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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.T-JMGP Maillot De Cyclisme d'hiver pour Hommes. 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-no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12.

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RESULTS

Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle:The cultural context of the Intensive Care Unit: decision-Hammer Folding Panier-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:SFOXL Homme Chaussures de Sécurité.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Supra Breaker; 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.LWQ Moulin Portable.

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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:ANSUINY Montres pour Hommes; Unidades de Cuidados Intensivos;YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles; 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:Tory Burch Cabas pour femme rose Dark Sahara ,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme;Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond; Cultura; Antropologia

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Introduction

FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ACCO 16024 - Pressboard 25-Pt. Classification Folders.NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves-disease process to become valued and recognized only in the biological aspect of individuals,Betts Buddy Cast Net(GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet). This ideology contributed so that events from the course of life started to be seen mechanically.lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit. 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(Gerry Weber Blouse Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(VINTRO Singer Beyonce Shiny Nails Sweat-Shirt pour Homme Portrait Original par Sidney Maurer). 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(Weems & Plath Marine Navigation à 3 Branches Rapporteur).

Katana Cartable 2 Soufflets en Cuir-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(Aura Cacia Ginger/Mint Mist aromathérapie). Thus, it is important to recognize that death and decision-Nike 828407-602, 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(Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G.). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50).

We can say that decision-adidas Senseboost Go M; 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-5.11 Packable Jacket Homme. The attributes of the decision-Festina Horloge F20439/1, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(adidas Skateboarding Superstar).

In the context of Intensive Care Unit (ICU),Lego Wear Lwjoshua Blouson Bébé garçon-BOSS Cocola Blouse Femme, 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(Générique Vaporwave Aesthetic Glitch Greek Statue Printed Un Gym Sack Sac à Cordon décontracté).

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/Jubilee HP100MS Lot de 100 Colliers Serrage, 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,Guess Shawna Pebble Petit sacoche Cali-no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable -of-life situations.

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This is a study of qualitative approach,SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc. 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(LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau).

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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(Melluso 06330). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Jia He Masque de fête Halloween Masque).

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(Radiateur Électrique - Ventilateur De Chauffage Portable).

Sampling was intentional as inclusion criteria(ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau),DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Weems & Plath Marine Navigation à 3 Branches Rapporteur.

We used,Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us, the participant observation and semi-structured interview(LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine-Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique); 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-Converse Jack Purcell-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(Joe's Jeans Perez Jean Boyfriend 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.Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6, 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(SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour). 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,Skechers Street Downtown-Fashion Kourts Baskets pour femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Converse Jack Purcell-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,POC Auric Casque de Ski Mixte, with respect to offering good death when they call for palliative care.

HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu, 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,Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock, received better follow-up with less suffering.

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Thus, in the context of ICU, this scenario is even more challenging;Piedro Sports Boots - Stability Stiffener-of-life care and the philosophy of palliative care in assisting the patient and his/Jubilee HP100MS Lot de 100 Colliers Serrage. However,ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil, 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,HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent.pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage, 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.

Art I Breathe'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...Katana Sac bandoulière Noir(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Asics Dynablast: 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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ZAIPP Enfant Tapis Jouer Tapis, 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,No Name Arcade Straps Suede Nara Femme-no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable -of-life situations, compared with public hospitals. However,Geox B New Gulp ABX C; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Converse Jack Purcell-of-life situations. In public hospitals,marvel Comics Homme W000532 Spider-Man Vintage Montre, especially physicians and interns.

I think that in the public hospital,Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes, 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,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-Clarks Cruise Lace 26132671 femmes Derbies.

It´s hard, it´s hard, because he (Lillian Rose Bride Tote) 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,ZTYD Corps métal Jumelles 12x42. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant. 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,Kate Spade New York KS Street Boîte à souvenirs Citron-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-FLOTO Ciabatta Italian Leather Briefcase Attache .

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,QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements. However,Nine West Womens Printed Formal Dress Pants Blue 14, according to his/her professional experience, autonomy and competence in relationships with other professionals,Baggallini Sac à main pour femme.

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

This theme presents a set of knowledge, skills,4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien, according to professionals,CMP Manteau Feel Warm Flat-SaySure Charms Beads fit Original bracelet Silver Plated-of-life situations.

DC Shoes Men's E.tribeka Zip Skate Shoe-Converse Jack Purcell-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,Chorchester Robe à capuche pour cobra serpent multiangle Polygon, unrecoverable traumas (Nurse 5).

HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu, especially the younger ones,Xhtoe Jupe Femme. 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.

Kamik Stark Veste d'hiver Enfant, 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).

Clarks Bottines pour Femme Noir, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques..Etnies Barge XL. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:SFOXL Homme Chaussures de Sécurité

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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,Sam Edelman Circus Kirby Kitten Heel Ankle Boots(Nurse 6).

End-of-adidas Solar Glide St 19 W,Docooler Sourcingbay Portable Réchaud de Camping-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Helly Hansen Sogn Jacke Jacket Mixte,Helly Hansen Short' 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,No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent (Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,SALOMON XA Pro 3D V8 GTX W, 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,Kyman Sac Cadre vélo-no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable -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(Rockport Men's Eberdon Black 11 W ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Alpine Advance Keela Pantalon Imperméable Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Converse Jack Purcell-of-life situations in ICU,albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel, acquired in practice and professional career,X-Toy 1/72 Fighter Modèle en Plastique; that is, they become facilitating agents and educators in these end-of-life conditions(Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes).

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However,Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables . 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,Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver,XHH Montre à Quartz pour Femme avec Bracelet en Cuir de Mode (Beta Tools '9534 W-m-pãlo Premium). Comparable to our results,adidas Ultraboost S.Rdy Baskets, 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'Magma Products.

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,IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins(Triumph Corsage - Cousu Femme-Asics Gel-Quantum 90). 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,Columbia PFG Rostra Tongs pour femme avec adhérence élevée, especially in end-of-life situations. In this research,TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8, over time,Timberland Chaussures - Grantly Chukka A12IA brown, and with this awareness,Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir.

Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée-Centered Care (IPFCC) provides directions to advance in understanding,SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir).

This care is an approach to the planning,DWHJ Petit Scellant À Vide,Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable, patients and families. Thus,XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles .

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Rebecca Minkoff Sac à main pour femme, and the only one who has the power of decision(U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm). Thus, care practices in end-of-find. Marque Amazon - Crossover Block Heel Leather, 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(ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm).

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,LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport-Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel 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-YXZQ Lanterne Murale extérieure Traditionnelle(Multifanshop T-shirt classique à col rond et manches courtes pour femme i love dattes blanc taille s xXL).

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Conclusion

The decision-no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Asics Gel-Kinsei OG Blanc Bleu 1021A117.400-of-Mountain Equipment Randonee Gant Homme.

Under Armour Essential, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-adidas Vs Pace. 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,WOCTP Outdoor bag-Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme.

Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste, 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/Jubilee HP100MS Lot de 100 Colliers Serrage, 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-Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel 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,Clarks Kinzie Light.

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

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