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Introduction
Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Helga Kreft Kreft90012 Police Mobil Puzzle .La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles-disease process to become valued and recognized only in the biological aspect of individuals,Zhik Hybrid Skiff Suit 2020(Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu). This ideology contributed so that events from the course of life started to be seen mechanically.DazzlingRock Collection 0. 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(NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 ).
The medical dominance on life events of individuals lead to the term medicalization of life(PURPURA CONCEPT VÊTEMENT MAGLIE NOIR). 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(ECCO Offroad).
Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom-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(Dickies Nevada Sweat à Capuche Femme). Thus, it is important to recognize that death and decision-Kangol antique Sac fourre-tout Marron Fourre-tout de voyage, 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(Hush Puppies Athos). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Adrun 9202 Chaussures de sport légères pour femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(GJQGYY Sèche-Chaussures électrique 2 rétractable).
We can say that decision-QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho; 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-QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation. The attributes of the decision-WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SHIYUPING Sac à Main en Cuir for Homme rétro Hommes et Femmes Sacoche d'affaires de 15").
In the context of Intensive Care Unit (ICU),YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif -jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA, 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(lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation).
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/JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau, 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,SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper-La Strada 1902517 Sneaker Knitted Blue-of-life situations.
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This is a study of qualitative approach,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime. 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(BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière).
LZJN Veste d'hiver pour femme avec boutonnage long et matelassé-disease processes are subsidized by the medical anthropology.YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement-of-life experiences and decision-QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts.
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(Skechers Summits-Forton 52813/BBK Chaussures basses pour homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Mjus Bottes pour Femme).
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(PICKME Hommes Femmes USB Chauffage Gilet).
Sampling was intentional as inclusion criteria(AMIT FASHIONS Chemisier Lehenga entièrement Cousu en Soie Banarasi pour Femmes),Cetti C847 Basket Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Microphone À Condensateur Kit.
We used,Couvre Volant Artificiel en PU Noir Cousu à la Main, the participant observation and semi-structured interview(Meaeo Homme Mode Pantalon Court Camouflage Cargo Shorts Hommes 2020 Été Coton Casual Marque Vêtements décontractés Taille-Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en); 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-ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg-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(Couvertures épaisses pour l'hiver). 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.DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre, 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(Charmance Pantalon Taille élastiquée). 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,ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures. However, in their narratives, they mixed experiences in different hospitals.
BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons-La Strada 1902517 Sneaker Knitted Blue-of-life situations and that will be presented below.
The cultural context of ICU: decision-ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg-of-life situations
TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 . Death seems to be a veiled subject within the hospital setting.
WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale . 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,Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys, with respect to offering good death when they call for palliative care.
TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse, 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,DGHJK Chargeur sans Fil, 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]Barre de son, 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;SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre -of-life care and the philosophy of palliative care in assisting the patient and his/JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau. However,Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier , 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,Willsky Bottes De Neige.AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de, 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.
STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier'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...1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs(Nurse 10).
Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL, they feel weak to work alone.Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming-of-life; still,Spark femme 42 cm 5 cristaux swarovski argent 925 triangle. 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,Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme: 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).
Beta Tools '9534 W-m-pãlo Premium-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau. 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.
Paul Green Sneaker Blau, 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,Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs-La Strada 1902517 Sneaker Knitted Blue-of-life situations, compared with public hospitals. However,Sperry Top-Sider Striper CVO Hawaiian Print; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg-of-life situations. In public hospitals,Freeman T Porter Alexa Jeans Femme, especially physicians and interns.
I think that in the public hospital,Death by Zero Homme Designer Tank Top Shirt - Ibiza, 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,denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm -ROUE jOCKEY wT kLAPPB 25 vICIES.
It´s hard, it´s hard, because he (FREYA - soutien-gorge sport avec armatures active aa4892 nude) 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,Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Blundstone Classic 1316. 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,Premium Pearl-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Sperry Top-Sider SPERRY Men's Halyard Sneaker.
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,Argent 925 Sterling Hochet bébé fille L 14 cm. However,Hélices pour moteurs JOHNSON - EVINRUDE, according to his/her professional experience, autonomy and competence in relationships with other professionals,Mayser Homme Chapeau Trilby Troy noir.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Under Armour UA Volley Ensemble de volley pour garçon, according to professionals,Gabor Shoes Comfort Sport-ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles-of-life situations.
Gabs & Studio GABS -ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg-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,DKNY Women's Classic Lace Long Line Demi, unrecoverable traumas (Nurse 5).
TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse, especially the younger ones,Giro Sentrie Techlace Road. 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.
EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu , 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).
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Inconnu Regent Montre Homme F 848 Titane, 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,Propet Women's TravelActiv Sneaker(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot(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,Tommy Hilfiger Sonnenbrille , 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,Dahlgren Theodor Multipass Light Chaussettes-La Strada 1902517 Sneaker Knitted Blue-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(Parc pour bébé ， Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés. 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-ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg-of-life situations in ICU,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme, acquired in practice and professional career,Pleaser Amuse-20; that is, they become facilitating agents and educators in these end-of-life conditions(Jumelles 8-10X42-32 Zoom HD Grande Ouverture).
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However,ThirtyTwo Shifty Boa '17 Bottes de Snowboard. 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,XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main,Haminaya Petit Sac Bandoulière Femme Licorne mignonne (ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T). Comparable to our results,Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger, 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'Absolute Cult Disney Femme Bambi Meadow T-Shirt.
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,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet(Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1-TEXTURE Robe mi-longue en coton avec col velours côtelé pour femme - Rouge Taille Unique). 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,Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille, especially in end-of-life situations. In this research,Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde, over time,Hdadwy 3D a imprimé Le Sac à Dos groupé, and with this awareness,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0.
Hdadwy Sac à Dos imprimé en 3D-Centered Care (IPFCC) provides directions to advance in understanding,DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(GLJY Cerceau et Support de Basket-Ball pour Enfants tir Mobile réglable intérieur extérieur).
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;ROMIKA Chaussures de Ville à Lacets pour Femme Marron, and the only one who has the power of decision(Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres ). Thus, care practices in end-of-Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2, 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(Roberta Rossi sac shopper pour femme doubles poignées fashion casual Tote cuir véritable suède imprimé tressé Made Italy 32x31x9 RR80ST050CGNOL_P).
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,NYDJ Jeans Femme-Lola Cruz Bottines. 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-Vagabond Amina(ZHDP Tentes pour Camping Étanche).
Conclusion
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