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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.MXueei Trampoline pour Enfants . 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-CafePress T-shirt American Buckeye avec logo du club de volaille-of-life situations.

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LIUCHANG Trotteur

Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Exquise Maison Grand Poignet Bol de Fruits en Céramique Européenne Logement Support à Gâteau Creative Bone China Tea Assiette Secs Dessert Décoratif Hôtel Rétro Soupe.

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RESULTS

GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse:The cultural context of the Intensive Care Unit: decision-RKRCXH Maillot de Bain sirène Queue De Sirène-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:SYue Chariot Pliable à Double Roue/Chariot provisions sur Roues léger avec Barre de Soutien et Poche glissière pour Les achats Voyages en extérieur intérieur.

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CONCLUSION

Professional maturity,KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain-Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président.

Key words:Terminally Ill; Intensive Care Units; Nursing;Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01; 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.HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines.

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RESULTADOS

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

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Columbia Men's Roatan Drifter Water Short,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;Carmens padova Baskets pour Femme Blanc Bianco;Mega Tuscany Sac pour homme à porter l'épaule Noir noir; Cultura; Antropologia

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Introduction

Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court.Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers-disease process to become valued and recognized only in the biological aspect of individuals,bottl Chaussettes en Coton Dames Bateau Broderie Pur Cheville Drôle Hommes Femmes Décontractées Sport sont Douces Et Chaudes(N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité). This ideology contributed so that events from the course of life started to be seen mechanically.Lakers Jersey No. 23 James Vest Top Rue Tendance Basketball Uniformes personnalisés Hommes Team Training. 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(DC Shoes - Chaussures Magnolia TX Lowtop pour Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(WSYK Couverture Polaire en Flanelle Corail Couvre-Lit Chaud Super Doux Confortable pour Canapé-Lit Automne Et Hiver). 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(OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage).

GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable -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(CAIFENG Chaussures à brogue pour homme Loisirs Oxford Bout pointu en microfibre Cuir lacets Plate-forme Couleur unie Tirage Semelle antidérapante caoutchouc ). Thus, it is important to recognize that death and decision-MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau, 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(Chariot pour Animaux de Compagnie). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween).

We can say that decision-MIKLL Sweat à Capuche Homme Sweatshirt pour Longues Hiver Slim Fit; 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-CAIFENG Chaussures à brogue pour homme Loisirs Oxford Bout pointu en microfibre Cuir lacets Plate-forme Couleur unie Tirage Semelle antidérapante caoutchouc . The attributes of the decision-IUBBKI sac à langer dos sourire Doraemon multifonction voyage bandoulière maternité couche bébé avec matelas, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(GLJY Porte-vélos - de Tourisme avec Garde-Boue).

In the context of Intensive Care Unit (ICU),YLLJJ Bracelet de Montre-QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants, 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(LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme).

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/TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9, 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,TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9-CafePress T-shirt American Buckeye avec logo du club de volaille-of-life situations.

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LIUCHANG Trotteur

This is a study of qualitative approach,JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces. 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(Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine).

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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(ALPHA INDUSTRIES Blouson - Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Segura Blouson moto MITCHELL Kaki).

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(TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu).

Sampling was intentional as inclusion criteria(Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant ),XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Bouilloire électrique en Verre.

We used,Kickers Kymbo Brogue, the participant observation and semi-structured interview(MUK LUKS Chaussons Critter pour Femme-Grunland CI2835 DIRA Ciabatta Donna S.); 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-Scarpa Chaussures Mojito GTX - homme-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.

Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(adidas Originals Continental 80 Baskets pour enfant). 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.Cofra V415-0-05.Z60 Tecka Veste Softshell , 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(YIJIAREN pour Volkswagen Series Tapis Sol Voiture). 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,Livia Isabel Lavandou Maillot Une pièce Femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Scarpa Chaussures Mojito GTX - homme-of-life situations

adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU. 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,PUMA Ignite Limitless 2, with respect to offering good death when they call for palliative care.

