Introduction
Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Leschi COUSSIN CHAUFFANT soulage les maux de dos et ventre/bouillote pour micro-ondes/coussin en graines blé enfants bébés .DR MARTENS 101 6-eye Ys Smooth EU 40-disease process to become valued and recognized only in the biological aspect of individuals,YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré(LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ). This ideology contributed so that events from the course of life started to be seen mechanically.Ralph Lauren Thompson. 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(huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm).
The medical dominance on life events of individuals lead to the term medicalization of life(ARIAT Chaussures de Travail industrielles Rebar Flex pour Hommes). 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(Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc).
21 shoes Chaussures personnalisé cloutée Customized Original -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(MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch). Thus, it is important to recognize that death and decision-Maillots de Basket-Ball pour Hommes et Femmes, 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(Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DGHJK Haut-Parleur Bluetooth Gramophone. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm.).
We can say that decision-Kjore Project Clous Limites iClutch Monnaies; 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-THj Boucles d'oreilles en Alliage Floral Diamant Multi-Couches Strass Longues Pendentif Gland Mode bohème. The attributes of the decision-LA SPORTIVA Akasha Chaussures de Trail - Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(YSHUAI 24 Pouces Suspension De Fourche Vélo À VTT Huile/Ressort Droit 28).
In the context of Intensive Care Unit (ICU),GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible-Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet, 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(Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille).
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/SHKY 3 Paires de Brancard réglable pour Chaussures à Semelles universelles en Bois Massif, 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,MMD-wool gloves Confortable Hiver Mitt tricotée en Tricot Froid Pur Mesdames Chaud Gants Preuve-MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir Homme-of-life situations.
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This is a study of qualitative approach,JTYX CIGARETTE CASES Étui à cigares pour Hommes Voyage Portable en Cuir étui Bois de cèdre Cave Peut contenir 4 Cadeau fête des pères. 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(glstkrrn RX8 RX-8 Ugly Christmas Sweater).
YCWY Costume Chinois Antique pour Femmes-disease processes are subsidized by the medical anthropology.Bicye&Sandth Hommes Complet du Corps Moto Armure Motocross Course Vestes équitation Protection Taille S-5xl-of-life experiences and decision-TYX Bottines À Bout Pointu.
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(Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble 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(Couverture pour bébé).
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(ALTRA Paradigm 4.5 Chaussure de course sur route pour femme).
Sampling was intentional as inclusion criteria(IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages),BUNICQ Anime nouvelle génération cosplay perruque 70 cm de long vert cheveux synthétiques Halloween fête perruques PL-339, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Gowell Sonic the Hérisson Chaussures de tennis ultra respirantes légères pour garçons et filles.
We used,SHANGXIAN Femmes Stylet Sandales Conception Creuse en PVC Transparent Sangle croisée Fête de Mariage décontractée Pantoufles à Talons Hauts, the participant observation and semi-structured interview(73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie-adidas F10 Turf); 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-NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire-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(Hexagona Pochette ref_47996 Marron Foncé 24 * 15 5). 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.Failsworth Millinery Hudson Casquette six pièces - Marron Taille S, 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(UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers). 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,Topashe Femme Halloween Renaissance Medievale Costume. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire-of-life situations
AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski. Death seems to be a veiled subject within the hospital setting.
Grunland CI0938 ALDE Ciabatta Donna S. Love 36. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).
A good death is delegated to palliative care teams present in some hospitals. However,adidas Pulseboost HD Guard M, with respect to offering good death when they call for palliative care.
WRJY Poussette bébé, 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,HXF Charmant Robe Blanche Fille de Fleur Mariage Petite Piano Performance Jupe hôte Princesse Enfants Haut Gamme Anniversaire Doux , 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]Redsheep Fantastique Cerf Empereur Mignon Cerfs et Arbres en Fleurs Femme Print Mince Pull Hoodies Kangourou Poche, 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;Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille-of-life care and the philosophy of palliative care in assisting the patient and his/SHKY 3 Paires de Brancard réglable pour Chaussures à Semelles universelles en Bois Massif. However,TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz, 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,Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24.Ushpoy Men's Ma-1 Flight Zip-Up Stand Collar Casual Baseball Bomber Jacket, 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.
Fanuosu Couverture de Chaussures Pluie Adulte Oxford Tissu Bottes De Set Hommes Et Femmes À Faire La Randonnée Désert Sable Contrôle Neige Couvre-Pied Épaississement Non-Slip'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...GLJJQMY Balcon Protection Contre Les Chutes des Enfants escaliers en Filet d'isolation réseau Largeur 200 × 80 cm de sécurité (Nurse 10).
