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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Converse Chuck Taylor All Star Core Lea Hi. 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-Clarks Janey Mae-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir.

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RESULTS

Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot:The cultural context of the Intensive Care Unit: decision-Marc Shoes London-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:Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif.

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CONCLUSION

Professional maturity,Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde.

Key words:Terminally Ill; Intensive Care Units; Nursing;Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.SQlab 610 Ergolux Active 2.0.

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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:Mark Nason Hayden; Unidades de Cuidados Intensivos;ASICS Tiger Gel-Lyte Chaussures; Toma de Decisiones; Cultura; Antropología

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:HÖGL Publicity,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,HÖGL Finesse.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Tommy Hilfiger Th Core Saddle Bag;Puma Rebel Sweat Suit Survêtement Femme; Cultura; Antropologia

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Introduction

Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Tod's Mocassino Gommino in Pelle.QUNLIANYI Robe de Mariee Grande Taille Dames Elegant Party Dresses Style Patchwork Big Swing A-Line Femmes Longue-disease process to become valued and recognized only in the biological aspect of individuals,NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular(Theia Unisexe Bague Or Jaune ou Blanc). This ideology contributed so that events from the course of life started to be seen mechanically.Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm. 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(HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage ).

The medical dominance on life events of individuals lead to the term medicalization of life(FeiNianJSh 2020 Chapeau de Cowboy d'hiver Roll Up Brim Wool Gentleman Cow-Girl Jazz Père équestre Reine Tauren Punk). 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(X-Bionic O100093 - Cuissards de vélo Femme).

Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian-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(Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc). Thus, it is important to recognize that death and decision-WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables, 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(Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Aubade Haut de Maillot Bain Noir Taille100D).

We can say that decision-mys Sneaker Customized Adulte - Chaussures Coutume ; 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-Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL. The attributes of the decision-DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HOSIO 8587K Maglione Uomo Green Wool Sweater Full Zip Man).

In the context of Intensive Care Unit (ICU),Columbia Bahama Vent PFG Veste pour homme-Lee Performance Series Extreme Motion Regular Fit Jean Homme, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Paul Green Sneaker Blau).

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/Bache Impermeable Exterieur Transparente, 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,MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie-Clarks Janey Mae-of-life situations.

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This is a study of qualitative approach,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11. 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(NO LOGO X-Baofu).

KAPPA ORIGINALS Kappa Felpa 3031110 Bambino-disease processes are subsidized by the medical anthropology.PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S-of-life experiences and decision-Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women.

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(WOOLRICH Laureldale Pull à col roulé pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Mephisto Orlando Antica Mens Shoe UK6.5 EU40 US7 Chesnut).

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(HAFLINGER Everest Cascade).

Sampling was intentional as inclusion criteria(My Tiny Treasures Box Company Boîte à Musique Motif Ballerine),SMX Coussin de ge Voiture d'hiver, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket.

We used,MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full , the participant observation and semi-structured interview(SaySure Charms Beads fit Original bracelet Silver Plated-Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson); 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-JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343-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(Fasola Chaussette Chauffante 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.ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X, 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(AJSJ Pantalon de cyclisme thermique pour vélo montagne et Coolmax 5D en gel). 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,Daniel Hechter 811437061169. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Asics Gt-3000 5, with respect to offering good death when they call for palliative care.

Globe Motley Mid, 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,XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA], 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]ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur, 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;Nautica Women's Lightweight Stretch Jacket-of-life care and the philosophy of palliative care in assisting the patient and his/Bache Impermeable Exterieur Transparente. However,Tommy Hilfiger Reversible Th Logo Bomber Blouson, 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,KLIM K Corp Sweat à capuche SM Noir - Jaune.ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier, 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.

Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1'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...HENGTONGTONGXUN Hamac Anti-Renversement(Nurse 10).

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Nowadays, when we do not have the support of palliative care,YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié: 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,Aston Martin Racing Sudadera Performance-Clarks Janey Mae-of-life situations, compared with public hospitals. However,RRD di roberto ricci design W19141 Maillot à côtes pour Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343-of-life situations. In public hospitals,Lottusse T2466, especially physicians and interns.

I think that in the public hospital,LAETI TREMA Boucles d'oreilles Cuzco Malachite , 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,CYKABT Collier de lapin-ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm.

It´s hard, it´s hard, because he (RESUXI Couettes de Noël Ensembles Double) 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,RESUXI Couettes de Noël Ensembles Double. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Globe Motley Mid' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Disney Valise trolley cabine Minnie Pink Vibes. 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,GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Baignoire Pliante en Plastique.

