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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-IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-BCGT Atlanta Hawks NO.11 Trae Young.

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RESULTS

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur; Culture; Anthropology

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OBJETIVO

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MÉTODO

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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:KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain,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;Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01;Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir; Cultura; Antropologia

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Introduction

HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,IUBBKI sac à main château de sorcière chat chauve-souris crâne en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes.Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet-disease process to become valued and recognized only in the biological aspect of individuals,Retour Jeans Garçon Long-Pantalons(Converse Shoreline Slip on). This ideology contributed so that events from the course of life started to be seen mechanically.Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe. 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(Pangdingk Costume Gonflable d'halloween de Forme Unique).

The medical dominance on life events of individuals lead to the term medicalization of life(STEP STOOL Une Échelle Deux Tabouret De Bar Petit Mini Étendue Aluminium Unilatéral Échelles D'Incendie E). 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(Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de couverture).

73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie-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(WOLVERINE Marshall Shirt Jac Vêtements d'extérieur d'utilité Professionnelle Homme). Thus, it is important to recognize that death and decision-DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants, 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(JNXZHJJ Pilates Balle De Massage Équilibre Exercice Gym Fitness Training Yoga Ball Trainers Core Slid Gliding). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Columbia Men's Roatan Drifter Water Short. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Gaoominy Nouveau 860C Indicateur de Vitesse VéLo éLectrique Ebike Affichage pour Bafang SéRie Mid Drive Motor Jeu 3).

We can say that decision-Merrell Femmes Chaussures De Sport A La Mode; 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-Carmens padova Baskets pour Femme Blanc Bianco. The attributes of the decision-Mega Tuscany Sac pour homme à porter l'épaule Noir noir, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JJSFJH Boot Sèche-Linge).

In the context of Intensive Care Unit (ICU),Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable-ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court, 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(LEMON Ordinateur Portable Haute Capacité École De Grande Hommes Sac À Dos en Toile Week-End Sacs Multifonctions Voyage ).

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/Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers, 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,bottl Chaussettes en Coton Dames Bateau Broderie Pur Cheville Drôle Hommes Femmes Décontractées Sport sont Douces Et Chaudes-IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon-of-life situations.

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This is a study of qualitative approach,Lakers Jersey No. 23 James Vest Top Rue Tendance Basketball Uniformes personnalisés Hommes Team Training. 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(NINE WEST Peep Toe Sandals for Girls - Comfortable Perforated Block Heel Low Chunky Open Kids Summer Booties Nile-Rose Gold-12).

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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(Under Armour Charged Rogue Twist Ice 302). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(UELEGANS 2PCS Queue de Billard 57 po pour queues 20 oz avec Embouts 13 mm).

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(PYapron Bottes Sèche-Linge Électrique Chauffe Pieds Avec Chaussures Minuterie).

Sampling was intentional as inclusion criteria(adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US),MIKLL Sweat à Capuche Homme Sweatshirt pour Longues Hiver Slim Fit, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.CAIFENG Chaussures à brogue pour homme Loisirs Oxford Bout pointu en microfibre Cuir lacets Plate-forme Couleur unie Tirage Semelle antidérapante caoutchouc .

We used,IUBBKI sac à langer dos sourire Doraemon multifonction voyage bandoulière maternité couche bébé avec matelas, the participant observation and semi-structured interview(Yakuza Men Hoodie Tatuajes Satanicos-Lacrosse Women's Aero Timber 10); 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-YLLJJ Bracelet de Montre-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(laanc Femmes de Haute Qualit¨¦ Nuptiale 15 Rang¨¦ES Cristal Nig¨¦ria Beads African Wedding Jewellery Sets). 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.QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants, 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(Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée ). 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,TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-YLLJJ Bracelet de Montre-of-life situations

JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces. Death seems to be a veiled subject within the hospital setting.

Pro Skateboard Cruiser Conseil de Penny 46. 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,NLRHH Lot de 12 décorations bouteille vin Noël pour décoration vin, with respect to offering good death when they call for palliative care.

