tag:blogger.com,1999:blog-24439499985732138452024-03-14T05:39:06.341-03:00Síndrome de Edwards - T18Aqui você pode acompanhar crianças com a T18 e suas famílias! Siga também o Instagram @trissomia18Unknownnoreply@blogger.comBlogger38125tag:blogger.com,1999:blog-2443949998573213845.post-63543141657325425672022-05-12T08:56:00.000-03:002022-05-12T08:56:58.244-03:00II CONGRESSO NACIONAL DOS AMORES PERFEITOS 2022 - PROGRAMAÇÃO<p> </p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='361' height='300' src='https://www.blogger.com/video.g?token=AD6v5dwCwrl_8-cW8s1pqG-XOt1hVa87CzYxHy1PvbWKLble4HPiCEwLzA2K8CYgyONSf-_UAD2wZxtSNTCmk9nRyw' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div><br /><p></p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-39606911722119946732021-05-01T01:12:00.004-03:002022-01-16T16:19:44.417-03:00Informações Úteis - Dia de Conscientização sobre a Síndrome de Edwards 2021<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBcLbV3Y-CHXHoOWjAn6lxyLMkylUmIOb5277BweHj4BHrwpxmDpxsik5GuuxF5XyIO4KzmQs_2mL9KtHH33hI08HxDcOPPWwQk9dj-gtjjRgqeCS94gzLURPUMEtOi6asMrBdN2X7-Z5z/s1080/Post+Convite.png" style="margin-left: 1em; 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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-32932653603530873872020-03-18T14:21:00.001-03:002020-03-18T14:21:03.880-03:00Quarentena Eterna<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEggb6ILfi9E_2IXtzHnVz6PzQO5u6VC05LupDFMiggWzrQHfxR_YtoBbypb2jV9ADAxy6Nl9seebUwqfPPgkRU346ocbyu2FF2SPC0Sk2p6yWHagO2QHaUrIdk-usKAhL6AGsbfcpYD3CR0/s1600/marco+trissomias.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="983" data-original-width="983" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEggb6ILfi9E_2IXtzHnVz6PzQO5u6VC05LupDFMiggWzrQHfxR_YtoBbypb2jV9ADAxy6Nl9seebUwqfPPgkRU346ocbyu2FF2SPC0Sk2p6yWHagO2QHaUrIdk-usKAhL6AGsbfcpYD3CR0/s320/marco+trissomias.jpeg" width="320" /></a></div>
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Março é o mês em que muitos países do mundo conscientizam sobre as trissomias. Delas a mais conhecida é a Síndrome de Down (T21), onde o cromossomo 21 tem uma cópia a mais.<br />
Há 15 anos, eu e muitas outras famílias, temos buscado deixar a Síndrome de Edwards (T18) conhecida também. Nela é acometido o cromossomo 18 e a criança tem sinais e sintomas mais graves que a T21, na maioria das vezes.<br />
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Deus conhece meu coração e atos e sabe que não sou capaz de desejar sofrimento a nenhuma vida, o que não me isenta totalmente de causá-lo.Mas enfim hoje, dia 18 de março de 2020 grande parte do mundo se sente quase que exatamente como nós, famílias de crianças, jovens e adultos com doenças raras e pouco conhecidas até pela Medicina.<br />
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Vivemos confinados eternamente, ora pelo receio do preconceito, ora pela falta de acessibilidade, ora pela vulnerabilidade da saúde dos nossos amores. Muitos de nós não pode nunca sair de casa não por medo de contaminação por Covid 19, ou de contaminar alguém, mas porque simplesmente não temos com quem deixar o filho ou não conseguimos chegar com ele em lugar algum.<br />
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O que assusta a todos, no mundo inteiro hoje, é a rotina de famílias de pessoas com doenças raras: vivemos um momento altamente tecnológico e não há remédios, nem tratamentos, nem respostas para as nossas dúvidas e angústias.<br />
Nosso caso, não é algo que vai passar, mas a nossa realidade de todos os dias, minutos, segundos.<br />
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Assim como todos os habitantes da Terra nesse momento histórico, temos que conviver o tempo todo com a possibilidade de sermos visitados pela morte, sem que ela seja anunciada pelo interfone. E sofremos, e gritamos e como muitos hoje aí pelo planeta não somos ouvidos. Nossos amados são escolhidos para morrer como muitas pessoas queridas hoje em dia…<br />
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Talvez tenhamos sido criteriosamente escolhidos para viver uma realidade tão dura,para que sejamos nós a apoiar e levar esperança para quem ainda acredita que pode tudo. Já descobrimos que a única força inesgotável do Universo é o amor e a união.<br />
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Vamos contar para todos que mesmo quando nos sentimos invisíveis e desamparados ainda existe alguma força interna que nos mantém. Vamos compartilhar o poder do olhar, este sim podemos comandar, em tudo o que está à nossa volta e dentro de nós.<br />
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E assim, significar e explicar por que a Natureza permite que alguém venha com cromossomos a mais…<br />
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Fazemos parte do grupo que cuida agora porque aprendemos com nossos filhos a engolir o pânico e sorrir, a enxugar as lágrimas e continuar e a compreender que não devemos esperar por dias melhores, já que o dia melhor é hoje, agora!Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-2936059435276319812020-03-06T00:11:00.001-03:002020-03-06T00:16:23.232-03:00Acompanhe Municípios e Estados onde temos projetos de lei e leis que tornam 06 de maio o Dia de Conscientização Sobre a Síndrome de Edwards-T18<iframe height="400" src="https://www.google.com/maps/d/u/3/embed?mid=1H28FJTxvla7qWS-vvfItoiKoTveBz-4S" width="430"></iframe>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-70593571676018134902020-02-08T00:17:00.003-03:002020-02-08T00:17:58.901-03:00ESTADOS E MUNICÍPIOS APOIAM O ESFORÇO DAS FAMÍLIAS PARA MAIOR VISIBILIDADE DA T18<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiD67Y_TMXWhf8BVKMgk12VhXZLCBAQ-pBteJYOZnMOT2d7kN5DAkk4PBVdTHvxGAzFo3ZL-f0VDPL4hwqP3FNZs99O4k9YpKa1qT8-4kldrqO2K3Y2ZMP6YlDP16NafHNYJWlCBIv3qazZ/s1600/LEI.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1099" data-original-width="1017" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiD67Y_TMXWhf8BVKMgk12VhXZLCBAQ-pBteJYOZnMOT2d7kN5DAkk4PBVdTHvxGAzFo3ZL-f0VDPL4hwqP3FNZs99O4k9YpKa1qT8-4kldrqO2K3Y2ZMP6YlDP16NafHNYJWlCBIv3qazZ/s320/LEI.jpeg" width="296" /></a></div>
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-14734383312450495592019-10-15T12:39:00.001-03:002019-10-15T12:39:42.428-03:00Audiência Pública em Campinas-SP sobre a Lei que faz de 06 de maio o "Dia da Conscientização sobre a Síndrome de Edwards - T18"<div class="separator" style="clear: both; text-align: center;">
<iframe width="320" height="266" class="YOUTUBE-iframe-video" data-thumbnail-src="https://i.ytimg.com/vi/LrVSl2dzFGo/0.jpg" src="https://www.youtube.com/embed/LrVSl2dzFGo?feature=player_embedded" frameborder="0" allowfullscreen></iframe></div>
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-65834834652158696212019-05-19T03:07:00.002-03:002019-05-19T03:07:39.516-03:00Atores Globais apoiam a campanha pelo Dia de Conscientização sobre a Síndrome de Edwards <div class="separator" style="clear: both; text-align: center;">
<iframe width="320" height="266" class="YOUTUBE-iframe-video" data-thumbnail-src="https://i.ytimg.com/vi/SJFWqtwMB-E/0.jpg" src="https://www.youtube.com/embed/SJFWqtwMB-E?feature=player_embedded" frameborder="0" allowfullscreen></iframe></div>
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-82869606863474568632019-05-19T03:05:00.000-03:002019-05-19T03:05:30.584-03:00A Dra. Michelle Detoni explica como ocorre a Síndrome de Edwards - T18<br />
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-89780519853312840382019-01-02T01:49:00.001-02:002019-01-02T01:49:07.387-02:00Existem outros "erros" que podem acontecer no cromossomo 18 <div class="separator" style="clear: both; text-align: center;">
Assista o médico geneticista Dr Charles Marques Lourenço e entenda mais sobre o que é Síndrome de Edwards e também o que não é</div>
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-33562308211229432302018-05-28T02:17:00.000-03:002018-05-28T02:19:56.789-03:00Estamos a um passo da Lei Federal<div class="separator" style="clear: both; text-align: center;">
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<span id="goog_135780460"></span><span id="goog_135780461"></span><br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-65618300308546151302018-05-28T02:02:00.000-03:002018-05-28T02:02:36.194-03:00O PODER DO AMOR <br />
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<span data-offset-key="6fdjv-0-0" style="background-color: white; color: #1d2129; font-family: "helvetica" , "arial" , sans-serif; font-size: 14px; white-space: pre-wrap;"><span data-text="true" style="font-family: inherit;"><br /></span></span>
