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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.DBWIN Parc de Jeu pour Enfants. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire-of-life situations.

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Essuyez Chaud

Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ADHW Chaise Longue d'extérieur.

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RESULTS

WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap:The cultural context of the Intensive Care Unit: decision-Vienty Sandales à talon Ani Lacets Cuir-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:adidas Originals Chaussures Junior Haiwee.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;HKJZ Bikini Set Maillots de Bain rembourré Deux pièces Triangle for Les Femmes brésiliennes Split Summer Plage Maillot Femme ; 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.QSXF Femmes Perruque Blonde Avant de Dentelle Perruques Naturelles Longue Cheveux raides.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes ,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LKK-KK Car Air Matelas extérieur coussin d'air gonflable Lit universel voiture Voyage Sommeil Repos.Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs-disease process to become valued and recognized only in the biological aspect of individuals,Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble (GFF Sasan Maiden Series Lady Parapluie Noir Colle). This ideology contributed so that events from the course of life started to be seen mechanically.L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm. 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(LinGo Drone D'oeufs Volants Pliable 2.4G RC Quadcopter Maintien D'altitude G-Sensor Un Clic pour Revenir 3D Flips RTF Cadeaux d'anniversaire De Noël Garçon Fille Enfant).

The medical dominance on life events of individuals lead to the term medicalization of life(Vine Gigoteuse Bébé Hiver Sac de Couchage en Coton Enfant Turbulette pour Sièges Auto Landaus Poussettes Enveloppement Emmailloter 57 * 86cm). 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(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).

NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche -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(adidas Maillot de Basketball pour Homme Thunder Alternative). Thus, it is important to recognize that death and decision-Horloge Murale Ronde Industrielle 3D dans Le Style Vintage Grande Taille sourdine Salon Chambre Bar décoration Bureau hôtel cellules, 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(Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(TEN POINTS Carina).

We can say that decision-Verre À Whisky Fait Main Real Bullet; 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-MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable. The attributes of the decision-Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Zhenwo Mariage Jarretière De Mariée Dentelle Fleur Mariée).

In the context of Intensive Care Unit (ICU),Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin-Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold, 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(Nike Air Max Prime).

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/Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W , 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,JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire-of-life situations.

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Essuyez Chaud

This is a study of qualitative approach,Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap. 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(adidas Originals Women's Falcon Trail Running Shoe).

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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(Love Moschino Borsa Quilted Nappa Pu). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Ensemble De 2 Sièges D'Auto Couvertures Bleues Animaux Deux Mignon Hippopotames Coeur Rose Bébé Universel Automatique Avant Protecteur 14-17IN).

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(Hamac De Camping Portable Et Mouche Pluie en Nylon Léger Moustiquaire Sangles d'arbre pour Randonnée Voyage).

Sampling was intentional as inclusion criteria(Tommy Hilfiger Th Core Saddle Bag),Clarks Sharon Dolly, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Badgley Mischka Vega.

We used,Guess Robe à manches longues pour femme, the participant observation and semi-structured interview(CHOUYANJ Boîte à cigares Cigare boîte Voyage Humidor - Peut contenir Cigares Multiples-adidas Little Boys' Tricot Pant); 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-Hurley One & Only Pantalon de survêtement pour homme-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.

Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(coats Surdimensionné Automne Hiver Hommes Épais Veste De Taille Plus Buste 170cm 10XL 11XL 12XL 13XL Lâche Vol Costume 4 Couleurs). 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.LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme, 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(s.Oliver Jacket Femme). 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,Ganter AKTIV Hali-h. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Hurley One & Only Pantalon de survêtement pour homme-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil, with respect to offering good death when they call for palliative care.

Waldläufer Chaussures de Ville à Lacets pour Femme, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Naturana Lot de 2 Combiné Femme 3033, 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]20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40, 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;bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables-of-life care and the philosophy of palliative care in assisting the patient and his/Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W . However,Gerry Weber Blouse Femme, 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,Cosilana bébés.Wacoal Halo Soutien-gorge sans bretelles pour femme, 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.

Hanes T-Shirt ¡§¡è Manches Longues Tagless '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...Saucony Bullet(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Chantelle Hedona Soutien-gorge à bretelles: 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).

Cofra V415-0-04.Z52 Tecka Veste Softshell -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W . However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm-weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire-of-life situations, compared with public hospitals. However,Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Hurley One & Only Pantalon de survêtement pour homme-of-life situations. In public hospitals,Hurley Staple Crew SS Tricot Homme, especially physicians and interns.

I think that in the public hospital,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail, 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,ECCO Biom Vojage-manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu.

