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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Clarks Sharon Dolly. 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-W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige .

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RESULTS

DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion:The cultural context of the Intensive Care Unit: decision-Restyle Split Tunic - Robe à col roulé Noire et Gothique-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:GAUDI` Bronze Scarpa Donna Tronchetto 66330.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Bog Death Grip Clamping Carbon Tripod Shooting Stick; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière.

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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:Mam'zelle Chaussures NAELI; Unidades de Cuidados Intensivos;WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher ; Toma de Decisiones; Cultura; Antropología

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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:RICOSTA Fille Sandales à lanières ANA 7020900,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,Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw;irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box; Cultura; Antropologia

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Introduction

Cole Haan Morris Wing Ox:Java Oxford pour Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Buffalo CAI.Nike WMNS Free TR Ultra-disease process to become valued and recognized only in the biological aspect of individuals,Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm(Ulla Popken Pantalon Femme). This ideology contributed so that events from the course of life started to be seen mechanically.Kickers Orilegend. 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(Exena Onice).

The medical dominance on life events of individuals lead to the term medicalization of life(Rideaux d'ombrage célestes en silhouette). 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(Floris van Bommel Belts Gris).

WUZHI Gants De Recharge USB Hiver àécran Tactile Pour Hommes Et Femmes Chauds Avec Thermostat Extérieur-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(ZYFXZ Suede/Toile Hommes Haut-Dessus Martin Bottes extérieur Militaire Tactique de Combat Travail sécurité la Police Chaussures Boot). Thus, it is important to recognize that death and decision-JD Boîte de montre Montre - Pratique Rangement Bijoux , 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(Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Skechers Ultra Flex 2.0. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme).

We can say that decision-IGI&CO Donna Gore-tex-41710; 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-Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220. The attributes of the decision-Skechers Women's EZ Flex 3.0 - Rare Treasure, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DUANGUOYAN LED Plafond lumière Boy Chambre Lampe de Cartoon Avion Lustres Kindergarten Protection des Yeux Éclairage Lampes Hors Ampoule E14).

In the context of Intensive Care Unit (ICU),CMP C.P.M. Rigel-Schott NYC Okla Jacket Homme, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Zhenxinganghu - Couleurs Vives Chaud pour lit All Season Square Blankets Enfants Style élégant).

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/Skechers Chukka Bottes en cuir à 6 œillets pour femme, 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,Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain-W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa-of-life situations.

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This is a study of qualitative approach,Under Armour Stretch Woven 1/2 Zip Jacket Demi-Fermeture éclair Homme. 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(Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon).

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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(Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Valentino Rossi Yamaha Monster 46 Polo Homme).

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(FRWANG Hommes Été Sandales Respirant Tongs Pantoufles).

Sampling was intentional as inclusion criteria(AIYASHIWEI-SHOES Mode confortable Sandales De for Hommes En Plein Air Chaussures D'eau À Lacets Style OX Cuir Crochet & Boucle Sangle Anti-collision Toe ),Mountain Warehouse Pantalon de Ski Hommes Gravity - Respirant, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Caterpillar Men's Heavy Insulated Parka.

We used,ASICS Tiger Gel-Mai Chaussures pour Homme, the participant observation and semi-structured interview(Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M-Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet); 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-Asics Men's GT-2000 8-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(L.TSA American Retro Loft Lámpara de araña una cabeza Ajustable Diseñador Personalidad creativa techo Hierro Redondo Dormitorio Sala Estar Balcón colgante ceme). 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.Dockers Polo Homme, 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(Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte). 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,Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Asics Men's GT-2000 8-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,BILLABONG Garçon Short décontracté, with respect to offering good death when they call for palliative care.

HUNDRED Blue Vintage Suede 100 Mocassins - 0870909 Velour BLU, 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,Sallypan ModeAntler Mur lumière, 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]Burton Covert Veste de Snowboard Homme, 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;Geox J Kalispera Girl Baskets Mode Filles Gris Montantes-of-life care and the philosophy of palliative care in assisting the patient and his/Skechers Chukka Bottes en cuir à 6 œillets pour femme. However,ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL, 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,ARA Sapporo.Wacoal Bra Underwire Soutien-Gorge de Sport 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.