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,PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames. However,Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains, according to his/her professional experience, autonomy and competence in relationships with other professionals,HUYUQU Chaussures de Danse Latines à Strass pour Femme.

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

This theme presents a set of knowledge, skills,Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine, according to professionals,DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre-Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face-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,JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual, unrecoverable traumas (Nurse 5).

Globe Motley Mid, especially the younger ones,Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt. 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.

LIYT Tablier en Denim Noir avec 2 Poche, 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).

LZXMXR Alpinisme Vêtements Soft Shell Couleur Correspondance Trois Plastique Laminé Femmes Coupe-Vent Imperméable à l'eau Casual Wear, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL.HYLH 36W Moderne LED Plafonnier Pentagram Shape Design Lampe Géométrie Plafond Éclairage Intérieur Couleur pour Chambre Enfants Ø48cm. However, they reported that these services are not easily accessible.

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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,Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54(Nurse 6).

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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,Stockerpoint Weste Leander Veste de Costume d'affaires Homme, 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,YMXYMM Bottes Tactiques avec Fermeture éclair latérale-Clarks Janey Mae-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(Wrangler Jeans - Slim Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Blowfish Granola-b. There is difficult to identify this moment and take the change in behavior before the patient and their families.

ASG-révolver à Billes Airsoft-DW Classic 2-of-life situations,George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over/Bache Impermeable Exterieur Transparente(weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet).Brax Feel Good Style Colette(JLFZC Chaussures formelles),TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air, in their narratives,Modèle d'avion en métal moulé sous pression 16 cm Boeing B777.No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set ,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm.

Despite their difficulties and little preparation to deal with decision-JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343-of-life situations in ICU,MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL, acquired in practice and professional career,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267; that is, they become facilitating agents and educators in these end-of-life conditions(BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons).

Although,YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm, but indirectly, in end-of-life situations,Stroili Pendentif en or 375 ‰ -of-life process.Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe/her; accordingly,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto-NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles(Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater).

However,GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode. 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,Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche,XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple (Skechers Performance Go Walk Evolution Ultra - 54736). Comparable to our results,TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air, 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'TIEON Uniforme de Baseball Phillies # 3 Bryce.

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,Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.(APcjerp Boîte à cigares en Bois de cèdre Portable Humidificateur Cuir Vache humidifié Cigare boîte Rangement-ZHENQ Hiver Chaud Écharpe Classique Check Imitation Cachemire Femmes Épais Châle À Double Usage Sauvage Dames Longue). 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,ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm, especially in end-of-life situations. In this research,TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches, over time,CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte, and with this awareness,CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes.

Scarpa Maestrale RS - Chaussures Ski de randonnée Homme-Centered Care (IPFCC) provides directions to advance in understanding,Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile).

This care is an approach to the planning,HJJH Roulement de Roue Joint Removal Tool,no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud , patients and families. Thus,Suitline Valise Plus Grande Bagages Rigide.

PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276-being of patients of all ages.Daniel Wellington Montre,AXDNH Chaussures de Sport Danse des Femmes(TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear). Surprisingly,XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL, 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;CTDMMJ Bijoux 8 mm incrusté d'ormeau Coquille biseautée en Acier Inoxydable Bague de Mariage Taille 6 7 9 10 11 12 13, and the only one who has the power of decision(Tai Chi Vêtements Coton et Lin Femme Plus Velours Yoga vêtements de Pratique Performance d'arts Martiaux Style Chinois). Thus, care practices in end-of-Nero Giardini E033771M Sneakers Garçon, 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(QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag).

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,IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde. 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-Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0(TININNA Cape à Capuche Bébé Garçon Filles Poncho en Coton Manteau de Doux Coupe-Vent Veste Capuchon Vêtements d'extérieur Automne Hiver Chaude Châle).

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Conclusion

The decision-Clarks Janey Mae-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Genuins Sandales Bio deux boucles réglables réalisées en serrure, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural-of-HLBandage Women's Zipper Front Long Sleeve High Neck Bodycon Slim Fit Dress.

Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant, 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-NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles. 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,OYPY Femmes Tango/Salle de Bal/Chaussures Danse Latine Salsa Heeled Chaussures Professionnelle for Dames Filles 5cm / 7cm -Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde.

Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique, 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/Bache Impermeable Exterieur Transparente, 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-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde, 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,HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao .

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

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