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1.
BMC Palliat Care ; 21(1): 8, 2022 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-35016670

RESUMO

OBJECTIVES: Intervention fidelity is imperative to ensure confidence in study results and intervention replication in research and clinical settings. Like many brief protocol psychotherapies, Dignity Therapy lacks sufficient evidence of intervention fidelity. To overcome this gap, our study purpose was to examine intervention fidelity among therapists trained with a systematized training protocol. METHODS: For preliminary fidelity evaluation in a large multi-site stepped wedge randomized controlled trial, we analyzed 46 early transcripts of interviews from 10 therapists (7 female; 7 White, 3 Black). Each transcript was evaluated with the Revised Dignity Therapy Adherence Checklist for consistency with the Dignity Therapy protocol in terms of its Process (15 dichotomous items) and Core Principles (6 Likert-type items). A second rater independently coded 26% of the transcripts to assess interrater reliability. RESULTS: Each therapist conducted 2 to 10 interviews. For the 46 scored transcripts, the mean Process score was 12.4/15 (SD = 1.2), and the mean Core Principles score was 9.9/12 (SD = 1.8) with 70% of the transcripts at or above the 80% fidelity criterion. Interrater reliability (Cohen's kappa and weighted kappa) for all Adherence Checklist items ranged between .75 and 1.0. For the Core Principles items, Cronbach's alpha was .92. CONCLUSIONS: Preliminary findings indicate that fidelity to Dignity Therapy delivery was acceptable for most transcripts and provide insights for improving consistency of intervention delivery. The systematized training protocol and ongoing monitoring with the fidelity audit tool will facilitate consistent intervention delivery and add to the literature about fidelity monitoring for brief protocol psychotherapeutic interventions.


Assuntos
Neoplasias , Respeito , Idoso , Estudos Transversais , Feminino , Humanos , Pacientes Ambulatoriais , Reprodutibilidade dos Testes
2.
Brain Nerve ; 74(1): 14-16, 2022 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-34992163

RESUMO

Dr. Koan Ogata is recognized as a key founder of modern Japanese medicine, and he greatly respected the words of Professor Christoph Hufeland at Berlin University. Professor Hufeland noted the importance of writing a case report for every doctor who consults patients during the day and writes case reports at night. Both Professor Hufeland and Dr. Ogata thought that writing these records would truly train young doctors as writers, while educating other doctors worldwide as readers. In this short paper, the way to realize such behavior is described according to the increasing experiences gathered at the Okayama University where Dr. Ogata was born.


Assuntos
Médicos , Universidades , Humanos , Respeito , Redação
3.
Am J Hosp Palliat Care ; 39(1): 54-61, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33926243

RESUMO

BACKGROUND: Nearly 500,000 older Americans die a cancer-related death annually. Best practices for seriously ill patients include palliative care that aids in promoting personal dignity. Dignity Therapy is an internationally recognized therapeutic intervention designed to enhance dignity for the seriously ill. Theoretically, Dignity Therapy provides opportunity for patients to make meaning by contextualizing their illness within their larger life story. The extent to which Dignity Therapy actually elicits meaning-making from patients, however, has not been tested. AIM: The current study examines (i) extent of patient meaning-making during Dignity Therapy, and (ii) whether baseline psychospiritual distress relates to subsequent meaning-making during Dignity Therapy. DESIGN: Participants completed baseline self-report measures of psychospiritual distress (i.e., dignity-related distress, spiritual distress, quality of life), before participating in Dignity Therapy. Narrative analysis identified the extent of meaning-making during Dignity Therapy sessions. PARTICIPANTS: Twenty-five outpatients (M age = 63, SD = 5.72) with late-stage cancer and moderate cancer-related symptoms were recruited. RESULTS: Narrative analysis revealed all patients made meaning during Dignity Therapy but there was wide variation (i.e., 1-12 occurrences). Patients who made greater meaning were those who, at baseline, reported significantly higher psychospiritual distress, including greater dignity-related distress (r = .46), greater spiritual distress (r = .44), and lower quality of life (r = -.56). CONCLUSION: Meaning-making was found to be a central component of Dignity Therapy. Particularly, patients experiencing greater distress in facing their illness use the Dignity Therapy session to express how they have made meaning in their lives.


