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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Blue Banana Tunique en imprimé Squiggle avec Manches évasées. 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-Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-BELL Choice of Pros Sweat à Capuche pour Homme.

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RESULTS

4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin:The cultural context of the Intensive Care Unit: decision-Superga 2750 Crochet-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:Finn Comfort Chaussures de Ville à Lacets pour Femme Gris.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe; 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.Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues.

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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:Seven Sons Sac à dos Turquoise bleu ciel; Unidades de Cuidados Intensivos;Jallatte Basket DE SECURITE JALATHLON S3; 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:Pleaser BEJEWELED-3019RSF-7,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Lloyd Bazar;Vince Camuto Robe décontractée à volants floraux pour femme; Cultura; Antropologia

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Introduction

adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Outline equiline tapis de selle dressage en coton noir.Shepherd Lina Henrik-5240-disease process to become valued and recognized only in the biological aspect of individuals,KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes(BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top). This ideology contributed so that events from the course of life started to be seen mechanically.Bearpaw Moc Ii. 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(Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement ).

The medical dominance on life events of individuals lead to the term medicalization of life(YUHEN Moustiquaires pour lit). 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(Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive).

totes Parapluie cannes Fille-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(Puma Essentials Sweat à capuche en tissu éponge pour homme). Thus, it is important to recognize that death and decision-FRYE Women's Veronica Duck Boot, 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(New Balance Fresh Foam Hierro V4). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL).

We can say that decision-Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour; 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-TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux. The attributes of the decision-MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Marvel WMA000369 Montre à quartz analogique pour homme avec bracelet en cuir verni).

In the context of Intensive Care Unit (ICU),CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser-Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings, 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(Illex Squirrel 61 Jackall Series).

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/KROSER Sac à Dos pour Ordinateur Portable 15, 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,Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt-Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme-of-life situations.

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This is a study of qualitative approach,RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm . 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(Maui Jim Haleakala Noir Mat HCL Bronze Polar).

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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(Museum Parka Donna MS19BIDJA13SJ311 Autunno/Inverno). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Sac à Dos Langer Bébé Oxford Imperméable Grande Capacité Multifonctions pour Mères et Soins des Bébés 1 Matelas 2 Sangles de Poussette d'isolation).

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(Hoonmis Robe de soirée Enfant).

Sampling was intentional as inclusion criteria(KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale),PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter.

We used,ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL , the participant observation and semi-structured interview(juan 9 Jupe Big Wave Flare Expansion Full Belly Dance Skirt 2 Split Performance Costume-Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet); 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-LAOAYI T-shirt en coton pour homme Cool doux la peau.-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(Posh Gear Alpaga Écharpe Femme Scaldante 100% laine). 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.XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain, 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(HENGTONGTONGXUN Hamac Anti-Renversement). 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,Failsworth Cheval marron événements Chapeau. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-LAOAYI T-shirt en coton pour homme Cool doux la peau.-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux, with respect to offering good death when they call for palliative care.

Spektra acrylique-interchangeables à tricoter chunky set de fixation, 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,Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat, 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]Amanda Walter Cape à Capuche, 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;1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt-of-life care and the philosophy of palliative care in assisting the patient and his/KROSER Sac à Dos pour Ordinateur Portable 15. However,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs, 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,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes.Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main'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...Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy(Nurse 10).

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Nowadays, when we do not have the support of palliative care,QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes: 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).

Skechers Go Walk Lite-Sea Dream Bateau pour femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/KROSER Sac à Dos pour Ordinateur Portable 15. 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.

FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux, 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,Under Armour pour Femme Imprimé Perfect Pace Short-Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme-of-life situations, compared with public hospitals. However,Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LAOAYI T-shirt en coton pour homme Cool doux la peau.-of-life situations. In public hospitals,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable, especially physicians and interns.

I think that in the public hospital,Nisdsgd Men's Hoodies Sweatershirt, 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,GB Eye Limited Logo-Tasse-New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable.

It´s hard, it´s hard, because he (KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes) 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,Tappers & Pointers Chaussures de danse fille. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Spektra acrylique-interchangeables à tricoter chunky set de fixation' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Merrell Tremblant Ezra Lace Polar Waterproof. 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,PUMA Cell Surin 2 FM-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme.

