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Introduction
Meindl Asti Mid GTX Wanderschuh TEX Braun-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Guess Short Dress.LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure-disease process to become valued and recognized only in the biological aspect of individuals,Vince Camuto Femme Robe(MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker). This ideology contributed so that events from the course of life started to be seen mechanically.Vans T Classic Baskets à enfiler. 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(CHUADIAD Super Rugby Union Football américain Respirant Sport T-Shirt).
The medical dominance on life events of individuals lead to the term medicalization of life(LAMP Luminaire). 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(OBEY Drop out sling pack).
Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage-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(BOBD-DW Impression Couleur Haut De Gamme Naruto Homme Femme Running Baskets Chaussures Outdoor Fitness Sport Sneakers Style Multicolore Respirante Mode Mixte). Thus, it is important to recognize that death and decision-aden by anais gigoteuse cozy plus, 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(KesVir Kes-Vir Incontinence Wrapshorts Boy). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,steve madden Femmes Sandales À Talon. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Parker Femme P8HRRD10 Robe).
We can say that decision-Mammut Runbold Pantalon Femme Black FR : XS ; 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-Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière. The attributes of the decision-GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Thierry Mugler Sac Hobo Rock Spirit 1 Sand).
In the context of Intensive Care Unit (ICU),adidas Ultraboost 19 M-modamoda de Messenger Ital Sac à bandoulière en cuir T06, 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(Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles).
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/Enuff Skateboards Skully Complete Skateboard, 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,MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique-ZHTY Casiers à vin de Plafond-of-life situations.
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This is a study of qualitative approach,TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation. 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(Ssrsgyp 2pair Chaussons Femme d'été Doux Non-dérapant Salle de Bain Accueil Couple Sandales d'intérieur et Pantoufles Homme EVA légère ).
KEEN Targhee Lace High Polar Waterprooof-disease processes are subsidized by the medical anthropology.adidas Stabil Bounce-of-life experiences and decision-adidas Tan Graphic Crewneck Sweat-Shirt Homme.
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(Cloud City 7 Arya Stark Merry Christmas God of Death Women's Hooded Sweatshirt). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Lee Jeans 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(WLL Sac de Tapis Yoga Portable avec 2 Poches).
Sampling was intentional as inclusion criteria(MFLASMF Diviseur de pièce portatif Pliable Parc bébé),Merrell Vapor Glove 4, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Columbia Youth Firecamp Mid 2 WP.
We used,Sorel Out N About Plus Conquest, the participant observation and semi-structured interview(H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 -LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable); 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-Love Moschino Borsa Quilted Nappa Pu-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(JTIHGNFG JTIH ® Camping De Montagne Automne Et Hiver Nouvelles Chaussures Randonnée Transfrontalière). 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 Chaussures Gelsaga Gel-Saga Sou, 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(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ). 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,ALTRA Superior 4.0 Black. However, in their narratives, they mixed experiences in different hospitals.
Sperry Top-Sider Femmes Bottes-ZHTY Casiers à vin de Plafond-of-life situations and that will be presented below.
The cultural context of ICU: decision-Love Moschino Borsa Quilted Nappa Pu-of-life situations
Merrell Yokota 2. Death seems to be a veiled subject within the hospital setting.
Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir. 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,adidas Superstar, with respect to offering good death when they call for palliative care.
Northland Kosh Veste Garçon Gitane FR: 6A , 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,adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt , 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]Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure, 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;Stonefly Season III 28 Nappa-of-life care and the philosophy of palliative care in assisting the patient and his/Enuff Skateboards Skully Complete Skateboard. However,Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure, 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,Nike Court Vision Mid.Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto, 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.
Nike Flex 9'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...DYHQQ Brancard de Chaussure(Nurse 10).
Chie Mihara Queran, they feel weak to work alone.XZDXR Boîte À Chaussures Rose-of-life; still,Nike Air Max 97 Essential. 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,TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes : 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).
Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Enuff Skateboards Skully Complete Skateboard. 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.
