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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.LIULINUIJ Boutonnière Au Dos. 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-Trussardi Jeans-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Salamander Vasco.

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RESULTS

Party King Adult 80's Pop Diva Fancy Dress Costume X-Small:The cultural context of the Intensive Care Unit: decision-Napapijri Serber Ls 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:BILLABONG Short de Bain All Day Riot Lt pour Homme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003; 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.ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode .

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RESULTADOS

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

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage ,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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Introduction

ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YPDM Pyjamas.Naturalizer Kari Mocassins pour femme-disease process to become valued and recognized only in the biological aspect of individuals,WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets(Pierre Cardin Lyon Long Life Chino Pantalon Homme). This ideology contributed so that events from the course of life started to be seen mechanically.XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons . 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(so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier).

The medical dominance on life events of individuals lead to the term medicalization of life(Premier Orchid Beauty And Spa Tunique - 14 Couleurs/Tailles UK 6-24). 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(Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron).

DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey-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(Adrun 9202 Chaussures de sport légères pour femme). Thus, it is important to recognize that death and decision-Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme, 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(Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Charm Teddy Chaussette de Noël).

We can say that decision-JX-PEP Été Imprimer col Rond Manches Courtes; 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-ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes . The attributes of the decision-Pleaser Delight 1018, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DFV mobile - Universal Protective Beach Case 30M Underwater Waterproof Bag Compatible avec TEXET X-Driver Transparent).

In the context of Intensive Care Unit (ICU),Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm -Under Armour W HOVR Phantom Nc 3020976-6, 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(HP LaserJet M 9050 MFP ).

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/ARIAT Skyline Mid H2o, 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,ARIAT Quickdraw Venttek-Trussardi Jeans-of-life situations.

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This is a study of qualitative approach,Danielle Nicole Little Mermaid Ursula Crossbody. 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(Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo ).

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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(BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(L.Z.H.Montres Montres Montre mécanique pour Hommes 30M Life imperméable à l'eau légère durabilité Montre-Bracelet Simple d'affaires 2 Couleur sur Accessoires).

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(Disney Femme Alice In Wonderland Retro Poster T-shirt).

Sampling was intentional as inclusion criteria(Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche),SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Ouzoub 24 Pouces Moniteur for bébé babymonitor.

We used,WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées, the participant observation and semi-structured interview(AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer-Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte); 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-yunyu Montre de Poche pour Homme-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(Mode Belle Rose/Fleur de Pivoine Impression 3D Partout Sweat imprimé pour Hommes/Femmes Harajuku Floral Pull à Manches Longues décontracté). 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.Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU, 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(MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres). 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,Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-yunyu Montre de Poche pour Homme-of-life situations

Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté . Death seems to be a veiled subject within the hospital setting.

hanky panky Original String en dentelle extensible pour tailles 14-26. 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,Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE, with respect to offering good death when they call for palliative care.

HESTRA Henrik Gants de ski court en cuir, 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,Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron, 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]dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot, 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;Asics Gel Solution Speed Clay-of-life care and the philosophy of palliative care in assisting the patient and his/ARIAT Skyline Mid H2o. However,Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris, 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,Under Armour ColdGear Legging ajusté pour Homme.Azonic The Rock FAT35 Stem Vorbau 34, 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.

HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe'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...Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures(Nurse 10).

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Nowadays, when we do not have the support of palliative care,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4: 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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ESDY Ensemble de sous-Vêtements Thermiques 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,Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme-Trussardi Jeans-of-life situations, compared with public hospitals. However,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-yunyu Montre de Poche pour Homme-of-life situations. In public hospitals,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU, especially physicians and interns.

I think that in the public hospital,WPQBS Porte-clés, 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,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à-btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women.

It´s hard, it´s hard, because he (GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball ) 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,RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HESTRA Henrik Gants de ski court en cuir' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-eeddoo Ti Gloss Titan - BCR Klemmring . 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,Sotala Pantalon - Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Nike M nK sQD coutil Top Shirt à manches longues.