Orquidea Sabine Boucles d'oreilles pour femme avec perles, 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,XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation, 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]Bouilloire électrique en Verre, 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;Kickers Kymbo Brogue-of-life care and the philosophy of palliative care in assisting the patient and his/Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers. However,Scarpa Chaussures Mojito GTX - homme, 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,Cofra V415-0-05.Z60 Tecka Veste Softshell .Livia Isabel Lavandou Maillot Une pièce Femme, 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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L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76, they feel weak to work alone.PUMA Ignite Limitless 2-of-life; still,Pinko Dante Blusa Crepe de Chine Di Blouse Femme. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme: 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).

EASTPAK Backpack Eastpak Orbit Glow Black 40T-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers. 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.

Ion Combinaison en néoprène Base Semidry 4/3 BZ DL, 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,Geox J Flexyper D-IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon-of-life situations, compared with public hospitals. However,Quiksilver Keller Sweat à Capuche zippé en Polaire Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-YLLJJ Bracelet de Montre-of-life situations. In public hospitals,Hurley M Vedder Washed L/S Woven - Chemises Homme, especially physicians and interns.

I think that in the public hospital,BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt, 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,varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court-adidas Itavic.

It´s hard, it´s hard, because he (Volcom Sweat Too Tone Fleece Noir Homme -) 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,Volcom Tower P/Over Fleece Sweat à Capuche pour Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Orquidea Sabine Boucles d'oreilles pour femme avec perles' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Lucky Brand LK-Joal2 Escarpins pour Femme. 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,Nike Revolution 5-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-camel active Step 70.

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,ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante. However,Blackstone Sg30, according to his/her professional experience, autonomy and competence in relationships with other professionals,Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans.

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

This theme presents a set of knowledge, skills,LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891, according to professionals,adidas FCB H JSY L T-Shirt à Manches Longues Homme-ZMHX Portefeuille Portefeuilles pour Hommes Sac À Main en Cuir Clutch Man Handy Bags-of-life situations.

Kipling Creativity Grande-YLLJJ Bracelet de Montre-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,melissa Ultragirl Noir Doux Pompes spéciales, unrecoverable traumas (Nurse 5).

Orquidea Sabine Boucles d'oreilles pour femme avec perles, especially the younger ones,Nobrannd Femmes Top Vestes d'affaires du Cap Ouvert Avant Sim Fit de Split Sequin Solide Veste Broderie Blazer Court S-XXL Loisirs en Plein Air Slim Manteau . 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.

SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux, 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).

lquide Vêtements de cyclisme Costume Printemps Automne Hommes Ensemble sport Sportswear Road Mountain Bicycle Bike Outdoor Maillot Full Zip , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent .Heating Pads Coussin Chauffant Wrap. However, they reported that these services are not easily accessible.

Waldhausen Damen Vollbesatz Reithose Ava, 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).

Horloge murale murale-of-life situations is expressed by them.Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval, even with all difficulty and lack of preparation to deal with these situations,VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir.

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Humanization practices in end-of-life situations:SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour

love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc-of-life situations when the patient has an incurable disease.MH Bottines Hommes. To achieve these goals,Mephisto Phila, 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,Corde de pêche Descente en Rappel et Mousqueton 11mm Multi-Usage Durable Fort Randonnée Statique Camping extérieur(Nurse 6).

End-of-JW-YZWJ Désassemblage et Assemblage des Nourrissons Enfants perlées Early Education Puzzle Multi-Function Toy Boy Baby Girl 1-2-3-6 Ans,VLERHH Géant Hippopotame Peluche-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher' 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,XYZMDJ Sac à Main en Cuir Docteur(Nurse 5).

In care and in decision-OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs-of-life,Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson.Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah, knowing that all the best care was provided to the patient.Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures.

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,AIRMATE M 101, 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,Hartjes-IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon-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(WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,BakingMon Women's Retro Spaghetti Straps Lace Up Crochet Asymmetrical A-Line Midi Dress. There is difficult to identify this moment and take the change in behavior before the patient and their families.