<span data-offset-key="6fdjv-0-0" style="background-color: white; color: #1d2129; font-family: "helvetica" , "arial" , sans-serif; font-size: 14px; white-space: pre-wrap;"><span data-text="true" style="font-family: inherit;"><span data-offset-key="6fdjv-0-0" style="font-family: Helvetica, Arial, sans-serif;"><span data-text="true" style="font-family: inherit;">Eventos e apoios em todo o país pelo Dia de Conscientização sobre a Síndrome de Edwards! </span></span><span blockkey="6fdjv" class="_5zk7" contentstate="k { "entityMap": undefined, "blockMap": OrderedMap { "6fdjv": a { "key": "6fdjv", "type": "unstyled", "text": "O PODER DO AMOR - Eventos e apoios em todo o país pelo Dia de Conscientização sobre a Síndrome de Edwards! #todososamoressãoperfeitos #trissomia18 #t18brasil #sindromedoamor https://youtu.be/IxXLZC8AMGk", "characterList": List [ j { "style": OrderedSet {}, "entity": null }, j { "style": OrderedSet {}, "entity": null }, j { "style": OrderedSet {}, "entity": null }, j { 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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-15097277444592993522018-05-27T14:50:00.003-03:002018-05-28T02:15:22.484-03:00MANTENHA SEMPRE COM VOCÊOs "18 Mitos e Verdades sobre a Síndrome de Edwards (T18)" foram baseados na coleta de dados de 800 famílias por mais de 10 anos. Tenha sempre com você e compartilhe com os profissionais que acompanham seu filho. Solicite arquivo para impressão pelo e-mail sindromedoamor@gmail.com<br />
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-77396549319914791562018-05-22T22:46:00.001-03:002018-05-28T02:15:45.572-03:00Artigo Publicado no American Journal of Medical Genetics Part C (Seminars in Medical Genetics)<div class="separator" style="clear: both; text-align: center;">
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<span lang="PT" style="color: #212121;"><span style="font-size: xx-small;">Tradução do
artigo publicado no American Journal of
Medical Genetics Part C (Seminars in Medical Genetics)<o:p></o:p></span></span><br />
<span style="color: #212121; font-size: xx-small;">Obs: A tradução não é profissional. Caso queira sugerir uma opção mais adequada pedimos que nos envie o trecho para o e-mail trissomia18@gmail.com</span></div>
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<span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121;">Tomada de decisão compartilhada e os caminhos Abordagem
no pré-natal e pós-natal - Gestão da Trissomia 13 e Síndromes Trissomia 18</span></b><b><span style="color: #212121;"><o:p></o:p></span></b></span></div>
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<span style="font-size: xx-small;"><span style="background: white; color: #212121;">O tratamento médico de crianças
com as síndromes trissomia 13 e trissomia 18 é desafiador e controverso. Ambas
as condições têm alta mortalidade neonatal e infantil, e as crianças
sobreviventes exibem deficiências cognitivas e motoras. Atualmente, existe uma
tensão nas comunidades neonatal e perinatal em relação aos cuidados. Um ponto
de vista sustenta que a gestão deve consistir apenas em cuidados de conforto,
enquanto outra opinião recomenda a oferta de intervenção médica e cirúrgica em
situações apropriadas.</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">INTRODUÇÃO</span></span><br />
<span style="font-size: xx-small;"><span style="color: #212121; font-family: "calibri" , sans-serif;"><br /></span><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Com o advento da terapia intensiva neonatal cuidado no início dos anos 70, controvérsia em torno da gestão de bebês com risco de vida e os chamados Anomalias “letais” tornaram-se comuns tópico dentro das disciplinas de pediatria e bioética. Dois fundos para trás-papéis em pediatria por Fost [1981] e Duff [1982] enquadraram o debate sobre não-tratamento seletivo de </span><span style="color: #212121; font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">recém-nascidos há pouco mais de três décadas.<o:p></o:p></span><br /><span style="color: #212121; font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Em 1982, os regulamentos “Baby Doe”resultou de preocupações geradas por um caso bem divulgado de um recém-nascido com Síndrome de Down cujos pais escolheram para não realizar a cirurgia [Smith et al. 1984]. Este caso transformou a natureza do debate ético por parte dos marcando a importância de considerar tratamento medicamente indicado para crianças com síndrome de Down. Pela Década de 1990, as discussões sobre tratamento de recém-nascidos com anomalias começaram a se concentrar no cuidado de recém-nascidos com a trissomia 13 e síndromes trissomia 18. Dois trabalhos em particular [Bos et al., 1982; Paris et al. 1992] e uma pesquisa mais recente de neonatologistas em Nova Iorque [Carey, 2009] documentam o que foi considerou a abordagem convencional para manejo de neonatos com estas duas síndromes - uma retenção ou retirada do apoio tecnológico e cirurgia. A justificativa para isso abordagem padrão, não intervencionista baseou-se na alta associação mortalidade neonatal e neuropatia profunda incapacidade evolutiva em crianças com ambas as síndromes [Lorenz e Hardart, 2014].</span><br /><span style="color: #212121; font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="color: #212121; font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Na década de 1990, discussões sobre não tratamento seletivo de recém-nascidos com graves anomalias começaram a se concentrar em o cuidado de recém-nascidos com trissomia 13 e trissomia 18 síndromes. Dois trabalhos em particular e mais recente pesquisa de neonatologistas em Documento de Nova York o que tem foi considerado a abordagem convencional para manejo de neonatos com essas duas síndromes – uma retenção ou retirada de </span><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">apoio tecnológico e cirurgia.<o:p></o:p></span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Um diálogo ativo sobre este tema cuidados circunvizinhos em trissomia 13 e 18 surgiu dentro da pediatria e literatura bioética. Perguntas relacionadas cuidados de trissomia 13 e 18 pacientes são</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">comum na perinatal e configurações neonatais. A prevalência total trissomia 13 e trissomia 18 (eletiva terminação de gravidezes, natimortos e nascidos vivos) é de aproximadamente 1: 1.800</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">nos Estados Unidos [Crider et al., 2008].</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Este número ressalta o fato de que a experiência de ter uma gravidez com qualquer condição não é um evento raro, afetando mais de 2.000 famílias dos EUA anualmente.</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Vários desenvolvimentos recentes acrescentou mais dimensões ao debate. Primeiro, os testes pré-natais não invasivos para trissomia 13 e 18 é de baixo risco para um gravidez e pode aumentar o número diagnósticos pré-natais [Porreco et al. 2014]. Em segundo lugar, embora apenas 50% dos bebês com as duas síndromes sobreviver a primeira semana de vida e aproximadamente 5–10% sobrevivem ao primeiro ano, evidências recentes indicam que intervenções tecnológicas e cirurgia, incluindo cirurgia cardíaca, pode melhorar sobrevivência infantil em trissomia 18 [Janvier et al., 2012]. </span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Nos EUA, um banco de dados foi estabelecido para pacientes com trissomia 13 e trissomia 18, que pode produzir estatísticas de resultados para mais estudos [Kosho et al., 2006; Ver também www.trisomy.org). Esses dados o potencial para influenciar decisões sobre cuidados no futuro. Um terceiro fator é o maior foco na autonomia parental em o processo de tomada de decisão ética como sugerido por McGraw e Perlman [2008]. No Japão, um grupo propôs uma diretriz que pode ser útil para as famílias, reconhecendo a necessidade de uma relação de confiança enquanto determinam um plano de cuidados para recém-nascidos com doenças médicas graves [Kosho, 2008].</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><b><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Estudos dos pontos de vista dos pais expandiram ainda mais a discussão. Em uma grande pesquisa, os pais em grupos de apoio para crianças com trissomias 13 e 18 relataram que seus filhos enriqueceram a vida de suas famílias; eles frequentemente descrevem seus filhos como muito mais felizes do que seus médicos tinham antecipado. Muitos pais observaram que seus filhos e famílias experimentam obter uma melhor qualidade de vida e menos dor e sofrimento que seus cuidados previram [Janvier et al., 2012].</span></b><br /><b><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span></b><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Outra pesquisa de pais de crianças com Trissomia 18 descobriu que a maioria dos pais encontrou diariamente felicidade no nascimento de seus filhos e existência [Kosho et al., 2013]. Um final fator digno de consideração é a realidade que as crianças com essas trissomia síndromes, mesmo quando seus cariótipos são idênticos, têm uma grande variedade de anomalias, algumas das quais ameaçam a vida e alguns menos medicamente significativos.</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Uma tensão filosófica palpável centra-se em determinar o que está no melhor interesse de cada criança. Fatores em favor de uma abordagem de cuidados puramente conforto incluir questões tão importantes como a experiência potencial de dor e sofrimento percepção de letalidade uniforme e alocação de recursos escassos. Por outro lado, os fatores que sustentam mais intervenção incluem o valor de servindo a vida, o fato de que o desconforto de muitas intervenções é temporária, e procedimentos cirúrgicos melhoraram vem para muitas crianças.