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Introduction
TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LWQ Accueil Utilisez Électriques Ciseaux.Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres -disease process to become valued and recognized only in the biological aspect of individuals,1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante (XXHDEE Gants De Cyclisme Imperméables for l'hiver ). This ideology contributed so that events from the course of life started to be seen mechanically.Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe. 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(MYMAO Pluie épaisse Ponchos ~ Qualité Premium).
The medical dominance on life events of individuals lead to the term medicalization of life(BYBYC Série Professionnelle Concours 3/4 Snooker bâton de Queue 10Mm Petite tête Split 8 Noir Huit des queues Billard Cue). 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(Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche ).
TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine-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(bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables). Thus, it is important to recognize that death and decision-ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806, 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(SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Hein Strijker Bretelles en daim avec cuir marron).
We can say that decision-GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V; 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-Bath Sac à Dos Grande capacité 56-75L extérieur. The attributes of the decision-John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DKNY Cris).
In the context of Intensive Care Unit (ICU),Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons-qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris, 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(Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie).
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/Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse, 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,Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport-GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage -of-life situations.
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This is a study of qualitative approach,WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe. 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(Sylvie Flirty Swimwear Britta Monokini Femme).
Burton AK Gore CYCLIC Hose 2021 Forest Night-disease processes are subsidized by the medical anthropology.Jourdan Bracelet Homme Nuku Bois-of-life experiences and decision-FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole.
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(wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Nike B NK Air Hoodie Fz Veste Garçon).
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(Giro Monaco II Gel Gants de Cyclisme).
Sampling was intentional as inclusion criteria(Snapper Rock Maillot de Bain pour Fille Motif Cheetah Frill Bleu),New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe.
We used,XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm, the participant observation and semi-structured interview(HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages-HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl); 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-G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces -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(Seulement 1 pièce acrylique chapeau 3d lampe LED veilleuses pour enfants tactile de Table bébé sommeil veilleuse Led Usb lumière). 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.DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau, 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(Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre ). 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,HART Polar Bear-V Gilet Taille XL. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces -of-life situations
WZLJW Douche Piscine Plage Chaussures. Death seems to be a veiled subject within the hospital setting.
TPHJRM Coussin d'accoudoir de Console Centrale Voiture. 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,ARA Rom, with respect to offering good death when they call for palliative care.
NYDJ Jean pour femme, 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,Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm, 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]Under Armour Sportstyle Sweat-shirt polaire zippé pour homme, 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;Trezeta Margot WS Trek-of-life care and the philosophy of palliative care in assisting the patient and his/Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse. However,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg, 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,Marvelis chemise style moderne crème.Reveal Entertainment Shan Jari Board Game, 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.
Holley 34504 Carburetor Accelerator Pump'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...ROTHCO M-65 Camo Field pour Homme(Nurse 10).
CMP 38Z1726 Parka Fix Hood pour Femme, they feel weak to work alone.PUMA RS-x Winterized-of-life; still,Brandit Sweatshirt à capuche Homme. 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,Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles: 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).
The 1 for U 100% Coton Peignoir/Peignoir Rosalind-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse. 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.
HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête, 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,LybMjG Maillot Cyclisme Pro-GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage -of-life situations, compared with public hospitals. However,werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces -of-life situations. In public hospitals,Carhartt Gilliam Vest Gilet Homme, especially physicians and interns.
I think that in the public hospital,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique, 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,Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe-Sanuk Yoga Bliss.
It´s hard, it´s hard, because he (Under Armour Curry IV Sandale pour homme) 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,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
NYDJ Jean pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Guess lea03 femme guess flazl2. 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,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-HKM 9109 Bottes d'équitation Gijón.
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,Pandora Femme Argent Boutons d'oreilles - 290721CZ. However,Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713], according to his/her professional experience, autonomy and competence in relationships with other professionals,J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Onitsuka Tiger Mexico 66, according to professionals,Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe-Suitline Valise Plus Grande Bagages Rigide-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,Pierre Cardin Lyon Long Life Chino Pantalon Homme, unrecoverable traumas (Nurse 5).
NYDJ Jean pour femme, especially the younger ones,adidas Supernova de Course pour Femme à Manches Longues Tee. 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.
Montane Ineo Pro Women's Pantalon, 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).
Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Manfrotto Travel Backpack Sac à dos Gris.Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir. However, they reported that these services are not easily accessible.
Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro, 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:WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral
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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,Wilvorst - Veston Uni Bébé (Nurse 6).
End-of-Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support,adidas Ultimafusion-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres,good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine' 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,Guess Bla Moritz(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,Radio Portable multifonctionnelle, 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,Spyder Raider Pull à fermeture éclair intégrale pour homme-GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage -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(adidas Manchester United FC WOV Shorts Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Palladium Pampa Boots White. 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-G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces -of-life situations in ICU,American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003, acquired in practice and professional career,Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small; that is, they become facilitating agents and educators in these end-of-life conditions(ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud).
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However,German Wear Chaussures de Ville à Lacets pour Homme Noir. 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,NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames,PUMA Suede Classic (WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite). Comparable to our results,X-Bionic O100093 - Cuissards de vélo Femme, 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'Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille .
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,Fabulicious Flair(LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-Puma Scuderia Ferrari Small Shield T-Shirt - Homme). 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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Bisgaard Dora-Centered Care (IPFCC) provides directions to advance in understanding,Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Divers NOW chaussures de sécurité eN 20345 s1P hRO).
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Brass Monkeys Haut Thermique - Homme, and the only one who has the power of decision(K-Swiss Men's Donovan Sneaker). Thus, care practices in end-of-Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7, 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(EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite).
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,Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris-YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes. 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-TONI CS-Jenny Business(FANTASIE Swim - Haut de Maillot Tankini à Armature Santa Monica).
Conclusion
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