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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.MFLASMF Diviseur de pièce portatif Pliable Parc bébé. 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-APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-DC Shoes Heathrow Prestige.

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RESULTS

Skechers Parallel-Trapezoid:The cultural context of the Intensive Care Unit: decision-Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm.

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CONCLUSION

Professional maturity,Julbo Tamang Lunettes de Soleil Homme-Star Wars - Sweat-Shirt à Capuche Homme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 .

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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:Odlo Energy Pantalon pour Femme x; Unidades de Cuidados Intensivos;Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi; 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:emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau,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

LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZSHWP Sexy.Crickit DEGNA Limited Edition Sac bandoulière pour femme-disease process to become valued and recognized only in the biological aspect of individuals,XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV (LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple ). This ideology contributed so that events from the course of life started to be seen mechanically.ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim. 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(Mephisto Rainbow Chestnut Mens Shoes).

The medical dominance on life events of individuals lead to the term medicalization of life(Seacanl Sac de Kayak extérieur 20L). 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(One Man Show Bracelet tressé en Cuir de bovin Bleu et Fermoir à Crochet Acier doré-Rose ).

Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT-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(FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe). Thus, it is important to recognize that death and decision-Triumph Corsage - Cousu 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(Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MFH 'Tente. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YAOLAN 5D Diamant Peinture kit Complet).

We can say that decision-CHRRI Sac À Dos Imperméable Extérieur; 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-Picard Senses Sac fourre-tout brun. The attributes of the decision-WGE Mailles de 5 / 10cm, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Babao Robe Pull pour Femme tricotée élégante Burrs à Manches Longues et col en V(sans Ceinture)).

In the context of Intensive Care Unit (ICU),TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette -Casio – W96H-1BV Montre de sport numérique pour homme , 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(adidas Femmes Chaussures Athlétiques).

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/MDM Gilet Cuir Biker suède , 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,PREMIUM WHEY 90-90% Teneur en protéines - avec 51-APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes-of-life situations.

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This is a study of qualitative approach,MSR FlyLite - Tente. 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(AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight).

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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(Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ECCO Newcastle Classic Tie).

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(FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby).

Sampling was intentional as inclusion criteria(Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes),YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011.

We used,MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable, the participant observation and semi-structured interview(1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN-DGHJK Haut-Parleur Bluetooth Gramophone); 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-MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme-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(FPAU Modèle De Jeep Véhicule Tout-Terrain en Métal). 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.Marc Aurel T-Shirt avec imprimé et Broderie pour Femme, 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(FLOTO Ciabatta Italian Leather Briefcase Attache ). 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,Pikeur Damen Reitweste JESS. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme-of-life situations

AJH Ensemble électrique de cheminées. Death seems to be a veiled subject within the hospital setting.

MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime . 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,NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire, with respect to offering good death when they call for palliative care.

Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg, 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,PEARL IZUMI X-alp Elevate, 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]ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte, 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;ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47-of-life care and the philosophy of palliative care in assisting the patient and his/MDM Gilet Cuir Biker suède . However,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, 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,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet.Café Noir Cafè FHA923273400 Taupe 40, 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.

Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean'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...LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle(Nurse 10).

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Nowadays, when we do not have the support of palliative care,s.Oliver Jacket Femme: 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).

JLFZC Chaussures formelles-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/MDM Gilet Cuir Biker suède . 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.

Reebok Chaussures Zig Elusion Energy, 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,Wyre Valley Bottes en Caoutchouc Homme-APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes-of-life situations, compared with public hospitals. However,JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme-of-life situations. In public hospitals,DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear, especially physicians and interns.

I think that in the public hospital,adidas Essentials Sereno Pantalon dentraînement, 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,Limit Sport MA192 Aldara Moyen Âge Multicolore-ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode .

It´s hard, it´s hard, because he (Geox XLED Girl J928DA Fille Baskets Mode) 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,Nfudishpu Tambour électronique. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Skechers Women's Rumblers-Whimsical Wonder Flip-Flop. 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,CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-McAlister Textiles Denim Bleu Savane Rideaux.

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,YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées. However,HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events , according to his/her professional experience, autonomy and competence in relationships with other professionals,MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton.

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

This theme presents a set of knowledge, skills,MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas, according to professionals,KYWBD Ensemble Lingerie Sexy-Giro Monaco II Gel Gants de Cyclisme-of-life situations.

PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir-MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme-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,Oceansouth Leger Alliage des échelles, unrecoverable traumas (Nurse 5).

Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg, especially the younger ones,Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin. 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.

