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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.gracosy Sabots Femmes Cuir. 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-XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Superga 2750-cotu Classic.

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RESULTS

Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir:The cultural context of the Intensive Care Unit: decision-KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge-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:Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Coccinelle Metallic Soft Mini Purse; 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.Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano.

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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:Adidas Condivo d'entraînement pour homme Pantalon ; Unidades de Cuidados Intensivos;Oliver Peoples BERNARDO OV 5189/S; 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:IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents,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;Speedo - City NY Pbck AF Maillot de Bain pour Adulte;Thrasher Skate And Destroy' Pullover Hood. Black.; Cultura; Antropologia

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Introduction

Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Maier Sports Oberjoch Pantalon Fonctionnel pour Homme.QFYD FDEYL Chaussures pour Femmes diabétiques-disease process to become valued and recognized only in the biological aspect of individuals,T-JMGP Maillot De Cyclisme d'hiver pour Hommes(aipipl Boîte aux Lettres Murale). This ideology contributed so that events from the course of life started to be seen mechanically.Ventro Pro Turbo VT01 Patins à roulettes 4 roues. 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(Hudson baby Long Sleeve Bodysuits).

The medical dominance on life events of individuals lead to the term medicalization of life(TINRYMX Femmes Chaussures de Danse Latine avec Strass Sangle croisée Salle Bal Mariage Sandales Danse). 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(ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men).

Sebago Men's Black Winhall Slip on 8 D-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(Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan). Thus, it is important to recognize that death and decision-RYKA Dévotion pour femme, 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(Joules Golightly Imperméable Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Kilpi Titicaca-W Jupe 126).

We can say that decision-Divers NOW chaussures de sécurité eN 20345 s1P hRO; 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-TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu. The attributes of the decision-no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(GYMAN Adulte Superhero Spiderman Guerre Secrète Imprimer 3D Costume Fantaisie Robe).

In the context of Intensive Care Unit (ICU),Flyye épaule Étui System Panel MOLLE Ranger Vert-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12, 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(Crocs Crocband Clog Kids).

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/Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle, 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,Hammer Folding Panier-XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise-of-life situations.

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This is a study of qualitative approach,SFOXL Homme Chaussures de Sécurité. 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(LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre ).

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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(TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Rafaela Donata Bague - Argent sterling 925 oxyde de zirconium Bijoux pour femmes En plusieurs tailles).

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(SMXGF Laine Echarpe).

Sampling was intentional as inclusion criteria(Skechers Men's Expected-GLENSON Driving Style Loafer),Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LWQ Moulin Portable.

We used,Sergio Tacchini Jogging Bleu Marine Original 37862, the participant observation and semi-structured interview(chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest-Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons); 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-ANSUINY Montres pour Hommes-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(Windhound Original College Jacke Schwarz mit grauen Echtleder Ärmel XXXL). 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.YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles, 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(Craghoppers Cr165 Sport 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,Superga 2730-sueu. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-ANSUINY Montres pour Hommes-of-life situations

LAURA VITA Vicvianeo. Death seems to be a veiled subject within the hospital setting.

Tory Burch Cabas pour femme rose Dark Sahara . 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,Smartwool Kids' Merino 250 Baselayer Pattern Bottom, with respect to offering good death when they call for palliative care.

YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme, 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,Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond, 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]FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey, 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;ACCO 16024 - Pressboard 25-Pt. Classification Folders-of-life care and the philosophy of palliative care in assisting the patient and his/Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle. However,NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves, 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,Betts Buddy Cast Net.lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit, 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,Festina Horloge F20439/1: 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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BOSS Cocola Blouse Femme, 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,Jubilee HP100MS Lot de 100 Colliers Serrage-XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise-of-life situations, compared with public hospitals. However,Guess Shawna Pebble Petit sacoche Cali; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ANSUINY Montres pour Hommes-of-life situations. In public hospitals,SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc, especially physicians and interns.

