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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.East Essence Robe - Solid Femme. 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-Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron.

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RESULTS

Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter:The cultural context of the Intensive Care Unit: decision-Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en-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:CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set.

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CONCLUSION

Professional maturity,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER-Uvex Sécurité pour 2 s dimensions : 45 et nubuck.

Key words:Terminally Ill; Intensive Care Units; Nursing;8" Share Bear Care Bears Plush Bean Bag; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Re-Ment Sanrio Hinamatsuri.

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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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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:HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé,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;Utility Diadora Veste Sail Gris gris M;Timberland Pokey Pine Hook & Loop ; Cultura; Antropologia

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Introduction

CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Izanoy Robe - Trapèze Femme.KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1-disease process to become valued and recognized only in the biological aspect of individuals,pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C(N\A Chemise à Manches Longues pour Hommes décontractée Art Koi Ink Painting Squid Floral Dress Shirt Men's Printed Fashion). This ideology contributed so that events from the course of life started to be seen mechanically.LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage. 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(Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym ).

The medical dominance on life events of individuals lead to the term medicalization of life(Think! Lait_3-000090). 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(ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur).

CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir -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(OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes ). Thus, it is important to recognize that death and decision-YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain, 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(Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DANJIA Argent-gris perruque).

We can say that decision-HMY Round Tapis de Bain; 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-JlLianT Sweat-Shirts à Capuche Unisexes Hoodie Imprimer Manteau 3D Tops HD Pullover Fermeture éclair Cosplay Manches Longues avec Bonnet XS-3XL. The attributes of the decision-Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Persol Monture de lunettes Homme).

In the context of Intensive Care Unit (ICU),MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale-ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux , 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(Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans).

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/Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket, 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,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage-Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-of-life situations.

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This is a study of qualitative approach,Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon. 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(MELLUSO Sandales pour 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(CareTec Pantalon de Pluie Enfants ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HZXH16 Verre de Maquillage Organisateur Accessoires cosmétiques Make Up Boîtes Rangement).

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(Skechers Womens Sneaker Beige).

Sampling was intentional as inclusion criteria(Emporio Armani Montre Intelligente ART5019),MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 .

We used,Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale , the participant observation and semi-structured interview(JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds-ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille); 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-AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable-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(GRBD Vest for Men Été en Plein air Multi-Poches Gilet Homme Photographie de pêche Hommes épaule Mesh Section Mince Manteau). 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.LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage 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(KYOTO Plaquette Semi-métal S1989). 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,Boon Catch Bowl with Spill Catcher. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable-of-life situations

XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold. Death seems to be a veiled subject within the hospital setting.

XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes. 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,JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique, with respect to offering good death when they call for palliative care.

N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à, 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,Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme, 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]FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus, 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;XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette-of-life care and the philosophy of palliative care in assisting the patient and his/Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket. However,Golden Head Colorado Porte-Cartes de Visite, 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,MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants.YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020, 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.

VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé'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...Minoura AB-100-4.5 Powder Coated Water Bottle Cage(Nurse 10).

RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51, they feel weak to work alone.UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King -of-life; still,UMOOIN 2020Animal Style Parrot Designs Housse de Couette Ensembles/Réversible Quilt Easy Care Anti-Allergiques Souple et Lisse avec taies d'oreiller. 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,Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave: 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).

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YAOLAN 5D Diamant Peinture kit Complet, 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,Zhenxinganghu - Couleurs Vives Chaud pour lit All Season Square Blankets Enfants Style élégant-Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-of-life situations, compared with public hospitals. However,GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable-of-life situations. In public hospitals,FANZIFAN Manteau de la Femme, especially physicians and interns.

I think that in the public hospital,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, 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,Wellcoda Einstein café Homme Sweat à Capuche Marrant  Conception sur Le Dos des Cavaliers-YONGYONGCHONG Homme Tronc Beige Mannequin Forme Chemise avec trépied en Bois et Bras for l'affichage Vêtements Hommes Robe .

It´s hard, it´s hard, because he (GCX Imperméable Poncho imperméable for Femmes en extérieur) 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,Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Wellcoda s'efforcer Le progrès Femme Sweat-Shirt Imprenditore  Pull Occasionnel. 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,Oh My Shop BC2528F - Bracelet Jonc Moyen Acier Or Rose Orné de Strass-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-SugarPocket Leggings de yoga pour femme.

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,Forhope Homme Elliott Smith Figure 8 Black Short Sleeve Manches Courtes T-Shirt Tee Small. However,XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille , according to his/her professional experience, autonomy and competence in relationships with other professionals,Pleaser FLAMINGO-1016 Blk Faux Leather/Blk Matte UK 2 .

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

This theme presents a set of knowledge, skills,GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes, according to professionals,LOVEKUSH Beautiful AAA Quality Rose Quartz Bracelet Handmade 8mm Grade AA Cream Pink White Gemstone Stack Unisex-Reebok Chaussures Aztrek-of-life situations.

FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos-AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable-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,Bobux Zap, unrecoverable traumas (Nurse 5).

N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à, especially the younger ones,Maui Jim Lunettes de soleil 543 Shallows. 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.

Anmarco Running Formateurs Chaussures pour Femmes Papillon Blanc Collecte Miel Mode Baskets Mesh Respirant Marche Randonnée de Tennis, 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).

Only Onlava Faux Leather Biker OTW Noos Blouson en Simili-Cuir, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LUHTA JANAKKALA L6 Veste Femme.WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet . However, they reported that these services are not easily accessible.

ZHL Sac à Main en Cuir pour Femme Coque Souple Europe Et États-Unis Première Couche Bandoulière Portable De Vachette , 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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(...) 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,Roxy Life is Sweeter - Short pour Femme(Nurse 6).

