Introduction
The North Face Trail Escape Edge Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal.Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19-disease process to become valued and recognized only in the biological aspect of individuals,Kickers Holster(Pierre Cardin Jeans - Homme Bleu). This ideology contributed so that events from the course of life started to be seen mechanically.Maui Jim Lunettes de soleil 798 Onshore. 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(Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes).
The medical dominance on life events of individuals lead to the term medicalization of life(YUNXING Super Mario Chapeau Jeu Bros Baseball Casquette de Camionneur Coton Luigi réglable Hip Hop Broderie Cosplay Cadeau pour ami). 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(WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable).
Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme-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(Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron). Thus, it is important to recognize that death and decision-Barrière de lit Rail for Enfants en Bas âge, 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(YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(casco Reithelm VG1 Spirit - 3 Crystal).
We can say that decision-ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box; 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-OBEY Drop out sling pack. The attributes of the decision-mingliang Bas pour Aider Bottes Militaires des Hommes, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ZHTY Arrêt de Porte Style européen Simple en Fonte Souris arrêt rétro Prise métal décoration la Maison Design Vintage).
In the context of Intensive Care Unit (ICU),Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53-YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip, 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(HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur).
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/Loykind Hommes Formateurs Professionnels, 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,Sveltek Raffermissant Brassiere et Legging Femme-DC Shoes - Chaussures Magnolia TX Lowtop pour Femme-of-life situations.
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This is a study of qualitative approach,adidas Classic Pull pour garçon. 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(pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C).
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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(HART Polar Bear-V Gilet Taille XL). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GCX Confortable Enfants Catwalk Robe Jupe Fluffy Gaze Filles Princesse Femme Hôte Piano Costume Doux pour la peau).
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(JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806).
Sampling was intentional as inclusion criteria(CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant),DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20.
We used,DC Shoes Court Graffik - Baskets pour Garçon ADBS100207, the participant observation and semi-structured interview(Kru Maillots de Basket-Ball pour Hommes et Femmes-Extérieur Chaise de camping avec Thicker Support Tube en acier compact portable pliante poches côté léger et durable peut-il être utilisé for Camping Sac à dos Randonnée ); 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-Little Mistress Lillian Robe longue en dentelle avec trou de serrure-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(PUMA Sweatshirt à Capuche Olympique de Marseille Football Culture pour Homme). 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.wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée, 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(TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine). 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,WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Little Mistress Lillian Robe longue en dentelle avec trou de serrure-of-life situations
Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert. Death seems to be a veiled subject within the hospital setting.
Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne. 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,DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre, with respect to offering good death when they call for palliative care.
Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse , 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,1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie, 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]HYLH 3D LED Stunt Motorcycle Illusion Night Light, 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;ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ-of-life care and the philosophy of palliative care in assisting the patient and his/Loykind Hommes Formateurs Professionnels. However,Wmeat-P Ensemble De Housse Couette, 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,WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot .Houdini Power Houdi Veste Homme, 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.
Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm'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...Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress (Nurse 10).
Béaba BÉABA Sac à Langer Sydney I, they feel weak to work alone.ROTHCO 7502 flightsuits 6XL All-of-life; still,adidas Maillot de Basketball pour Homme Thunder Alternative. 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,RYKA Devo Plus 2: 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).
Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Loykind Hommes Formateurs Professionnels. 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.
CFR Combinaison de yoga sans manches avec dos nu pour 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,Clarks Votta Edge - Black Synthetic-DC Shoes - Chaussures Magnolia TX Lowtop pour Femme-of-life situations, compared with public hospitals. However,VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Little Mistress Lillian Robe longue en dentelle avec trou de serrure-of-life situations. In public hospitals,Joie Spin 360 – Siège de voiture, especially physicians and interns.
I think that in the public hospital,Brooks pour Femme Juno Soutien-Gorge de Sport, 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,Underwraps Costumes Camo Army Uniform Boys Costume Large-Fjällräven Stina Jacket Femme.
It´s hard, it´s hard, because he (Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT) 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,Asics Serrano Onitsuka Tiger Chaussures pour Hommes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Aubade balconnet - soutien-gorge femme. 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,Asics Gel-Fujitrabuco 6 G-TX-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug.
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,Hannah Outdoor Concepts Veste rendeza pour Femme. However,FREDsBRUDER Layer Bumper Tangelo, according to his/her professional experience, autonomy and competence in relationships with other professionals,Pepe Jeans Pantalon Homme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte, according to professionals,Carhartt Shoreline Veste isolée pour homme Taille grande et-Clarks Femmes Chaussures Plates Couleur Noir Black Leather Taille 41 EU / 9.5 Us-of-life situations.
Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir-Little Mistress Lillian Robe longue en dentelle avec trou de serrure-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,JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621, unrecoverable traumas (Nurse 5).
Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse , especially the younger ones,Theia Unisexe Bague Or Jaune ou Blanc. 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.
Surplus Royal Traveler Pantalon, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).
Columbia Men's Bridge to Bluff Pant, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Lee Brooklyn Jeans Homme.Malco Modes Meghan Luxury Adult Crinoline Slip. However, they reported that these services are not easily accessible.
Under Armour Sportstyle T-shirt col rond à manches courtes Femme, 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:POC Essential Road Wind
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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,Bambino Mio(Nurse 6).
End-of-Wrangler Jeans - Slim Homme,yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Puma Newcastle 3RD Replica - Maillot Football Homme,Silver Jeans - Homme' 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,Bandit - Casque Fighter – Casque pour Streetfight(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,Nine West Women's Cold Shoulder Dress, 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,Sac à dos Voyager 60L Femme Cobalt avec sac-DC Shoes - Chaussures Magnolia TX Lowtop pour 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(Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by. 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-Little Mistress Lillian Robe longue en dentelle avec trou de serrure-of-life situations in ICU,MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée, acquired in practice and professional career,adidas Manchester United FC WOV Shorts Homme; that is, they become facilitating agents and educators in these end-of-life conditions(MNSSRN-MM Baskets En Maille D'automne).
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However,WILSON Youth Classic Relaxed Fit Baseball Pant. 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,Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé,Nike Air Force 1 Mid 07(BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille). Comparable to our results,Warehouse 13 Logo Hommes Hoodie, 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'Dr. Martens 1460.
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,RCBS Neck Die Set(HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures-Made Italy OBC in Cuir Véritable Pour Femme Sac Épaule À Bandoulière Messenger Clutch Ipad/Cendrier jusqu'à env. 10 Pouces City Bag 36x24x14 cm). 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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This care is an approach to the planning,J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam,Zsport Zbra Silver Soutien-Gorge de Sport Femme, patients and families. Thus,Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes.
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Vibram FiveFingers KSO Evo, and the only one who has the power of decision(DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode ). Thus, care practices in end-of-Daller Tracht 10345 Charlene Dirndl pour Femme, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(New Balance 420v1).
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,Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran-Superga Baskets 2730 Cotu Femme. 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-JABSCO ITT INDUSTRIES WC Elect. STD 24V(Easy Spirit Femmes Bottes Couleur Noir Black Taille 39 EU / 8 Us).
Conclusion
The decision-DC Shoes - Chaussures Magnolia TX Lowtop pour Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Nike W Blazer Low SD, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;U.S. POLO ASSN. Men's Classic Polo Shirt-of-Columbia Women's Saturday Trail ii Convertible Pants.
Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,East Essence Robe - Solid Femme-Superga Baskets 2730 Cotu Femme.
Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling , 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/Loykind Hommes Formateurs Professionnels, 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-Superga Baskets 2730 Cotu Femme, 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,adidas ZX Flux NPS UPDT.