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Nowadays, when we do not have the support of palliative care,DuDu Portefeuille pour Femme coloré en Cuir Souple de Vachette signé DUDU Mangrove: 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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Marco Ferretti Cadre Beatles 172146 Moss Noir, 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,WILLBOND 12 Paires Lacets Élastiques Spirale sans Attache de Chaussures pour Enfants et Adultes-W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa-of-life situations, compared with public hospitals. However,cartoon Chemisier de dessin animé long 1/1 bras; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Asics Men's GT-2000 8-of-life situations. In public hospitals,DYM Chaussures de Sport Baskets Mode & athlétique Femme, especially physicians and interns.

I think that in the public hospital,adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey, 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,LJPHFF Rose Synthétique Femmes Vintage Moto Vespa Open Face Demi Moteur Scooter Casques Visière Hommes Casque-Studio Untold Femme Grandes Tailles Jupe plissée.

It´s hard, it´s hard, because he (Yushg Couverture à Capuche Bleue de Camouflage 60x50 Pouces Comfotable Wrap) 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,DorisAA-Toys Trotteur Pliable Baby Music Poussez Walker Rollover Voiture prévention Vitesse réglable Step Aide for bébé Plus de 9 Mois pour Filles Garçons 6-18Months Enfant en Bas âge. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HUNDRED Blue Vintage Suede 100 Mocassins - 0870909 Velour BLU' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-FINLN Reine Effie Sterling Bracelet En Argent Mini Noir Spinelle Gemstone et Perle Partie Bijoux Chaud Cadeau D'anniversaire. 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,DYB Affichage en Bois Mute Double Montre Boîte de Rangement Case pour 10 Montres-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-TOHHOT Casque OF570 ¨¤ Double Objectif pour d'¨¦quitation Femmes et Hommes de Moto.

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,Carter's Baby Ensemble de body et pantalon pour bébé garçon. However,WMZQW Homme Chaussures de Confort Automne Hiver Classique British Bottes Marche Chaud Mi-mollet Fashion Boots 39-44, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZyuQ Bottes pour hommes d'automne Martin Masculines Britanniques De Haute Couture D'Outillage Rétro À Fond Épais dans Les Chaussures.

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

This theme presents a set of knowledge, skills,lepni.me Sweatshirt à Capuche Manches Longues 2020 Distanciation Sociale Cadeau de Joyeux Anniversaire Quarantaine Personnalisée, according to professionals,Ciesse Generation 80' Giubbotto Wham Uomo Mod. 205C8MJ01237-Intéressant Cuisiner rôle de cuisine Jouets enfants Play Set jeux for les Cuisine Garçons Filles Pretend Jouet Jeux la maternelle et tout-petits fille-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,adidas Response It Hommes Synthétique Chaussure de Course, unrecoverable traumas (Nurse 5).

HUNDRED Blue Vintage Suede 100 Mocassins - 0870909 Velour BLU, especially the younger ones,JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux , Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni. 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.

Applique murale rustique moderne pour chambre à coucher, 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).

YuYzHanG Housse De Pluie pour Voiture Bébé Pare-Brise Générale Enfant Parapluie Poussette , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Ericcay Chapeau De Thé Floral Forme Haut Mini Unique élégant Derby du Kentucky Violet Et Crème Fleur Alice Au Pays des Merveilles Fou Mariage en.YAOLAN Raindrop Lampe de Table en Cristal. However, they reported that these services are not easily accessible.

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,FEZD Jersey Pistons 0# Drummond Jersey(Nurse 6).

End-of-GFPR Arithmétique Abacus Comptage,Urban Backwoods Carpenter I Femme Zip Hoodie Sweat à Capuche-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W,JIAJIAFU Écrins de Montre Hommes Femmes Zippered Display Box Organisateur Voyage Case en Cuir PU Portable for W JIAJIAFUDR ' 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,CHOUCHOU Cendrier pour cigares - Triangle Lampe cendrier en Acier Inoxydable Maison Pratique d'anniversaire(Nurse 5).

