Humour in adult cancer care: a concept analysis

The Relationship Between the Humor Styles of Nurses and Psychological Well-Being During the COVID-19 Pandemic Period

BACKGROUND

The previous studies have revealed that the psychological state of nurses, who work in the front line, is negatively affected by the situations that created high pressure such as epidemics and disasters in the past.

OBJECTIVES

The aim of the study was to determine some characteristics that affect nurses' humor styles and psychological well-being during the COVID-19 pandemic period, and to determine the relationship between humor styles and psychological well-being.

METHOD

The research was conducted in a cross-sectional study. The sample of the study consists of 260 nurses from a city in eastern Turkey. The data have been collected by using a personal information form, the Humor Styles Scale, and the Psychological Well-Being Scale in the study. Frequency, arithmetic mean, minimum and maximum, correlation analysis t test in the independent groups, 1-way analysis of variance, Mann-Whitney U test, and Kruskal-Wallis test have been used in the analysis of the data. This study aligns with the Strengthening the Reporting of Observational Studies in Epidemiology checklist.

RESULTS

It is determined that the mean age of the nurses is 28.35 ± 6.19 years, and the age range is between 20 and 47 years. It is determined that there is a statistically significant positive relationship between "self-improving humor" and "participatory humor," which are among the harmonious/positive humor styles of the nurses, and the total Psychological Well-Being Scale score (P < .05). It is determined that there is a statistically significant negative relationship between "aggressive humor," which is one of the inharmonious/negative humor styles, and the total Psychological Well-Being Scale score (P < .05).

DISCUSSION

The results support that nurses' use of self-enhancing and participatory humor contributes to psychological well-being.

An Overview of Cancer in Djibouti: Current Status, Therapeutic Approaches, and Promising Endeavors in Local Essential Oil Treatment

Djibouti, a developing economy, grapples with significant socioeconomic obstacles and the prevalence of infectious pathologies, including certain forms of neoplasms. These challenges are exacerbated by limited access to affordable medical technologies for diagnosis, coupled with a lack of preventive interventions, particularly in disadvantaged areas. The attention devoted to local phytotherapeutic treatments underscores the uniqueness of Djibouti's flora, resulting from its distinctive geographical position. International focus specifically centers on harnessing this potential as a valuable resource, emphasizing the phytoconstituents used to counter pathologies, notably carcinomas. This comprehensive overview covers a broad spectrum, commencing with an examination of the current state of knowledge, namely an in-depth investigation of oncological risk factors. Essential elements of control are subsequently studied, highlighting the fundamental prerequisites for effective management. The significance of dietary habits in cancer prevention and support is explored in depth, while traditional methods are examined, highlighting the cultural significance of indigenous essential oil therapies and encouraging further research based on the promising results.

Motivating nurses' coworker-directed helping behaviour during the COVID-19 pandemic: Role of managerial humour and nurses' power distance orientation

AIMS

The aims of the research are to investigate (1) the influence of managerial humour on nurses' coworker-directed helping behaviour, (2) the mediating effect of nurses' feelings of energy between managerial humour and nurses' coworker-directed helping behaviour and (3) the moderating effect of nurses' power distance orientation.

DESIGN

This is a quantitative study. A three-wave survey design was conducted to collect data from direct managers to nurse dyads.

METHODS

The random sampling method was employed. Data were collected from the supervisor to subordinate dyad at three time points during the first half of 2021. A total of 235 paired data sets of nurses and their direct managers were collected from a large state-owned Chinese hospital. We used hierarchical regression analyses via SPSS 22.0 software to examine the hypotheses.

RESULTS

(1) Managerial humour can foster nurses' coworker-directed helping behaviour via accumulating their feelings of energy. (2) Power distance orientation moderates the effect of managerial humour on feelings of energy as well as the indirect effect of managerial humour on nurses' coworker-directed helping behaviour via feelings of energy, in a way that these effects are stronger when nurses have higher (vs. lower) level of power distance orientation.

CONCLUSION

Managerial humour can increase nurses' feelings of energy, which in turn, motivates them to help their coworkers. Nurses' power distance orientation is an important boundary condition that constrains managerial humour effectiveness.

IMPACT

Hospital managers could use more humour during their interactions with nurses because managerial humour can promote nurses' feelings of energy and coworker-directed helping behaviour. Hospitals can take humour into account during managers' selection and training to improve management effectiveness. Managers in eastern countries should use more humour during their interactions with followers.

