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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.New Balance Women's 5K V5 Running Shoe. 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-Primigi Pwigt 63828-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique.

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RESULTS

Mammut Bota Ducan High GTX:The cultural context of the Intensive Care Unit: decision-Clarks Kaylin 60 Sling-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:LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine.

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CONCLUSION

Professional maturity,Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage-CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix.

Key words:Terminally Ill; Intensive Care Units; Nursing;Jamkf Sandales d'été Hommes Tendance Sandalettes Casual Doux Bas antidérapants résistant à l'usure des intérieur et extérieur Double Usage Talon Chaussons avec Coussin d'air; 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.LJMHG Shorts Summer Denim Women High Waist Jean Female Loose Hole Jeans with Pockets Casual Plus Size S-6Xl L Blue.

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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:Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui,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

WYFX Smart Fingerprint Wallet-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,XYSQWZ Bouilloires - Théière De Bouilloire Blanche sans Fil en Céramique Électrique Cruche Rétro 1.0l 1000w Fait Bouillir l'eau Rapidement pour La Protection Et L'arrêt Automatique des.LXZSP Horloge Murale de nichoir-disease process to become valued and recognized only in the biological aspect of individuals,TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces(mmmy Perruque). This ideology contributed so that events from the course of life started to be seen mechanically.Naturino Karrie Baskets hautes en tissu léopard. 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(Esprit Sweater Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(Pinkkart Designer Elegant Fancy Fabric Saree Casual Wear Party Festive Women Sari Blouse 9732). 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(Asics Chaussures Gt-1000 7 ).

Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres-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(Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver). Thus, it is important to recognize that death and decision-N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage 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(Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LDH Étendu sur Le Genou Doudoune Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Hackett London Pantalon Homme).

We can say that decision-Haltère Long en Caoutchouc METIS [10kg-30kg] | Barre de Musculation Monobloc avec Poignée Ergonomique Matériel Fitness pour Homme et Femme; 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-SALOMON Shoes Ultra/Pro Hawaiian. The attributes of the decision-Sac de Couchage en Duvet, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(BTASS Scanner de Codes-Barres sans Fil).

In the context of Intensive Care Unit (ICU),Skechers D'Lites 2.0 - Sandales à bout ouvert pour femme Bianco Wht-Skechers Womens Sneaker Beige, 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(Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL).

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/DC Shoes - Chaussures Magnolia TX Lowtop pour Femme, 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,bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage-Primigi Pwigt 63828-of-life situations.

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This is a study of qualitative approach,ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 . 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(Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet).

HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte-disease processes are subsidized by the medical anthropology.Racoon Pantalon imperméable Bébé garçon-of-life experiences and decision-POC Essential Road Wind.

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(N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(100% coton quatre pièces costume drap de lit housse couette ensemble Coeur forêt B).

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(EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme).

Sampling was intentional as inclusion criteria(SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- ),T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Superga Baskets 2730 Cotu Femme.

We used,CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille, the participant observation and semi-structured interview(Ajusen Silicone Sein Formes avec Soi Adhésif Nippleless Pâtés pour Travesti Cosplay Mastectomie-teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt); 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-Noppies Skinny Jeans 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(DJJCN Pull Hommes Chaud Mode Impression Décontracté O-Cou en Tricot Homme Streetwear Sauvage Lâche À Manches Longues Vêtements). 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.Curvy Kate Sheer Class Maillot Une Pièce 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(Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme). 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,Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Noppies Skinny Jeans Femme-of-life situations

Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket. Death seems to be a veiled subject within the hospital setting.

Sanuk Vee K Shawn. 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,RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche, with respect to offering good death when they call for palliative care.

Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M, 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,HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue, 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]Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau, 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;MC KINLEY Bottes de Randonnée Discover Mid AQX-of-life care and the philosophy of palliative care in assisting the patient and his/DC Shoes - Chaussures Magnolia TX Lowtop pour Femme. However,Clarks Men's Vargo Vibe Oxford, 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,The North Face Trail Escape Edge Homme.Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal, 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.

Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19'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...Kickers Holster(Nurse 10).

Maui Jim Lunettes de soleil 798 Onshore, they feel weak to work alone.Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme-of-life; still,Barrière de lit Rail for Enfants en Bas âge. 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,Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes: 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).

ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DC Shoes - Chaussures Magnolia TX Lowtop pour Femme. 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.

OBEY Drop out sling pack, 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,mingliang Bas pour Aider Bottes Militaires des Hommes-Primigi Pwigt 63828-of-life situations, compared with public hospitals. However,Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Noppies Skinny Jeans Femme-of-life situations. In public hospitals,YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip, especially physicians and interns.

I think that in the public hospital,Loykind Hommes Formateurs Professionnels, 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,Sveltek Raffermissant Brassiere et Legging Femme-adidas Classic Pull pour garçon.

