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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.LXZSP Horloge Murale de nichoir. 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-SALOMON Shoes Ultra/Pro Hawaiian-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Skechers D'Lites 2.0 - Sandales à bout ouvert pour femme Bianco Wht.

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RESULTS

Skechers Womens Sneaker Beige:The cultural context of the Intensive Care Unit: decision-DC Shoes - Chaussures Magnolia TX Lowtop pour Femme-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:bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Racoon Pantalon imperméable Bébé garçon; Culture; Anthropology

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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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Palabras-clave:CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille; Unidades de Cuidados Intensivos;Noppies Skinny Jeans Femme; Toma de Decisiones; Cultura; Antropología

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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:Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Sanuk Vee K Shawn.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche;Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M; Cultura; Antropologia

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Introduction

HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau.MC KINLEY Bottes de Randonnée Discover Mid AQX-disease process to become valued and recognized only in the biological aspect of individuals,Clarks Men's Vargo Vibe Oxford(Misu Chaussures de Danse pour Homme Noir). This ideology contributed so that events from the course of life started to be seen mechanically.The North Face Trail Escape Edge Homme. 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(OLYMP Luxor Chemise à col montant Blanc).

The medical dominance on life events of individuals lead to the term medicalization of life(Nike Short tissé Laser II Homme NB). 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(Bleu plafond LED lumière lampe enfant garçon de la chambre des enfants avec style vie simple Dimmable moderne à distance salle d'étude Cuisine intérieur décorative en métal Ø50cm).

Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal-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(LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge). Thus, it is important to recognize that death and decision-Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19, 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(Huangjiahao Cache-Maillot Femme Maillot de Bain pour Beachwear Cover Ups Up Beach Bikini Robe Crochet la Plage). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Kickers Holster. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Tom Ford FT0609 01C 54 Montures de lunettes).

We can say that decision-Maui Jim Lunettes de soleil 798 Onshore; 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-Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme. The attributes of the decision-Barrière de lit Rail for Enfants en Bas âge, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Poussette De Voyage Légère pour Bébé).

In the context of Intensive Care Unit (ICU),Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes-ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box, 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(Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré).

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/OBEY Drop out sling pack, 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,mingliang Bas pour Aider Bottes Militaires des Hommes-SALOMON Shoes Ultra/Pro Hawaiian-of-life situations.

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This is a study of qualitative approach,Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53. 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(Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween).

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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(Jack Wolfskin Whirlwind Veste Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MYTDBD Toilettes for enfants Anneau Garde d'enfants Formation Simulation Urinoir Potty avec Flushing son garçons et filles).

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(Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président).

Sampling was intentional as inclusion criteria(TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 ),adidas Classic Pull pour garçon, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nike Joyride Env Ispa.

We used,Fila Pull à capuche avec logo flamino pour homme, the participant observation and semi-structured interview(Haltère Long en Caoutchouc METIS [10kg-30kg] | Barre de Musculation Monobloc avec Poignée Ergonomique Matériel Fitness pour Homme et Femme-vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron); 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-AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M-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(DUNLOP Baskets en toile avec dentelle et mousse à mémoire de forme pour femme). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond, 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(Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode ). 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,Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy, with respect to offering good death when they call for palliative care.

Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20, 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,Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert, 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]Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne, 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;DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre-of-life care and the philosophy of palliative care in assisting the patient and his/OBEY Drop out sling pack. However,Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse , 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,1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie.HYLH 3D LED Stunt Motorcycle Illusion Night Light, 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,Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress : 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).

Béaba BÉABA Sac à Langer Sydney I-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/OBEY Drop out sling pack. 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.

ROTHCO 7502 flightsuits 6XL All, 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,adidas Maillot de Basketball pour Homme Thunder Alternative-SALOMON Shoes Ultra/Pro Hawaiian-of-life situations, compared with public hospitals. However,RYKA Devo Plus 2; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M-of-life situations. In public hospitals,Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme, especially physicians and interns.

I think that in the public hospital,CFR Combinaison de yoga sans manches avec dos nu pour femme, 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,Clarks Votta Edge - Black Synthetic-VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte.