PATIENT OR PUBLIC CONTRIBUTION

Nurses and their direct managers from a large state-owned Chinese hospital contributed to this study by completing the survey.

"It's Hard, but We Could Kind of Laugh About It": Exploring the Role of Humor in Brain Cancer Caregiving

Research exploring the benefits of humor for caregivers is limited and, to date, no qualitative studies have explored the role of humor in brain cancer caregiving. To address this gap, we analyzed transcripts from twenty-one in-depth telephone interviews conducted with brain cancer caregivers from a strengths perspective. Thematic analysis using Braun and Clarke's method revealed that humor functions as (1) an innate element of the self and relationship, (2) an expression of mutual connection and understanding, (3) a way of managing difficult or awkward moments, (4) a form of avoidance or a welcome distraction, and may be (5) helpful, or unhelpful, depending on where someone is in the brain cancer trajectory. Findings suggest that humor represents an important yet complex individual and family strength for health service providers to identify and build upon.

A Concept Analysis on Disaster Resilience in Rescue Workers: The Psychological Perspective

OBJECTIVE

The term disaster resilience has not been well defined. The purpose of this article is to scrutinize the concept of disaster resilience in rescue workers.

METHODS

A systematic search was conducted of the PsychInfo, PubMed, ISI Web of Science, MEDLINE, CINAHL, Embase, and Scopus databases using the key terms. The framework from Walker and Avant was used to analyze the concept of disaster resilience.

RESULTS

A total of 26 papers was included in this analysis. The attributes of disaster resilience have been identified from the literature as including personality, perceived control, self-efficacy, coping strategies, and social support. The antecedents of disaster resilience are disastrous events and preparedness for disaster. The consequences of disaster resilience are psychological well-being, posttraumatic growth, and enhanced work engagement.

CONCLUSION

This concept analysis presents a definition of the concept of disaster resilience that could contribute to the development of a standardized screening or assessment tool and tailored training programs to strengthen disaster resilience among those who are willing to be deployed to engage in disaster rescue work and those who have been involved in such work.

Gender Differences in the Use of Engagement and Disengagement Coping Strategies in Patients With Cancer Receiving Chemotherapy

OBJECTIVES

To evaluate the relationship between gender and coping strategies in patients with cancer undergoing chemotherapy in outpatient settings.

SAMPLE & SETTING

Women (N = 277) and men (N = 293) were recruited from two comprehensive cancer centers, one Veterans Affairs hospital, and four community-based oncology programs.

METHODS & VARIABLES

Coping data were obtained from patients with gastrointestinal (n = 412) or lung (n = 158) cancer through the Brief COPE scale.

RESULTS

In terms of engagement coping strategies, women reported higher scores for positive reframing, religion, and using instrumental support. Men reported higher scores for humor. In terms of disengagement coping strategies, women reported higher scores for denial, venting, and self-distraction. Men reported higher scores for substance use.

IMPLICATIONS FOR NURSING

Gender-based stereotypes of emotional expectations may affect how patients express themselves and the ways in which support is offered. Clinicians should be aware of their own preconceived notions about sex and gender and reflect on how these may influence the psychosocial care they provide.

Effects of Therapeutic Clowning on Pain and Anxiety During Intrathecal Chemotherapy in Turkey

PURPOSE

The aim of the present study was to explore the effect of therapeutic clowning on pain and anxiety during intrathecal chemotherapy.

DESIGN & METHODS

The study was conducted using a quasi-experimental method with a pretest-posttest control group design. The study sample was composed of children between 7 and 12 years old (N = 78) who had been diagnosed with acute myeloid leukaemia and acute lymphoblastic leukaemia and were undergoing intrathecal chemotherapy in a hospital in Turkey. The study was conducted with children who received services at this hospital. The results were obtained from 74 children (i.e. 36 in the control group, 38 in the clown group). The data were collected with a questionnaire developed by the researchers, the Visual Analogue Scale (VAS) and the Faces Pain Rating Scale (FACES). VAS and FACES were used to measure pain and anxiety levels. Therapeutic clowning was applied to children in the intervention group. Analyses included percentage distributions, mean, chi-square, t-test, variance, and correlation analysis.

