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KANBUR S, BAŞTEMUR Ş. Why Laughing Heals? A Review on the Use of Humor in Therapy. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1179671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Humor is an important tool for expressing many emotions such as happiness, sadness, anger and surprise. In recent years, the use of humor has started to gain the quality of a therapy approach. The use of humor in therapy helps clients to express meaningless situations or inconsistencies in their lives in a humorous way by making them entertaining. At this point, it is very important for the counselor to be able to understand the purpose of the clients' arrival and their sense of humor depending on this purpose and to make interventions accordingly. Since the concepts of humor therapy and Laughter Therapy / Laughter Yoga are often used interchangeably in the literature, this study synthesizes both therapy approaches and tries to reveal their elements and importance. In this review, it is aimed to examine all aspects of the emergence of the use of humor in therapy, basic concepts, sub-dimensions of humor, counselor-client relationship using humor in therapy, humor therapy process, laughter therapy / laughter yoga process, laughter therapy / laughter yoga techniques, studies on the use of humor in therapy, why humor should or should not be used in therapy. In these respects, this study is expected to contribute to the literature and help fill the existing gaps. In addition, it is predicted that the widespread use of humor therapy and the use of humor therapy in different studies will benefit many clients and experts working in this field.
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Affiliation(s)
| | - Şule BAŞTEMUR
- ORDU ÜNİVERSİTESİ, EĞİTİM FAKÜLTESİ, EĞİTİM BİLİMLERİ BÖLÜMÜ, REHBERLİK VE PSİKOLOJİK DANIŞMANLIK ANABİLİM DALI
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Amoatika DA, Brown MJ, Addo PNO, Kaur A. Coping strategies among older adults living with HIV/AIDS with history of childhood sexual abuse. Int J STD AIDS 2023; 34:687-693. [PMID: 37147925 DOI: 10.1177/09564624231173030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Background: Childhood sexual abuse (CSA) may be a risk factor for poor mental health in adulthood. Survivors may experience emotions detrimental to their social and mental wellbeing. Some of these emotions may include anger, fear, rage, helplessness, guilt, shame, which may impact their coping strategies. The aim of this study was to determine the association between CSA and coping among older adults living with HIV (OALH). Method: Data were obtained from 91 OALH via convenience sampling. The participants were recruited from an immunology clinic and were at least 50 years or older and living with HIV. CSA was operationalized using questions from the Adverse Childhood Experiences Questionnaire. Coping was assessed using the Brief COPE Inventory. Crude and adjusted linear regression models, controlling for age, sex, race, gender, and income were used to determine the association between CSA and each coping subscale. The analyses were conducted in SAS version 9.4. Results: Crude analyses showed statistically significant associations between CSA and specific coping strategies: humor (β = 1.244; p = 0.0018), religion (β = 1.122; p = 0.0291), Self-blame (β = 1.103; p = 0.0154), planning β = 1.197; p = 0.0196), venting (β = 1.218; p = 0.0063), substance use (β = 0.828; p = 0.0335) and instrumental support (β = 0.949; p = 0.0416) After adjusting for sociodemographic characteristics, there was a statistically significant association between CSA and humor (β = 1.321; p = 0.0048) and self-blame (β = 1.046; p = 0.0382). Conclusion: OALH with a history of CSA were more likely to use humor and self-blame as coping strategies. Trauma-informed interventions should be geared towards decreasing self-blame for OALH who are CSA survivors.
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Affiliation(s)
- Daniel A Amoatika
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Prince N O Addo
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Amandeep Kaur
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Blasco-Belled A, Tejada-Gallardo C, Alsinet C. Positive psychology interventions can improve mental health for chronic pain patients: a systematic review and meta-analysis. Psychol Health 2023:1-17. [PMID: 37644768 DOI: 10.1080/08870446.2023.2250382] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/06/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE This study examines the efficacy of positive psychology interventions (PPIs) for patients with chronic pain through a systematic review and meta-analysis. PPIs are defined as strategies that involve focusing on positive emotions, thoughts, and behaviors that improve mental health by increasing mental well-being and reducing psychological distress. DESIGN The search was conducted using the PubMed, Scopus, PsycINFO, and Cochrane Library databases. MAIN OUTCOME MEASURES Subjective, psychological, and social well-being were used as indicators of mental well-being, and depression, anxiety, and stress symptoms were used as indicators of psychological distress. Results: Nine studies were included. Eight studies evaluated subjective well-being, seven evaluated depression, and three evaluated anxiety symptoms. No studies examined psychological well-being, social well-being, or stress. PPIs were found to be effective in promoting subjective well-being post-treatment (Hedges' g = 0.40; 95% CI [0.06, 0.73]) and reducing anxiety (Hedges' g = -0.32, 95% CI [-0.59, -0.06]), but no significant results were found for depression (Hedges' g = -0.23, 95% CI [-0.50, 0.04]). CONCLUSION The included investigations, while limited, suggest the utility of PPIs in mitigating the psychological consequences of chronic pain. Researchers and practitioners are encouraged to implement PPI practices.
