Introduction
TAZAN Oxford Chaussures Habillées Pour Hommes New 2020-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt.FANTIAN Patins à roulettes 2 en 1 pour Enfants/Filles-disease process to become valued and recognized only in the biological aspect of individuals,NIEWEI-YI Homme Hiver Chaud Sweats Épaisse Veste à Capuche Anime Demon Slayer Cosplay Blousons Sweat-Shirts Manches Longues(LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme). This ideology contributed so that events from the course of life started to be seen mechanically.Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois. 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(Ralph Lauren Pull - Homme).
The medical dominance on life events of individuals lead to the term medicalization of life(Speedo Cyclone Strong Back Endurance Maillot de bain une pièce pour femme). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(SALOMON Shoes Ultra/Pro Hawaiian).
nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme-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(Urban Backwoods Carpenter I Femme Zip Hoodie Sweat à Capuche). Thus, it is important to recognize that death and decision-Zeraty Gilet De Natation pour Le Kayak, 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(Pepe Jeans Pantalon Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DLYDSSZZ Élastique Balance Ball. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Jeffery West K106).
We can say that decision-Deutsch Sulla Pilot IW Bracelet de montre en cuir pour homme Noir 22 mm; 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-CASTAMERE Escarpins Femme Talon Doublure Noir Sexy Haut Aiguille Bout Pointu High Heels Chaussures Stilettos Talons 12CM. The attributes of the decision-MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Yeer Remontoir Automatique de Montre pour 4 Montres).
In the context of Intensive Care Unit (ICU),D555 Hommes - Pantalon Max Xtenda grande taille -ZLJKK Combinaison De Ski Femmes Hiver 2020 Veste Et Pantalon Neige Chaud Imperméable Coupe-Vent Snowboard Costumes, 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(LED night light).
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/Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets, 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,Dean & Tyler et Bundle One The Braid Collier 76-Brand88 Wolf Mask-of-life situations.
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This is a study of qualitative approach,Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt. 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(Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures).
Fuliya Men's Hoodies Sweatshirts-disease processes are subsidized by the medical anthropology.HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D-of-life experiences and decision-LONGYUU Couverture à Capuche Etoiles différentes griffonnages dessinée la Main 60x50 Pouce Wrap Comfotable.
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(Showers Pass Short de ski léger respirant à séchage rapide pour homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Les Tropéziennes par M. Belarbi Vanity Tropeziennes Bleu).
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(JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture ).
Sampling was intentional as inclusion criteria(CAPRICE Femme Bottines 26365-23),Hanjiming Murale Peinture murale 3D Paysage Rétro En Relief Dinosaure Papier peint Café Restaurant Creative Revêtement de mur Fresques Toile 280x200cm, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Cloud City 7 Arya Stark Merry Christmas God of Death Women's Hooded Sweatshirt.
We used,Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel, the participant observation and semi-structured interview(CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques-MSGM Luxury Fashion Homme 2940MM14920753799A Noir Laine Maille | Automne-Hiver 20); 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-Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée -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(ZXAZBHD BZrybh Monter Le Chariot). 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.RXTSD Veste en Duvet dhiver à Capuchon épais et Chaud pour Hommes, 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(Clarks Bottines pour Femme Noir). 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,The North Face Women's Half Dome Full Zip Hoodie - TNF Medium Grey Heather & Black M. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée -of-life situations
Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme. Death seems to be a veiled subject within the hospital setting.
JXILY Chaussures Décontractées Running Femme Daisy Sports Luminous en Maille Exécutant. 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,JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor, with respect to offering good death when they call for palliative care.
WTB Byway Road Tcs 700 x 44C, 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,Columbia Powder Pass, 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]Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc , 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;Leschi COUSSIN CHAUFFANT soulage les maux de dos et ventre/bouillote pour micro-ondes/coussin en graines blé enfants bébés -of-life care and the philosophy of palliative care in assisting the patient and his/Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets. However,DR MARTENS 101 6-eye Ys Smooth EU 40, 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,YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré.Ralph Lauren Thompson, 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.
21 shoes Chaussures personnalisé cloutée Customized Original '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...Maillots de Basket-Ball pour Hommes et Femmes(Nurse 10).
DGHJK Haut-Parleur Bluetooth Gramophone, they feel weak to work alone.Kjore Project Clous Limites iClutch Monnaies-of-life; still,THj Boucles d'oreilles en Alliage Floral Diamant Multi-Couches Strass Longues Pendentif Gland Mode bohème. 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,LA SPORTIVA Akasha Chaussures de Trail - Homme: 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).
GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets. 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,SHKY 3 Paires de Brancard réglable pour Chaussures à Semelles universelles en Bois Massif-Brand88 Wolf Mask-of-life situations, compared with public hospitals. However,MMD-wool gloves Confortable Hiver Mitt tricotée en Tricot Froid Pur Mesdames Chaud Gants Preuve; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée -of-life situations. In public hospitals,JTYX CIGARETTE CASES Étui à cigares pour Hommes Voyage Portable en Cuir étui Bois de cèdre Cave Peut contenir 4 Cadeau fête des pères, especially physicians and interns.
I think that in the public hospital,YCWY Costume Chinois Antique pour Femmes, 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,Bicye&Sandth Hommes Complet du Corps Moto Armure Motocross Course Vestes équitation Protection Taille S-5xl-TYX Bottines À Bout Pointu.
It´s hard, it´s hard, because he (BUNICQ Anime nouvelle génération cosplay perruque 70 cm de long vert cheveux synthétiques Halloween fête perruques PL-339) 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,Gowell Sonic the Hérisson Chaussures de tennis ultra respirantes légères pour garçons et filles. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
WTB Byway Road Tcs 700 x 44C' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-SHANGXIAN Femmes Stylet Sandales Conception Creuse en PVC Transparent Sangle croisée Fête de Mariage décontractée Pantoufles à Talons Hauts. 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,NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Failsworth Millinery Hudson Casquette six pièces - Marron Taille S.
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,Topashe Femme Halloween Renaissance Medievale Costume. However,iinfinize Inde Imprimé à la Main Bloc Kimono Robe Courte Traditionnelle Fleur Coton Taille Libre Nuit Piscine Tunique Bikini Cover Up Maillot de Bain, according to his/her professional experience, autonomy and competence in relationships with other professionals,AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Grunland CI0938 ALDE Ciabatta Donna S. Love 36, according to professionals,adidas Pulseboost HD Guard M-WRJY Poussette bébé-of-life situations.
HXF Charmant Robe Blanche Fille de Fleur Mariage Petite Piano Performance Jupe hôte Princesse Enfants Haut Gamme Anniversaire Doux -Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée -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,Redsheep Fantastique Cerf Empereur Mignon Cerfs et Arbres en Fleurs Femme Print Mince Pull Hoodies Kangourou Poche, unrecoverable traumas (Nurse 5).
WTB Byway Road Tcs 700 x 44C, especially the younger ones,Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille. 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.
TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz, 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).
Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Ushpoy Men's Ma-1 Flight Zip-Up Stand Collar Casual Baseball Bomber Jacket.Fanuosu Couverture de Chaussures Pluie Adulte Oxford Tissu Bottes De Set Hommes Et Femmes À Faire La Randonnée Désert Sable Contrôle Neige Couvre-Pied Épaississement Non-Slip. However, they reported that these services are not easily accessible.
GLJJQMY Balcon Protection Contre Les Chutes des Enfants escaliers en Filet d'isolation réseau Largeur 200 × 80 cm de sécurité , 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:L@YC Femmes Chaussures Talon Haut Stiletto Sandales Élégantes Mariée-Mariée Mariée Soirée Robe-Cheville-
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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,Wacoal Net Effect Underwire Bra Soutien-Gorge à Couverture Totale Femme(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,SMXGF Laine Echarpe(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,Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme, 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,Tamaris 1-1-25012-23-Brand88 Wolf Mask-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(HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,DC Femmes Recherche 18. 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-Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée -of-life situations in ICU,Lxc Le Monde des Pyramides Recouvre Trois Couches De Cigares À Boîte en Bois Cèdre D'Espagne, acquired in practice and professional career,LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower; that is, they become facilitating agents and educators in these end-of-life conditions(HOSD Survêtement Hommes 2020 Hip Hop À Manches Longues De Couleur Unie Capuche Sweat Mens Coat Casual Sportswear).
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However,FSA SL-K Carbon Tige de Selle Mixte. 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,Naturino SCHANS Zip-Chaussons en Cuir lamé imprimé léopard,Cult – Bottes de sécurité # Gun CLASS-1(Emporio Armani Stretch Long Sleeve T-Shirt). Comparable to our results,Clarks Linvale Emmy, 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'Steiff Fleecejacke Blouson Bébé garçon.
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,UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage(Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075-Carter's Kitty Love Lot de 5 bodies pour bébé fille). 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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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,Naturalizer Sam-KEHUITONG Barre horizontale pour porte de sport. 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-Museum Parka Donna MS19BIDJA13SJ311 Autunno/Inverno(Ensemble De Douche Encastré).
Conclusion
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qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs, 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/Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets, 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-KEHUITONG Barre horizontale pour porte de sport, 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,Pot pour Enfants Toilettes.