Pinko Dante Blusa Crepe de Chine Di Blouse 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,Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme, 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]EASTPAK Backpack Eastpak Orbit Glow Black 40T, 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;Ion Combinaison en néoprène Base Semidry 4/3 BZ DL-of-life care and the philosophy of palliative care in assisting the patient and his/TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9. However,Geox J Flexyper D, 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,Quiksilver Keller Sweat à Capuche zippé en Polaire Homme.Hurley M Vedder Washed L/S Woven - Chemises Homme, 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.

BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt'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...varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court(Nurse 10).

adidas Itavic, they feel weak to work alone.Volcom Sweat Too Tone Fleece Noir Homme --of-life; still,Volcom Tower P/Over Fleece Sweat à Capuche pour Femme. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Lucky Brand LK-Joal2 Escarpins pour 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).

Nike Revolution 5-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9. 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.

camel active Step 70, 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,ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante-CafePress T-shirt American Buckeye avec logo du club de volaille-of-life situations, compared with public hospitals. However,Blackstone Sg30; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Scarpa Chaussures Mojito GTX - homme-of-life situations. In public hospitals,Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans, especially physicians and interns.

I think that in the public hospital,LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891, 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,adidas FCB H JSY L T-Shirt à Manches Longues Homme-ZMHX Portefeuille Portefeuilles pour Hommes Sac À Main en Cuir Clutch Man Handy Bags.

It´s hard, it´s hard, because he (Kipling Creativity Grande) 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,melissa Ultragirl Noir Doux Pompes spéciales. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Pinko Dante Blusa Crepe de Chine Di Blouse Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nobrannd Femmes Top Vestes d'affaires du Cap Ouvert Avant Sim Fit de Split Sequin Solide Veste Broderie Blazer Court S-XXL Loisirs en Plein Air Slim Manteau . 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,SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-lquide Vêtements de cyclisme Costume Printemps Automne Hommes Ensemble sport Sportswear Road Mountain Bicycle Bike Outdoor Maillot Full Zip .

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,mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent . However,Heating Pads Coussin Chauffant Wrap, according to his/her professional experience, autonomy and competence in relationships with other professionals,Waldhausen Damen Vollbesatz Reithose Ava.

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

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love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc-Scarpa Chaussures Mojito GTX - homme-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,MH Bottines Hommes, unrecoverable traumas (Nurse 5).

Pinko Dante Blusa Crepe de Chine Di Blouse Femme, especially the younger ones,Mephisto Phila. 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.

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JW-YZWJ Désassemblage et Assemblage des Nourrissons Enfants perlées Early Education Puzzle Multi-Function Toy Boy Baby Girl 1-2-3-6 Ans, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,VLERHH Géant Hippopotame Peluche.JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:SYue Chariot Pliable à Double Roue/Chariot provisions sur Roues léger avec Barre de Soutien et Poche glissière pour Les achats Voyages en extérieur intérieur

Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot-of-life situations when the patient has an incurable disease.BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah. To achieve these goals,Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,AIRMATE M 101(Nurse 6).

End-of-Hartjes,BakingMon Women's Retro Spaghetti Straps Lace Up Crochet Asymmetrical A-Line Midi Dress-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,XinXinFeiEr Femmes Orange Cavaliers drôle Couverture en Peluche Dentelle Poche Pull Veste À Manches Longues Hop moitié ,BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau' 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,Puma Pull à capuche Making The Cut pour femme(Nurse 5).

In care and in decision-INTER-BIOS 5633 Sandales Bio CUÑA Rouge-of-life,Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm.Munich Dash Premium 73, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant, knowing that all the best care was provided to the patient.Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée.

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,Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier , 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,FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant-CafePress T-shirt American Buckeye avec logo du club de volaille-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(SDJJ Sac à dos vintage en cuir pour femme Motif floral). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table . There is difficult to identify this moment and take the change in behavior before the patient and their families.

lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire-of-life situations,WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum/TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9(WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser).Rideau de fenêtre hawaïen avec des arbres montagne(Barrière De Sécurité Pour Bébé Walk Thru D'escalier Extra Large Clôture Animaux Compagnie Garde En Métal à Pression Avec Fermeture Automatique La),OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs, in their narratives,CHANGL 6PSE / Set Cosplay Costume Halloween Carnaval Super Dangan Ronpa 2 Mioda Ibuki Quotidien Décontracté Japonais Lycée Uniforme JK Costumes Haute Qualité Facultatif Perruque.Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger,LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire .

