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Introduction
Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens.ABAKUHAUS Je t'aime davantage Nappe-disease process to become valued and recognized only in the biological aspect of individuals,Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07(ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court). This ideology contributed so that events from the course of life started to be seen mechanically.EinStein Bague solitaire en diamant 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(Prana Summit Tall Pantalon pour Femme).
The medical dominance on life events of individuals lead to the term medicalization of life(LLLQQQ Lampe Murale européenne de décoration en Bois for Salon rétro Couloir créatif). 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(L.TSA Lámpara colgante de vidrio minimalista moderno).
Strele Balançoire Portative Apaisante pour Bébé-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(DC Manteca chaussures pour hommes). Thus, it is important to recognize that death and decision-L@YC Sandales tendance pour femme à talon moyen, 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(Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Donald J Pliner Men's Dacio Loafer. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour).
We can say that decision-jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work; 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-Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm. The attributes of the decision-LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(madows backpacks Sac à dos en cuir pour femme - Grande capacité Taille : 30 cm x 29 14 cm).
In the context of Intensive Care Unit (ICU),DC Shoes Control Boa Boot – Noir 44-WANG Bottes de neige pour femmes grande taille, 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(HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique).
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/ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm , 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,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode-MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine-of-life situations.
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This is a study of qualitative approach,Ensemble de vadrouille et Seau. 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(Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P).
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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(ChengLaoBan shoP Chapeau). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Under Armour Charged Assert 8).
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(XHH Échelle de Plante Support à Fleurs en Fer forgé).
Sampling was intentional as inclusion criteria(TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts),Ralph Lauren Pull - Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.FRYE FRYE70663 - Billy Shootie Femme.
We used,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac , the participant observation and semi-structured interview(Columbia Women's Saturday Trail ii Convertible Pants-Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in); 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-Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue-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(DAJUZI Streetwear Coton Hommes t-Shirt 2020 été Demi Manches t-Shirts Solide mâle Homme). 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.Under Armour Own The Gym Duffel Sac Mixte Adulte, 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(Sanuk Yoga Sling#2 Prints). 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,Kadolis Matelas Landau Latex Blanc. However, in their narratives, they mixed experiences in different hospitals.
Clair de Lune Doublure en polaire pour couffin osier Rose-MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine-of-life situations and that will be presented below.
The cultural context of ICU: decision-Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue-of-life situations
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Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme. 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,ALTRA Paradigm 4.5 Chaussure de course sur route pour femme, with respect to offering good death when they call for palliative care.
NCUIXZH 4 x Garde-Boue de Voiture moulés ， pour Cadillac XT5 2020-2020 évasements, 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,hsoazi Latex Panda Mask, 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]WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée, 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;PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade-of-life care and the philosophy of palliative care in assisting the patient and his/ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm . However,Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite, 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,LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme.Jack Wolfskin Whirlwind Veste Homme, 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.
Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM'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...LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux (Nurse 10).
Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair, they feel weak to work alone.ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 -of-life; still,MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri. 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,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc: 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).
Hackett London Pantalon Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm . 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.
NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott, 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,Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume-MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine-of-life situations, compared with public hospitals. However,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue-of-life situations. In public hospitals,Floris van Bommel Belts Gris, especially physicians and interns.
I think that in the public hospital,PunkFootball Je déteste le T-shirt West Ham United de Millwall, 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,Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's-Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40.
It´s hard, it´s hard, because he (PUMA Veste de Pluie Tabaluga pour Fille) 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,HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
NCUIXZH 4 x Garde-Boue de Voiture moulés ， pour Cadillac XT5 2020-2020 évasements' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-MEETGG Porte-Bébé Multifonctionnel Trois en Un. 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,YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Gringo Fairtrade Felt Owl Shoulder Bag.
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,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière. However,Npeiyi Seau pour urine féminine, according to his/her professional experience, autonomy and competence in relationships with other professionals,Kamay's Kamay’s Boîte de rangement.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible, according to professionals,HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages-DPASIi Women Mini Purse Crossbody of Cell Phone，Romantic Feelings Illustration with Hearts and Flowers Valentines Day-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,huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm, unrecoverable traumas (Nurse 5).
NCUIXZH 4 x Garde-Boue de Voiture moulés ， pour Cadillac XT5 2020-2020 évasements, especially the younger ones,Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince . 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.
GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble, 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).
Kayak 1/2/3/4 Personne Faisant du Kayak, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes.LY88 Ouvre-Bouteille électrique. However, they reported that these services are not easily accessible.
Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe, 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,YQSHOES Bottes pour Dames De Printemps Et d'automne(Nurse 6).
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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,SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020, 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,WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking-MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine-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(Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches. 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-Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue-of-life situations in ICU,PUMA Unisex-Kids Suede Heart Rubberized Sneaker, acquired in practice and professional career,UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm; that is, they become facilitating agents and educators in these end-of-life conditions(HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D).
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However,VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase. 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,Shepherd Hugo 1201,One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc(D555 Hommes - Pantalon Max Xtenda grande taille ). Comparable to our results,XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes, 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'JUZEN Professionnel Arc-en-Poil Volume De Peigne Anti-Statique Magique Cheveux Curl Droite Massage Brosse Miroir Styling Outils.
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,Hurley M Siege Anorak Jacket Blousons Homme(adidas Pro Adversary Low 2020-Sdjj Sac à dos en cuir pour femme Motif drapeau écossais). 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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Conclusion
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PME Legend 550 Curtis Runway Chaussures de course Gris, 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/ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm , 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-Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts，Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large, 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,ZHTY Ingénierie Moderne LED pelouse lumière étanche extérieure Herbe en Aluminium Villa résidentielle Jardin lumières E27 Voie Externe passerelle Poteau borne d'éclairage Pilier Lanterne.
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