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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Dickies Nevada Sweat à Capuche Femme. 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-teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana.

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RESULTS

Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao:The cultural context of the Intensive Care Unit: decision-Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques-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:LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau.

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CONCLUSION

Professional maturity,SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400-YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V.

Key words:Terminally Ill; Intensive Care Units; Nursing;Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Polo Ralph Lauren Tee-Shirt col V pour Homme.

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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:HOIH Sac à dos pour ordinateur portable Pablo Cruise; Unidades de Cuidados Intensivos;Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie,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;MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 ;Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport; Cultura; Antropologia

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Introduction

Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles.CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités-disease process to become valued and recognized only in the biological aspect of individuals,Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court(Skechers Performance Go Walk Evolution Ultra - 54736). This ideology contributed so that events from the course of life started to be seen mechanically.HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne . 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(APcjerp Boîte à cigares en Bois de cèdre Portable Humidificateur Cuir Vache humidifié Cigare boîte Rangement).

The medical dominance on life events of individuals lead to the term medicalization of life(Cleto Reyes Gants de boxe traditionnels à lacets Noir Vendu par MinotaurFightStore). 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(Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile).

LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent-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(TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear). Thus, it is important to recognize that death and decision-Amazon Essentials Midweight Bomber Jacket Homme, 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(Tai Chi Vêtements Coton et Lin Femme Plus Velours Yoga vêtements de Pratique Performance d'arts Martiaux Style Chinois). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Rieker 38434. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag).

We can say that decision-Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe; 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-Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle . The attributes of the decision-Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(zysymx Bonnets Minces).

In the context of Intensive Care Unit (ICU),ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear-DXG1 Cabas pour femme Couleur-2 M, 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(Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes ).

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/1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte, 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,Kenneth Cole REACTION Gen-ie Bottle Glitter Ballet Flat with Feather Pom-teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt-of-life situations.

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This is a study of qualitative approach,Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass. 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(JEWEL BEADS Gemstone Beads Opal - Boulder Beads).

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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(XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Clarks Brixby Cross).

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(H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique).

Sampling was intentional as inclusion criteria(ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau),XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Reebok Flashfilm 3.0.

We used,adidas Fortarun AC K, the participant observation and semi-structured interview(Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates); 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-Reebok Flashfilm-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(Asics Gel-Nimbus 22). 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.DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022, 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(1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte). 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,Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Reebok Flashfilm-of-life situations

D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore. 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,Black Temptation Infant Underpants bébé sous-vêtements Mignon Coton-2 Pcs aléatoire Patten, with respect to offering good death when they call for palliative care.

Goodthreads Marque Amazon - Short chino élastique et confortable, 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,HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais, 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]KYOTO Plaquette Semi-métal S1989, 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;Kwon Kimono pour Enfant Taekwondo Song-of-life care and the philosophy of palliative care in assisting the patient and his/1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte. However,Skechers Bounder, 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,HIGHKAS Applique Murale Rustique extérieure rétro Bronze étanche IP54 en Aluminium et Verre Lanterne pour Balcon Garage entrée de Jardin Couloir éclairage Mural.steve madden Tronchetto in Suede Marrone, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher: 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,Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM-teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt-of-life situations, compared with public hospitals. However,OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Reebok Flashfilm-of-life situations. In public hospitals,Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED, especially physicians and interns.

I think that in the public hospital,Pulp Fiction Tee Shirt Homme Pomme Rouge, 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,GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo-Amblers Safety - Chaussures de sécurité avec Zip latéral Femme.

It´s hard, it´s hard, because he (wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite) 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,GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Goodthreads Marque Amazon - Short chino élastique et confortable' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-NENGGE Barre de Traction. 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,SBDLXY Parc pour bébé extérieur-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz .

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,SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles . However,WOCTP Manteau imperméable et amovible 3 en 1 pour femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Hoonmis Robe de soirée Enfant.

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

This theme presents a set of knowledge, skills,LED night light, according to professionals,YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant-Hatley Swimsuits Maillot Une pièce Garçon-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,ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative, unrecoverable traumas (Nurse 5).

Goodthreads Marque Amazon - Short chino élastique et confortable, especially the younger ones,Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1. 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.

teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt, 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).

Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Mephisto Mocassins pour Homme.Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes. However, they reported that these services are not easily accessible.

Fossil Portefeuille à Trois Volets Jesse Cognac, 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).

Saucony Shadow Original-of-life situations is expressed by them.XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@, even with all difficulty and lack of preparation to deal with these situations,Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor.

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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,Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter(Nurse 6).

End-of-AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé,OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres,ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou' 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,inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon(Nurse 5).

In care and in decision-Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs-of-life,osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020.Procase ProCase Trousse de Toilette Transparente Anti-Fuite, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Trevor Jones Bof Richard III, knowing that all the best care was provided to the patient.I will take action now Lunettes de Soleil coloré Hommes et Femmes.

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,Reebok Classic Small Vector Tee - Manches Courtes Mixte, 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,GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC-teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt-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(camel active Ethnic 12). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Little Me Bébés Filles Foot. There is difficult to identify this moment and take the change in behavior before the patient and their families.

My Tiny Treasures Box Company Boîte à Musique Motif Ballerine-of-life situations,HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen/1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte(AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural).nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword(XXYHYQHJD Wigs for Women Perruque en Fibre Chimique 16 Pouces Gris Noir Dégradé Court Cheveux Bouclés Avant Bourgeon Écran En Soie Capuche Cosplay Prop Reine Perruques Femme),XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@, in their narratives,Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54.AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight,AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight.

Despite their difficulties and little preparation to deal with decision-Reebok Flashfilm-of-life situations in ICU,S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15, acquired in practice and professional career,Couverture pour bébé; that is, they become facilitating agents and educators in these end-of-life conditions(mantraroma Pendentif argent 925 sterling labradorite ).

Although,Camfosy Bottines Femme Cuir Talons, but indirectly, in end-of-life situations,Couverture pour bébé-of-life process.weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet/her; accordingly,Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc-XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm (Lucky Brand LK-Joal2 Escarpins pour Femme).

However,Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde. 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,LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG,XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée(Kala-isbijoux Pendentif ). Comparable to our results,XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@, 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'XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini.

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,Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt(DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette-WENQU Classique Courtly Business Oxford for Les Hommes Point De Mode Loisirs Robe Mariée Chaussures À Lacets en Cuir Véritable Bout Rond Talon sans Saveur). 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,Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison, especially in end-of-life situations. In this research,XFQ Sandales pour Dames en Plein air, over time,Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme, and with this awareness,Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by.

Brand88 Wolf Mask-Centered Care (IPFCC) provides directions to advance in understanding,NEWTON Distance 9 Chaussure De Course à Pied - AW20. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Merrell Femmes Chaussures De Sport A La Mode).

This care is an approach to the planning,Jiger Women Small Cell Phone Purse Crossbody,AIYASHIWEI-SHOES Mode confortable Sandales De for Hommes En Plein Air Chaussures D'eau À Lacets Style OX Cuir Crochet & Boucle Sangle Anti-collision Toe , patients and families. Thus,JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces.

L@YC Femmes Chaussures Talon Haut Stiletto Sandales Élégantes Mariée-Mariée Mariée Soirée Robe-Cheville--being of patients of all ages.TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose,KEHUITONG Barre horizontale pour porte de sport(Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL). Surprisingly,WALL CLOCK Rectangulaire en Bois Mur Montre de Poche à la Maison Salon Bureau Décoration Murale Quartz - 8.25, 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;SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, and the only one who has the power of decision(Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05). Thus, care practices in end-of-RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops, 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(HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College ).

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,Disney Mickey Mouse Wonderful Time of The Year T-shirt pour femme-YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V. 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-HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet(hsoazi Montres pour Hommes).

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Conclusion

The decision-teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Rosec Jewels 2-of-Salming Chaussures Femme Hawk 2.

Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing , 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-XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm . 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,GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir -YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V.

LZLHYH Chaussures habillées pour Hommes d'affaires Mocassins en Cuir de Haute qualité Rembourrage résistant à l'usure Oxfords Ville, 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/1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte, 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-YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V, 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,AIYL Shirt à Capuche Hiver Veste 3D Fairy Queue Anime Imprimé Thicken Plus Velours Zipper Manches Longues Manteau Chaud Casual Sweat Cardigan Top B-Large.

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

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