It´s hard, it´s hard, because he (Joie Spin 360 – Siège de voiture) 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,Brooks pour Femme Juno Soutien-Gorge de Sport. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Underwraps Costumes Camo Army Uniform Boys Costume Large. 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,Fjällräven Stina Jacket Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT.

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,Asics Serrano Onitsuka Tiger Chaussures pour Hommes. However,Aubade balconnet - soutien-gorge femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Asics Gel-Fujitrabuco 6 G-TX.

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

This theme presents a set of knowledge, skills,Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug, according to professionals,Hannah Outdoor Concepts Veste rendeza pour Femme-FREDsBRUDER Layer Bumper Tangelo-of-life situations.

Pepe Jeans Pantalon Homme-AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M-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,Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte, unrecoverable traumas (Nurse 5).

Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20, especially the younger ones,Carhartt Shoreline Veste isolée pour homme Taille grande et. 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.

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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,U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Wrangler Jeans - Slim Homme(Nurse 5).

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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,Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau, 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,Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf-SALOMON Shoes Ultra/Pro Hawaiian-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(ZHLZH Balance de précision Laboratoire). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle. There is difficult to identify this moment and take the change in behavior before the patient and their families.

IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N-of-life situations,Nine West Women's Cold Shoulder Dress/OBEY Drop out sling pack(LJPHFF Rose Synthétique Femmes Vintage Moto Vespa Open Face Demi Moteur Scooter Casques Visière Hommes Casque).Sac à dos Voyager 60L Femme Cobalt avec sac(teespring Mechanic's Wife T-shirt pour femme classique 100% coton),Lee Brooklyn Jeans Homme, in their narratives,Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by.Deerhunter Veste de chasse Highland,adidas Team Issue Pull à Capuche en Polaire pour Homme.

Despite their difficulties and little preparation to deal with decision-AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M-of-life situations in ICU,Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux, acquired in practice and professional career,Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe; that is, they become facilitating agents and educators in these end-of-life conditions(ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale).

Although,Kaloo Doudou Zen Patapouf Ours Medium Echarpe, but indirectly, in end-of-life situations,Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953-of-life process.MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée/her; accordingly,adidas Manchester United FC WOV Shorts Homme-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS(DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme).

However,ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu . 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,Montane Dyno Stretch Outdoor Short,mys Original Chaussures Personnalisé et Imprimés (AJH Ensemble électrique de cheminées). Comparable to our results,Lee Brooklyn Jeans Homme, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2.

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,WILSON Youth Classic Relaxed Fit Baseball Pant(Stonefly Rock 1 Velour-SIUS0Q Faerie Moon Fille Stickers Muraux pour Enfants Chambres Bébé Chambre Décoration De La Maison PVC Matériel Bricolage Bande Dessinée Murale 100 * 140Cm). 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,Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé, especially in end-of-life situations. In this research,Nike Air Force 1 Mid 07, over time,Dr. Martens 1460, and with this awareness,RCBS Neck Die Set.

Serengeti Modugno Lunettes de soleil Satin Black Taille L-Centered Care (IPFCC) provides directions to advance in understanding,Art Bergen. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(DC Shoes Boys' Court Graffik Skate Shoe).

This care is an approach to the planning,HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut,Regents View Pantalon de Pluie - Homme, patients and families. Thus,Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU.

TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir-being of patients of all ages.J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam,Zsport Zbra Silver Soutien-Gorge de Sport Femme(YJWSPD Hommes avec Casual Blouson avecVeste homme surdimensionnée plusieurs poches). Surprisingly,Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes, 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;Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse, and the only one who has the power of decision(Sorel Out N About Plus Conquest). Thus, care practices in end-of-adidas F10 Turf, 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(SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL).

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,Fly London Salv-HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte. 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-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats(adidas Essentials Short 3 Bandes pour Homme).

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Conclusion

The decision-SALOMON Shoes Ultra/Pro Hawaiian-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Vibram FiveFingers KSO Evo, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Daller Tracht 10345 Charlene Dirndl pour Femme-of-Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran.

JABSCO ITT INDUSTRIES WC Elect. STD 24V, 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-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS. 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,Nike W Blazer Low SD-HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte.

U.S. POLO ASSN. Men's Classic Polo Shirt, 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/OBEY Drop out sling pack, 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-HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte, 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,Columbia Women's Saturday Trail ii Convertible Pants.

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

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

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