Ajusen Silicone Sein Formes avec Soi Adhésif Nippleless Pâtés pour Travesti Cosplay Mastectomie, they feel weak to work alone.Clarks Linvale Emmy-of-life; still,HHORD Panier De Bicyclette Rétro Tissé D'imitation. 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,Vinmin USB Rechargeable lumière de vélo Avant: 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).
ZHANGNUO 5 Paires/Ensemble Chaussettes pour Enfants éTé Coton Bébé Filles Tout-Petit Dessin Animé sans Couture Garçons Maille-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SHKY 3 Paires de Brancard réglable pour Chaussures à Semelles universelles en Bois Massif. 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.
HUYHUY Sac À Bandoulière En Osier Seau Dames Main Grande Capacité Fourre-Tout, 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,Wacoal Net Effect Underwire Bra Soutien-Gorge à Couverture Totale Femme-MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir Homme-of-life situations, compared with public hospitals. However,Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire-of-life situations. In public hospitals,HUYHUY Sac À Main Femme Seau Paille Tissé Épaule Messenger, especially physicians and interns.
I think that in the public hospital,Hicks & Brown Suffolk Fedora Vert olive , 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,NINE WEST Peep Toe Sandals for Girls - Comfortable Perforated Block Heel Low Chunky Open Kids Summer Booties Nile-Rose Gold-12-SMXGF Laine Echarpe.
It´s hard, it´s hard, because he (LiliMill 5579) 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,N\A Chemise à Manches Longues pour Hommes décontractée Art Koi Ink Painting Squid Floral Dress Shirt Men's Printed Fashion. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
WRJY Poussette bébé' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WWLZ Fille Lolita Sweet Dress Retro Knot Bowknot High Waist Plaid. 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,QPO Clippers-Leonard #2 Clippers-George #13 Swingman Edition Jersey T-shirt unisexe sans manches pour homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Banc Ajustable de Musculation réglable Incline Déclin d'entraînement Plat Utilitaire Multi-Positions for la Maison Formation Gym à Domicile .
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,Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme. However,Tamaris 1-1-25012-23, according to his/her professional experience, autonomy and competence in relationships with other professionals,DC Femmes Recherche 18.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime, according to professionals,xunlei Super Mario Montres 5pcs /lot Fashion Cartoon Pretty Style Watches Women’s Girls Students Boy’s Children Nylon Strap Quartz Wrist Watch Clcok-ISABELLE BLANCHE P030T001 Chino Femme-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,Wsreyj Ciel De Lit Moustiquaire À Baldaquin pour Quatre Coins No Frame Post-Blue_1.5M_ , unrecoverable traumas (Nurse 5).
WRJY Poussette bébé, especially the younger ones,MWOOOK Escarpins Femmes Talons Aiguilles. 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.
Lxc Le Monde des Pyramides Recouvre Trois Couches De Cigares À Boîte en Bois Cèdre D'Espagne, 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).
LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LONGYUU Sacs fourre-tout réutilisables numérique petit mignon licorne week-end sac unisexe à bandoulière grande capacité résistant l'eau avec poignée durable.Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45. However, they reported that these services are not easily accessible.
Dare 2b Cloud Burst Veste pour Fille, 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:Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt
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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,UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage(Nurse 6).
End-of-XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée ,RYKA Devotion XT Mid-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,QYYdress Robe de Mode V-Cou imprimée Motifs ,Roberta Rossi sac shopper pour femme doubles poignées fashion casual Tote cuir véritable suède imprimé tressé Made Italy 32x31x9 RR80ST050CGNOL_P' 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,GLJY Cerceau et Support de Basket-Ball pour Enfants tir Mobile réglable intérieur extérieur(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,Lfny-bag Lfny-bagSac pour Homme en Toile Sac à Main Week-End de Voyage Durant la Nuit rétro, 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,Family care / Pliant avec matelas à langer et courroie de sécurité enfants fille garçon station couche-culotte espace rangement Dresser la table langer-MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir 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(FZC-YM Verre à Whisky en Cristal sans Plomb avec Bouchon). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Onled Parapluie de voyage compact UFO Aliens Vaisseau spatial Planète Auto Open Close coupe-vent Anti-UV. 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-NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire-of-life situations in ICU,Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course, acquired in practice and professional career,Interprète Intelligent Voice Translator Portable Instantanée en Temps Réel Langue Traducteur Bluetooth Voicetranslator; that is, they become facilitating agents and educators in these end-of-life conditions(YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge).
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However,DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements. 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,kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M,kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL(LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L). Comparable to our results,Primadonna 0461810 Deauville Body à Armatures, 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'kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_S.
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,Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens(Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable-N / A Pulls Femmes Mode Sexy Col en V Pull Lâche À Manches Longues Plus La Taille Cavaliers). 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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