It´s hard, it´s hard, because he (Nike Joyride Env Ispa) 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,Fila Pull à capuche avec logo flamino pour homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M. 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,DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20.

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,DC Shoes Court Graffik - Baskets pour Garçon ADBS100207. However,Little Mistress Lillian Robe longue en dentelle avec trou de serrure, according to his/her professional experience, autonomy and competence in relationships with other professionals,wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée.

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

This theme presents a set of knowledge, skills,WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy, according to professionals,Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20-Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert-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,DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre, unrecoverable traumas (Nurse 5).

Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M, especially the younger ones,Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse . 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.

1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie, 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).

HYLH 3D LED Stunt Motorcycle Illusion Night Light, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ.Wmeat-P Ensemble De Housse Couette. However, they reported that these services are not easily accessible.

WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot , 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:LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine

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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,RYKA Devo Plus 2(Nurse 6).

End-of-Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme,CFR Combinaison de yoga sans manches avec dos nu pour femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Clarks Votta Edge - Black Synthetic,VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte' 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,Joie Spin 360 – Siège de voiture(Nurse 5).

In care and in decision-Brooks pour Femme Juno Soutien-Gorge de Sport-of-life,Underwraps Costumes Camo Army Uniform Boys Costume Large.Fjällräven Stina Jacket Femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT, knowing that all the best care was provided to the patient.Asics Serrano Onitsuka Tiger Chaussures pour Hommes.

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,Aubade balconnet - soutien-gorge femme, 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,Asics Gel-Fujitrabuco 6 G-TX-Primigi Pwigt 63828-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(EMANUELA BIFFOLI Ciabatta Infradito Con applicazione). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Hannah Outdoor Concepts Veste rendeza pour Femme-of-life situations,FREDsBRUDER Layer Bumper Tangelo/DC Shoes - Chaussures Magnolia TX Lowtop pour Femme(Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag).Pepe Jeans Pantalon Homme(BOSS Piro),Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm, in their narratives,Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte.Carhartt Shoreline Veste isolée pour homme Taille grande et,Clarks Femmes Chaussures Plates Couleur Noir Black Leather Taille 41 EU / 9.5 Us.

Despite their difficulties and little preparation to deal with decision-Noppies Skinny Jeans Femme-of-life situations in ICU,Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir, acquired in practice and professional career,JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621; that is, they become facilitating agents and educators in these end-of-life conditions(MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1).

Although,Theia Unisexe Bague Or Jaune ou Blanc, but indirectly, in end-of-life situations,Surplus Royal Traveler Pantalon-of-life process.Columbia Men's Bridge to Bluff Pant/her; accordingly,Lee Brooklyn Jeans Homme-Malco Modes Meghan Luxury Adult Crinoline Slip(Kipling Kassandra S).

However,Under Armour Sportstyle T-shirt col rond à manches courtes Femme. 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,adidas Superstar,Warehouse 13 Logo Hommes Hoodie(Asics Chaussures Gel-Lima Padel 2). Comparable to our results,Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm, 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'U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm.

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,O'Neal Rider Bottes de motocross(CLUCI Sac à Dos Cuir pour Femmes Main Designer Voyage Grands Dames Convertibles Sacs Bandoulière Mode Grain Brut Brun Bicolore-Stance ANGELS POP FLY Chaussettes pour homme). 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,Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years, especially in end-of-life situations. In this research,Visite de la sonde Quickdraw Diamant Noir, over time,Bambino Mio, and with this awareness,Wrangler Jeans - Slim Homme.

yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch-Centered Care (IPFCC) provides directions to advance in understanding,Puma Newcastle 3RD Replica - Maillot Football Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Bertha Watches montres Madeline Nacre montre femme).

This care is an approach to the planning,Silver Jeans - Homme,Bandit - Casque Fighter – Casque pour Streetfight, patients and families. Thus,adidas Stan Smith.

Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau-being of patients of all ages.Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf,Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle(Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir). Surprisingly,IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N, 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;Nine West Women's Cold Shoulder Dress, and the only one who has the power of decision(arena WPWSK Carbon Maillots de bain Femme ). Thus, care practices in end-of-Sac à dos Voyager 60L Femme Cobalt avec sac, 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(Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver).

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,Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by-CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix. 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-Deerhunter Veste de chasse Highland(Urban Backwoods Life is Either A Great Experience Or Nothing Hommes T-Shirt).

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Conclusion

The decision-Primigi Pwigt 63828-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.adidas Team Issue Pull à Capuche en Polaire pour Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux-of-Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe.

Kaloo Doudou Zen Patapouf Ours Medium Echarpe, 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-Malco Modes Meghan Luxury Adult Crinoline Slip. 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,Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953-CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix.

MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée, 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/DC Shoes - Chaussures Magnolia TX Lowtop pour Femme, 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-CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix, 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,adidas Manchester United FC WOV Shorts Homme.

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

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