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1.
J Clin Nurs ; 29(11-12): 1903-1912, 2020 Jun.
Article in English | MEDLINE | ID: mdl-30357979

ABSTRACT

AIMS AND OBJECTIVES: To answer the question "What is the lived experience of hospitality during a patient's hospital stay for elective surgery?" BACKGROUND: Hospitality centres on a host offering comfort to others, as in a personal care context. Caring constitutes the essence of what it is to be human, having a profound effect on well-being and recovery from surgery. Caring is one of the most elusive and diversely contested concepts in nursing; however, care provided by nurses seldom transcends as deep human connections and social utility. This study explored the nature, meaning and experience of hospitality as care from the perspective of elective surgery patients. Consolidated Criteria for Reporting Qualitative criteria were used. DESIGN: A hermeneutic phenomenological methodology. METHODS: Data were gathered through semi-structured, face to face interviews with seven patients from both private and public hospitals, and from different cultural backgrounds. RESULTS: Three interpretative notions were as follows: experiences of hospitality as feeling "really" cared for, being at ease and being healed. Hospitality exists in the receiver's lived experience, evoking a special moment which leads to feelings of great comfort and feelings of being truly cared about. When hospitality is received, patients feel a connection; they begin to trust and their healing begins. CONCLUSION: The offering of often small, yet heartfelt acts of hospitality, indicated that nurses can evoke powerful lived experiences which benefit patients undergoing elective surgery. RELEVANCE TO CLINICAL PRACTICE: The importance of prioritising emotional and social connections to the hospitality experience needs emphasis at all levels of the clinical structure. Hospitality as caring needs to form a part of all undergraduate and postgraduate nursing curricula, and ongoing professional development. The participant quotes presented in this article could form exemplars for the provision of hospitable nursing care practices, highlighting nurses getting to know and understand their patients, and being interested in their lives.


Subject(s)
Nurse-Patient Relations , Nursing Staff, Hospital/standards , Patient Satisfaction , Adult , Empathy , Female , Humans , Male , Nurse's Role , Nursing Staff, Hospital/psychology , Qualitative Research
2.
Pain ; 160(2): 442-462, 2019 Feb.
Article in English | MEDLINE | ID: mdl-30247267

ABSTRACT

Excitatory interneurons account for the majority of neurons in the superficial dorsal horn, but despite their presumed contribution to pain and itch, there is still limited information about their organisation and function. We recently identified 2 populations of excitatory interneuron defined by expression of gastrin-releasing peptide (GRP) or substance P (SP). Here, we demonstrate that these cells show major differences in their morphological, electrophysiological, and pharmacological properties. Based on their somatodendritic morphology and firing patterns, we propose that the SP cells correspond to radial cells, which generally show delayed firing. By contrast, most GRP cells show transient or single-spike firing, and many are likely to correspond to the so-called transient central cells. Unlike the SP cells, few of the GRP cells had long propriospinal projections, suggesting that they are involved primarily in local processing. The 2 populations also differed in responses to neuromodulators, with most SP cells, but few GRP cells, responding to noradrenaline and 5-HT; the converse was true for responses to the µ-opioid agonist DAMGO. Although a recent study suggested that GRP cells are innervated by nociceptors and are strongly activated by noxious stimuli, we found that very few GRP cells receive direct synaptic input from TRPV1-expressing afferents, and that they seldom phosphorylate extracellular signal-regulated kinases in response to noxious stimuli. These findings indicate that the SP and GRP cells differentially process somatosensory information.


Subject(s)
Gastrin-Releasing Peptide/metabolism , Interneurons/physiology , Spinal Cord Dorsal Horn/cytology , Substance P/metabolism , Action Potentials/drug effects , Action Potentials/genetics , Analgesics/pharmacology , Animals , Capsaicin/pharmacology , Cholera Toxin/metabolism , Extracellular Signal-Regulated MAP Kinases/metabolism , Gastrin-Releasing Peptide/genetics , In Vitro Techniques , Interneurons/drug effects , Luminescent Proteins/genetics , Luminescent Proteins/metabolism , Mice , Mice, Inbred C57BL , Mice, Transgenic , Neurotransmitter Agents/pharmacology , Patch-Clamp Techniques , Physical Stimulation , Protein Precursors/genetics , Protein Precursors/metabolism , RNA, Messenger/metabolism , Sensory System Agents/pharmacology , Statistics, Nonparametric , Substance P/genetics , Tachykinins/genetics , Tachykinins/metabolism , Transduction, Genetic
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