Assuntos
Neoplasias , Qualidade de Vida , Idoso , Humanos , Pessoa de Meia-Idade , Neoplasias/terapia , Cuidados Paliativos , Respeito
4.
Am J Hosp Palliat Care ; 39(1): 39-44, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34002630

RESUMO

AIM: To describe healthcare professionals' and volunteers' experiences of a pathway for movement on a hospice ward. METHOD: This was a qualitative study with an inductive approach. Data were collected in a hospice setting through 4 focus group interviews with healthcare professionals and volunteers (n = 12). The focus group participants varied in age, profession, and length of experience in palliative care. The interviews were audio recorded, transcribed and analyzed with qualitative content analysis. RESULTS: Dignity through movement at the end of life was the main theme, complemented by 4 sub-themes. Two descriptive sub-themes: "A practical tool to facilitate physical activity" and "Companionship and goals give meaning to the day," and 2 interpretative sub-themes: "Regaining control and having a choice" and "Feeling normal and alive" based on participants' views of patient experiences. SIGNIFICANCE OF RESULTS: Indications are that the pathway for movement addresses a wide range of experiences related to different aspects of being human in a difficult situation. Experiences of movement and physical activity can promote wellbeing, dignity, and a sense of feeling "at home" for patients within hospice care. The pathway for movement is simple to set up, offers access to appropriate physical activity and seems to benefit patients both in the early and later phases of palliative care.


Assuntos
Cuidados Paliativos , Respeito , Morte , Atenção à Saúde , Humanos , Pesquisa Qualitativa
5.
Soins Psychiatr ; 42(337): 42-45, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34895694

RESUMO

The notion of dignity is not synonymous with autonomous freedom (autonorma). It has an objective dimension, which is based on the individual's belonging to humanity. This is often neglected in psychiatry, even though it is what leads to the universal prevailing over singular preferences when a value specific to the human condition and to the suffering that inhabits it is at stake. To be of this universality while being a clinic of singularity representes the nobility of psychiatry and its vocation to make mental health live.


Assuntos
Psiquiatria , Respeito , Liberdade , Acesso aos Serviços de Saúde , Humanos , Pessoalidade
6.
Medicina (Kaunas) ; 57(12)2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34946263

RESUMO

Background: The literature on professionals' perceptions of dignity at the end-of-life (EOL) shows that there is a need for studies set in different cultural contexts. Lithuania represents one of these little-studied contexts. The aim of this study is to understand professionals' attitudes, experiences, and suggestions concerning EOL dignity to provide knowledge upon which efforts to improve EOL care can be grounded. The research questions are "How do Lithuanian health care professionals understand the essence of dignity at the end-of-life of terminally ill patients?" and "How do they believe that dignity at the EOL can be enhanced?". Materials and Methods: The study was exploratory and descriptive. It employed an interpretive phenomenological method to understand the essence of the phenomenon. Lightly structured interviews were conducted with professionals who had EOL experience, primarily with elderly and late middle-aged patients. from medicine, nursing, social work, and spiritual services. The interviews were primarily conducted by audiovisual means due to pandemic restrictions. Using a constant comparative method, the research team systematically codified text and developed themes by consensus after numerous analytic data iterations. Results: Four primary themes about EOL dignity were identified: Physical Comfort, Place of Care and Death, Effects of Death as a Taboo Topic, and Social Relations and Communication. A fifth, overarching theme, Being Heard, included elements of the primary themes and was identified as a key component or essence of dignity at the EOL. Conclusions: Patient dignity is both a human right and a constitutional right in Lithuania, but in many settings, it remains an aspiration rather than a reality. Being Heard is embedded in internationally recognized patient-centered models of EOL care. Hearing and acknowledging individuals who are dying is a specific skill, especially with elderly patients. Building the question "Is this patient being heard?" into practice protocols and conventions would be a step toward enhancing dignity at the EOL.