</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Além disso, o conflito, que até este ponto temos descrito como um dilema intelectual, é também se reflete no contexto de famílias cujas expressões únicas de amor, esperança e medo são muito mais profundo do que é articulado por mero discurso acadêmico. O desafio é assustador. Isso nos obriga a estabelecer um processo que integre fatos calmos sobre cada criança com os valores que são importantes para as famílias e profissionais.</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif; mso-ansi-language: PT; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Reconhecendo a pontualidade e relevância das tensões existentes Nesse dilema de cuidado, procuramos para reformular este discurso com dois modalidades: tomada de decisão compartilhada [Kon, 2010] e caminho de cuidados integrados maneiras [Allen et al., 2009]. Essas estratégias gies surgiram dos esforços para estabelecer um cuidado centrado no paciente e provar o resultado do paciente.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Uma filosofia filosófica palpável, centros de tensão na determinação o que é do melhor interesse de cada criança. Fatores em favor de uma abordagem de cuidados puramente conforto incluir questões tão importantes como a experiência potencial de dor e sofrimento, percepção de letalidade uniforme, e alocação de recursos escassos.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Por outro lado, fatores apoiando mais intervenção incluir o valor de preservar vida, o fato de que o desconforto de muitos as intervenções são temporárias, e procedimentos cirúrgicos têm melhores resultados para muitas crianças.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">A tomada de decisão compartilhada é um processo que visa ao desenvolvimento colaborativo desenvolvimento de metas de cuidado, engajamento a experiência e as perspectivas de pais e médicos. É projetado para moldar cada etapa da gestão clínica mento. Comunicação proativa fundamentada no diálogo entre os médicos e as famílias é a base da partilha tomando uma decisão. Tomada de decisão compartilhada tem recebido maior atenção como modelo em cuidados médicos padrão.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Os caminhos de cuidados são baseados em evidências, Abordagens passo a passo específicas da condição projetado para melhorar a padronização qualidade e resultados. Eles são tipicamente empregados no tratamento de diagnósticos comuns onde o consenso existe sobre o padrão de atendimento. Nos ampliou a aplicação de vias de abordagem de uma tarefa tipicamente estrutura orientada a um relacionamento estrutura baseada, aplicando-a onde o padrão de cuidado é menos claro. Estes caminhos expandidos aproximam conversas chave na decisão importante aponta para informar o desenvolvimento de um plano de cuidado, com atenção especial dirigido a antecipar a decisão futura pontos.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">As vias de cuidado são evidências com base em condições específicas, abordagens escalonadas projetadas melhorar o atendimento padronização, qualidade e resultados. Eles são tipicamente empregados no tratamento de diagnósticos comuns onde existe consenso sobre o padrão de atendimento.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Informados por esses paradigmas, grupo multidisciplinar explorou a tensão em torno da tomada de decisão—tanto no pré-natal como no pós-natal fetos, bebês e crianças mais velhas com trissomia 13 e 18. Propomos que o modelo de decisão compartilhada fazendo no contexto dos caminhos abordagem fornece um único e prático estratégia para a definição atual e futura objetivos do cuidado de crianças com trissomia 13 e trissomia 18, bem como em outras condições médicas complexas em todo o continuam idade.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">MÉTODOS</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Um grupo de trabalho de 35 pessoas se reuniu no Pavilhão Fulginiti da Universidade Centro de Bioética do Colorado e Humanidades. Quatro dos autores (JC, VS, SS, PH) convidaram membros do grupo de trabalho, incluindo pais de crianças com trissomia 18, juntamente com profissionais das áreas de obstetrícia enfermagem, enfermagem pediátrica, genética aconselhamento, psicologia, materno-fetal</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">medicamento, pediatria geral, neonatologia-bioética, cuidados paliativos e pasto-ral cuidados. Ausente da conferência eram grupos como cardiologistas, pais de crianças com trissomia 13, e pais que escolheram a terminação em a hora do diagnóstico pré-natal.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Primeiro identificamos variadas perspectivas associadas à complexidade de o cuidado de crianças com trissomias 13 e 18, incluindo preocupações em torno também muito ou pouco tratamento, e depois propuseram três princípios importantes, dois dos quais que são temas centrais neste trabalho.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Esses conceitos incluem:</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(i)<span style="font-family: "times new roman"; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">compartilhada tomando uma decisão;<o:p></o:p></span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(ii) antecipar a decisão pontos, a essência dos caminhos</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">abordagem; e</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> (iii) integração, interdis-colaboração disciplinar. Nosso foco então</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">virou-se para várias decisões específicas pontos. Eles estão listados no Quadro 1.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Em seguida, exploramos as tarefas e os processos necessários de cada ponto decisivo.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">RESULTADOS</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Tabela I, a peça central deste trabalho, relata nossos resultados. Esta tabela não é pretende ser uma lista de verificação, mas sim guia para envolver os caminhos na tomada de decisão compartilhada. Dentro</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">desse espírito, recomendamos que cianos convidam histórias e valores das famílias</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Para integrá-los no plano de Cuidado. É igualmente essencial que os médicos reconhecer como seus próprios valores poderiam influenciar o processo de tomada de decisão, identificando se e quando é apropriado</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">para introduzir essas perspectivas. Vários temas eram comuns em</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">cada um dos pontos de decisão. Nós recomendamos consertar a individualização da decisão processo de fabricação, desde as necessidades das famílias variam amplamente, e as trissomias associadas diagnósticos podem variar muito de caso para o caso.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Na cuidadosa organização de o processo de tomada de decisão para cada</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">paciente, enfatizamos atenção especial sendo dada a vários fatores em cada ponto de decisão</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Tabela I): Metas de atendimento,</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Caixa 1 Pontos de Decisão</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">• Diagnóstico e cuidados pré-natais</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">• Cuidados de parto e parto</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">• diagnóstico pós-natal</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">• Cuidados neonatais</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">• Antecipar possível alta para casa</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">profissionais sugeridos envolvidos, recursos necessários, experiências parentais e desejos e desafios profissionais e estratégias. As duas últimas colunas são apresentado separadamente porque parental experiências e desafios médicos abrangem todos os pontos de decisão.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">DISCUSSÃO</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Nós desenvolvemos um modelo que liga tomada de decisão compartilhada com uma abordagem caminhos percorridos para ajudar clínicos como eles se envolvem famílias em moldar metas de cuidado. Incorporando fatos médicos com os valores que são importantes para a família, em seguida, canalizar -los através da abordagem caminhos Idealmente ajuda médicos e famílias a trabalhar juntos para antecipar situações futuras exigindo decisões.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Nós reconhecemos que esta abordagem não irá eliminar todos complexidade ou conflito. Nossos resultados não devem ser interpretados como um algoritmo a ser seguido estritamente.