RESULTS

Results showed that children in the clown group had significantly lower pain and anxiety than children in the control group (p < .001).

CONCLUSIONS

According to the results, therapeutic clowning was effective in relieving the pain and anxiety of children between the ages of 7 and 12 years who undergone intrathecal chemotherapy.

PRACTICE IMPLICATIONS

Due to its positive effects, therapeutic clowning could be explore for use in other areas of paediatric nursing for the children between the ages of 7 and 12 years as a complementary treatment.

Perceived changes in psychological and physical symptoms after hospital clown performances in a cancer setting

Background: The therapeutic role of humor and hospital clowns has become a focus of interest in recent decades. Most of the research in the area has focused on children; here, we explore the influence of clown performances on adult cancer patients, their companions, and health-care staff.Methods: Ninety-nine cancer patients and 113 companions were assessed pre- and post-interventions performed by professional clowns; 31 health professionals were asked about the possible influence of the presence of clowns in hospital on their work.Results: Patients felt that clowning performances helped to reduce their level of psychological symptoms, but not their physical symptoms. Companions reported improvements in all the psychological symptoms explored. Health professionals reported that the presence of clowns in the workplace improved their well-being.Conclusions: Clowning performances helped to improve psychological functioning in all the populations studied, especially in companions. Adult hospitals should consider promoting clowning interventions to improve general well-being.

Embedding spiritual care into everyday nursing practice

This article explains how patients' spiritual needs can be embedded into everyday nursing practice, rather than being seen as an additional task for nurses to undertake. It outlines an integrated person model of care, which involves the nurse using the unique contact involved in providing physical care to meet the patient's spiritual needs. In addition, nurses can use the principles of therapeutic relationships such as empathy and providing a non-judgemental presence to support spiritual care, as well as respecting patients' dignity and individuality. This article also describes techniques for discussing spirituality with patients, and explains how touch can be a useful therapeutic intervention that can enhance patients' spiritual well-being.

Associations of work stress and humor with health status in hospital nurses-A cross-sectional study

AIMS AND OBJECTIVES

To analyse the relationship among hospital nurses' socio-demographic data, work stress, humor and health conditions, and to determine the predictors of nurses' health status.

BACKGROUND

Humor can decrease the feelings of helplessness, fear and anxiety, and that may result in the development of positive emotions, which might have a good impact on health.

DESIGN

This research applied cross-sectional designs and used structured questionnaires which included socio-demographic data, an Effort-Reward Imbalance questionnaire (ERI), humor and 12-item Chinese health questionnaires (CHQ). A total of 236 nurses in a regional hospital in Taiwan were recruited. SPSS was used for the data analysis in the study. The STROBE was chosen as a checklist for this study.

RESULTS

The results showed that the significant predictors of the participants' health were "whether experienced significant life events during the past 3 months," "the degree of work stress" and the level of "humor."

CONCLUSIONS

It is recommended that administrators pay attention to the cultivation of nursing staff's humor, such as providing nurses with musical CDs or humorous books and providing stress management training courses to nurses.

RELEVANCE TO CLINICAL PRACTICE

It is necessary for hospital managers to determine and deal with the causes of work stress to avoid the development of health problems in the nursing personnel. Furthermore, in order to develop stress-releasing strategies, it is necessary to provide nurses with stress management and resilience enhancement courses. Cultivating a humor competency of nurses is also recommended to alleviate the work stress.

The perceptions of nurses, patients and family members regarding nurses' empathetic behaviours towards patients suffering from cancer: a descriptive qualitative study

Background

Although evidence suggests that empathic behaviour is an essential component in nursing care that affects the psychological distress experienced by cancer patients, it remains a neglected issue in nursing in Iran.

Methods

This study was conducted on 33 participants selected through purposive sampling. Data were collected using in-depth interviews and were then analysed using qualitative content analysis with an inductive approach.

Findings

Three categories of data thus emerged, comprising: (a) empathetic attention; (b) empathetic presence; and (c) the facilitators of empathetic behaviour.

Conclusions

The findings can help oncology nurses provide more empathetic care to patients and their family members.

The Use of Humor in Palliative Care: A Systematic Literature Review

BACKGROUND

Humor has its own place in the context of medicine. Nevertheless, its acceptance by terminal stage patients and health-care professionals has not been studied in depth and is not free from controversy.