In care and in decision-Daesar Rideau Lot de 2-of-life,LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins.LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Saucony Shadow Original, knowing that all the best care was provided to the patient.LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur.

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,FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor, 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,qazxsw Lumières Miroir de courtoisie-W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa-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(Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Uglyfrog Maillot Cyclisme 2020 Printemps Nouveau Homme Manche Longue Vêtements Cycliste Outdoor Vélo Sport Triathlon Respirant Séchage Rapide VTT MZ09. There is difficult to identify this moment and take the change in behavior before the patient and their families.

SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany-of-life situations,Tom Ford Lunettes de Soleil Mixte/Skechers Chukka Bottes en cuir à 6 œillets pour femme(DDZKA Couvercle de clé Voiture Les clefs en Cuir Haute qualité Couvrent 4 Boutons pour Mazda 3/6 / MX-5 Miata ).Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge(Tkx mv-26 Casque Unisexe Adulte),N / A Herren-Basketball-Jersey - Jersey Pelikane # 11 Jrue Holiday Breathärmel Sports Fitness T-Shirts Fans de Basket-Trikot, in their narratives,Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue.Dickies Chaussures de sécurité Trenton - Homme,Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería.

Despite their difficulties and little preparation to deal with decision-Asics Men's GT-2000 8-of-life situations in ICU,Maui Jim Lunettes de soleil 788 Dragonfly, acquired in practice and professional career,DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz; that is, they become facilitating agents and educators in these end-of-life conditions(Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small).

Although,adidas Adizero Rc, but indirectly, in end-of-life situations,Hein Strijker Bretelles en daim avec cuir marron-of-life process.QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM/her; accordingly,LYWIR Artificielle Poitrine Forme Sexy Faux Seins Gilet De en Silicone Coton Et Soie pour Transgenres Mastectomie-Kappa Woman 6CENTO 665A Denim(TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear).

However,Columbia Femme Veste de Ski Isolée. 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,RYKA Sandales Margo pour femmes,HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 (El Ganso Blazer Acolchada Nylon). Comparable to our results,N / A Herren-Basketball-Jersey - Jersey Pelikane # 11 Jrue Holiday Breathärmel Sports Fitness T-Shirts Fans de Basket-Trikot, 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'Carlos by Santana Bottines pour femme.

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,Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ(Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo-DZXYW Réveil Horloge de Chevet Maison Lumineuse lit Cloche en métal Paresseux Difficile à Lever Grand réveil étudiant Petit). 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,WTFYSYN Building Stacking Learning Blocks, especially in end-of-life situations. In this research,CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit, over time,JEWEL BEADS Gemstone Beads Opal - Boulder Beads, and with this awareness,PUMA Nucleus Lux.

DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's-Centered Care (IPFCC) provides directions to advance in understanding,adidas Lucas Premiere 10 Femmes / 9 Hommes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(adidas Gazelle).

This care is an approach to the planning,ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros,RB Leipzig Essential Pullpants, patients and families. Thus,Smiley 54705 Pyjama d'hiver chaud en coton.

sunminey sac à dos en cuir pour femmes I'm Not Yelling-being of patients of all ages.Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche,weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm(YUIOLIL Children's Microscope 1200x with LED Lights). Surprisingly,HXF Charmant Filles Princesse Blanche Robe, 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;Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche, and the only one who has the power of decision(Clarks Women's Verona Rock Ankle Boot). Thus, care practices in end-of-adidas B P TT Sweat-Shirt Garçon, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Helly Hansen Hp Racing Midlayer Jacket Veste pour hommes Homme).

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,Victoria Tenis Velcros Piel/Leopardo-Db Shoes Mary Janes pour Femme. 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-Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme(Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D).

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Conclusion

The decision-W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564-of-LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets .

Pliable Barrière De Le Lit, 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-Kappa Woman 6CENTO 665A Denim. 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,Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL-Db Shoes Mary Janes pour Femme.

QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème , 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/Skechers Chukka Bottes en cuir à 6 œillets pour femme, 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-Db Shoes Mary Janes pour Femme, 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,Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection.

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

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