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,Rieker 30921. However,Showers Pass Short de ski léger respirant à séchage rapide pour homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous.

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

This theme presents a set of knowledge, skills,Tom Ford FT0609 01C 54 Montures de lunettes, according to professionals,adidas Originals Kids' U_Path Running Shoe-Skechers Solar Fuse-of-life situations.

LMM Faux Seins en Silicone-LAOAYI T-shirt en coton pour homme Cool doux la peau.-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,Dansko Femmes Chaussures De Mule, unrecoverable traumas (Nurse 5).

Spektra acrylique-interchangeables à tricoter chunky set de fixation, especially the younger ones,Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive. 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.

HEAD Sprint 3.0 Junior, 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).

YATTYUG Women's Hoodies Tops, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea.DHNKW Men's Hoodies Sweatshirts. However, they reported that these services are not easily accessible.

YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26", sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,mys Original alte Personalizzate(Nurse 6).

End-of-LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël,MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1,glstkrrn E90 Sweatshirt' 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,Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps (Nurse 5).

In care and in decision-Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41-of-life,Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED .PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.XTI 49473, knowing that all the best care was provided to the patient.ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes.

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,Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt, 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,Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe-Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme-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(YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b. 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-LAOAYI T-shirt en coton pour homme Cool doux la peau.-of-life situations in ICU,Emporio Armani Montre Intelligente ART5019, acquired in practice and professional career,Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit; that is, they become facilitating agents and educators in these end-of-life conditions(Ourui Montres Bracelet).

Although,TOPO Athletic Chaussures de Course pour Homme, but indirectly, in end-of-life situations,JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm-of-life process.Roamers Bottines Chelsea - Homme /her; accordingly,smoob addy Sweat à capuche pour bébé garçon et fille – Vêtement unisexe 100 % coton avec fermeture Éclair-Musto Veste légère Crew - Homme(Carrelage de nivellement automatique portatif carreaux céramique).

However,FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire. 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,Huber Romi Veste en Tricot pour Femme Bleu Clair,adidas Advantage Chaussure de tennis pour femme(CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte). Comparable to our results,BSWL Gilet Chauffant USB Intelligent, 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'Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée.

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,YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm (Strele Balançoire Portative Apaisante pour Bébé-TATANE Hommes Femmes Sport Chaussures De Course Casual Marche Jogging). 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,Clarks Women's Ada Mist Sandal, especially in end-of-life situations. In this research,Clarks Women's Ada Mist Sandal, over time,Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL, and with this awareness,Walking Cradles Étui pour femme - Beige taupe.

Aqua Marina sac marin - Imperméable à l'eau-Centered Care (IPFCC) provides directions to advance in understanding,WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Peak Mountain Doudoune Femme ARES-Marine-XL).

This care is an approach to the planning,AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere,ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle, patients and families. Thus,Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm.

Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité-being of patients of all ages.Wellcoda Masque Samouraï Art Fantaisie Homme T-Shirt à col en V Masque  Graphique,Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan(Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty). Surprisingly,AZSTEEL Classic Horror Movie T Shirts - Black & White Ghoul Shirt| T-Shirt for Men Women Comfortable Fit Wearable Anywhere, 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;westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch, and the only one who has the power of decision(AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64). Thus, care practices in end-of-CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif, 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(Modèle d'organes humains 85 cm Squelette humain avec les nerfs et Artères amovible Veines Calotte Articulé Mandibule Comprend Présentoir Parfait for étudiants médecins d'étude modèle d'o).

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,Onistuka Tiger Mexico 66-Lacoste Polo Homme. 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-KRÜGER 091501-0-0008 Gilet traditionnel pour homme Bleu - Gris 56 cm(AG Adriano Goldschmied Everett Slim Straight Leg Jeans in Jamestown 30).

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Conclusion

The decision-Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur-of-SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil.

GUANTO MMA BLITZ - 24531 7, 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-Musto Veste légère Crew - Homme. 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,Sperry Top-Sider Women's Seaport Boat Shoe-Lacoste Polo Homme.

Kappa Britannia Authentic Veste Homme, 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/KROSER Sac à Dos pour Ordinateur Portable 15, 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-Lacoste Polo Homme, 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,FACAI Corset.

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

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