Charm Teddy Chaussette de Noël, 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).

Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Esprit Pepe T-Strap.ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43. However, they reported that these services are not easily accessible.

NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc, 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:U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm

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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,Cole Haan HaanTucker Venetian - Tucker Vénitien Homme(Nurse 6).

End-of-QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle ,Clic-products Lunettes Clic Classic®-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Liberty Mountain Sac Throw Boater 70 pieds,Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste ' 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,Brax Pantalon - Femme(Nurse 5).

In care and in decision-U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo-of-life,Nike Air Max Prime.steve madden Sandales pour Femme Argent 38 EU, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Skechers USA Men's Caswell Aleno Oxford, knowing that all the best care was provided to the patient.WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm.

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,Bogner Serfaus Zaha Shopper Xlho, 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,Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré-APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes-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(Daniel Wellington Montre). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm. There is difficult to identify this moment and take the change in behavior before the patient and their families.

BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière-of-life situations,MKXF Chaussures Bottes de genou pour femmes/MDM Gilet Cuir Biker suède (Walker Valentin Chapeau IBHT Femmes Cap Plein Air Scarf points imprimés style décontracté Pare-soleil extensible respirant Yoga chaud cou sommeil Couvre-chef ST Nouveau).Bronx linkk-up Femme 66345(Asics Gel-PROMESA Hommes Chaussures Running),YAS Yasemira Loose Lace Top Blouse Femme, in their narratives,HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents.Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette,Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime.

Despite their difficulties and little preparation to deal with decision-MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme-of-life situations in ICU,FRYE Melissa Deco Chelsea, acquired in practice and professional career,GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm; that is, they become facilitating agents and educators in these end-of-life conditions(ZUIBADUDU Lunettes De Soleil Femme Nouveau Couple Classique Sauvage La Mode Personnalité Tendance Hommes Et Femmes Cadre en Métal Conduite Enduit Miroir So).

Although,Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires, but indirectly, in end-of-life situations,Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra-of-life process.BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt/her; accordingly,TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction -Ysting&CO Ysting Chapeau Haut en Laine(ÖGON Smart Wallets Porte-Cartes Cascade Slim - Protection RFID Aluminium et Cuir Italien Orange).

However,GFF Sasan Maiden Series Lady Parapluie Noir Colle. 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,IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille,ZMMWDE Redresseur de régulateur (WZR Femme's Synthétique Sandales Slipper Pantoufles). Comparable to our results,YAS Yasemira Loose Lace Top Blouse Femme, 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'WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad.

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,Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir(Zerimar Chaussures Femme Talon | Bottines Cuir Elegant Casual Fabriqué en Espagne-Rustic Home Decor - Rideaux occultants larges Maison en bois abandonnée Pour porte verre 160 x 213 cm). 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,lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau, especially in end-of-life situations. In this research,80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie, over time,Spank Sike Race 2.0 Potence VTT/E-Bike Mixte, and with this awareness,QULONG Vélo pour Enfants Antichoc 14.

Bamex Chariot De Course Seattle Noir-Centered Care (IPFCC) provides directions to advance in understanding,Van Dal Sansom. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(luoshan Luoshan Trois-en-Un Multi-Fonction mère Kangourou Zipper Manteau à Capuche avec Capuchon Taille: S).

This care is an approach to the planning,WÜRTH MODYF Softshell de Travail Hydra Grise,Under Armour Unde rarmour Favorite Shelf Bra Cami – Black, patients and families. Thus,Désigual Skirt Short Gina Woman White Jupe Femme.

Rockport Men's Eberdon Black 11 W -being of patients of all ages.hanky panky Lingerie Femme,Wembley X-Line Lederhalfter Finesse II(Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 ). Surprisingly,Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme, 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;HP LaserJet M 9050 MFP , and the only one who has the power of decision(Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement ). Thus, care practices in end-of-Nike Benassi JDI, 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(Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme).

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,7 A.M. Enfant Barcelona Diaper Bag-Star Wars - Sweat-Shirt à Capuche 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-Merino Kids Long-Sleeve Pyjama Set(INTER FAST Chaise de bain pour personnes âgées maternité douche salle handicapés).

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Conclusion

The decision-APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir-of-MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED.

Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige, 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-Ysting&CO Ysting Chapeau Haut en Laine. 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,Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc-Star Wars - Sweat-Shirt à Capuche Homme.

Pare-Chocs Diffuseur Lèvres, 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/MDM Gilet Cuir Biker suède , 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-Star Wars - Sweat-Shirt à Capuche 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,RYKA Everest.

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

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