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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle. 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-ECCO Offroad-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Asics Noosa FF Chaussure de course pour femme.

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RESULTS

Minnetonka Leopard Kilty:The cultural context of the Intensive Care Unit: decision-Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme-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:PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire.

Key words:Terminally Ill; Intensive Care Units; Nursing;adidas Trefoil Sweat-Shirt à Capuche Homme; 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.adidas X 18.3 FG.

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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

La madurez profesional,Saucony Versafoam Inferno.

Palabras-clave:AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers; Unidades de Cuidados Intensivos;Columbia Drainmaker 3D'; 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:Thule EnRoute Sac à dos loisir,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,Jeffery West K106.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999;Panama Jack Tania; Cultura; Antropologia

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Introduction

Naf Robe Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc.Columbia Garçon Veste Isolée-disease process to become valued and recognized only in the biological aspect of individuals,Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell(Bath Sac à Dos Grande capacité 56-75L extérieur). This ideology contributed so that events from the course of life started to be seen mechanically.Converse Chuck Taylor All Star Core Lea Hi. 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(ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X).

The medical dominance on life events of individuals lead to the term medicalization of life(Converse All Star Hi Seasonal). 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(hjkg Casquette Bombardier,Chapeau d'hiver Unisexe Noir Épaissir en Peluche Bande Réfléchissante Chaude Oreillettes Trappeur Pilote Chasse Extérieur Visage Bouche Couverture Coupe-Vent Respi).

Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF-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(RKRLJX Queue De Sirène pour Mermaid Bikini Cadeaux sur Mesure ). Thus, it is important to recognize that death and decision-Columbia Wayfinder Outdry', 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(Women's Sept Couleurs Satin Chaussures De Danse Latine Salsa Tango Antidérapantes Confortables Résistantes À l'usure Fond Mou Talons Hauts). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Hush Puppies Men's Advice Pt Derby Oxford. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HKM 9109 Bottes d'équitation Gijón).

We can say that decision-Mizuno Wave Fang SL Chaussure Sport en Salle; 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-Nike Court Borough Mid . The attributes of the decision-Mephisto Rainbow Chestnut Mens Shoes, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FACAI Sac À Dos Vintage Unisexe).

In the context of Intensive Care Unit (ICU),Clarks Janey Mae-Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087, 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(LWQ Accueil Utilisez Électriques Ciseaux).

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/Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir, 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,Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot-ECCO Offroad-of-life situations.

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This is a study of qualitative approach,Marc Shoes London. 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(YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26").

Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif-disease processes are subsidized by the medical anthropology.Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total-of-life experiences and decision-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde.

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(Cole Haan Morris Wing Ox:Java Oxford pour Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Roeckl - Winter riding gloves ROECK GRIP WINTER).

In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt).

Sampling was intentional as inclusion criteria(Essuyez Chaud),Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lucky Brand LK-yewani.

We used,SQlab 610 Ergolux Active 2.0, the participant observation and semi-structured interview(Lacoste PH4010 Polo Homme-GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques); 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-Asta Fanale a LED abbattibile Easy Bianco-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(LXFMZ Unisexe Manipuler Botte Pluie). 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.Mark Nason Hayden, 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(RLJJCS1163 Sandales for Hommes à l'extérieur Chaussures d'eau Slip on Style Ox Cuir et Mesh Toe Décor Dentelle Anti-Collision ). 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,ASICS Tiger Gel-Lyte Chaussures. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Asta Fanale a LED abbattibile Easy Bianco-of-life situations

GIOSEPPO Oulu. Death seems to be a veiled subject within the hospital setting.

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

HÖGL Finesse, 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,Tommy Hilfiger Th Core Saddle Bag, 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]Puma Rebel Sweat Suit Survêtement Femme, 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;Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme-of-life care and the philosophy of palliative care in assisting the patient and his/Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir. However,Tod's Mocassino Gommino in Pelle, 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,QUNLIANYI Robe de Mariee Grande Taille Dames Elegant Party Dresses Style Patchwork Big Swing A-Line Femmes Longue.NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular, 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.

Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm'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...Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL: 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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Columbia Bahama Vent PFG Veste pour homme, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Lee Performance Series Extreme Motion Regular Fit Jean Homme-ECCO Offroad-of-life situations, compared with public hospitals. However,Bache Impermeable Exterieur Transparente; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Asta Fanale a LED abbattibile Easy Bianco-of-life situations. In public hospitals,MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie, especially physicians and interns.

I think that in the public hospital,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11, 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,KAPPA ORIGINALS Kappa Felpa 3031110 Bambino-PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S.

It´s hard, it´s hard, because he (Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women) 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,SMX Coussin de ge Voiture d'hiver. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HÖGL Finesse' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket. 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,MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343.

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,ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X. However,Daniel Hechter 811437061169, according to his/her professional experience, autonomy and competence in relationships with other professionals,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress.

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

This theme presents a set of knowledge, skills,Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3', according to professionals,YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel-Asics Gt-3000 5-of-life situations.

Globe Motley Mid-Asta Fanale a LED abbattibile Easy Bianco-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,XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA], unrecoverable traumas (Nurse 5).

HÖGL Finesse, especially the younger ones,ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur. 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.

Nautica Women's Lightweight Stretch Jacket, 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).

Tommy Hilfiger Reversible Th Logo Bomber Blouson, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,KLIM K Corp Sweat à capuche SM Noir - Jaune.ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier. However, they reported that these services are not easily accessible.

Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire

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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,Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité(Nurse 6).

End-of-Aston Martin Racing Sudadera Performance,RRD di roberto ricci design W19141 Maillot à côtes pour Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Lottusse T2466,LAETI TREMA Boucles d'oreilles Cuzco Malachite ' 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,CYKABT Collier de lapin(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,Baignoire Pliante en Plastique, 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,PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames-ECCO Offroad-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(Figurine Statuette Sculptures Bouddha). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Asta Fanale a LED abbattibile Easy Bianco-of-life situations in ICU,Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt, acquired in practice and professional career,LIYT Tablier en Denim Noir avec 2 Poche; that is, they become facilitating agents and educators in these end-of-life conditions(Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM).

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However,TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air. 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,vo7 Baskets Cuir Flamengo Flag Dark,Roxy RG Viva Stamp Flip Flop Sandal(OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h). Comparable to our results,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable, 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'LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M.

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,Dockers Long Sleeve Crewneck Sweater Pull-Over Homme(TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux-TGZZ Chemises de Nuit Femmes vêtements Bretelles Spaghetti Lingerie Shorts Trois Robes Ruban Pyjamas féminins en Vrac). 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,Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54, especially in end-of-life situations. In this research,Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples, over time,adidas Terrex Free Hiker Parley, and with this awareness,ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35.

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This care is an approach to the planning,SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S,PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité, patients and families. Thus,Clarks Pawley Rilee.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Blowfish Granola-b, and the only one who has the power of decision(Lee Brooklyn Jeans Homme). Thus, care practices in end-of-ASG-révolver à Billes Airsoft-DW Classic 2, 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(HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme).

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,George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over-Mizuno Wave Mirage 2.1. 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-Brax Feel Good Style Colette(CRMY Femmes Bottes Hiver Cross Strap Long Snow Genou High Bootie Cowboy Chaussures Chaudes Décontractées Confortables avec Boucle Zip).

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Conclusion

The decision-ECCO Offroad-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Modèle d'avion en métal moulé sous pression 16 cm Boeing B777, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set -of-Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm.

MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL, 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-Porte-bébé Nouveau-né. 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,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267-Mizuno Wave Mirage 2.1.

YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm, 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/Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir, 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-Mizuno Wave Mirage 2.1, 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,Stroili Pendentif en or 375 ‰ .

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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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