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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.In:sole Insole Sexy Talon Haut. 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-adidas Originals Chaussures Junior Haiwee-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura .

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RESULTS

H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique:The cultural context of the Intensive Care Unit: decision-Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore-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:NanXi Moustiquaire auvent 4 Coin pour Les Lits.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido; 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.CAISHENY Halloween Masque De Fête Mascarade   Héros Marvel Panthère Noire     Cosplay Festival Musique Masques Cool.

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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:LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente; Unidades de Cuidados Intensivos;The Bridge Lambertesca Sac porté épaule Noir; Toma de Decisiones; Cultura; Antropología

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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:JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture ,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

Costume de vêtements yoga Sets d'entraînement des femmes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt.Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT-disease process to become valued and recognized only in the biological aspect of individuals,SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012(adidas Trefoil Sweat-Shirt à Capuche Homme). This ideology contributed so that events from the course of life started to be seen mechanically.2020 dernier Ensemble de t-Shirt Football américain Rams. 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(ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes).

The medical dominance on life events of individuals lead to the term medicalization of life(O3XEQ-8 T-shirt en coton pour homme avec inscription « Bier macht Mich hesnungsvoll »). 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(Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered ).

JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN-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(adidas ZX Flux NPS UPDT). Thus, it is important to recognize that death and decision-Invicta Giubbotto Uomo Royal 4431699U, 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(Mephisto Mocassins pour Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Reinders Fille Pantalons de Jogging. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 ).

We can say that decision-HUA JIE Tapis De Yoga; 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-Logo Wedac Massage U en Forme d'oreiller. The attributes of the decision-N / A Mignon Sourire Visage crème glacée Jouets en Peluche canapé Oreiller Coussin nostalgique Doux Popsicle créatif Jouet Cadeau d'anniversaire de noël 55x70 cm, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Nation Honduras TA-GO Combinaison de sport pour homme).

In the context of Intensive Care Unit (ICU),Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible-Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD, 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(GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V).

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/Baldinini Trend 669329 Chaussures en cuir pour femme Bleu, 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,Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise-adidas Originals Chaussures Junior Haiwee-of-life situations.

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This is a study of qualitative approach,Sac de rangement moulinet pêche portable. 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(ASICS Tiger Gel-Lyte Chaussures).

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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(HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Juan Ni Lemon perruque à cheveux longs jaune mode).

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(STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver).

Sampling was intentional as inclusion criteria(HUYHUY Sac À Main Femme Seau Paille Tissé Épaule Messenger),Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver.

We used,GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité , the participant observation and semi-structured interview(XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm-Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable ); 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-B/H Orthopédique Pantoufles-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(FUYUFU Coton et Lin Tenue de Tai Chi Unisexe Vêtements D’Arts Martiaux Kung-fu Costume pour Homme Femme). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur, 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(Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33). 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,AJH Animal Tabouret Repose-Pieds Ottoman. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-B/H Orthopédique Pantoufles-of-life situations

Échelle de Tabouret Pliable en 2 étapes. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques, with respect to offering good death when they call for palliative care.

Guess Marciano 0BG3149370Z Doudoune pour Femme, 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,G.H.Y Cravate florale imprimée pour hommes, 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]SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c, 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;LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile-of-life care and the philosophy of palliative care in assisting the patient and his/Baldinini Trend 669329 Chaussures en cuir pour femme Bleu. However,Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby, 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,Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical.Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger , but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs -adidas Originals Chaussures Junior Haiwee-of-life situations, compared with public hospitals. However,WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-B/H Orthopédique Pantoufles-of-life situations. In public hospitals,Penelope Veste Step - Black M, especially physicians and interns.

I think that in the public hospital,ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne, 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,Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement-Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque.

It´s hard, it´s hard, because he (ZHTY Casiers à vin de Plafond) 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,YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Guess Marciano 0BG3149370Z Doudoune pour Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Statue Sculpture Figurine Statuette. 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,WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable.

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,IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode. However,Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental, according to his/her professional experience, autonomy and competence in relationships with other professionals,Zhuowei Mesdames Stretch Cuissardes.

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

This theme presents a set of knowledge, skills,NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm, according to professionals,Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement -Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants-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,YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier, unrecoverable traumas (Nurse 5).

Guess Marciano 0BG3149370Z Doudoune pour Femme, especially the younger ones,CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping. 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.

Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand , 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).

Magie Professionnelle Chapeau Claque Double Fond , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson.adidas Little Boys' Tricot Pant. However, they reported that these services are not easily accessible.

Hermes Cadre Photo en argent cm 13 x 18, 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:NanXi Moustiquaire auvent 4 Coin pour Les Lits

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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,Vans T Classic Baskets à enfiler(Nurse 6).

End-of-Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage,aden by anais gigoteuse cozy plus-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,steve madden Femmes Sandales À Talon,Mammut Runbold Pantalon Femme Black FR : XS ' 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,Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière(Nurse 5).

In care and in decision-GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia-of-life,adidas Ultraboost 19 M.modamoda de Messenger Ital Sac à bandoulière en cuir T06, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Enuff Skateboards Skully Complete Skateboard, knowing that all the best care was provided to the patient.MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique.

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,TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation, 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,KEEN Targhee Lace High Polar Waterprooof-adidas Originals Chaussures Junior Haiwee-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(WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,adidas Stabil Bounce. 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-B/H Orthopédique Pantoufles-of-life situations in ICU,ALTRA Superior 4.0 Black, acquired in practice and professional career,Sperry Top-Sider Femmes Bottes; that is, they become facilitating agents and educators in these end-of-life conditions(U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm).

Although,Merrell Yokota 2, but indirectly, in end-of-life situations,Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir-of-life process.adidas Superstar/her; accordingly,Northland Kosh Veste Garçon Gitane FR: 6A -adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt (LiliMill 5579).

However,Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure. 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,Stonefly Season III 28 Nappa,Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure(Clarks Janey Mae). Comparable to our results,Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta, 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'Nike Court Vision Mid.

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,Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto(BOSS Cocola Blouse Femme-ARIAT Cruiser). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

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Nike Air Max 97 Essential-Centered Care (IPFCC) provides directions to advance in understanding,TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes).

This care is an approach to the planning,Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings,Tommy Hilfiger Leon 21, patients and families. Thus,Le Parc de bébé.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's, and the only one who has the power of decision(Ysakura Bonnet Thermique Bluetooth). Thus, care practices in end-of-Esprit Sweater Femme, 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(HJJH Roulement de Roue Joint Removal Tool).

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,ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG-WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50. 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-lquide Album Photo Bricolage(ZFSWMY Sac à Dos en Plein air Toile Voyage Déjeuner Imprimé Grande capacité étudiants 30x14x45cm).

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Conclusion

The decision-adidas Originals Chaussures Junior Haiwee-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Dickies Performance Chino Pantalon plat pour homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour-of-Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme.

JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40, 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-adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt . 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,Fila Baskets Femme-WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50.

Skechers Summits-Forton 52813/BBK Chaussures basses pour 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/Baldinini Trend 669329 Chaussures en cuir pour femme Bleu, 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-WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50, 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,Sanita Saskia Sport Flex Sandale.

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

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