Assuntos
Respeito , Assistência Terminal , Idoso , Morte , Pessoal de Saúde , Audição , Humanos , Pessoa de Meia-Idade
7.
J Law Med ; 28(4): 1114-1126, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34907690

RESUMO

The Human Rights Review Tribunal of New Zealand recently determined that it has the power to award damages for loss of dignity in cases where the person whose rights have been breached does not have the mental capacity to understand that this is the case, or the impact of that breach on their dignity. In defining the meaning of dignity, determining how to assess its loss (by way of an objective rather than subjective test) and categorising the nature of damages for loss of dignity as vindicatory rather than compensatory, the Tribunal broke new ground. However, after analysing the Tribunal's decision, and considering relevant case law, this article concludes that the Tribunal's decision was flawed, and that the legislation only allows for the award of compensatory damages. Legislative change would be required to expand the scope of remedies available to include vindicatory damages.


Assuntos
Direitos Humanos , Respeito , Emoções , Humanos , Nova Zelândia
8.
Br J Community Nurs ; 26(11): 526-531, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34731040

RESUMO

Although dignity has been widely explored in the context of healthcare, it has rarely been the subject of empirical exploration when care is delivered by community district nursing teams. This paper demonstrates how a commonplace community nursing task (changing dressings) can constitute a clinical lens through which to explore the ways in which community nurses can influence patients' dignity. This ethnographic study involved two research methods: interviews with patients and nurses (n=22) and observations of clinical interactions (n=62). Dignity can manifest during routine interactions between community nurses and patients. Patient-participants identified malodour from their ill-bodies as a particular threat to dignity. Nurses can reinforce the dignity of their patients through relational aspects of care and the successful concealment of 'leaky' bodies.


Assuntos
Comunicação , Enfermagem em Saúde Comunitária/métodos , Relações Enfermeiro-Paciente , Enfermeiros de Saúde Comunitária/psicologia , Pacientes/psicologia , Pessoalidade , Respeito , Antropologia Cultural , Atitude do Pessoal de Saúde , Bandagens , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , População Urbana
9.
BMJ Case Rep ; 14(11)2021 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-34815225

RESUMO

Substance use disorder is a chronic disease carrying a high risk of morbidity and mortality. We report a case of a patient on long-term opioid agonist treatment who was diagnosed with metastatic cholangiocarcinoma and was referred to palliative care services almost contemporaneously with this diagnosis. In this report, we explore the challenges posed in offering holistic care during the end of life of a patient with a history of opioid dependence. A coordinated approach by addiction medicine and palliative care teams can allow patients from this complex cohort to ultimately die with dignity.


Assuntos
Cuidados Paliativos na Terminalidade da Vida , Transtornos Relacionados ao Uso de Opioides , Assistência Terminal , Humanos , Cuidados Paliativos , Respeito
10.
Rev Lat Am Enfermagem ; 29: e3498, 2021.
Artigo em Inglês, Espanhol, Português | MEDLINE | ID: mdl-34816869

RESUMO

OBJECTIVE: to discuss the classification of the health hazard allowance due to exposure to biological agents attributed to Nursing professionals, based on legal and occupational parameters supported on the principle of human dignity. METHOD: an original reflection study with theoretical analysis on legislation, jurisprudence and Occupational Health focused on the biological risks, health hazard and rights of Brazilian workers. The discussions were based on the current legislation and on scientific evidence. RESULTS: the classification of the health hazard allowance due to exposure to biological agents attributed to Nursing professionals is not in line with the factual situation experienced by them. CONCLUSION: it becomes necessary to broaden the discussion on the subject matter and to review the effective and fair compensation of Nursing professionals due to exposure to potentially contaminated biological agents in their work environments, given that the health hazard allowance is a worker's right and is based on human dignity.