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Em vez disso, o modelo serve como um guia para explorar, entender e responder ao circunstâncias únicas de cada criança e família, mesmo quando o filosófico home bases dos envolvidos aparecem em primeiro a diferir.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">O modelo é projetado para ativar a tomada de decisão compartilhada através as considerações importantes em cada tomada de decisão no caminho em a fim de resolver algumas das tensões envolvido nos cuidados perinatais e infantis de crianças com trissomia 13 e 18.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Nós desenvolvemos um modelo que liga a decisão compartilhada fazendo com um expandido abordagem de vias para ajudar clínicos como eles se envolvem famílias na formação de metas de Cuidado.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Restrições de tempo são muito reais impedimento à adoção de um processo de conversas serializadas e diferenciadas. No entanto, este modelo oferece a oportunidade de melhorar a qualidade de tomada de decisão com as famílias, acelerando a clarificação dos objetivos do cuidado.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Como os médicos usam modelo, propomos que eles relatem outros desafios potenciais do processo.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Recomendamos que este modelo seja testado para avaliar sua eficácia, não apenas com a população de crianças em quem as nossas estão discussões focadas, mas também com outras pacientes com diagnósticos complicados. Sugerimos um estudo mais aprofundado do modelo com foco na avaliação da família e satisfação profissional. Além do que, ,o uso de tomada de decisão compartilhada como um estrutura de orientação pode beneficiar futuro grupos que abordam outros desafios em todo o espectro etário.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Em conclusão, decisão compartilhada fazendo integrado com um caminho abordagem é um modelo que demonstra compromisso profissional para além da crise mais imediata ou ponto de decisão.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Este modelo, que incorpora a ética tomada de decisões fundamentada, guias médicos e famílias desde a época do diagnóstico inicial, através do restante do cuidado da criança e da família.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">AGRADECIMENTOS</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Os autores apreciam o apoio da Organização de Suporte para Trissomia 18, 13 e Transtornos Relacionados, a Fundação Trissomia 18 e as American Journal of Medical Genetics. Dentro Além disso, o apoio administrativo foi fornecida pela Universidade de Colorado, Divisão de Neonatologia, o Centro da Universidade do Colorado para Bioética e Humanidades e Feliz Martinez do Departamento de Pediatria</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">rics, Universidade de Utah. Os autores reconhecer a entrada de todo o grupo de trabalho.</span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Tabela1: </span><br />
<span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: #212121; font-family: "arial" , sans-serif;"><span style="white-space: pre-wrap;">Abordagem de caminhos para compartilhar a tomada de decisão</span> para T13 e T18</span></span><br />
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<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.05pt;" valign="top" width="93"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Ponto de</span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> decisão<o:p></o:p></span></span></b></pre>
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<td colspan="2" style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.2pt;" valign="top" width="94"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Objetivos do </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">cuidado<o:p></o:p></span></span></b></pre>
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<td colspan="2" style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.65pt;" valign="top" width="94"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">Profissionais </span></b></span></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">sugeridos </span></b></span></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">envolvidos</span></b><b><span style="color: #212121; font-family: inherit , serif;"><o:p></o:p></span></b></span></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
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<td colspan="2" style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.3pt;" valign="top" width="94"><pre style="background: white; text-align: center;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">Recursos </span></b></span></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">sugeridos</span></b><b><span style="color: #212121; font-family: inherit , serif;"><o:p></o:p></span></b></span></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
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<td colspan="2" style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 72.75pt;" valign="top" width="97"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">Considerações </span></b></span></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">parentais</span></b><b><span style="color: #212121; font-family: inherit , serif;"><o:p></o:p></span></b></span></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
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<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.75pt;" valign="top" width="94"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Considerações </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">profissionais<o:p></o:p></span></span></b></pre>
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<td colspan="2" style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.75pt;" valign="top" width="94"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Cuidado</span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> Neo Natal<o:p></o:p></span></span></b></pre>
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<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.75pt;" valign="top" width="94"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">
<span style="background: white; color: #212121;">- Critérios de </span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">descarga </span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">mínima </span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">
</span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">- planos de</span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">esclarecimento</span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"> para </span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">fluidos e </span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">nutrição,</span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">respiração, </span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">apoio, estado</span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"> de </span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">reanimação</span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">diretivas antecipadas <o:p></o:p></span></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">-Incluir cuidados </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">paliativos </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">como </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">intervenções ativas</span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">que podem </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">coincidir com outros</span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> tratamentos<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Escreva uma descrição</span></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> do plano </span> e esclareça</span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"> antes da alta </span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Planos de documentos</span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> no registro médico <o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Promover conferências</span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> de casos <o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">- Flexibilidade na tomada </span></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">de decisões com planos</span></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> em evolução</span><span style="font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
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<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">
