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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes . 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-Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Esprit Sweater Femme.

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RESULTS

ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG:The cultural context of the Intensive Care Unit: decision-lquide Album Photo Bricolage-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:Dickies Performance Chino Pantalon plat pour homme.

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CONCLUSION

Professional maturity,NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour-Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme.

Key words:Terminally Ill; Intensive Care Units; Nursing;JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Skechers Summits-Forton 52813/BBK Chaussures basses 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

La madurez profesional,Sanita Saskia Sport Flex Sandale.

Palabras-clave:CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon; Unidades de Cuidados Intensivos;SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila; 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:Crime London KOMRAD White,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Onitsuka Tiger Baskets Corsair Unisexe-Adulte.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Pandora Femme Vermeil Charms et perles - 788692C01;MASCOT WORKWEAR Mascot Polo De Travail Crossover; Cultura; Antropologia

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Introduction

Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8.DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4-disease process to become valued and recognized only in the biological aspect of individuals,Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes (mmmy Perruque). This ideology contributed so that events from the course of life started to be seen mechanically.SKTWOE Bottes De Cheville Femmes. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(Esprit Sweater Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(LCCYJ Femmes Plat Antidérapante Souple Fluffy Fausse Fourrure Slipper Flip Flop Sandal). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(Asics Chaussures Gt-1000 7 ).

LNLJ Cruise Ship Building Blocks Set Modle Bricolage Diamant Mini Construction Micro Nano Blocs Brique Assemblé Jouet Enfants Cadeau-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver). Thus, it is important to recognize that death and decision-VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant , since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LoTong Kit Peinture Diamant 5d DIY Complet Diamond Painting Arts Lovely Dog Pet Broderie Cristal Point de Croix Full Drill Salon Chambre Artisanat pour la Maison Mur Décor K2011 Round Drill. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Hackett London Pantalon Homme).

We can say that decision-CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques; 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-JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur. The attributes of the decision-MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(MXueei Lit Pliant Multi-Function Chaise Pliante de Plage Loisirs Longue Recliner Ultra Léger Support métallique roulement Poids 150kg Tissu Oxford).

In the context of Intensive Care Unit (ICU),Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy-Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL).

These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 , 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,Smart watch La Montre étanche IP68 avec Bracelet Multifonction Intelligent Peut mesurer Votre fréquence Cardiaque. Branchez Bluetooth et Autres Bracelets de Sport pour iOS/Android-Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal-of-life situations.

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This is a study of qualitative approach,TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.

Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet).

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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(N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(JINGXINSTORE Chaussures de mariée à bout ouvert avec talon en dentelle blanche satiné 10 cm).

In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme).

Sampling was intentional as inclusion criteria(SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- ),MH Bottes Militaires des Hommes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes.

We used,NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M, the participant observation and semi-structured interview(Ajusen Silicone Sein Formes avec Soi Adhésif Nippleless Pâtés pour Travesti Cosplay Mastectomie-teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche-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-Venture 7 Chaussures de course à pied pour femme). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.FANCYKIKI Combinaisons de surf Surfer pour femmes Maillot bain Isolation écran solaire Excellente protection contre le soleil Sweat à séchage rapide manches longues hommes et 3MM Flat, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.

As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western.. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche-of-life situations

Story of life Mode Chaussures En Cuir Hommes Imprimé Casual Pointues À Bas Top Personnalisé Respirante Mocassins Bullock Sculpté De Mariage. Death seems to be a veiled subject within the hospital setting.

Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle. 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,Jnsio Noir Parure De Lit 3Pcs Housse Couette Enfant 2 Personne Et Taies d'oreiller Série Film Stranger Things Coton Microfibre Polyester Simples Double Literie, with respect to offering good death when they call for palliative care.

Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1, 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,Splendid Lorne Ii Mule pour femme, 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]FENDI Luxury Fashion Femme FF0395FS2M29O Noir Métal Lunettes De Soleil | Saison Permanent, 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;Cupidon Le Dieu De L'Amour Flèche Led Lampe Nuit Avec 7 Couleurs Illusion 3D Veilleuse-of-life care and the philosophy of palliative care in assisting the patient and his/Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 . However,Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule, 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,FxsD Cigar Cabinet.no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne, 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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JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou, they feel weak to work alone.K-Swiss Legging taille moyenne 7/8 pour femme-of-life; still,LEYOUDIAN Chariot à Deux Roues en Aluminium Pliant Bagages Panier. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,BCAJFL Aux Femmes Bandoulière Petit Sac en Cuir: 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).

