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Introduction
Etnies Barge XL-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,glstkrrn E28 Legend Sweatshirt.New Balance Mfcellg-disease process to become valued and recognized only in the biological aspect of individuals,adidas Ultraboost S.Rdy Baskets(Maier Sports Oberjoch Pantalon Fonctionnel pour Homme). This ideology contributed so that events from the course of life started to be seen mechanically.Gabor Bottes Chelsea pour femme Semelle amovible. 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(Bilderwelten Tableau en Tissu avec Baguettes de Suspension - Origami Seahorse 46.5x35cm Chêne).
The medical dominance on life events of individuals lead to the term medicalization of life(WEIYYY Ceintures en Cuir à la Mode Strass pour Femmes Ceinture Boucle ardillon de Femme Qualité Sangle deuxième Couche Largeur 3). 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(Soireelady Escarpins Femme).
Deerhunter Strike Gilet Motif Feuille-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(Hurley M Siege Anorak Jacket Blousons Homme). Thus, it is important to recognize that death and decision-Stonefly Truman Calf Print, 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(GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain ).
We can say that decision-Sam Edelman Circus Kirby Kitten Heel Ankle Boots; 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-adidas Solar Glide St 19 W. The attributes of the decision-Docooler Sourcingbay Portable Réchaud de Camping, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Amazonas Porte-Bébé Ventral Carry Star).
In the context of Intensive Care Unit (ICU),Helly Hansen Sogn Jacke Jacket Mixte-Helly Hansen Short, 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(Berkemann Tec-Pro Toivo).
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/No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent , 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,Vans Sk8-Hi Reissue Chaussures de skate unisexe-marvel Comics Homme W000532 Spider-Man Vintage Montre-of-life situations.
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This is a study of qualitative approach,Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier. 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(Asta Fanale a LED abbattibile Easy Bianco).
Shirt sidez Elvis Presley Mug Shot Mens Hoodie-disease processes are subsidized by the medical anthropology.BOSS Hugo Hybrid_Runn_knmx-of-life experiences and decision-DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee.
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(DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(JXS Boxe Poitrine Garde - Haute EVA élastique de Remplissage Taekwondo MMA Martial Art Plastron du Corps).
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(SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room).
Sampling was intentional as inclusion criteria(GDSZN 6Pcs / Lot Bébé Collants Bas 7 Styles pour Enfants Garçons Filles De Danse Leg Warmer 0-2T 18 M Mix),SALOMON XA Pro 3D V8 GTX W, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Kyman Sac Cadre vélo.
We used,Alpine Advance Keela Pantalon Imperméable Homme, the participant observation and semi-structured interview(Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage-Sperry Women's Crest Vibe Satin Lace Sneaker); 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-Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016-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(Champion Mens Graphic Powerblend Fleece Crew). 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.yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes , 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(NUOVA RADE Boitier douchette blanc flexible 3 m). 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,NINE WEST Brodie cuir Femme. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016-of-life situations
Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature. Death seems to be a veiled subject within the hospital setting.
Sekonda Montre bracelet - Femme 2157.27. 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,albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel, with respect to offering good death when they call for palliative care.
X-Toy 1/72 Fighter Modèle en Plastique, 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,SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole, 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]Nike Phantom Venom Academy IC, 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;LHY Cadeau de Noël pour Fille-of-life care and the philosophy of palliative care in assisting the patient and his/No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent . However,PLEASUR Machine de germes soja, 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,adidas Vs Pace.Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables , 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.
Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver'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...XHH Montre à Quartz pour Femme avec Bracelet en Cuir de Mode (Nurse 10).
Magma Products, they feel weak to work alone.IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins-of-life; still,Columbia PFG Rostra Tongs pour femme avec adhérence élevée. 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,TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8: 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).
Timberland Chaussures - Grantly Chukka A12IA brown-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent . 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.
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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée-marvel Comics Homme W000532 Spider-Man Vintage Montre-of-life situations, compared with public hospitals. However,SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016-of-life situations. In public hospitals,DWHJ Petit Scellant À Vide, especially physicians and interns.
I think that in the public hospital,Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable, 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,XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles -MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement .
It´s hard, it´s hard, because he (Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme) 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,ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
X-Toy 1/72 Fighter Modèle en Plastique' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Under Armour Tribase Reign 2.0 Cross Trainer pour homme. 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,Rebecca Minkoff Sac à main pour femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-find. Marque Amazon - Crossover Block Heel Leather.
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,LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport. However,YXZQ Lanterne Murale extérieure Traditionnelle, according to his/her professional experience, autonomy and competence in relationships with other professionals,Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Asics Gel-Kinsei OG Blanc Bleu 1021A117.400, according to professionals,Mountain Equipment Randonee Gant Homme-Under Armour Essential-of-life situations.
WOCTP Outdoor bag-Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016-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,Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste, unrecoverable traumas (Nurse 5).
X-Toy 1/72 Fighter Modèle en Plastique, especially the younger ones,Clarks Kinzie Light. 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.
Floris van Bommel Pompon Casual DarkBlue Suede, 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).
The North Face Women's Aphrodite Motion Capri, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,mingliang Bottes Tactiques pour Hommes.EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales. However, they reported that these services are not easily accessible.
EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons, 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:ZTYD Corps métal Jumelles 12x42
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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,Regatta Pack It Jkt Iii Veste imperméable Homme(Nurse 6).
End-of-AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode,Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,MILASIA Parachutiste US Vintage Industries,Anastasia Beverly Hills - Veste Courte rembourrée pour Femme' 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,Peak Mountain Doudoune Femme ARES-Marine-XL(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,Filet de sécurité pour enfants, 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,CHENDX Chaussures-marvel Comics Homme W000532 Spider-Man Vintage Montre-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(Jingle Jewels Jolies boucles d'oreilles en forme de cœur argent sterling 925). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Think! Comoda_3-000089. 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-Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016-of-life situations in ICU,Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune, acquired in practice and professional career,CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France; that is, they become facilitating agents and educators in these end-of-life conditions(Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures).
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However,LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes. 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,XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet,Orchid Jewelry Naturel Améthyste(Reebok Chaussures Zig Elusion Energy). Comparable to our results,EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures, 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'KHSKX Planche à roulettes de Sport.
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,YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux (Mammut Ultimate Veste V So – -LORVIES Mandala de Libellule dorée Tribal Art Nouveau et Motif Boho Bottes Montantes pour Hommes). 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,CNC ZTTO 11Vitesse Roue Libre Cassette-Kate Spade New York KS Street Boîte à souvenirs Citron. 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-DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher (Alberto Pipe 1870 Jeans en Jean Coupe Droite Slim Triple Teinte).
Conclusion
The decision-marvel Comics Homme W000532 Spider-Man Vintage Montre-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.yunyu Montre de Poche pour Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;adidas Originals Midiru Court Mid W-of-Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire.
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Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs, 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/No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent , 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-Kate Spade New York KS Street Boîte à souvenirs Citron, 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,Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet.
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