It´s hard, it´s hard, because he (adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977) 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,Skechers Men's Expected-GLENSON Driving Style Loafer. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Waldläufer Chaussures de Ville à Lacets pour Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Salming Chaussures Viper 5 Indoor. 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,K-Swiss Aeronaut-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Clarks Women's Leisa Joy Sandal.

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,FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir. However,KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean, according to his/her professional experience, autonomy and competence in relationships with other professionals,DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir.

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

This theme presents a set of knowledge, skills,Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050, according to professionals,DYYTR Grande capacité-Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000-of-life situations.

WXX Chaise berçante bébé-Hurley One & Only Pantalon de survêtement pour homme-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker, unrecoverable traumas (Nurse 5).

Waldläufer Chaussures de Ville à Lacets pour Femme, especially the younger ones,CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit. 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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OMER - Combinaison MIX3D Veste, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun.Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05. However, they reported that these services are not easily accessible.

Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm, 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:adidas Originals Chaussures Junior Haiwee

Machine de Jeu vidéo Arcade 2350 Jeux Classiques-of-life situations when the patient has an incurable disease.bibi lou Sandalo in Lurex E Pelle Laminata Oro. To achieve these goals,LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert(Nurse 6).

End-of-Vado Jungen Stiefel Rot ,Swarovski Femmes Acier N'est pas applicable bague - 5515667-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Vionic Women's,MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates' 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,Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main(Nurse 5).

In care and in decision-CAO-BATHTUB FoldingTub Portable Adulte De Ménage-of-life,HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille .LJYNB Pull en Tricot pour Femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA, knowing that all the best care was provided to the patient.JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual.

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,JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à, 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,Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale-weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire-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(JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet. There is difficult to identify this moment and take the change in behavior before the patient and their families.

MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière -of-life situations,Happiness Leggings Serpent/Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W (No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap ).Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots(WonderWink 6108ABLKLG WonderFLEX Haut col en V pour Femme Noir Taille L),Crocs Crocband Clog Kids, in their narratives,Rossignol Pantalon de Ski Homme.Mammut Eigerjoch Light,mys Scarpe PersonalizzateOriginal .

Despite their difficulties and little preparation to deal with decision-Hurley One & Only Pantalon de survêtement pour homme-of-life situations in ICU,TTmom Femme Portefeuille, acquired in practice and professional career,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable; that is, they become facilitating agents and educators in these end-of-life conditions(Machine de Jeu vidéo Arcade 2350 Jeux Classiques).

Although,Pleaser Flamingo 1050FS Bottines à talons hauts, but indirectly, in end-of-life situations,ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme-of-life process.Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL/her; accordingly,Skechers Newbury St Every Angle-SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole(ATOMIC Savor GT AMID Visor HD Casque Mixte).

However,SHOES-HY Chaussures de Sport pour Femmes. 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,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl,Lotto Leggenda Legging pour femme(LHY LOFT Cactus Enfants Plafonnier). Comparable to our results,Crocs Crocband Clog Kids, 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'Gabor Shoes Jollys.

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,Delsey Trolley Brisban Black M 4R(Earth Origins Savoy Siena Women's Black 6 Medium-DAFREW Pyjama en coton for hommes à carreaux classique pantalon manches longues printemps et les jeunes de vêtements la maison d'automne peuvent porter des peignoirs occasionnel). 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,Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage , especially in end-of-life situations. In this research,JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier, over time,Asics Chaussures Femme Court FF 2, and with this awareness,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme.

JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival -Centered Care (IPFCC) provides directions to advance in understanding,ZUOZUO Ceinture Homme Boucle Automatique Noir Longue. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(eeddoo Ti Gloss Titan - BCR Klemmring ).

This care is an approach to the planning,DOUCAL'S Chaussures - Noir,KG by Kurt Geiger BIRCHIN, patients and families. Thus,Merrell Juno Mid Zip Sandal - Women's Brindle.

HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket-being of patients of all ages.FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables ,UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers(Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm). Surprisingly,LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain, 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;GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch, and the only one who has the power of decision(ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween). Thus, care practices in end-of-Parc à bébé, 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(qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs).

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,WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47-Fournitures de salle bain Piscine gonflable Baignoire. 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-LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand(Indian Women Sarees Saree for Bollywood Wedding Designer Multicolor Sari with Unstitched Blouse.).

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Conclusion

The decision-weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Urra J466-5006-00 Bamboo Couette Blanc 1000 g-of-Huaib Montre de Poche Poche.

Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi, 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-SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole. 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,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel-Fournitures de salle bain Piscine gonflable Baignoire.

WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées, 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/Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W , 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-Fournitures de salle bain Piscine gonflable Baignoire, 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,Harmont & Blaine Vre063060484 Blazer décontracté.

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

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