<span style="background: white; color: #212121;">- Enfermeira<o:p></o:p></span></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Prestador de </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">primeiros-socorros<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Serviços de apoio, </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">por exemplo, capelão<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Subespecialistas </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">relevantes<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Assistente social </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">clínico<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> <o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Gerente de caso <o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Equipe de cuidados</span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> paliativos<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Prestador de cuidados </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">em domicílio<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> - Geneticista Médico</span><span style="font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
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<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Serviços paliativos<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Grupos de apoio<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Home care RN, </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">terapeutas, agências<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">- Suporte de </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">gerenciamento </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">de seguro / caso</span><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- encorajado a passar </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">tanto tempo</span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> com o bebê quanto </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">possível<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Considerado com </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">respeito</span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> pelas </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">preferências espirituais</span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> da família<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Guiado através de </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">mudanças</span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">nas decisões dos pais </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">em cada</span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">ponto de decisão<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- <b>Eliminação de termos </b></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><b>como</b></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><b>"vegetativo",</b></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><b>"Incompatível com</b></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><b> a vida"<o:p></o:p></b></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Aprecie a sensação de</span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> que </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">o bebê </span></span>é uma </pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> criança amada e </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">valorizada,</span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> e não um diagnóstico<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Ser aceito sem rótulos<o:p></o:p></span></span></pre>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;">
<span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">- Trabalhar para </span></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">integrar valores e fatos<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Antecipar mudanças </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">nas decisões <o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Fale com famílias</span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> alargadas, se solicitado<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Comprometer-se </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">a ter conversas em série<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Garantir que o</span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> relacionamento continue<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Evite julgar - Comunicar </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">o plano de cuidados com </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">outros profissionais<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> - Prepare a família para a </span></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">aparição do bebê</span><span style="font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
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<td style="border: none;" width="2"></td>
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<span style="font-size: xx-small;"><span style="font-family: "calibri" , sans-serif;"> </span><br /><span style="font-family: "calibri" , sans-serif;"> </span><br /><span style="font-family: "calibri" , sans-serif;"> </span><br /><span style="font-family: "calibri" , sans-serif;"> </span><br /><span style="font-family: "calibri" , sans-serif;"> </span><br /><span style="font-family: "calibri" , sans-serif;"> </span><br /><span style="font-family: "calibri" , sans-serif;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Tabela1 (cont)</span></span><br />
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<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.55pt;" valign="top" width="94"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Ponto de decisão<o:p></o:p></span></span></b></pre>
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<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.55pt;" valign="top" width="94"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Objetivos do </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">cuidado<o:p></o:p></span></span></b></pre>
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<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.55pt;" valign="top" width="94"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">Profissionais </span></b></span></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">sugeridos</span></b></span></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;"> envolvidos</span></b><b><span style="color: #212121; font-family: inherit , serif;"><o:p></o:p></span></b></span></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 73.55pt;" valign="top" width="98"><pre style="background: white; text-align: center;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">Recursos </span></b></span></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">sugeridos</span></b><b><span style="color: #212121; font-family: inherit , serif;"><o:p></o:p></span></b></span></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 69.75pt;" valign="top" width="93"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">Considerações </span></b></span></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">parentais</span></b><b><span style="color: #212121; font-family: inherit , serif;"><o:p></o:p></span></b></span></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 69.75pt;" valign="top" width="93"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Considerações</span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> profissionais<o:p></o:p></span></span></b></pre>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.55pt;" valign="top" width="94"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">
<!--[if !supportLineBreakNewLine]-->
<!--[endif]--><span style="background: white; color: #212121;"><o:p></o:p></span></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><b><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></b></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><b><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">Antecipação </span></b></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><b><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">possível de alta </span></b></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><b><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">para casa*</span></b><b><span style="font-family: "calibri" , sans-serif;"><o:p></o:p></span></b></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.55pt;" valign="top" width="94"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span style="font-family: "calibri" , sans-serif;">-</span><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">- Quadro de cuidados </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">paliativos para </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">fornecedores </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">e famílias<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Antecipar a mudança</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> de </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">mentes / planos<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Escreva um plano </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">completo,</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">incluindo DNR, pedidos,</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> etc e</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> EMR, e com a família<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Esclarecer antes da alta<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">- Plano de documentos </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">no EMR</span><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.55pt;" valign="top" width="94"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- profissionais de </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Cuidados</span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> paliativos <o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Suporte espiritual </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">para</span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> a família<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Geneticistas e outros</span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> especialistas<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Enfermeira em casa<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Terapeutas<o:p></o:p></span></span></pre>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 73.55pt;" valign="top" width="98"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">