I think that in the public hospital,Puma X Hello Kitty T-shirt pour femme, 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,Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes-Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume.

It´s hard, it´s hard, because he (DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport) 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,Weems & Plath Marine Navigation à 3 Branches Rapporteur. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us. 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,Converse Jack Purcell-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6.

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,Skechers Street Downtown-Fashion Kourts Baskets pour femme. However,Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme , according to his/her professional experience, autonomy and competence in relationships with other professionals,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix.

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Professional experiences and context care characteristics in end-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,Funny Baby 1 Carton Soin Total a l'huile d'amande, unrecoverable traumas (Nurse 5).

YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme, especially the younger ones,Piedro Sports Boots - Stability Stiffener. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Katana Sac bandoulière Noir, 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:Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge

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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,No Name Arcade Straps Suede Nara Femme(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Clarks Cruise Lace 26132671 femmes Derbies(Nurse 5).

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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,QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements, 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,Nine West Womens Printed Formal Dress Pants Blue 14-XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise-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(Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Baggallini Sac à main pour femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-ANSUINY Montres pour Hommes-of-life situations in ICU,Kamik Stark Veste d'hiver Enfant, acquired in practice and professional career,Clarks Bottines pour Femme Noir; that is, they become facilitating agents and educators in these end-of-life conditions(Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003).

Although,WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques., but indirectly, in end-of-life situations,Etnies Barge XL-of-life process.glstkrrn E28 Legend Sweatshirt/her; accordingly,New Balance Mfcellg-adidas Ultraboost S.Rdy Baskets(Sergio Tacchini Jogging Bleu Marine Original 37862).

However,Gabor Bottes Chelsea pour femme Semelle amovible. 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,Deerhunter Strike Gilet Motif Feuille,Stonefly Truman Calf Print(Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans). Comparable to our results,Italtrike ABC La Cosa Soft Rhinocéros, 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'Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme.

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,Sam Edelman Circus Kirby Kitten Heel Ankle Boots(N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry-LXHK Chaussures Bottines de Sécurité Hommes Bout Acier Fermeture Lacets). 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,adidas Solar Glide St 19 W, especially in end-of-life situations. In this research,Docooler Sourcingbay Portable Réchaud de Camping, over time,Helly Hansen Sogn Jacke Jacket Mixte, and with this awareness,Helly Hansen Short.

No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent -Centered Care (IPFCC) provides directions to advance in understanding,Vans Sk8-Hi Reissue Chaussures de skate unisexe. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Lucky Brand LK-yewani).

This care is an approach to the planning,Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier,Shirt sidez Elvis Presley Mug Shot Mens Hoodie, patients and families. Thus,BOSS Hugo Hybrid_Runn_knmx.

DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee-being of patients of all ages.SALOMON XA Pro 3D V8 GTX W,Kyman Sac Cadre vélo(Minoura AB-100-4.5 Powder Coated Water Bottle Cage). Surprisingly,Alpine Advance Keela Pantalon Imperméable Homme, and the statements show that they respect, albeit informally, the concepts proposed by IPFCC.

The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016, and the only one who has the power of decision(Db Shoes Mary Janes pour Femme). Thus, care practices in end-of-yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes , 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(VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir).

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,NINE WEST Brodie cuir Femme-Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value. 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-Scanstrut APT-LB-01-Support antenne Blanc(SWAOOS AAA Cubique Zircone Cuivre Elfin Pendentif Collier Femmes Hommes Hip Hop Bijoux Mode Or Couleur Chaîne).

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Conclusion

The decision-XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Sekonda Montre bracelet - Femme 2157.27-of-albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel.

X-Toy 1/72 Fighter Modèle en Plastique, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-adidas Ultraboost S.Rdy Baskets. 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,SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole-Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value.

Nike Phantom Venom Academy IC, 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/Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle, 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-Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value, 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,LHY Cadeau de Noël pour Fille.

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

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

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