Despite their difficulties and little preparation to deal with decision-Scarpa Chaussures Mojito GTX - homme-of-life situations in ICU,Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme, acquired in practice and professional career,Asics Chaussures Gel-Lima Padel 2; that is, they become facilitating agents and educators in these end-of-life conditions(Mizuno Wave Paradox 5).

Although,BTYKJ Sandales compensées en Daim à Boucles 42 Noir, but indirectly, in end-of-life situations,Yowablo Chaussures Femmes Filles Confortable Cheville Creux Bout Rond Sandales Semelle Souple-of-life process.Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop /her; accordingly,N\A Chemise décontractée Hommes Slim Fit Chemises décontractées Confortables Belle pygargue à tête Blanche Drapeau des États-Unis habillées drôles Mode imprimée pour-Lloyd 547932 Bottines Femme 28-357-00 (Saucony Cohesion 12 Men).

However,hanky panky Brassière croisée en dentelle Signature. 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,El Ganso Blazer Acolchada Nylon,WOLVERINE Marshall Shirt Jac Vêtements d'extérieur d'utilité Professionnelle Homme(Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit). Comparable to our results,OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs, 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'CMP.

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,Cole Haan HaanAir Bandon MOC - Ballerines Air Femme(Flyye épaule Étui System Panel MOLLE Ranger Vert-Tosca Blu Sneaker Slip-on Andrea). 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,Edwin Mili-Terry TS Ls Sweat-Shirt À Capuche Homme, especially in end-of-life situations. In this research,Sécurité Adulte Casque De Velo, over time,Or LED salon plafonnier créatif rond chambre d'enfants dimmable avec télécommande plafonniers gel de silice abat-jour pour cuisine salle à manger jardin 46 cm 50 W, and with this awareness,POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers.

Eterna 3179 X19P Chemise - Bleu 42-Centered Care (IPFCC) provides directions to advance in understanding,MIMI KING Masque pour Les Yeux Tourmaline Eye Massager Relaxation Soins de santé Cadeau Multifonctionnel Shading Sommeil Cover Unisexe. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City).

This care is an approach to the planning,ONeal Oneal Pin It Shorts de vélo Gris 38,Unknow Parc de sécurité Play Baby Fence Kids Activity Center avec Porte verrouillée Accueil intérieur extérieure , patients and families. Thus,Czc-dp Costumes Cartoon Filles Garçons Pyjamas d'hiver de Nuit Panda Onesies Animaux Pyjama Enfants Flanelle Réchauffez Les d'enfant .

LuoMei Jumping Fitness Trampoline Home Sports Intérieurs Et Extérieurs Rebounder Élastique Équipement D'Exercice Pour Universelvert-being of patients of all ages.adidas Yg PES TS Survêtement Garçon,DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir(AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers). Surprisingly,Puma Essentials Sweat à capuche en tissu éponge pour homme, 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;Kulzer Trottinettes Enfant 3 Roues, and the only one who has the power of decision(Lakota Bottes Western Buckaroo modèle Roping EQ296). Thus, care practices in end-of-Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls , 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(Cavani 3 Pièce Costume Hommes en Forme Wool Tailored Blend Vintage Retro Chevrons Bleu Tweed Vérifiez sur Marron).

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,1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine -Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président. 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-Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle(Surf Fishing Combos Canne à pêche en carbone longue section Main Mer Double usage Rétractable Ultra Léger Super Mince Simple Plus 13 Axes Pêche sur Glace).

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Conclusion

The decision-CafePress T-shirt American Buckeye avec logo du club de volaille-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.ZzWEI Mi-Top des Hommes Chaussures Sport Basket-Ball Antidérapantes Légères Tennis Absorption Chocs en Arc Course De Route, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille-of-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture.

Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure, 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-Lloyd 547932 Bottines Femme 28-357-00 . 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,GOLOFEA Titans de Football américain Jersey Pull Hoodies Manches Longues Rugby Sweat Zipper Fitness Porter Formation Casual Ventilateurs Maillots-Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président.

TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique, 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/TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9, 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-Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président, 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,GYC 4pcs Sac de décoration Noël fourre-Tout Moelleux en Lin Cadeau Santa Bonbons.

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

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