Assuntos
Saúde do Trabalhador , Respeito , Brasil , Humanos , Local de Trabalho
11.
J Aging Stud ; 59: 100970, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34794715

RESUMO

Worldwide, dementia-friendly initiatives are being developed primarily based on and driven by political strategies. Health professionals, local government officials, and initiators alike are working to create dementia-friendly communities, but little is known about how professionals discursively construct dementia-friendliness and how their various interpretations affect current practices in the field. This study aimed to explore how those involved in establishing dementia-friendly initiatives, nursing homes, and dementia villages ascribe meaning to and construct dementia-friendliness. Three focus groups were conducted, including two with five health professionals each from two nursing homes for people with dementia and one with seven initiators involved in the development and establishment of nursing homes and dementia villages. We further conducted a small-group interview with a consultant and a project worker representing a local authority. Seeing dementia-friendliness as a discursive construction, we conducted a critical discourse analysis, taking inspiration from the work of Norman Fairclough. The surveyed professionals reported relying on knowledge, responsibility, dignity, and illusion discourses to construct dementia-friendliness. Our results also indicated that the construct of dementia-friendliness fosters discursive battles indicated by dilemmas concerning the adequate and dignified treatment of people with dementia and health professionals' critical stances toward the construct of dementia-friendliness.


Assuntos
Demência , Ilusões , Grupos Focais , Humanos , Casas de Saúde , Respeito
12.
Trials ; 22(1): 751, 2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34711262

RESUMO

BACKGROUND: Family caregivers of dying cancer patients are affected by grief experiences and bereavement complications. Several approaches such as psycho-emotional care and an increase in spirituality have been suggested to diminish these complications. However, the knowledge about the effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of dying cancer patients is limited. This is a study protocol describing a hospital-based mixed-methods study on the effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of dying cancer patients. METHODS: This mixed-methods study will be done in an embedded explanatory design with two quantitative and qualitative phases. In the first phase (quantitative), a randomized clinical trial will be done, in which 200 family caregivers of dying cancer patients will be randomly assigned to one of the four groups: family-based single dignity intervention (group 1), expressive writing intervention (group 2), combined family-based single dignity intervention and expressive writing (group 3), and control (group 4). At baseline, 1 week and 2 weeks after the interventions, anticipatory grief will be assessed by a 13-item anticipatory grief scale. After the quantitative phase, the qualitative phase will be conducted through the conventional content analysis approach of Granheim and Lundman, in which an individual semi-structured interview will be taken from participants in the first phase to collect data on their experiences on interventions. Finally, data from the quantitative and qualitative phases will be analyzed and discussed. DISCUSSION: Family caregivers of dying cancer patients usually experience depression, anxiety, and psychological distress due to isolation and inadequate social support. Psychological interventions such as dignity and expressive writing interventions may help caregivers to obtain a better understanding of themselves and to increase their abilities to cope with caregiving difficulties. Therefore, there is a need for a comprehensive study confirming the effects of mentioned interventions on family caregivers of dying cancer patients. TRIAL REGISTRATION: Iranian Registry of Clinical Trials ( www.irct.ir ) identifier: IRCT20210111050010N1. Date of trial registration: Feb 6, 2021. This is the first version of this protocol.


Assuntos
Luto , Neoplasias , Cuidadores , Pesar , Humanos , Irã (Geográfico) , Neoplasias/terapia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Respeito , Redação
14.
Syst Rev ; 10(1): 269, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34654475

