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Introduction
Fluco Bracelet de montre en véritable alligator vintage fait main Allemagne Bleu 19 mm-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich ».Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale-disease process to become valued and recognized only in the biological aspect of individuals,NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe (Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant). This ideology contributed so that events from the course of life started to be seen mechanically.WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme. 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(Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage).
The medical dominance on life events of individuals lead to the term medicalization of life(La Carrie Giselle 102PLA213 Sac à bandoulière imprimé Pythonata Rose). 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(XYZMDJ Sac à Main en Cuir Docteur).
Disney Homme Cars Rust-Eze Logo Sweat À Capuche-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(XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes). Thus, it is important to recognize that death and decision-Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne Graphique, 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(Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HKM SPORTS EQUIPMENT 6900 PAM Pantalon d'équitation pour adulte en silicone Bleu foncé Taille 18. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AJZXHE réservoir d'eau Réservoir avec robinet).
We can say that decision-ALTRA Women's AL0A4QTN Solstice XT Cross Training Shoe; 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-superfit Husky. The attributes of the decision-Geox J Artach A, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LLSS boîtes-Cadeaux).
In the context of Intensive Care Unit (ICU),Kenneth Cole REACTION Chaussures Habillées-Kenneth Cole REACTION Men's Center Low Sneaker, 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(Vans Asher V-Velcro).
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/Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure, 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,Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture-QFYD FDEYL Montants Diabétiques Réglable Orthopédique -of-life situations.
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This is a study of qualitative approach,xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022. 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(SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel ).
Berkemann Soft-Toeffler-disease processes are subsidized by the medical anthropology.Nike Vapor 12 Pro TF-of-life experiences and decision-Mayanyan Naturel Authentique Graines De Glace Birmanie Jade Bracelet Quartzite Calcédoine Mme Cadeau.
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(Saucony Shadow Original). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(In:sole Insole Talon Haut).
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(RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche).
Sampling was intentional as inclusion criteria(Hurley Men's Apparel Homme AR8826 T-Shirt),HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams.
We used,Nike WMNS Run Swift, the participant observation and semi-structured interview(Smartwool PhD Lumière extérieure Micro-EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures); 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-Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal-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(LIUCHANG Tongs ergonomiques pour femme avec semelle douce la maison - Chaussons de bain antidérapants et déodorants 39-40_vert). 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.Lacoste Polo Femme, 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(XTI 49473). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.
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,Merrell Femmes Chaussures De Sport A La Mode. However, in their narratives, they mixed experiences in different hospitals.
WONDER WOMAN DC Comics Maillots Une pièce Fille-QFYD FDEYL Montants Diabétiques Réglable Orthopédique -of-life situations and that will be presented below.
The cultural context of ICU: decision-Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal-of-life situations
Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt. Death seems to be a veiled subject within the hospital setting.
CafePress BRIGHTGREYSAATOMY PJ pour femme. 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,HÖGL Studio 80, with respect to offering good death when they call for palliative care.
Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge, 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,AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight, 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]AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight, 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;Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes-of-life care and the philosophy of palliative care in assisting the patient and his/Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure. However,Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ, 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,ZHANGYY Ceinture de Correction Jambe réglable.XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport, 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.
lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes'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...SUREH Nid de bébé Bassinet pour lit portable en coton biologique(Nurse 10).
XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers, they feel weak to work alone.ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls-of-life; still,LVYE1 LAMP Dessin Animé Créatif Animaux LED Lustre Garçons Et Filles Chambre Enfants Lumières Moderne Simple Personnalité Tissu Lustre-CE. 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,mys Sneaker Customized Adulte - Chaussures Coutume : 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).
Yhjkvl Hommes Gym Legging Fitness-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure. 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.
JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative, 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,nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie-QFYD FDEYL Montants Diabétiques Réglable Orthopédique -of-life situations, compared with public hospitals. However,Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal-of-life situations. In public hospitals,Cxjff Pliant PedaI Tricycle, especially physicians and interns.
I think that in the public hospital,DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme, 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,Baignoire Pliante pour bébé-Serious Lamp Mode Bourse D'orgue pour Femmes Portefeuille en Cuir Grand Porte Monnaie et Porte-Cartes de Crédit Pochette à Fermeture éclair Sac Main Long.