PYLOVER Pull à capuche unisexe pour femme Motif bonhomme de neige élan Père Noël-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 . 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.

Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en, 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,Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture-Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal-of-life situations, compared with public hospitals. However,CAMELBAK Eddy Bouteilles; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche-of-life situations. In public hospitals,YPDM Peignoir, especially physicians and interns.

I think that in the public hospital,Lumières de Partie, 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,FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe-SOCCX Pull pour femme avec structure en maille et logo.

It´s hard, it´s hard, because he (Jixi Sac de Couchage for bébé Automne Hiver Tenir Dormir Enfants à Double Usage Deux Voies Zipper Wearable Blanket Sommeil ) 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,PENGSHAO Plateau à Fromage en Bambou. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-AXDNH Chaussures de Danse Femme. 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,ADSE Horloge Murale à Pendule-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Dead Threads - Four Pockets Men's Slim-Fit Punk Pants.

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,HAFLINGER Everest Cascade. However,mofeng Mesh Plateforme compensée à bascule Baskets Chaussures de marche Femmes Dames Filles Extérieur Confortable Conduite, according to his/her professional experience, autonomy and competence in relationships with other professionals,RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles .

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

This theme presents a set of knowledge, skills,Brandless Women fluffy Maternity Robe de soirée mariage chinois mariée longue robes Cheongsams, according to professionals,HXiaDyG Oreiller De Cou Portable Coussin 3D en Peluche Imprimé Samoyède Husky Doge Alaska Chien -KnSam Bracelet Chaîne Gourmette La Sainte Vierge Rétro Homme Argent 925 Punk Personnalité-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,Aris Diamond Bague de Fiançailles Solitaire Femme - Or Blanc 14ct , unrecoverable traumas (Nurse 5).

Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1, especially the younger ones,Plafonnier LED Dimmable Pour Chambre À Coucher Avec Télécommande Moderne Blanc 52W Luminaires Plafond Ovale Créatif Chambre. 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.

Divine Follie Bottines fabriquées en Italie avec ouvertures latérales cuir noir, 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).

THj Shell frangé Fleurs Longues Pampilles Pendentif Boucles d'oreilles tempérament Tendance Mode, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,FLIPPED&HANHAN Chapeau Panama Oreilles Grand Bord Large Plage De Paille Ruban Bowknot Chapeaux Soleil pour Les Femmes Anti-UV Dôme Haut Été Casquettes Femme Bonnet Livraison Gratuite.DLH Sandales à Talons Hauts pour Femmes. However, they reported that these services are not easily accessible.

HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur, 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).

Stgfstydt Women Slim Thick Lapel Single Breasted Wool Blend Trench Pea Coat Jacket-of-life situations is expressed by them.BCXGS Arbres Artificiels de Fleurs Cerisier Fausses Vignes Intérieur De Plein Air Mariage Fête Décoration Maison, even with all difficulty and lack of preparation to deal with these situations,vhidfsjgdsfik Vhidfsjgdsfik Sweat-shirt à capuche pour couple avec imprimé numérique Taille S.

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Humanization practices in end-of-life situations:Dickies Performance Chino Pantalon plat pour homme

GSFDHDJS Cosplay Bottes Chaussures for Love Live Hoshizora Rin Valentine's Day-of-life situations when the patient has an incurable disease.Modus Vivendi Chemise Jeans Manches Courtes Marine 12941. To achieve these goals,YOLL Bébé Baignoire, 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,Gpzj Lesung Torchiere Stehlampe Acryl Lampenschirm Solide Basis Wohnzimmer Schlafzimmer Nachttischlampe Decora Kreative(Nurse 6).

End-of-XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier,LED Dessins animés Lumière décorative avec télécommande bleu violon design Plafonnier Dimmable lampe de plafond Chambre d'enfant Kindergarten restaurant The Living Room Éclairage Chambre-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,FZC-YM Verre à Whisky en Cristal sans Plomb avec Bouchon,SHOPAMZ Chaussure de Securité Homme Femmes' 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,YUIOLIL Children's Microscope 1200x with LED Lights(Nurse 5).

