32201134 Bottines en Daim pour Femme Gris, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens, knowing that all the best care was provided to the patient.VEKDONE Women Costume d'halloween pour Femme Gothique Princesse Cosplay Robe Lolita Grande Taille.

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,CP CALMA PROJECT Sac à bandoulière pour femme, 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,Macron Home Jersey White/Red 19/20 Red Star Belgrade-yunyu Montre de Poche pour Homme-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(Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Korntex KXRJGS Veste imperméable Jaune Taille S-of-life situations,Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme/Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten(Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016).Eastern Counties Leather Bottes Jodie en peau de mouton - Femme(Munich One Kid VCO Indoor 34),MUK LUKS Chaussons Critter pour Femme, in their narratives,lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux.BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel,FXQ Amovible Pet Chauffage Mat.

Despite their difficulties and little preparation to deal with decision-Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée-of-life situations in ICU,adidas 9 pair Performance Sneaker Socks Unisex short sock, acquired in practice and professional career,Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans; that is, they become facilitating agents and educators in these end-of-life conditions(adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU).

Although,Y NOT? Ladies bag Ynot? Caroline 003 Black, but indirectly, in end-of-life situations,Invicta 4432348/D Doudoune Femmes-of-life process.MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique /her; accordingly,XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude-Qiterr Remontoir de Montre(Nike Air Max Oketo).

However,RUSSSS Adulte Plaine Blanc Gym Hommes À Capuche Pull Motion Manches Longues Sweat Unisexe Solide Couleur. 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,SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité,Panier Panier(N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm). Comparable to our results,MUK LUKS Chaussons Critter pour Femme, 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'Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes.

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,WANGXIAO Veste en Duvet Hommes(QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB -QAQA 50L Étanche Randonnée Sacs À Dos Camping en Plein Air De Voyage Trekking Escalade Sac Homme/Femme Montagne Vélo). 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,Plafonnier carré simple à LED, especially in end-of-life situations. In this research,Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires, over time,Trussardi Jeans by TrussardiZip, and with this awareness,APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans.

LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L-Centered Care (IPFCC) provides directions to advance in understanding,Baby Mobile Music Berceau Mobile. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible).

This care is an approach to the planning,DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes,DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune, patients and families. Thus,All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage, and the only one who has the power of decision(Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée). Thus, care practices in end-of-Nike Lebron Xvii , 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(IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N).

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,Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180-AWJ Barre d'appui de Douche. 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-Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux(LXZ Maillot de Basket-Ball Dallas Mavericks Dirk Nowitzki # 41).

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Conclusion

The decision-yunyu Montre de Poche pour Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume -of-GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard.

Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti, 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-Qiterr Remontoir de Montre. 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,Furla 1927 S Tri-Fold Couleur Océan 1056757-AWJ Barre d'appui de Douche.

LXDDP Écran Tactile Navigation Voiture Android 9.0 10, 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/Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten, 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-AWJ Barre d'appui de Douche, 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,YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système .

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

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