RESUMO

BACKGROUND: Intrapartum mistreatment of women is an ubiquitous public health and human rights challenge. The issue reportedly has severe maternal and neonatal outcomes including mortality, and generally leads to a decreased satisfaction with maternity care. Intrapartum mistreatment, despite being ubiquitous, indicates higher incidence amongst adolescent parturients who are simultaneously at a higher risk of maternal morbidity and mortality. Studies have suggested that Respectful Maternity Care interventions reduce intrapartum mistreatment and improve clinical outcomes for women and neonates in general. However, evidence on the effect of RMC on adolescents is unclear. Hence, the specific aim of this study is to synthesise the available evidence relating to the provision of RMC for adolescents during childbirth. METHODS: The methodology of the proposed systematic review follows the procedural guideline depicted in the preferred reporting items for systematic review protocol. The review will include published studies and gray literature from January 1, 1990, to June 30, 2021. Electronic databases including MEDLINE, PubMed, ScienceDirect, Cochrane, CINAHL, PsycINFO, Scopus, Google Scholar and Web of Science will be searched to retrieve available studies using the appropriate search strings. Studies included in the review will be appraised for quality using tools tailored to each study design. If appropriate, we will conduct random effects meta-analysis of data to summarise the pooled estimates of respectful maternity care prevalence and outcomes. The selection of relevant studies, data extraction and quality assessment of individual studies will be carried out by two independent authors. RESULTS: Summaries of the findings will be compiled and synthesised in a narrative summary. In addition to the narrative synthesis, where sufficient data are available, a random-effects meta-analysis will be conducted to obtain a pooled estimate value for respectful maternity care prevalence and outcomes. DISCUSSION: Respectful Maternity Care for adolescents holds great promise for improved maternal and neonatal care. However, there is a gap in knowledge on the interventions that work and the extent of their effectiveness. Findings from this study will be beneficial in improving Adolescents Sexual and Reproductive Health and Rights and reducing maternal mortality, especially for adolescents. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020183440.


Assuntos
Serviços de Saúde Materna , Obstetrícia , Adolescente , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Metanálise como Assunto , Parto , Gravidez , Respeito , Revisões Sistemáticas como Assunto
16.
Artigo em Inglês | MEDLINE | ID: mdl-34639423

RESUMO

The Fading Affect Bias (FAB) is the faster fading of unpleasant affect than pleasant affect. Research suggests that the FAB is an indicator of general healthy coping, but it has not shown consistent specific healthy coping via differential relations of the FAB to individual differences across event types. Although previous research did not find specific healthy coping for the FAB across romantic relationship events, these researchers did not include non-relationship control events. Therefore, we examined the relation of the FAB to various relationship variables across romantic relationship events and non-relationship control events. We found general healthy coping in the form of robust FAB effects across both event types and expected relations between relationship variables and the FAB. We also found three significant three-way interactions with the FAB showing specific healthy coping for partner-esteem, which is novel for the FAB. Rehearsal ratings mediated all the three-way interactions.


Assuntos
Adaptação Psicológica , Afeto , Emoções , Nível de Saúde , Relações Interpessoais , Respeito
17.
Br Dent J ; 231(8): 425, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34686785

Assuntos
Emoções , Respeito
18.
BMJ Open ; 11(10): e051220, 2021 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635524

RESUMO

OBJECTIVE: The purpose of this qualitative study was to explore clients' and midwives' perceptions of compassionate and respectful care during facility-based delivery in Bishoftu District, the regional state of Oromia, Ethiopia. SETTING: Public health facilities (two health centres and one district hospital). STUDY DESIGN: A qualitative exploratory descriptive research design was used. STUDY PARTICIPANTS: The research population included purposely sampled women who had given birth in a health facility in the previous 2 weeks and midwifery experts who provided maternity care in the health facility's labour and delivery wards. Data were gathered through an individual interview (with 10 midwives and 12 women in labour). Interviews were audio-recorded and transcribed immediately. For the research, thematic analysis was performed manually. Both a priori codes (from the query guide) and emerging inductive codes were used in the study. In the thematic data analysis, three inter-related stages were involved, namely data reduction, data display and data conclusion. RESULTS: From the analysis of in-depth interviews with labouring women, three themes emerged, namely: dignified and respectful care, neglectful care and unqualified staff. Five main categories emerged from in-depth interviews with midwives: trusting relationships formed with labouring women, compassionate and respect-based behaviour, good communication skills and holistic care, intentional disrespect toward women, and barriers to compassionate and respectful maternity care due to structural factors. These themes were discovered to be a rich and detailed account of midwives' perspectives on compassionate and respectful maternity care. CONCLUSION: The majority of women who witnessed or suffered disrespect and violence during labour and childbirth were dissatisfied with their maternity care during labour and delivery. Despite midwives' accounts showing that they were aware of the importance of compassionate and respectful maternity care, clients face verbal abuse, neglect, and a lack of supportive treatment during labour and childbirth. Clients' human rights were violated by disrespectful or abusive acts, whether perpetrated or observed. It is essential to address structural problems such as provider workload, and all other initiatives aimed at improving midwives' interpersonal relationships with women to provide compassionate and respectful client-centred maternity care.