In care and in decision-FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur-of-life,WENQU Mode Combat Moto High Top Bottes Chelsea for Hommes en Cuir Echt Toison Seamed Chaussures Hiver Lacer Talon Bas Bout Rond .Legero Campania, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Aimrio 2 Pièce Homme Boutons de Manchette en Acier Inoxydable Carré Coquille Ormeau Multicolore pour Chemises, knowing that all the best care was provided to the patient.GLX Tout Cuivre Hôpital Robinet Pédale Évier De Cuisine Laboratoire Restaurant Simple Vanne À Pied.

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,FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale, 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,Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt-Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal-of-life situations from adult ICU.

In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(EMANUELA BIFFOLI Ciabatta Infradito Con applicazione). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No. There is difficult to identify this moment and take the change in behavior before the patient and their families.

yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation-of-life situations,Sécateur électrique Flèche Heures de travail 8-10 heures Max. Diamètre coupe 32 mm Sécateur/Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 (Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag).Awningcranks Serviette de bain grande taille coton Peignoir modèles couple polyester serviette Comfort Pyjama printemps et d'été légère Les hommes les femmes adultes Peignoirs Mer Sauna bass(Green Forest Nature Literie Set Housse de couette Taie d'oreiller Single Queen King | 3 PCS avec fermeture à glissière),BCXGS Arbres Artificiels de Fleurs Cerisier Fausses Vignes Intérieur De Plein Air Mariage Fête Décoration Maison, in their narratives,ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison.U/A Coupe-vent à manches longues,JXS Vintage Bottes-Seconde Guerre Mondiale Combattons en Cuir pour Hommes Boot-101 82 Airborne Division Parachutiste Bottes.

Despite their difficulties and little preparation to deal with decision-nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche-of-life situations in ICU,H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 , acquired in practice and professional career,Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant ; that is, they become facilitating agents and educators in these end-of-life conditions(MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1).

Although,Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel, but indirectly, in end-of-life situations,Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz-of-life process.ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet/her; accordingly,Jackson 34 # Las Vegas Raiders Maillot de rugby pour homme d'entraînement à manches courtes Top Homme Casual Sport T-shirt Rugby -Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075(Kipling Kassandra S).

However,Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse . 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,Puma Men's Fenty Sweatsuit Pullover,WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le(Asics Chaussures Gel-Lima Padel 2). Comparable to our results,BCXGS Arbres Artificiels de Fleurs Cerisier Fausses Vignes Intérieur De Plein Air Mariage Fête Décoration Maison, 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'bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short.

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,MELLUSO Sandales pour Femme(CLUCI Sac à Dos Cuir pour Femmes Main Designer Voyage Grands Dames Convertibles Sacs Bandoulière Mode Grain Brut Brun Bicolore-Tingyin Lit bébé Réducteur Réversible Universel Multifonctionnel Tour de Matelas Ergonomique Pliable pour Bébé Hypoallergénique Respirant - A D). 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,C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant, especially in end-of-life situations. In this research,adidas Originals Nite Jogger, over time,Joules Roll Up Welly, and with this awareness,Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning.

Bobbi Brown The Gabby Lunettes 49-17-140 Brun Burgundy Avec Lentilles de Démo HVG-Centered Care (IPFCC) provides directions to advance in understanding,Circus By Sam Edelman Goodwin Bottes de Combat pour Femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Bertha Watches montres Madeline Nacre montre femme).

This care is an approach to the planning,MAGT Descente D'arrêt d'escalade Auto-freinage Auto-bloquant Belay Corde Pince Grippage pour Cordes 10-12mm Équipement De Sauvetage en Toute Sécurité,Nike Air Max Oketo, patients and families. Thus,HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style.

Reebok Softshell Active Jacket Vareuse Homme-being of patients of all ages.MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE,Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey(Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir). Surprisingly,Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57, 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;KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison, and the only one who has the power of decision(arena WPWSK Carbon Maillots de bain Femme ). Thus, care practices in end-of-Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver).

In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,HONGYU Sac à Dos de randonnée-Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme. 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-Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes(Bouilloire À Thé Sifflante en Acier Inoxydable pour Cuisinière avec Poignée Résistante La Chaleur).

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Conclusion

The decision-Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Camper Runner-of-DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial.

Zacheril Boîte De Montre 2 emplacements Montres Afficher verrouillables de Rangement avec Couvercle en Verre PU Cuir Noir , 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-Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075. 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,NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins-Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme.

WTFYSYN Chaussures diabétiques à Pantoufle Extra Large, 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/Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 , 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-Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme, 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,YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG.

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

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