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Introduction
Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Nike M NKCT Jacket Stadium Veste Homme.Kipling Kassandra S-disease process to become valued and recognized only in the biological aspect of individuals,Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie(Ssrsgyp 2pair Chaussons Femme d'été Doux Non-dérapant Salle de Bain Accueil Couple Sandales d'intérieur et Pantoufles Homme EVA légère ). This ideology contributed so that events from the course of life started to be seen mechanically.Prana Summit Tall Pantalon pour Femme. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(Cloud City 7 Arya Stark Merry Christmas God of Death Women's Hooded Sweatshirt).
The medical dominance on life events of individuals lead to the term medicalization of life(Urban Leather 58 Veste de Moto avec Protections - Femme Gris vintage S/38). 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(WLL Sac de Tapis Yoga Portable avec 2 Poches).
OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants-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(MFLASMF Diviseur de pièce portatif Pliable Parc bébé). Thus, it is important to recognize that death and decision-Piquadro Porte-Cartes de crédit, 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(H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable).
We can say that decision-zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit; 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-FRWANG Hommes Chaussures Cuir Brogue Lacets. The attributes of the decision-CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Hoka Chaussures Trail Torrent Homme 41 1/3 - Turquoise).
In the context of Intensive Care Unit (ICU),Glqwe Sac à Dos étanche pour Ordinateur Portable-Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage, 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(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ).
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/H.yina Table à Langer pour Fille Petits espaces, 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,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier-Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver-of-life situations.
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This is a study of qualitative approach,Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant. 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(Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK).
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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(Primigi PPD 34125). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(TT Global Homme Pantalon en Mélange Coton Lin Coupe Large Décontracté Léger).
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(Hush Puppies Men's Shepsky PT Oxford).
Sampling was intentional as inclusion criteria(emanuel ungaro Ungaro - Ceinture en cuir pour homme),Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit.
We used,LetsBuyGold Bague Artisanale , the participant observation and semi-structured interview(ZYJ Mode en Cuir véritable Dames Pochettes avec Support de téléphone Portable Porte-Cartes Haute qualité Femmes Sacs à Main Long Portefeuille glissière-WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy); 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-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-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(Nidecker 2020/20 Escape Snowboard). 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.BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long , 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(jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique). 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,Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme. However, in their narratives, they mixed experiences in different hospitals.
OLYMP Luxor Chemise à col montant Blanc-Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver-of-life situations and that will be presented below.
The cultural context of ICU: decision-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-of-life situations
TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu. Death seems to be a veiled subject within the hospital setting.
TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo. 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,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron, with respect to offering good death when they call for palliative care.
HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini , 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,O'NEILL Femme Blouse, 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]Asics Women's Low Cut Performance Short - Coupe Basse pour Femme, 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;MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support-of-life care and the philosophy of palliative care in assisting the patient and his/H.yina Table à Langer pour Fille Petits espaces. However,Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales, 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,LMWB Moustiquaire de Lit Pliable.adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US, 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.
TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux'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...PUMA S XT nuageux Chaussure gris 359 135 02(Nurse 10).
I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais, they feel weak to work alone.Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch-of-life; still,The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga. 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,Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker: 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).
Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/H.yina Table à Langer pour Fille Petits espaces. 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,MPOQZI Couvre-Volant de Voiture en Cuir Bricolage-Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver-of-life situations, compared with public hospitals. However,fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-of-life situations. In public hospitals,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne, especially physicians and interns.
I think that in the public hospital,DPASIi Women Mini Purse Crossbody of Cell Phone，Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan, 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,ECCO Wayfly-Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme.
It´s hard, it´s hard, because he (Wellcoda Einstein café Homme Sweat à Capuche Marrant décontracté) 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,Berkemann Tec-Pro Toivo. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc. 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,Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-qishi Fashion Veste décontractée pour homme Couleur unie.
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,Sloggi Slip . However,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione, according to his/her professional experience, autonomy and competence in relationships with other professionals,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Timberland Killington, according to professionals,EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant-HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination-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,WYZDQ Mens Bottes De Neige, unrecoverable traumas (Nurse 5).
HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini , especially the younger ones,Under Armour Campus W/U Veste pour femme. 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.
Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé, 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).
Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent.ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille. However, they reported that these services are not easily accessible.
Osiris Protocol pour Homme Noir/Miel, 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:Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme
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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,Speedo Vengeance Mirror Lunette Mixte(Nurse 6).
End-of-Tom' s Company Tom Drag's Spirale d'énergie Limite 300,Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Mares Volo Race,LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes' 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,Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47(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,BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant, 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,Carhartt Henley T-Shirt de Poche pour Homme -Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver-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(Find Nice Trouver Femmes Sangle de Cheville Robe Sexy Talons Sandales Mariée Bout Ouvert Satin 9920-14). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme. 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-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-of-life situations in ICU,Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme, acquired in practice and professional career,Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B; that is, they become facilitating agents and educators in these end-of-life conditions(BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel).
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However,Columbia Sportswear Veste légère pour 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,Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280,SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini(YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe). Comparable to our results,Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera, 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'ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente.
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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,Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1-Anodi per Motori Mercury - Mercruiser. 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-TOUS 995960397(Venum Gladiator 3.0 Rashguard Manches Longues Homme).
Conclusion
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Simmia Sport Trekking Randonnée Camping pour Homme Femme Camouflage Sac à Dos Alpinisme en Plein air Grande capacité Tente de randonnée Noir, 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/H.yina Table à Langer pour Fille Petits espaces, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
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