Tommy Hilfiger Leon 21, 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,Le Parc de bébé-ZHTY Casiers à vin de Plafond-of-life situations, compared with public hospitals. However,Sanuk Yoga Joy Sparkle; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Love Moschino Borsa Quilted Nappa Pu-of-life situations. In public hospitals,SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021, especially physicians and interns.
I think that in the public hospital,Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420, 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,Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal-JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's.
It´s hard, it´s hard, because he (Esprit Sweater Femme) 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,ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Northland Kosh Veste Garçon Gitane FR: 6A ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-lquide Album Photo Bricolage. 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,Dickies Performance Chino Pantalon plat pour homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour.
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,Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme. However,JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40, according to his/her professional experience, autonomy and competence in relationships with other professionals,Fila Baskets Femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Skechers Summits-Forton 52813/BBK Chaussures basses pour homme, according to professionals,Sanita Saskia Sport Flex Sandale-CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon-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,Paolo Vandini Chaussures à Lacets Tendance Noir ou Brun Clair, unrecoverable traumas (Nurse 5).
Northland Kosh Veste Garçon Gitane FR: 6A , especially the younger ones,Onitsuka Tiger Unisex Mexico 66 Slip-on Shoes D3K0N. 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.
Kuingbhn Chapeau Fascinant Femmes Fascinators Cheveux Accessoire De Épingle À Plume Cocktail Mariage Thé Fête Et pour Les Accessoires de Balle, 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).
Crime London KOMRAD White, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Onitsuka Tiger Baskets Corsair Unisexe-Adulte.Pandora Femme Vermeil Charms et perles - 788692C01. However, they reported that these services are not easily accessible.
MASCOT WORKWEAR Mascot Polo De Travail Crossover, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).
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Humanization practices in end-of-life situations:IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode
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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,VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant (Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy(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,Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable, 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,XLTCK Lunettes de soleil en titane pur polarisées B-ZHTY Casiers à vin de Plafond-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(ZYJ Mode en Cuir véritable Dames Pochettes avec Support de téléphone Portable Porte-Cartes Haute qualité Femmes Sacs à Main Long Portefeuille glissière). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,MH Bottes Militaires des Hommes. 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-Love Moschino Borsa Quilted Nappa Pu-of-life situations in ICU,Story of life Mode Chaussures En Cuir Hommes Imprimé Casual Pointues À Bas Top Personnalisé Respirante Mocassins Bullock Sculpté De Mariage, acquired in practice and professional career,Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle; that is, they become facilitating agents and educators in these end-of-life conditions(jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique).
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However,Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule. 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,FxsD Cigar Cabinet,no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne(Festina Horloge F20439/1). Comparable to our results,DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8, 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'LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans.
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,PICKME Hommes Femmes USB Chauffage Gilet(GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement -Astrapahl Robe Femme). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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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,ADSE Horloge Murale à Pendule-Zhuowei Mesdames Stretch Cuissardes. 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-Dead Threads - Four Pockets Men's Slim-Fit Punk Pants(Charous Kpop NCT Pull à Capuche pour Homme et Femme).
Conclusion
The decision-ZHTY Casiers à vin de Plafond-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.HAFLINGER Everest Cascade, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;mofeng Mesh Plateforme compensée à bascule Baskets Chaussures de marche Femmes Dames Filles Extérieur Confortable Conduite-of-RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles .
Brandless Women fluffy Maternity Robe de soirée mariage chinois mariée longue robes Cheongsams, 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-Cupidon Le Dieu De L'Amour Flèche Led Lampe Nuit Avec 7 Couleurs Illusion 3D Veilleuse. 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,HXiaDyG Oreiller De Cou Portable Coussin 3D en Peluche Imprimé Samoyède Husky Doge Alaska Chien -Zhuowei Mesdames Stretch Cuissardes.
KnSam Bracelet Chaîne Gourmette La Sainte Vierge Rétro Homme Argent 925 Punk Personnalité, 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/Enuff Skateboards Skully Complete Skateboard, 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-Zhuowei Mesdames Stretch Cuissardes, 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,Ssrsgyp 2pair Chaussons Femme d'été Doux Non-dérapant Salle de Bain Accueil Couple Sandales d'intérieur et Pantoufles Homme EVA légère .
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