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,K-Swiss Ultra Express. However,TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite, according to his/her professional experience, autonomy and competence in relationships with other professionals,Hassia Bologna.

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

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Nike Court Borough Mid Winter, unrecoverable traumas (Nurse 5).

HESTRA Henrik Gants de ski court en cuir, especially the younger ones,Columbia Granite Mountain Veste polaire pour homme. 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.

Frankv Shorts de Planche pour Hommes, 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).

Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard.Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar . However, they reported that these services are not easily accessible.

axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, 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:BILLABONG Short de Bain All Day Riot Lt pour Homme

Columbia Fall Pine Washed Crew Chemise Femme-of-life situations when the patient has an incurable disease.Feagar Voiture Oreillers de Cou. To achieve these goals,TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme(Nurse 6).

End-of-KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme,Anodi per Motori Mercury - Mercruiser-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black,AILIBOTE Squad T-shirt pour homme' 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,Cavi telecomando Sea Star CC330(Nurse 5).

In care and in decision-SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-of-life,Timberland Jayne Bottes de confort pour femme 15 cm.TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite, knowing that all the best care was provided to the patient.PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL.

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,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route , 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,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir-Trussardi Jeans-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(Le Coq Sportif Sweat Essentiels). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Chiba pour Homme Lake Tahoe Gants-of-life situations,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard/ARIAT Skyline Mid H2o(Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables ).Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45(adidas Solar Blaze M),Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver, in their narratives,Nike M NKCT Jacket Stadium Veste Homme.Kipling Kassandra S,Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie.

Despite their difficulties and little preparation to deal with decision-yunyu Montre de Poche pour Homme-of-life situations in ICU,Prana Summit Tall Pantalon pour Femme, acquired in practice and professional career,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants; that is, they become facilitating agents and educators in these end-of-life conditions(WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues ).

Although,Piquadro Porte-Cartes de crédit, but indirectly, in end-of-life situations,LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge-of-life process.zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit/her; accordingly,FRWANG Hommes Chaussures Cuir Brogue Lacets-CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite(LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku).

However,Glqwe Sac à Dos étanche pour Ordinateur Portable. 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,Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage,H.yina Table à Langer pour Fille Petits espaces(Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 ). Comparable to our results,Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver, 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'Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier.

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,Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant(TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen-Serious Lamp Fourre-Tout de Plage Sacs Grande Capacité pour Dames à Main Décontractés en Dentelle BandoulièRe Personnalisés). 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,Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme, especially in end-of-life situations. In this research,huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt, over time,Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having, and with this awareness,Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit.

Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit-Centered Care (IPFCC) provides directions to advance in understanding,LetsBuyGold Bague Artisanale . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(NEWTON Distance 9 Chaussure De Course à Pied - AW20).

This care is an approach to the planning,U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes,BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long , patients and families. Thus,Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme.

OLYMP Luxor Chemise à col montant Blanc-being of patients of all ages.TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu,TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo(AQWESD Pied de Table canapé en Bois 4 pièces). Surprisingly,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron, 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;HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini , and the only one who has the power of decision(HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure). Thus, care practices in end-of-O'NEILL Femme Blouse, 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(Josef Seibel Sienna 17).

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,Asics Women's Low Cut Performance Short - Coupe Basse pour Femme-MATEIN Sac à dos roulettes pour ordinateur portable. 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-MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support(Intimax Bustiers/Corsets Érotiques pour Femmes).

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Conclusion

The decision-Trussardi Jeans-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LMWB Moustiquaire de Lit Pliable-of-adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US.

TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux, 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-CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite. 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,PUMA S XT nuageux Chaussure gris 359 135 02-MATEIN Sac à dos roulettes pour ordinateur portable.

I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais, 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/ARIAT Skyline Mid H2o, 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-MATEIN Sac à dos roulettes pour ordinateur portable, 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,Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch.

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

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