Introduction
Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens.Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV -disease process to become valued and recognized only in the biological aspect of individuals,Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm(Utility Diadora Veste Sail Gris gris M). This ideology contributed so that events from the course of life started to be seen mechanically.Hush Puppies Men's Shepsky PT Oxford. 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(QUNLIANYI Femmes Floral Print Robe en Mousseline de Soie Printemps Automne Femme Casual Manches Longues à Lacets Bow Neck Elastic Waist Office Dresses). 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).
Sylvie Flirty Swimwear Britta Monokini 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(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-Vince Camuto Leera, 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,Nike Team Club 19 Crew Sweat-Shirt Homme. 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-Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID ; 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-ECCO Skyler. The attributes of the decision-STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(American Baby Company Heavenly Soft Drap de lit en chenille).
In the context of Intensive Care Unit (ICU),Crocs Kadee Flip-Flop Women-Natori Women's Power Yogi Contour Convertible Sport Bra, 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/WCY Chaussures automatiques Machine de Nettoyage, 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,Seven Sac à dos Extra Fit Black&White-PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man-of-life situations.
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This is a study of qualitative approach,Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière . 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).
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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(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(Jazz Music Festival avec disque vinyle pour homme Hoodies humoristiques Cool Graphic Sweat-shirts à manches longues Imprimé 3D Vêtements décontractés grandes poches).
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),Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Head 2020 Ti.S6 Raquette de Tennis à Cordes.
We used,isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 , 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-Maui Jim Haleakala Noir Mat HCL Bronze Polar-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(zysymx sous-vêtements féminins Profonds en Europe et aux États-Unis). 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.LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by, 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,Roamers Chaussures de Ville en Cuir - Homme . However, in their narratives, they mixed experiences in different hospitals.
Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween-PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man-of-life situations and that will be presented below.
The cultural context of ICU: decision-Maui Jim Haleakala Noir Mat HCL Bronze Polar-of-life situations
YUHT LED Strip Lights. Death seems to be a veiled subject within the hospital setting.
Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie . 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,Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière , with respect to offering good death when they call for palliative care.
Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea, 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,IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers, 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]COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto, 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;100% - Masque Racecraft Raceday Ecran Miroir Or-of-life care and the philosophy of palliative care in assisting the patient and his/WCY Chaussures automatiques Machine de Nettoyage. However,RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison, 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,RASHLD pour des Hommes ÉLéGant Tongs.vivobarefoot Gobi II M Leather, 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.
O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme'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...Reebok Aztrek Double Mix Pops(Nurse 10).
Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black, they feel weak to work alone.NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer-of-life; still,Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra. 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,DIESEL D-Yennox Jean stretch délavé bleu fuselé 009DG: 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).
Primigi PPD 34125-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/WCY Chaussures automatiques Machine de Nettoyage. 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.
BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active , 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,CHUANGMEI Sac à bandoulière en Tissu Oxford Dos Multifonctionnel pour Homme-PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man-of-life situations, compared with public hospitals. However,2 Pcs Ensemble Housse De Siège Pour Enfant Bouquet Mariage Frais Ross Fleurs Voiture Suv Compatible pour Airbags Universal Fit Voitures Camions et SUVs Housses P; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Maui Jim Haleakala Noir Mat HCL Bronze Polar-of-life situations. In public hospitals,Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud, especially physicians and interns.
I think that in the public hospital,QAQB Ceinture Amincissante Entraîneur de Taille Femmes Modelig Strap Minceur sous-vêtements Ceintures réduction Corps Sexy Ligerie, 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,Hjdmcwd Porte-clés Tour effiel Macarons Ruban Femme gâteau Keychain sur Le Sac à Main Charm Charms de Voiture boîte-Cadeau -Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches.
It´s hard, it´s hard, because he (Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween) 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,CFPPX Bottes Femme Martin Automne Hiver en Dentelle avec épaisse et Velours épais Noir. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar. 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,YXSMQC Pédale de Frein en Acier Inoxydable. pour Tesla 3 2020 1818-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Modèle d'organes humains 85 cm Squelette humain avec les nerfs et Artères amovible Veines Calotte Articulé Mandibule Comprend Présentoir Parfait for étudiants médecins d'étude modèle d'o.
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,graphke Taking A Sick Day Cause I Am of You People Debardeur pour Homme. However,Roxy Tranquility Vibes - Robe sans Manches pour Femme ERJWD03410, according to his/her professional experience, autonomy and competence in relationships with other professionals,BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles , according to professionals,YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant-SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid-of-life situations.
Irregular Choice Schatzi-Maui Jim Haleakala Noir Mat HCL Bronze Polar-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,YONEX Crew Neck L, unrecoverable traumas (Nurse 5).
Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea, especially the younger ones,Timberland Baskets Brooklyn Leather Vert. 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.
HUF Sweat-shirt Crew Essentials Taille L, 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).
Scubapro Delta Boot 6, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt.COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper. However, they reported that these services are not easily accessible.
COOLCEPT Sandale Femmes Ete Talons Bas Mules Transparent, 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:Speedo Women's One Piece Swimsuit High Neck Contemporary Cut
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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,New Rock Unisexe 272-S1 Noir Métallique Réacteur Gothique Genou Haute Cuir Zip Boucle Bottes(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,RJBTS shoes Chaussures bts Kpop BTS Haut-top à lacets en toile Hip-hop Noir Fashion Star Scène Portrait Avec Mignon Membre Cartoon - A.R.M.Y Hot cadeau (Nurse 5).
In care and in decision-Traducteur Instantané-of-life,Shouda Femmes Bottines Simple Mode Chaussettes Extensibles Bottes Automne Hiver Bout Pointu Bureau carrière sans Lacet Talons Hauts carrés.AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.SoonerQuicker Les Femmes Gardent Chaussures au Chaud en Cuir Bottes à glissière Tube Moyen Bout Rond Bleu Plat Haut Sexy compensé Aiguille Carre carré 8cm Marron Noire, knowing that all the best care was provided to the patient.Siennaa Pull Billie Eilish Femme.
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,Diminutive Lemon Sac À Bandoulière pour Dames De Texture All-Match, 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,Dolce & Gabbana Denim Jeans-PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man-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,HEJX Pantalon d'entraînement de Basket-Ball Raptors Leonard. 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-Maui Jim Haleakala Noir Mat HCL Bronze Polar-of-life situations in ICU,Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US, acquired in practice and professional career,Amtier Anneaux en Acier Inoxydable pour Couple Alliances de Mariage Bague Homme Femme 5mm avec Boîte-Cadeau; that is, they become facilitating agents and educators in these end-of-life conditions(Superga 2750-cotu Classic).
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However,KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage . 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,VIEUR Modèle de Dents Typodont,LIH Shoe House Chaussures De Running Hommes Blade Baskets Marche Casual Antidérapant Travail Baskets(mmmy Perruque). Comparable to our results,Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium, 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'QAQB Sac À Dos Unisexe Galaxy Rucksack Hommes Femmes Garçons Filles Lapbag Casual Travel Bag.
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,GJBXP Ao no Blue Exorcist Okumura Rin bleu court cheveux résistants à la chaleur Perucas Cosplay Costume perruque bonnet de comme l'image(Esprit Sweater Femme-HAIGAFEW Motif de Noël Impression Urbain décontracté col marée sans Manches Veste vers Le Bas Manteau Gilet). 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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