OBJECTIVES

To understand the significance, appropriateness, and pertinence of the use of humor in palliative care and to analyze its applicability.

DESIGN

A narrative systematic review was undertaken and included in PROSPERO.

DATA SOURCES

Online searches were carried out on PUBMED, PSYCINFO, EBSCO (CINHAL), EMBASE, SCIELO, SCOPUS, TESEO, WEB of SCIENCE, and COCHRANE between their launch date and December 31, 2015, complemented with manual searches with queries to experts. A total of 156 studies were identified, which were then filtered in pairs by means of an established hierarchy, selecting studies that discussed the use of humor specifically in palliative care from all perspectives and designs, and finally published in Spanish, English, French, or Portuguese. Critical reading of all the selected studies took place, with no exclusions due to quality evaluation.

RESULTS

Thirty-four studies were included. Five main topics were identified: (1) definition of humor, (2) use and functions of humor in palliative care, (3) how to use humor, (4) when not to use humor, and (5) humor before and after the diagnosis of terminal illness.

CONCLUSIONS

Humor plays an unquestionable role in palliative care, but its use needs training and appropriate use.

Development of Trust in an Online Breast Cancer Forum: A Qualitative Study

Background

Online health forums provide peer support for a range of medical conditions including life-threatening and terminal illnesses. Trust is an important component of peer-to-peer support, although relatively little is known about how trust forms within online health forums.

Objective

The aim of this paper is to examine how trust develops and influences sharing among users of an online breast cancer forum.

Methods

An interpretive qualitative approach was adopted. Data were collected from forum posts from 135 threads on 9 boards on the UK charity, Breast Cancer Care (BCC). Semistructured interviews were conducted with 14 BCC forum users. Both datasets were analyzed thematically using Braun and Clarke’s approach and combined to triangulate analysis.

Results

Trust operates in 3 dimensions, structural, relational, and temporal, and these intersect with each other and do not operate in isolation. The structural dimension relates to how the affordances and formal rules of the site affected trust. The relational dimension refers to how trust was necessarily experienced in interactions with other forum users: it emerged within relationships and was a social phenomenon. The temporal dimension relates to how trust changed over time and was influenced by the length of time users spent on the forum.

Conclusions

Trust is a process that changes over time and which is influenced by structural features of the forum, as well as informal but collectively understood relational interactions among forum users. The study provides a better understanding of how the intersecting structural, relational, and temporal aspects that support the development of trust facilitate sharing in online environments. These findings will help organizations developing online health forums.

Humor as a Communication Strategy in Provider-Patient Communication in a Chronic Care Setting

Humor is a potential communication strategy to accomplish various and potentially conflicting consultation goals. We investigated humor use and its reception in diabetes consultations by analyzing how and why humor emerges and its impact on the interaction. We did this by using an interactional sociolinguistics approach. We recorded 50 consultations in an Irish diabetes setting. Analysis of the humor events drew on framework analysis and on concepts from Conversation Analysis and pragmatics. The study also comprised interviews using tape-assisted recall. We identified 10 humor functions and two umbrella functions. A key finding is that most humor is relationship-protecting humor initiated by patients, that is, they voice serious messages and deal with emotional issues through humor. Our findings imply that patients' and providers' awareness of indirect communication strategies needs to be increased. We also recommend that researchers employ varied methods to adequately capture the interactive nature of humor.

Psychometric evaluation of the Holden Communication Scale (HCS) for persons with dementia

OBJECTIVE

To investigate the psychometric properties of the Holden Communication Scale (HCS) and the association between scores on HCS and cognitive function among persons with dementia.

METHOD

Internal consistency was assessed by the Cronbach's α coefficient and inter-item correlations. Test-retest was carried out to test the instrument's stability. An exploratory factor analysis with the principal components extraction method and oblimin rotation was performed to evaluate construct validity. Pearson's correlation coefficients were calculated to explore associations between the scores on the HCS and cognitive function.

RESULTS

A total of 128 persons with moderate-to-severe cognitive impairment (mean Mini-Mental State Examination (MMSE) score 8.9 (SD 7.0)) participated. The mean age was 85.2 (SD 7.2) and 101 of the participants were women. The Cronbach's α of the HCS was 0.94 and test-retest reliability was r=0.71. The corrected item-total correlation ranged from 0.63 to 0.79 and factor analysis showed a 1-factor structure of the HCS, which explained 63% of the variance. However, a forced 3-factor structure explained 76% of the variance. The correlation between cognitive function as measured by the MMSE and ability to communicate as measured with HCS was found to be moderate for those with an MMSE score of 0-10 (-0.61) and low for persons with an MMSE score of 11-20 (-0.06).