Assuntos
Serviços de Saúde Materna , Tocologia , Atitude do Pessoal de Saúde , Parto Obstétrico , Etiópia , Feminino , Humanos , Parto , Gravidez , Relações Profissional-Paciente , Pesquisa Qualitativa , Respeito
19.
Reprod Health ; 18(1): 194, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34598705

RESUMO

BACKGROUND: Ensuring the right to respectful care for maternal and newborn health, a critical dimension of quality and acceptability, requires meeting standards for Respectful Maternity Care (RMC). Absence of mistreatment does not constitute RMC. Evidence generation to inform definitional standards for RMC is in an early stage. The aim of this systematic review is clear provider-level operationalization of key RMC principles, to facilitate their consistent implementation. METHODS: Two rights-based frameworks define the underlying principles of RMC. A qualitative synthesis of both frameworks resulted in seven fundamental rights during childbirth that form the foundation of RMC. To codify operational definitions for these key elements of RMC at the healthcare provider level, we systematically reviewed peer-reviewed literature, grey literature, white papers, and seminal documents on RMC. We focused on literature describing RMC in the affirmative rather than mistreatment experienced by women during childbirth, and operationalized RMC by describing objective provider-level behaviors. RESULTS: Through a systematic review, 514 records (peer-reviewed articles, reports, and guidelines) were assessed to identify operational definitions of RMC grounded in those rights. After screening and review, 54 records were included in the qualitative synthesis and mapped to the seven RMC rights. The majority of articles provided guidance on operationalization of rights to freedom from harm and ill treatment; dignity and respect; information and informed consent; privacy and confidentiality; and timely healthcare. Only a quarter of articles mentioned concrete or affirmative actions to operationalize the right to non-discrimination, equality and equitable care; less than 15%, the right to liberty and freedom from coercion. Provider behaviors mentioned in the literature aligned overall with seven RMC principles; yet the smaller number of available research studies that included operationalized definitions for some key elements of RMC illustrates the nascent stage of evidence-generation in this area. CONCLUSIONS: Lack of systematic codification, grounded in empirical evidence, of operational definitions for RMC at the provider level has limited the study, design, implementation, and comparative assessment of respectful care. This qualitative systematic review provides a foundation for maternity healthcare professional policy, training, programming, research, and program evaluation aimed at studying and improving RMC at the provider level.


Assuntos
Serviços de Saúde Materna , Obstetrícia , Feminino , Pessoal de Saúde , Humanos , Parto , Gravidez , Respeito
20.
Kennedy Inst Ethics J ; 31(3): 223-246, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34565743

RESUMO

This paper presents a challenge to the view that benign 'white lies' may be therapeutic in dementia care and preferable to more truthful alternatives. Drawing on Sissela Bok and Bernard Williams, the paper develops three key points: first, that another person's dementia is not a reason to suspend one's customary reluctance to deceive others; second, that the commonly drawn contrast between benign deceit and blunt disclosure is too simple to frame arguments for the acceptability of deceit in dementia care; and third, truthful regard-regard for a person living with dementia as one for whom truth matters, as it does for oneself-is a foundation for beneficent concern that is neither infantilizing nor condescending. The paper proposes that a morally significant human bond is established through regard for another person as one for whom truth matters, just as it does for oneself, irrespective of another's dementia, and that within dementia care, the commission of deceit should be seen as an unsettling exception to a general principle of truthfulness.


Assuntos
Decepção , Demência , Relações Interpessoais , Obrigações Morais , Pessoalidade , Respeito , Revelação da Verdade/ética , Atitude , Beneficência , Cuidadores , Dissidências e Disputas , Emoções , Família , Amigos , Humanos , Princípios Morais , Apoio Social , Valor da Vida
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