<span style="background: white; color: #212121;">- Suporte proativo na </span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">busca de apoio médico </span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">e hospitalar - Grupos de </span></span></span></pre>
<pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;">suporte em vigor<o:p></o:p></span></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Cuidados auxiliares</span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> em vigor <o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Assessoria e apoio </span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">financeiro<o:p></o:p></span></span></pre>
<pre style="text-align: justify;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> - Provedor de hospital</span></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">comunitário pode precisar </span></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">de suporte de </span></span></pre>
<pre style="text-align: justify;"><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">subespecialidade</span><span style="font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 69.75pt;" valign="top" width="93"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 69.75pt;" valign="top" width="93"><pre style="text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
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</tbody></table>
<span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">DNR = Não Ressuscitar</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">EMR = registro médico eletrônico</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">* Muitos dos pontos-chave da tabela foram identificados e detalhados em um artigo de Elias et al. 2012 Encaminharíamos os leitores a este artigo como um modelo para a transição para o cuidado domiciliar de qualquer criança ou bebê com necessidades complexas de cuidado. Muitas das experiências e sentimentos possíveis e profissionais comuns aos outros pontos de decisão não foram repetidos na tabela.</span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"> </span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"> </span><br /><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"> </span><br /><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Tabela1: (cont)</span><br /><span style="color: #212121; font-family: "calibri" , sans-serif;"> </span></span><br />
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 1184;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.75pt;" valign="top" width="94"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Ponto de</span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> decisão<o:p></o:p></span></span></b></pre>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.75pt;" valign="top" width="94"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Objetivos do </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">cuidado<o:p></o:p></span></span></b></pre>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">Profissionais </span></b></span></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">sugeridos</span></b></span></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;"> envolvidos</span></b><b><span style="color: #212121; font-family: inherit , serif;"><o:p></o:p></span></b></span></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre style="background: white; text-align: center;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">Recursos sugeridos</span></b><b><span style="color: #212121; font-family: inherit , serif;"><o:p></o:p></span></b></span></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white; text-align: center;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: inherit , serif;">Considerações parentais</span></b><b><span style="color: #212121; font-family: inherit , serif;"><o:p></o:p></span></b></span></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Considerações </span></span></b></pre>
<pre style="text-align: center;"><b><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">profissionais<o:p></o:p></span></span></b></pre>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.75pt;" valign="top" width="94"><pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><b><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">Diagnóstico e </span></b></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">cuidados pré-natais</span></b><b><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></b></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.75pt;" valign="top" width="94"><pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">
<span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">- Determinar se o </span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">paciente</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;"> deseja mais informações. </span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">Em caso afirmativo,</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;"> como-ultra-som, </span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">amniocentese,</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;"> etc. </span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">
</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">- Reconheça que as </span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">metas podem</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;"> mudar </span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">
</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">- Discutir a contenção do </span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">cuidado pré-natal </span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">
</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">- Antecipe</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;"> decisões de trabalho e </span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">entrega,</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;"> incluindo monitoramento</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;"> fetal </span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">e via de entrega</span></span><span style="color: #212121;"><o:p></o:p></span></span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Obstetra<o:p></o:p></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">
<span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">- Perinatologista<o:p></o:p></span></span></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - conselheiro genético<o:p></o:p></span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> - Neonatologista</span><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Suporte Espiritual<o:p></o:p></span></span></pre>
<pre style="background: white;"><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span style="color: #212121; font-family: "calibri" , sans-serif;"> </span><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">- Organizações </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">profissionais<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- organizações de apoio<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Recursos da Web<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">- Cuidados após a perda </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">perinatal (lembranças, </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">fotos, autópsia, </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">aconselhamento genético)</span><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Experiências:<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Negação, culpa, raiva<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- impotência<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- A criança do</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> sentimento-</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">medo em conflito </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">morre,</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> tem medo da </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">criança vive,</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> amor profundo<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">- Tristeza - a perda </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">da criança </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">esperada não pode</span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"> voltar </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">para casa, como se supõe</span><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre><span style="font-size: xx-small;"><span style="color: #212121; font-family: "calibri" , sans-serif;"> </span><span style="font-family: "calibri" , sans-serif; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">
