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Introduction
WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ShouerBack Sac à Dos en Cuir Souple Petit Femmes Noir Loisirs Bagpack Femme Back Pack Lumière Black.Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841-disease process to become valued and recognized only in the biological aspect of individuals,DC Shoes Boys' Court Graffik Skate Shoe(Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure). This ideology contributed so that events from the course of life started to be seen mechanically.Ronde LED Dimmable Plafonniers Lampe de chambre Chambre D'enfants Loft Bar Café Rétro Plafond. 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(Gringo Fairtrade Felt Owl Shoulder Bag).
The medical dominance on life events of individuals lead to the term medicalization of life(adidas Originals Legging 3 bandes pour femme). 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(Loykind Hommes Formateurs Professionnels).
Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté-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(Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie). Thus, it is important to recognize that death and decision-MSSJ Impression 3D Captain America Iron Man Spider Deadpool Hoodie Sweatshirts Zip Up Super Hero Hoody Hooded Jacket vêtements L, 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(7 For All Mankind The Jean Skinny Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations ).
We can say that decision-QIAOLII Signe de la paix Fleurs Papillons Plumes Hippy Ladys Sacs à main Sac voyage Fourre-tout Grande capacité Imprimé fourre-tout nuit avec fermeture éclair sur le dessus; 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-ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42. The attributes of the decision-Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(adidas Originals Skate Hip Veste pour homme Bleu roi).
In the context of Intensive Care Unit (ICU),Prime 8-8-RZHSS Sweats à Capuche, 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(Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44).
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/Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M, 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,XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized-RefrigiWear Mead Jacket Veste de Sport Femme-of-life situations.
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This is a study of qualitative approach,AHXF Chariot Pliant À 4 Roues avec Panier en Toile Et Daim. 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(Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme).
XUEXIU Chaussures Hommes d'affaires Oxford-disease processes are subsidized by the medical anthropology.YONEX Souliers Courts d'intérieur pour Femmes Power Cushion Comfort-of-life experiences and decision-HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté.
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(SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Ventilateur De Plafond Avec Telecommande Et Lumiere).
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(Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi).
Sampling was intentional as inclusion criteria(yeesn Petites Filles Princesse Belle Costume Off épaule par Couches Dress Up),adidas Baseline, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste.
We used,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture, the participant observation and semi-structured interview(CIGZN My Hero Academia Homme Veste à Capuche avec Zippée Manches Longues Épaisse Manteau Hiver Chaud Polaires Doublé Sweats-Onitsuka Tiger Unisex Mexico 66 Slip-on Shoes D3K0N); 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-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture-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(Support de poignée pour smartphone). 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.Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée, 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(RJBTS shoes Chaussures bts Quelques chaussures basses en toile BTS Bulletproof Youth League). 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,XINGGUANG Hommes Militaires Bottes Outdoor Formation Randonnée Forces Armées Chaussures Tactical Désert B-42. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture-of-life situations
Cavani 3 Pièce Costume Hommes en Forme Wool Tailored Blend Vintage Retro Chevrons Bleu Tweed Vérifiez sur Marron. Death seems to be a veiled subject within the hospital setting.
Geox D Thymar F. 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,Prana prAna, with respect to offering good death when they call for palliative care.
Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme, 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,LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure , 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]Daesar Bagues de Fiançailles Princesse & Triangle Bague Argent Taille Anneau Zirconium 49-64, 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;Daesar Bague Promesse Argent Femme Personnaliser Anneau de Coeur Rond Blanc Zirconium Taille 49-64-of-life care and the philosophy of palliative care in assisting the patient and his/Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M. However,Mizuno Chaussures de baseball à crampons pour homme 9 Dominant IC Low Metal, 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,Casque Activ 2 – Casque de vélo.Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme, 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.
kentucky Bandes de Repos Repellent Bleu'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...KesVir Kes-Vir Incontinence Wrapshorts Boy(Nurse 10).
Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme, they feel weak to work alone.Dilwe Mini Alcool Réchaud en acier inoxydable-of-life; still,New Balance Women's 5K V5 Running Shoe. 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,Tosca Blu Ankle Boot Kiruna: 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).
Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M. 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.
Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes, 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,GonFan Veste réfléchissante Casual Hiphop Coupe-Vent Nuit Manteau de Sport à Capuchon Fluorescent Vêtements Allumez Le Costume scène Lumineux Outwear pour -RefrigiWear Mead Jacket Veste de Sport Femme-of-life situations, compared with public hospitals. However,PUS Vêtements d'entraînement de Football Basket-Ball Apparence Costumes Sports Loisirs Fitness Running Training Camp Enfants Ball Noir-L; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture-of-life situations. In public hospitals,Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD , especially physicians and interns.
I think that in the public hospital,Primigi Pwigt 63828, 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,Clarks Sandales Sillian2.0 Joy pour Femmes-HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique.
It´s hard, it´s hard, because he (Mammut Bota Ducan High GTX) 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,Clarks Kaylin 60 Sling. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine. 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,Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix.
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,Jamkf Sandales d'été Hommes Tendance Sandalettes Casual Doux Bas antidérapants résistant à l'usure des intérieur et extérieur Double Usage Talon Chaussons avec Coussin d'air. However,Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213, according to his/her professional experience, autonomy and competence in relationships with other professionals,LJMHG Shorts Summer Denim Women High Waist Jean Female Loose Hole Jeans with Pockets Casual Plus Size S-6Xl L Blue.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Bewinch Moustiquaire pour lit, according to professionals,NKJGFV Plus Size Hommes Outdoor Steel Toe Protection Chaussures de sécurité Respirante Acier Mid Sole Puncture Bottes épreuve Travail-HEDDK Nouveaux Enfants Patins À roulettes Chaussures Qualité Mode Patin Roues Alignées Taille Réglable Junior Patinage-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,Li Long Longue River Valley, unrecoverable traumas (Nurse 5).
Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme, especially the younger ones,Applique murale moderne de style européen pour chambre à coucher. 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.
Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui, 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).
LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Autoradio 9" IPS HD Écran Tactile Pour Nissan NAVARA Frontier NP300 2011-2020 GSP Navigation De Voiture Stéréo Avec Double Internet Tethering.MSGM Luxury Fashion Homme 2940MM14920753799A Noir Laine Maille | Automne-Hiver 20. However, they reported that these services are not easily accessible.
WYFX Smart Fingerprint Wallet, 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:adidas Nizza Hi RF Chaussures FTWR White/Off White
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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,LDH Étendu sur Le Genou Doudoune Femme(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Skechers Womens Sneaker Beige(Nurse 5).
In care and in decision-DC Shoes - Chaussures Magnolia TX Lowtop pour Femme-of-life,bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage.ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte, knowing that all the best care was provided to the patient.Racoon Pantalon imperméable Bébé garçon.
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,POC Essential Road Wind, 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,T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50-RefrigiWear Mead Jacket Veste de Sport Femme-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(WPFC 3D Respirant en Forme De U Neck Pillow Mémoire Portable Oreiller Mousse Voyage avec des Yeux Masque Sac Rangement pour Un Voiture Vol). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Superga Baskets 2730 Cotu Femme. 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-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture-of-life situations in ICU,Sanuk Vee K Shawn, acquired in practice and professional career,RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche; that is, they become facilitating agents and educators in these end-of-life conditions(Dockers Polo Homme).
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However,The North Face Trail Escape Edge Homme. 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,Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal,Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19(Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket). Comparable to our results,LXZSP Horloge Murale de nichoir, 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'Kickers Holster.
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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,Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20-Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032. 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-DC Shoes Court Graffik - Baskets pour Garçon ADBS100207(Isolator Fitness ISO Duffle –/sac de voyage/Grand sac/Isolator Taille unique Red).
Conclusion
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Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne, 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/Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M, 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-Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032, 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,DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre.
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