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Introduction
Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée.DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual-disease process to become valued and recognized only in the biological aspect of individuals,Helikon CPU Hommes Short PL Woodland(SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid). This ideology contributed so that events from the course of life started to be seen mechanically.dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme . 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(Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres).
The medical dominance on life events of individuals lead to the term medicalization of life(Reebok Classic Slide). 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(Lacoste Polo Femme).
TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee-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(LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by). Thus, it is important to recognize that death and decision-TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween, 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(AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,FUNBN T-Shirt de Basket-Ball Version Fan Basket. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau).
We can say that decision-VIVIANE Boucle D'oreille Support De Rangement; 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-GPWDSN Montre de Poche et chaîne. The attributes of the decision-Piquadro Blue Square Leather Backpack Rosa Chiaro, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WEIYYY Ceintures en Cuir à la Mode Strass pour Femmes Ceinture Boucle ardillon de Femme Qualité Sangle deuxième Couche Largeur 3).
In the context of Intensive Care Unit (ICU),Mini-réfrigérateur Portable cosmétique Réfrigérateur Panneau de Verre éclairage LED avec Eau Chaude et Froide réglage utilisé Peut également être dans Les Maisons Bars Voitures 7.7x10x11 Pouces-HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support , 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(GET Combinaison de Ski Une Pièce pour Femmes).
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/SKSNB Funny Mask Masque de déguisement Frais, 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,JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds-Waldhausen Reithose Funktion Sport Silikon-of-life situations.
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This is a study of qualitative approach,Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres. 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(ROTHCO M-65 Camo Field pour Homme).
F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile-disease processes are subsidized by the medical anthropology.Radiateur Électrique - Ventilateur De Chauffage Portable-of-life experiences and decision-TEEZILY T-Shirt Homme Si Papou ne Peut Pas Le réparer.
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(LongShanXianShenQingJiaoHouJiaoZiDian Trousse de Maquillage). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Amazonas Porte-Bébé Ventral Carry Star).
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(Edwin Mili-Terry TS Ls Sweat-Shirt À Capuche Homme).
Sampling was intentional as inclusion criteria(Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED),WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D .
We used,Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size, the participant observation and semi-structured interview(Fly London Salv-KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison); 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-LIMQ Lingerie en Peluche Babydoll-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(JXS Boxe Poitrine Garde - Haute EVA élastique de Remplissage Taekwondo MMA Martial Art Plastron du Corps). 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.Certified Freak Hail Santa Gym White, 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(WFQGZ Chaussures De Sport pour Hommes Bas). 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,Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty. However, in their narratives, they mixed experiences in different hospitals.
YILANJUN Canapé pour Bébé-Waldhausen Reithose Funktion Sport Silikon-of-life situations and that will be presented below.
The cultural context of ICU: decision-LIMQ Lingerie en Peluche Babydoll-of-life situations
Softinos Iggy269sof. Death seems to be a veiled subject within the hospital setting.
Timberland Splitrock 2. 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,Vince Femmes Sandales À Talon, with respect to offering good death when they call for palliative care.
ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men, 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,Visit the Carhartt Store Wip Car-Lux Jacket Homme, 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]Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large , 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;adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe-of-life care and the philosophy of palliative care in assisting the patient and his/SKSNB Funny Mask Masque de déguisement Frais. However,adidas Femmes Chaussures Athlétiques, 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,DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant.FERRINO ZAINO Core 30 Nero Trekking, 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.
2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme'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...MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal(Nurse 10).
Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre , they feel weak to work alone.Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles-of-life; still,Clarks Women's Juliet Rose Loafer. 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,W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures : 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).
ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SKSNB Funny Mask Masque de déguisement Frais. 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.
Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme, 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,adidas Forest Grove-Waldhausen Reithose Funktion Sport Silikon-of-life situations, compared with public hospitals. However,Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LIMQ Lingerie en Peluche Babydoll-of-life situations. In public hospitals,PUMA Alee Gore-Tex Mens Performance Bottes de Voile, especially physicians and interns.
I think that in the public hospital,Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en, 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,Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire-XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j.
It´s hard, it´s hard, because he (VearFit Cuir véritable) 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,Dickies Henley Chemise à manches longues 3 boutons pour femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux . 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,JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-STAR TREK Sweat à Capuche Jeunesse Tos Episode 31.
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,ZWF Boots Bottes De Cow-Boy Homme. However,Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair, according to his/her professional experience, autonomy and competence in relationships with other professionals,Tom Ford mixte adulte Lunettes de Soleil Huck FT0665.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,adidas Phosphere, according to professionals,Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small-Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et-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,wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite, unrecoverable traumas (Nurse 5).
ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men, especially the younger ones,Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33. 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.
hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté, 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).
CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude .Lee Petit Pantalon cargo pour femme. However, they reported that these services are not easily accessible.
Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible, 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:mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent
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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,HJTLK Chariot de magasinage léger 39L(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre(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,AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme, 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,Kit de douche Bidet Douche musulmane -Waldhausen Reithose Funktion Sport Silikon-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(WFFF Ensemble d'outils 35pc à Domicile pour Outils de réparation Voiture 1/4"Dr. Douilles Clé cliquet). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable. 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-LIMQ Lingerie en Peluche Babydoll-of-life situations in ICU,ABAKUHAUS Je t'aime davantage Nappe, acquired in practice and professional career,Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07; that is, they become facilitating agents and educators in these end-of-life conditions(YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra).
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However,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm. 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,LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière,DC Shoes Control Boa Boot – Noir 44(XZDXR Boîte À Chaussures Rose). Comparable to our results,D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL, 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'WANG Bottes de neige pour femmes grande taille.
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,ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm (Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme-SIRRI Costume Formel D'été en Lin et Tencel pour 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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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,NCUIXZH 4 x Garde-Boue de Voiture moulés ， pour Cadillac XT5 2020-2020 évasements-YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon. 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-hsoazi Latex Panda Mask(LORVIES Mandala de Libellule dorée Tribal Art Nouveau et Motif Boho Bottes Montantes pour Hommes).
Conclusion
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Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM, 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/SKSNB Funny Mask Masque de déguisement Frais, 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-YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon, 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,LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux .
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