</span><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="white-space: pre-wrap;">Desafios profissionais<o:p></o:p></span></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Preocupação com</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> restrições de tempo<o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Falta de treinamento </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">sobre compartilhar notícias</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> difíceis<o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> - Confusão sobre os papéis </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">dos </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">provedores </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">- Valores conflitantes</span><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
</td>
</tr>
<tr style="height: 49.6pt; mso-yfti-irow: 2;">
<td style="border-top: none; border: solid windowtext 1.0pt; height: 49.6pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.75pt;" valign="top" width="94"><pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><b><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">Cuidados de </span></b></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">parto e parto</span></b><b><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></b></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 49.6pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.75pt;" valign="top" width="94"><pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Planejar conversas em</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">série <o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Promover o cuidado</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> interdisciplinar<o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Definir a terminologia </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">com cuidado<o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> -Descrever e discutir </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">adamente</span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> e como está ocorrendo</span><o:p></o:p></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 49.6pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Obstetra<o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Neonatologista<o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Pediatra<o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Capelão<o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Assistente Social<o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Enfermeiro<o:p></o:p></span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 49.6pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">
<span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">- Conferência de</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;"> atendimento antes</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;"> da entrega com o </span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">desenvolvimento de</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;">um plano de atendimento</span></span></span></span></pre>
<pre><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"><span style="background: white; color: #212121;"><span style="white-space: pre-wrap;"> por escrito</span></span><span style="color: #212121;"><o:p></o:p></span></span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 49.6pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Medos<o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Enfrentando o futuro </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">incerto<o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Sendo mal</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> interpretado</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> julgado <o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">
</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Compartilhando </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">dignidade</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> com</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> o irmão da criança, outros </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">amigos</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> da família<o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> - Antecipar o abandono </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">em </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">qualquer fase do percurso</span><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 49.6pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Preferências pessoais</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> diferentes dos pais<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Pressão para fazer o</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> diagnóstico correto em</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> tempo hábil<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Necessidade de manter </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">tanto</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> a objetividade quanto a </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">empatia<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">-Profissão de fracasso e luto<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Diagnóstico e incerteza</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> prognóstica<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- intimidação sobre a</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> importância da</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> linguagem<o:p></o:p></span></span></pre>
<pre style="background: white;"><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.75pt;" valign="top" width="94"><pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><b><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></b></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">Nos casos em que o </span></b></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">diagnóstico é feito </span></b></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><b><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">após o parto</span></b><b><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></b></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.75pt;" valign="top" width="94"><pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Promover a ligação com</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> o recém-nascido<o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> - Entregar informações </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">de maneira </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">oportuna e de fácil </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">compreensão<o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> - Iniciar uma discussão </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">preliminar</span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> antes do bem diagnóstico, </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">para </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">permitir o tempo </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">apropriado </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">para processamento </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">ou informação</span><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Enfermeira<o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">-Obstetra<o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Perinatologista<o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Neonatologista<o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Pediatra<o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Capelão<o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Médico Geneticista<o:p></o:p></span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Treinar na entrega</span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> de notícias difíceis<o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> <o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Cuidados após a perda </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">neonatal (lembranças, </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">fotos, autópsia, </span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">aconselhamento genético)<o:p></o:p></span></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;"> </span></o:p></span></pre>