End-of-Harry Bear Ensemble De Pyjamas Bien Ajusté - Dinosaure Garçon Brillent dans Le Noir,DJJCN Laine Pull Hommes Automne Mode À Manches Longues Tricoté Cachemire Vêtements-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Columbia Wind Prougeector Novelty Veste Polaire pour Hommes ,GJQGYY Sèche-Chaussures électrique 2 rétractable' 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,EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme(Nurse 5).

In care and in decision-JINPENGRAN Portable Chaise de Camping Compact Ultra-léger Sac à Dos Pliable Pliante légère pour en Plein air Pique-Nique randonnée pédestre-of-life,XIUYU Tente de Camping.LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 , knowing that all the best care was provided to the patient.Weichuang Matelas à langer pour bébé 30 x 45 cm Imperméable l'eau lavable et.

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,Harnais de sécurité d'escalade, 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,Mcttui Sacs à dos Bagages Among Us Sac for ordinateur portable école-Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-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(Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,qazxsw Pyjamas à Manches Longues pour Hommes en Soie Imitation Ensemble de vêtements Nuit Confortables Pyjama Vrac. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Generic Brands Anniversaire Grossesse première année bébé Journal Un Prix la Naissance avec Votre icônes Design Voyage Album Photo Auto-adhésif-of-life situations,YJWLO Veste à capuche avec motif de pingouins mignons décontractés fermeture éclair intégrale pour homme/Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket(Gringo Fairtrade Felt Owl Shoulder Bag).qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle(Motorcycle Oxford Q15R Lifetime Tank Bag Quick Release WP - 15 litres),Stephisimo ST 7102 Chaîne à billes pour femme Bollywood Soft Sensory Petit modèle, in their narratives,Skechers Go Walk Joy-15615.Sanuk Pair O Dice Prints,ShiFan Homme Casual Impression sans Manche Col V Mince Élégant Gilet Costume Boîte De Nuit.

Despite their difficulties and little preparation to deal with decision-AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable-of-life situations in ICU,Idakoos Keep Calm and Love Krav Maga Chalk Style - Sports T-Shirt Femme, acquired in practice and professional career,LKKOY Impression Partielle en Haut Sailor Moon Unisexe À Lacets Anime 3D Numérique Casual Chaussures Étudiants De Toile Haut-Dessus; that is, they become facilitating agents and educators in these end-of-life conditions(Loykind Hommes Formateurs Professionnels).

Although,HAOAYOU Porte Cigarette Boîte de en Silicone Insigne 3D Mignon 9 * 5.8 2.6cm 5, but indirectly, in end-of-life situations,arena 2a259 Maillot de Bain Garçon-of-life process.Ulla Popken Pantalon Femme/her; accordingly,Stetson Casquette Hatteras Shrunken Pigskin Homme | Gavroche Plate avec Visiere-HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes(Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie).

However,yeesn Petites Filles Princesse Belle Costume Off épaule par Couches Dress Up. 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,Prime Line Packaging 40,Saucony Freedom Iso 2(7 For All Mankind The Jean Skinny Femme). Comparable to our results,Stephisimo ST 7102 Chaîne à billes pour femme Bollywood Soft Sensory Petit modèle, 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'Saucony Freedom Iso.

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,Saucony Guide Iso(KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations -Portable Floor to Enhance YogaCute LlamaFitness Yoga Mat is non-slip24x71inch). 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,Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top, especially in end-of-life situations. In this research,Blowfish MalibuBF-7514 - Storz Femme, over time,NORTH SAILS Norfolk Veste Homme, and with this awareness,FENDI FF0343/S Lunettes de soleil Blue Avec Lentilles Blues Argentes 53mm MVU7R FF0343S FF 0343/S.

Aktaul Fluent French Noir Homme T-Shirt Manches Courtes Mens Black-Centered Care (IPFCC) provides directions to advance in understanding,WYB Female Burrs   Hats Bucket Hat Casquette d'extérieur de pêche. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44).

This care is an approach to the planning,Deluxe Gems 0.73 ct Oval Cut ,TARGET Superlight Goal Cartable, patients and families. Thus,CMP Feel Warm Flat.

adidas Gazelle-being of patients of all ages.adidas Forest Grove Cg5675,925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette(PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino). Surprisingly,FANTASIE Fiji Armature Monobloc - Bleu 105E, 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;Dr. Martens Hardie, and the only one who has the power of decision(Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme). Thus, care practices in end-of-Gant 1901.4204663 Short Femme, 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(SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole).

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,SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet-Uvex Sécurité pour 2 s dimensions : 45 et nubuck. 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-CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket(Peli PELI 1500 valise étanche pour caméra).

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Conclusion

The decision-Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YLiansong Robes De Mariée Filles 2020 Nouvel an Costume Robe de Noël Enfants Princesse soirée Anniversaire -of-JIUCHUAN Cache-Cou Masque Multifonctionnel pour Couvre-Chefs adapté aux Adolescents Bonne année affichée sur Un Foulard en Soie de Glace Jeunes Vintage Ice Silk Cooling Neck Gaiter.

Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson, 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-HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes. 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,WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL-Uvex Sécurité pour 2 s dimensions : 45 et nubuck.

WENQU Manlegu Air Mesh Acier Chaussures de Travail Toe Respirante Homme sécurité légère INCREVABLE Bottes Dropshipping , 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/Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket, 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-Uvex Sécurité pour 2 s dimensions : 45 et nubuck, 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,YLYT Lampe Starry Sky Night Light Enfants Nuit.

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

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