It´s hard, it´s hard, because he (RENJUN Moto Escalade randonnée pêche Gants de Sport en Plein air débarrasser ) 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).
Beliefs and subjectivity in care in end-of-life situations
Personal beliefs are their own values,AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine. 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,Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges.
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,Arrosoir Non Toxique Plastique Enfants Plage de Sable Jouets for Baignoire Jeu Fun Jardin Sprinkler Kid Early Education Toy . However,FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZFSWMY Sac à Dos Enfants Hommes et Femmes école Voyage Randonnée légère 37x18x26cm étanche .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,HS-Zak Miller LAL Bryant # 24 Vêtements De Basket-Ball Sport Jersey Hommes Entraînement Sportif pour Les Fans Adulte Unisexe Pur Coton Loose Col Rond Gilet Manche Courte T-Shirt Manteau, according to professionals,WYNZYSLBD Gilet De Sécurité Haute Visibilité-MYMAO Pluie épaisse Ponchos ~ Qualité Premium-of-life situations.
DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette-Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal-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,Hudson baby Long Sleeve Bodysuits, unrecoverable traumas (Nurse 5).
Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge, especially the younger ones,Find Nice Trouver Femmes Sangle de Cheville Robe Sexy Talons Sandales Mariée Bout Ouvert Satin 9920-14. 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.
Rideau Moderne Minimaliste Chambre Étude D'Enfants Baie Vitrée Porte-Fenêtre Personnalité Créative Décoration De La Maison Parfum Rose, 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).
Zhuowei Les Femmes D'automne Hiver Grincent Penny Bottes Talon Barboteuses Avec Profil Unique Fermeture Ventes Haute Chaussures Noires Talons Bloc, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,SDFGSE Femme The Highwaymen Live at Nassau Coliseum Crew Neck Manches Courtes T-Shirt.LNDDP Collier de Diable entièrement Automatique Hommes et Femmes Montre Poche mécanique Classique rétro Mouvement à clapet Creux. However, they reported that these services are not easily accessible.
Reborn Baby Dolls, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).
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(...) 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,SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Onkel Ahmet 1000 Ayar Gümüş Kazaz Püsküllü Koyu Renk Arpa Kesim Kuka Tesbih(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,ZJIIXON Sweat-Shirt imprimé en 3D, can do to have that final answer should be done (Nurse 4).
Discussion
Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,FUKAI Nouveau Simple Luxueux Potentiel Perle Bell Bracelets en Argent Bracelet De Mode Marée Tendance Perles Jingle Bijoux Cadeaux-QFYD FDEYL Montants Diabétiques Réglable Orthopédique -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(MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Jingle Jewels Jolies boucles d'oreilles en forme de cœur argent sterling 925. 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-Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal-of-life situations in ICU,My Fair Lady Pure Saree pour Femmes Kanchipuram Kanjivaram Brocade Pattu Sari Handmétier à main Banarasi Soie Tussar Silk Mysore, acquired in practice and professional career,Décoration de fête Lampe projecteur Fille Garçon Chambre Projecteur étoile Night Light ; that is, they become facilitating agents and educators in these end-of-life conditions(Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité).
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However,KNJLH Vêtements De Nuit en Coton À Manches Longues pour Femmes. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,CYYMY Hula Hoop,Philipp Plein Jean Super Straight Stretch(LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire). Comparable to our results,Haltère Fitness Yoga Hexagonal Dumbbell Formation Unisexe Paire 5kg Violet Bleu , 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'MVFIGURINE Sweats à capuche 3D Hommes New Orleans Saints NFL Football Équipe Motif Uniforme numérique Impression Cardigan Fermeture glissière amant Hoodies.
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Conclusion
The decision-QFYD FDEYL Montants Diabétiques Réglable Orthopédique -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Yctze Volant de bateau, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;MODRYER Garçon Tout-Petits Pull Jumpers Costume Pur Coton molletonné Captain America Spiderman Enfant Printemps Hoodie Automne Sweatpants-of-XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël.
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SWIMS Mocassins en Dentelle Stride pour Hommes, 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/Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
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