<pre><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"><o:p><span style="font-size: xx-small;">
</span></o:p></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;"> - Informações de </span></span></pre>
<pre><span style="font-size: xx-small;"><span style="background: white; color: #212121; font-family: "calibri" , sans-serif;">contato do grupo de suporte</span><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">Esperanças e desejos<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Reconhecimento da </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">complexidade das </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">experiências<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Necessidade parental </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">de informações precisas</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> e completas sobre a </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">síndrome combinadas </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">com a disposição de </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">deixar o bebê "escrever </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">seu próprio livro"<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Ouvir sobre as </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">preferências de </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">entrega, </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">especialmente seção C<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Ser respeitado como </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">qualquer pai no processo </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">de pré-natal e parto<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Consultado considerando </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">equilíbrio de atmosfera</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> alegre / sombria na entrega<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">- Tempo disponível para </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">equilibrar as informações </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">de processamento com </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">a necessidade de mais</span><span style="color: #212121; font-family: "inherit" , serif;"><o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 70.8pt;" valign="top" width="94"><pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Reconhecer o choque e a</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> descrença<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Esteja ciente da importância </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">da cultura<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Use a linguagem "child-first"<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">- Use uma linguagem que</span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> não exceda </span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;">as capacidades da família<o:p></o:p></span></span></pre>
<pre style="background: white;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">- Pergunte sobre as esperanças </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">e </span></span></pre>
<pre style="background: white;"><span style="font-size: xx-small;"><span lang="PT" style="color: #212121; font-family: "calibri" , sans-serif;">medos dos pais</span><span style="color: #212121; font-family: "calibri" , sans-serif;"><o:p></o:p></span></span></pre>
<pre><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
</td>
</tr>
</tbody></table>
</div>
<br />
<div class="MsoNormal" style="text-align: justify;">
<span style="background: white; color: #212121;"><span style="font-size: xx-small;"> O objetivo deste manuscrito é apresentar um
modelo para o atendimento de fetos e lactentes com trissomia do cromossomo 13 e
18 durante o pré-natal, perinatal e períodos pós-natal. Adotando a abordagem
dos caminhos como um quadro, identificamos vários pontos de decisão,
caracterizando os objetivos do atendimento e os recursos necessários para os
pontos de vezes. Além disso, identificamos temas relacionados às experiências
parentais e profissionais. Os autores propor um modelo de atendimento para as
trissomias 13 e 18 que utiliza a tomada de decisão compartilhada como seu
princípio fundamental e os caminhos se aproximam como o método. Nosso modelo
exige uma investigação mais aprofundada como estratégia de cuidado para
torná-lo útil em outras situações médicas complexas. © 2016 Wiley Periodicals,
Inc.<o:p></o:p></span></span></div>
<pre style="background: white;"><span style="color: #212121; font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
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<pre style="background: white; text-align: justify;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: xx-small;"> </span></span></pre>
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-84635486021183290992018-05-16T00:19:00.000-03:002018-05-28T02:16:23.456-03:00Lei 16.653 de 12 de janeiro de 2018 <div class="separator" style="clear: both; text-align: center;">
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Esta é a lei que tornou o 06 de maio o Dia da Conscientização Sobre a Síndrome de Edwards no Estado de São Paulo. </div>
<div class="separator" style="clear: both; text-align: center;">
O projeto de lei para a lei nacional já está em tramitação e você pode opinar no link <a href="https://www12.senado.leg.br/ecidadania/visualizacaomateria?id=132821">https://www12.senado.leg.br/ecidadania/visualizacaomateria?id=132821</a></div>
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-9564582409319864272018-05-16T00:09:00.002-03:002018-05-16T00:09:44.922-03:00Será na Assembleia Legislativa de São Paulo o encerramento da Semana de Conscientização Sobre a Síndrome de Edwards<div class="separator" style="clear: both; text-align: center;">
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06 de maio - Ribeirão Preto -SP<br />
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06 de maio - Poá-RS<br />
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19 de maio - São Paulo-SP<br />
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05 de maio - Catete, Rio de Janeiro - RJ<br />
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06 de maio - Ilha do Governador, Rio de Janeiro-RJ<br />
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07 de maio - Ijuí-RS<br />
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06 de maio - Brasília<br />
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9 de maio - Campinas-SP<br />
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06 de maio - Rio de Janeiro</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-38713180401949000352018-04-15T19:50:00.000-03:002018-04-30T21:18:40.346-03:00Veja aqui mais famosos que estão apoiando o Dia da Conscientização Sobre a Síndrome de Edwards<div class="separator" style="clear: both; text-align: center;">
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-26357244000929883932018-04-07T17:09:00.000-03:002018-04-07T17:09:40.279-03:00Mais uma atriz amorosa apoia o Dia de Conscientização Sobre a Síndrome de Edwards<div class="separator" style="clear: both; text-align: center;">
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A atriz Susy Rêgo se emocionou ao falar do movimento T18 e nós também! Gratidão, querida!Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-79228888880002607902018-04-06T20:26:00.001-03:002018-04-06T21:21:18.878-03:00O ator global Mateus Solano apoia nossa causa!<br />
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<div class="MsoNormal" style="line-height: normal; margin-bottom: 30.0pt; text-align: justify;">
<span style="color: #555555; font-family: "arial" , sans-serif; font-size: 12.0pt;">O ator global Mateus Solano apoia a causa e deixou sua mensagem nas
redes sociais através de um depoimento por vídeo. ‘’A síndrome de Edwards é a
segunda condição genética mais comum no Brasil e mesmo assim ela é muito pouco
conhecida pelos profissionais de saúde, muitas vezes a constatação vem
acompanhada pela expressão incompatível com a vida, o que torna o diagnóstico
muito mais devastador para os pais.”</span><span style="font-family: "times new roman" , serif; font-size: 12.0pt;"><o:p></o:p></span></div>
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-2443949998573213845.post-4041421706957398302017-09-23T00:47:00.003-03:002017-09-23T00:50:27.933-03:00Projeto de Lei tornará o dia 06 de maio Dia da Conscientização da Sìndrome de Edwards no Estado de São Paulo<div class="separator" style="clear: both; text-align: center;">
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<br />Unknownnoreply@blogger.com0