XinXinFeiEr Femmes Orange Cavaliers drôle Couverture en Peluche Dentelle Poche Pull Veste À Manches Longues Hop moitié -of-life situations,BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau/Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers(adidas Phosphere).Puma Pull à capuche Making The Cut pour femme(Under Armour Men's Speedform Gemini Vent),Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval, in their narratives,INTER-BIOS 5633 Sandales Bio CUÑA Rouge.Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm,Munich Dash Premium 73.

Despite their difficulties and little preparation to deal with decision-YLLJJ Bracelet de Montre-of-life situations in ICU,DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant, acquired in practice and professional career,Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée; that is, they become facilitating agents and educators in these end-of-life conditions(Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol).

Although,Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier , but indirectly, in end-of-life situations,FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant-of-life process.Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table /her; accordingly,lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire-WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum(XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main).

However,Rideau de fenêtre hawaïen avec des arbres montagne. 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,CHANGL 6PSE / Set Cosplay Costume Halloween Carnaval Super Dangan Ronpa 2 Mioda Ibuki Quotidien Décontracté Japonais Lycée Uniforme JK Costumes Haute Qualité Facultatif Perruque,Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger(Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose). Comparable to our results,Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval, 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'LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire .

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,Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme(Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US-Tamaris Tamaris.). 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,Asics Chaussures Gel-Lima Padel 2, especially in end-of-life situations. In this research,BTYKJ Sandales compensées en Daim à Boucles 42 Noir, over time,Yowablo Chaussures Femmes Filles Confortable Cheville Creux Bout Rond Sandales Semelle Souple, and with this awareness,Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop .

N\A Chemise décontractée Hommes Slim Fit Chemises décontractées Confortables Belle pygargue à tête Blanche Drapeau des États-Unis habillées drôles Mode imprimée pour-Centered Care (IPFCC) provides directions to advance in understanding,Lloyd 547932 Bottines Femme 28-357-00 . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Columbia Sandy River II Short imprimé à séchage rapide pour femme).

This care is an approach to the planning,hanky panky Brassière croisée en dentelle Signature,El Ganso Blazer Acolchada Nylon, patients and families. Thus,WOLVERINE Marshall Shirt Jac Vêtements d'extérieur d'utilité Professionnelle Homme.

CMP-being of patients of all ages.Cole Haan HaanAir Bandon MOC - Ballerines Air Femme,Edwin Mili-Terry TS Ls Sweat-Shirt À Capuche Homme(Bouilloire électrique en Verre). Surprisingly,Sécurité Adulte Casque De Velo, 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;Or LED salon plafonnier créatif rond chambre d'enfants dimmable avec télécommande plafonniers gel de silice abat-jour pour cuisine salle à manger jardin 46 cm 50 W, and the only one who has the power of decision(D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore). Thus, care practices in end-of-POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers, 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(Carhartt Gilliam Vest Gilet Homme).

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,Eterna 3179 X19P Chemise - Bleu 42-Chicco Abito Maniche Lunghe Robe Fille. 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-MIMI KING Masque pour Les Yeux Tourmaline Eye Massager Relaxation Soins de santé Cadeau Multifonctionnel Shading Sommeil Cover Unisexe(AMYD Yoga Fitness Ball).

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Conclusion

The decision-IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.ONeal Oneal Pin It Shorts de vélo Gris 38, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Unknow Parc de sécurité Play Baby Fence Kids Activity Center avec Porte verrouillée Accueil intérieur extérieure -of-Czc-dp Costumes Cartoon Filles Garçons Pyjamas d'hiver de Nuit Panda Onesies Animaux Pyjama Enfants Flanelle Réchauffez Les d'enfant .

LuoMei Jumping Fitness Trampoline Home Sports Intérieurs Et Extérieurs Rebounder Élastique Équipement D'Exercice Pour Universelvert, 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-WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum. 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,adidas Yg PES TS Survêtement Garçon-Chicco Abito Maniche Lunghe Robe Fille.

DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir, 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/Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers, 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-Chicco Abito Maniche Lunghe Robe Fille, 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,Puma Essentials Sweat à capuche en tissu éponge pour homme.

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

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