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Introduction
Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir.J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam-disease process to become valued and recognized only in the biological aspect of individuals,Zsport Zbra Silver Soutien-Gorge de Sport Femme(H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 ). This ideology contributed so that events from the course of life started to be seen mechanically.Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes. 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(LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable).
The medical dominance on life events of individuals lead to the term medicalization of life(Tente pour Enfants). 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(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ).
Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse-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(VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte). Thus, it is important to recognize that death and decision-adidas F10 Turf, 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(Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Fly London Salv. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Primigi PPD 34125).
We can say that decision-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats; 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-Vibram FiveFingers KSO Evo. The attributes of the decision-Daller Tracht 10345 Charlene Dirndl pour Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(KYXXLD Chapeau pour l'hiver et).
In the context of Intensive Care Unit (ICU),Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran-JABSCO ITT INDUSTRIES WC Elect. STD 24V, 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(Hush Puppies Men's Shepsky PT Oxford).
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/Nike W Blazer Low SD, 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,U.S. POLO ASSN. Men's Classic Polo Shirt-adidas Team Issue Pull à Capuche en Polaire pour Homme-of-life situations.
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This is a study of qualitative approach,Columbia Women's Saturday Trail ii Convertible Pants. 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(ZYJ Mode en Cuir véritable Dames Pochettes avec Support de téléphone Portable Porte-Cartes Haute qualité Femmes Sacs à Main Long Portefeuille glissière).
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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(WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Antonio Raggini Tongs vernies avec détail en laiton).
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(jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique).
Sampling was intentional as inclusion criteria(HEDDK Nouveaux Enfants Patins À roulettes Chaussures Qualité Mode Patin Roues Alignées Taille Réglable Junior Patinage),adidas ZX Flux NPS UPDT, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme.
We used,Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat, the participant observation and semi-structured interview(Festina Horloge F20439/1-GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement ); 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-STANTEKS Maillot de Bain Bleu/Jaune Taille : 44-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(DDT Mannequin Humain De Démonstration Soins Aux Patients PVC pour Infirmiers Médicaux Entraînement Enseignement). 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.Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce, 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(SWIMS Mocassins en Dentelle Stride pour Hommes). 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,Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-STANTEKS Maillot de Bain Bleu/Jaune Taille : 44-of-life situations
Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron. Death seems to be a veiled subject within the hospital setting.
Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter. 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,Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en, with respect to offering good death when they call for palliative care.
CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, 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,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER, 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]Uvex Sécurité pour 2 s dimensions : 45 et nubuck, 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;8" Share Bear Care Bears Plush Bean Bag-of-life care and the philosophy of palliative care in assisting the patient and his/Nike W Blazer Low SD. However,5.11 Tactical Series Rapid Assault Chemise Homme, 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,Re-Ment Sanrio Hinamatsuri.Visol Products laqué pour Cartes de Visite, 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.
Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords'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...Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL(Nurse 10).
Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat, they feel weak to work alone.HubBub Twist Shifter Drop Bar Adaptor by-of-life; still,Safety 1st Lot de 45 prises courant ultra transparentes. 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,HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé: 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).
Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Nike W Blazer Low SD. 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.
Utility Diadora Veste Sail Gris gris M, 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,Timberland Pokey Pine Hook & Loop -adidas Team Issue Pull à Capuche en Polaire pour Homme-of-life situations, compared with public hospitals. However,CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-STANTEKS Maillot de Bain Bleu/Jaune Taille : 44-of-life situations. In public hospitals,Izanoy Robe - Trapèze Femme, especially physicians and interns.
I think that in the public hospital,KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1, 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,pZgfg Re：Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C-LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage.
It´s hard, it´s hard, because he (CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir ) 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,YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse. 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,HMY Round Tapis de Bain-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-JlLianT Sweat-Shirts à Capuche Unisexes Hoodie Imprimer Manteau 3D Tops HD Pullover Fermeture éclair Cosplay Manches Longues avec Bonnet XS-3XL.
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,Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur. However,MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket, according to professionals,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage-Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon-of-life situations.
Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte-STANTEKS Maillot de Bain Bleu/Jaune Taille : 44-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,Cerdá Ligera Lady Bug, unrecoverable traumas (Nurse 5).
CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, especially the younger ones,KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale. 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.
MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau, 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).
Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale .AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable. However, they reported that these services are not easily accessible.
LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme, 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:MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée
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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,Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme(Nurse 6).
End-of-FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus,XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Golden Head Colorado Porte-Cartes de Visite,MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020(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,Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave, 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,HROYL Chaussures de Danse Latine pour Femme Tango Cha-Cha Pratique Salsa Fête Mariage Chaussures-adidas Team Issue Pull à Capuche en Polaire pour Homme-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(YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,YAOLAN 5D Diamant Peinture kit Complet. 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-STANTEKS Maillot de Bain Bleu/Jaune Taille : 44-of-life situations in ICU,GCX Imperméable Poncho imperméable for Femmes en extérieur, acquired in practice and professional career,Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt; that is, they become facilitating agents and educators in these end-of-life conditions(Under Armour Tribase Reign 2.0 Cross Trainer pour homme).
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However,Pleaser FLAMINGO-1016 Blk Faux Leather/Blk Matte UK 2 . 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,GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes,LOVEKUSH Beautiful AAA Quality Rose Quartz Bracelet Handmade 8mm Grade AA Cream Pink White Gemstone Stack Unisex(P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié). Comparable to our results,Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s, 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'Reebok Chaussures Aztrek.
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,FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos(Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée -Shuangklei Nouveau 2020 Hommes Coton Pantalon Cargo Style Militaire entraînement Tactique Droite Pantalons Longs décontracté Joggers). 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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LUHTA JANAKKALA L6 Veste Femme-Centered Care (IPFCC) provides directions to advance in understanding,WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(MARCO TOZZI 23712 Femme Chaussures Noir).
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Conclusion
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