CONCLUSIONS

The HCS is a reliable and valid scale for assessing communication ability in persons with moderate and severe cognitive impairment, and might have a 1-factor or 3-factor structure.

"I Had a Little Bit of a Bloke Meltdown…But the Next Day, I Was Up": Understanding Cancer Experiences Among Aboriginal Men

BACKGROUND

Although cancer in indigenous populations is receiving increased research attention, there is a gap in understanding the particular experiences of Aboriginal men.

OBJECTIVE

The aim of this study is to integrate a range of primary and secondary accounts of the experiences of Aboriginal men in engaging with a cancer diagnosis and treatment in Australia.

METHODS

Secondary analysis of qualitative interviews (n = 54) conducted between 2008 and 2011 revealed recurrent themes regarding the cancer experiences of Aboriginal men in a subset of participant interviews (n = 23). The analysis reports themes that spanned the accounts of Aboriginal men with cancer (n = 6) and those of their carers (n = 12) and clinicians (n = 5).

RESULTS

Recurrent beliefs about the cancer experiences of Aboriginal men included that they "avoid seeking help" for health matters, including cancer symptoms, and to "get on with it," "not talk about it," and "manage without fuss" after a cancer diagnosis. Although some men described having to "accept vulnerability," emphasis was placed on appreciating men's desire to "protect cultural roles" and "connect with family and culture" throughout care and treatment, including through humor.

CONCLUSIONS

Men's accounts of the experiences of cancer diagnosis and care reveal more than simply individual challenge, extending to encompass the very real social and economic implications of illness and vulnerability for Aboriginal men today.

IMPLICATIONS FOR PRACTICE

Aboriginal men could be better engaged with cancer diagnosis and treatment if greater attention was paid to recognizing preferred approaches, including pragmatism and humor, and supporting connections to family and culture throughout the cancer journey.

Using Humor in Treatment of Substance Use Disorders: Worthy of Further Investigation

Throughout the literature, humor has demonstrated positive effects on memory and learning, as well as physiological and psychological well being. Research has described improvements in communication and trust through the use of humor in the nurse-patient relationship. The utilization of humor with certain populations, including those with anxiety disorders, cancer patients and mood disorders has also been widely described in the literature but little research has been conducted with humor use in patients' recovery from substance use disorders. This population might benefit from the thoughtful applications of humor to promote laughter and mirth as well as learning recovery principles. A review of the humor theories, theoretical processes and humor styles are discussed for their use in individuals with substance use disorders, in particularly for early recovery engagement in 12 step programs and other recover support social networks. The application of humor in efforts to support recovery with substance use disorder patients is worth investigating further.

A time to weep and a time to laugh: humour in the nurse-patient relationship in an adult cancer setting

PURPOSE

The literature highlights the value of humour in health-care settings. Humour impacts on the physiological, psychosocial and cognitive well-being of a person. The diagnosis of cancer is extremely stressful, and treatments are difficult. Patients and nurses may use humour as a coping mechanism to contend with the stresses caused directly or indirectly by cancer. This study investigated the use of humour during interactions between patients and nurses in an adult cancer ward.

METHODS

This study used a modified ethnographic methodology that included fieldwork participant observation and informal interviews (n=30 h) and formal interviews (n=10). In total, 9 nurses and 12 patients participated in participant observation. From these, five nurses and five patients were interviewed. Data were analysed using thematic analysis.

RESULTS

Findings highlighted the importance of humour in the nurse-patient relationship. Patients consciously use humour during nurse-patient interactions in an attempt to help nurses cope with the stress they encounter in clinical practice. Patients perceive having a sense of humour as a positive nurse attribute. Nurses expressed concerns regarding compromising professionalism when using humour and felt the need for guidance from senior staff. Constant assessment and reflection help ensure humour is used appropriately in the adult health-care setting.

CONCLUSION

The benefits of humour are recognised by both adult cancer patients and nurses. A deeper understanding of patient and nurse perceptions of the use of humour can inform strategies for its therapeutic use in the clinical setting.