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Introduction
Asta Fanale a LED abbattibile Easy Bianco-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Mark Nason Hayden.ASICS Tiger Gel-Lyte Chaussures-disease process to become valued and recognized only in the biological aspect of individuals,Leg Avenue Spooky Board Beauty Adult Sized Costumes(Utility Diadora Veste Sail Gris gris M). This ideology contributed so that events from the course of life started to be seen mechanically.GIOSEPPO Oulu. 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(Usb 3d Led Veilleuse F-16 Combat Falco Avion Warcraft Modèle Illusion Fighter Décoratif Lumières Warplane Lampe De Table Chevet).
The medical dominance on life events of individuals lead to the term medicalization of life(Lesif Sac à dos bandoulière Sibérie pour homme et 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(LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand).
Rocket Dog Sadea-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(LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant). Thus, it is important to recognize that death and decision-HÖGL Publicity, 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(Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HÖGL Finesse. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport).
We can say that decision-Tommy Hilfiger Th Core Saddle Bag; 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-Puma Rebel Sweat Suit Survêtement Femme. The attributes of the decision-Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Outdoor Research Women's Ferrosi Jacket Veste pour femme Femme).
In the context of Intensive Care Unit (ICU),Tod's Mocassino Gommino in Pelle-QUNLIANYI Robe de Mariee Grande Taille Dames Elegant Party Dresses Style Patchwork Big Swing A-Line Femmes Longue, 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(Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus).
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/NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular, 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,Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm-Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc-of-life situations.
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This is a study of qualitative approach,Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian. 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(Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL).
WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables-disease processes are subsidized by the medical anthropology.yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée-of-life experiences and decision-mys Sneaker Customized Adulte - Chaussures Coutume .
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(VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(JHKJ Femmes Bottes en Cuir Imperméable & Respirant Mode Bout Pointu Métal stiletto Bottines Hiver).
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(AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de).
Sampling was intentional as inclusion criteria(ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble),Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine.
We used,Columbia Bahama Vent PFG Veste pour homme, the participant observation and semi-structured interview(PME Legend 550 Curtis Runway Chaussures de course Gris-IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages); 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-Lee Performance Series Extreme Motion Regular Fit Jean Homme-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(TANGBC Sweats à Capuche hommeSweats pour Hommes et Femmes). 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.Bache Impermeable Exterieur Transparente, 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(DYHQQ Brancard de Chaussure). 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,MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie. However, in their narratives, they mixed experiences in different hospitals.
Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11-Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc-of-life situations and that will be presented below.
The cultural context of ICU: decision-Lee Performance Series Extreme Motion Regular Fit Jean Homme-of-life situations
KAPPA ORIGINALS Kappa Felpa 3031110 Bambino. Death seems to be a veiled subject within the hospital setting.
PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S. 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,Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women, with respect to offering good death when they call for palliative care.
SMX Coussin de ge Voiture d'hiver, 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,EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket, 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]MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full , 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;JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343-of-life care and the philosophy of palliative care in assisting the patient and his/NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular. However,ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X, 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,Daniel Hechter 811437061169.Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress, 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.
Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3''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...YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel(Nurse 10).
Asics Gt-3000 5, they feel weak to work alone.Globe Motley Mid-of-life; still,XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]. 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,ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur: 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).
Nautica Women's Lightweight Stretch Jacket-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular. 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.
Tommy Hilfiger Reversible Th Logo Bomber Blouson, 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,KLIM K Corp Sweat à capuche SM Noir - Jaune-Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc-of-life situations, compared with public hospitals. However,ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Lee Performance Series Extreme Motion Regular Fit Jean Homme-of-life situations. In public hospitals,Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1, especially physicians and interns.
I think that in the public hospital,HENGTONGTONGXUN Hamac Anti-Renversement, 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,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable-Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme.
It´s hard, it´s hard, because he (L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492) 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,YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
SMX Coussin de ge Voiture d'hiver' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit. 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,Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Aston Martin Racing Sudadera Performance.
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,RRD di roberto ricci design W19141 Maillot à côtes pour Homme. However,Lottusse T2466, according to his/her professional experience, autonomy and competence in relationships with other professionals,LAETI TREMA Boucles d'oreilles Cuzco Malachite .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,CYKABT Collier de lapin, according to professionals,ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm-RESUXI Couettes de Noël Ensembles Double-of-life situations.
RESUXI Couettes de Noël Ensembles Double-Lee Performance Series Extreme Motion Regular Fit Jean Homme-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,Disney Valise trolley cabine Minnie Pink Vibes, unrecoverable traumas (Nurse 5).
SMX Coussin de ge Voiture d'hiver, especially the younger ones,GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe . 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.
Baignoire Pliante en Plastique, 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).
PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains.HUYUQU Chaussures de Danse Latines à Strass pour Femme. However, they reported that these services are not easily accessible.
Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine, 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:Columbia Wayfinder Outdry'
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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,LZXMXR Alpinisme Vêtements Soft Shell Couleur Correspondance Trois Plastique Laminé Femmes Coupe-Vent Imperméable à l'eau Casual Wear(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air(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,Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples, 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,adidas Terrex Free Hiker Parley-Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc-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(GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35. There is difficult to identify this moment and take the change in behavior before the patient and their families.
Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy-of-life situations,Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy/NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular(American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003).SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S(Alda Joyeros Boucles des oreilles femme or blanc 18 carats petites étoiles),Cadeau Festival Haute Vitesse 360 Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face, in their narratives,PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité.Clarks Pawley Rilee,ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair.
Despite their difficulties and little preparation to deal with decision-Lee Performance Series Extreme Motion Regular Fit Jean Homme-of-life situations in ICU,Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet, acquired in practice and professional career,Stockerpoint Weste Leander Veste de Costume d'affaires Homme; that is, they become facilitating agents and educators in these end-of-life conditions(Superga 2750-cotu Classic).
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However,Modèle d'avion en métal moulé sous pression 16 cm Boeing B777. 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,No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set ,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm(mmmy Perruque). Comparable to our results,Cadeau Festival Haute Vitesse 360 Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face, 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'MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL.
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,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267(Esprit Sweater Femme-ZMMWDE Démarreur Moteur électrique du démarreur). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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Conclusion
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The difficulty for the expansion of knowledge in the decision-Mizuno Wave Fang SL Chaussure Sport en Salle, 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,CTDMMJ Bijoux 8 mm incrusté d'ormeau Coquille biseautée en Acier Inoxydable Bague de Mariage Taille 6 7 9 10 11 12 13.
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