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Affiliation(s)
| | | | - Carles Alsinet
- University of Lleida, Avinguda de l'Estudi General 4, Lleida, Spain
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Xie C, Li L, Li Y. Humor-based interventions for patients undergoing hemodialysis: A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 114:107837. [PMID: 37348309 DOI: 10.1016/j.pec.2023.107837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/29/2023] [Accepted: 06/02/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVES There is evidence that humor interventions can impact chronic kidney disease (CKD) patients. Synthesize relevant literature to understand the elements and mechanisms of implementation of humor interventions. METHODS Relevant peer-reviewed articles were searched. Data were extracted according to the Template for Intervention Description and Replication (TIDieR) checklist. RESULTS The initial search yielded 261 articles. Nine were included in the scoping review. The studies included laughter (n = 5) and humorous video interventions (n = 4) in a face-to-face group format. The tailoring and fidelity process needs to be more detailed in most studies. None of the studies mentioned the theoretical basis. The humor videos were provided by nurses and required various types of equipment. The video interventions were conducted during dialysis. The laughter intervention consisted of 3-4 themes guided by qualified therapists. The timing of the laughter intervention is chosen based on the patient's dialysis schedule and is maintained for 30 min. CONCLUSION The characteristics of the current study somewhat limit the understanding, replication, and implementation of evidence-based humor interventions. Future studies need to clarify the theoretical basis, tailoring, fidelity, and control groups. PRACTICE IMPLICATIONS Ongoing reporting and evaluation of the implementation of humor interventions may help better understand their underlying mechanisms.
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Affiliation(s)
- Chunyan Xie
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China; Xiangya Nursing School of Central South University, Changsha 410013, Hunan Province, China
| | - Li Li
- Xiangya Nursing School of Central South University, Changsha 410013, Hunan Province, China; Department of Urology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China.
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Axelrod V, Rozier C, Sohier E, Lehongre K, Adam C, Lambrecq V, Navarro V, Naccache L. Intracranial study in humans: Neural spectral changes during watching comedy movie of Charlie Chaplin. Neuropsychologia 2023; 185:108558. [PMID: 37061128 DOI: 10.1016/j.neuropsychologia.2023.108558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/01/2023] [Accepted: 04/04/2023] [Indexed: 04/17/2023]
Abstract
Humor plays a prominent role in our lives. Thus, understanding the cognitive and neural mechanisms of humor is particularly important. Previous studies that investigated neural substrates of humor used functional MRI and to a lesser extent EEG. In the present study, we conducted intracranial recording in human patients, enabling us to obtain the signal with high temporal precision from within specific brain locations. Our analysis focused on the temporal lobe and the surrounding areas, the temporal lobe was most densely covered in our recording. Thirteen patients watched a fragment of a Charlie Chaplin movie. An independent group of healthy participants rated the same movie fragment, helping us to identify the most funny and the least funny frames of the movie. We compared neural activity occurring during the most funny and least funny frames across frequencies in the range of 1-170 Hz. The most funny compared to least funny parts of the movie were associated with activity modulation in the broadband high-gamma (70-170 Hz; mostly activation) and to a lesser extent gamma band (40-69Hz; activation) and low frequencies (1-12 Hz, delta, theta, alpha bands; mostly deactivation). With regard to regional specificity, we found three types of brain areas: (I) temporal pole, middle and inferior temporal gyrus (both anterior and posterior) in which there was both activation in the high-gamma/gamma bands and deactivation in low frequencies; (II) ventral part of the temporal lobe such as the fusiform gyrus, in which there was mostly deactivation the low frequencies; (III) posterior temporal cortex and its environment, such as the middle occipital and the temporo-parietal junction, in which there was activation in the high-gamma/gamma band. Overall, our results suggest that humor appreciation might be achieved by neural activity across the frequency spectrum.
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Affiliation(s)
- Vadim Axelrod
- The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, 52900, Israel.
| | - Camille Rozier
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau, ICM, INSERM, CNRS, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Elisa Sohier
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau, ICM, INSERM, CNRS, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Katia Lehongre
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau, ICM, INSERM, CNRS, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Claude Adam
- AP-HP, Epilepsy Unit, Pitié-Salpêtrière Hospital, DMU Neurosciences, Paris, France
| | - Virginie Lambrecq
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau, ICM, INSERM, CNRS, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; AP-HP, EEG Unit, Neurophysiology Department, Pitié-Salpêtrière Hospital, DMU Neurosciences, Paris, France; AP-HP, Epilepsy Unit, Pitié-Salpêtrière Hospital, DMU Neurosciences, Paris, France
| | - Vincent Navarro
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau, ICM, INSERM, CNRS, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; AP-HP, EEG Unit, Neurophysiology Department, Pitié-Salpêtrière Hospital, DMU Neurosciences, Paris, France; AP-HP, Epilepsy Unit, Pitié-Salpêtrière Hospital, DMU Neurosciences, Paris, France; AP-HP, Center of Reference for Rare Epilepsies, Pitié-Salpêtrière Hospital, Paris, France
| | - Lionel Naccache
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau, ICM, INSERM, CNRS, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; AP-HP, Groupe hospitalier Pitié-Salpêtrière, Department of Neurophysiology, 47-83 boulevard de l'Hôpital, Paris 75013, France
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Xu J, Guan YX, Liu WT, Zhang Y, Zheng J, Zhang J, Wang C, Yang F, Yang Q. Intervention and application of clown care in nursing homes: a scoping review. Aging Clin Exp Res 2023; 35:937-952. [PMID: 36877456 DOI: 10.1007/s40520-023-02376-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 02/19/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND The purpose of this scoping review was to organize and describe the literature on the application of clown care to the elderly population in nursing homes, including intervention time, intervention methods and intervention effects, so as to provide reference ideas for other scholars to explore clown care programs suitable for the elderly population in nursing homes. METHODS Employing Arksey and O'Malley's methodology, we searched for PubMed, Web of Science, Embase, Cochrane, CNKI, WanFang, VIP, and CBM systematically and thoroughly, and the search period was from the establishment of each database to December 12, 2022. Two researchers with evidence-based learning experience independently conducted literature retrieval, information extraction, and cross-checking in strict accordance with the inclusion and exclusion criteria. The review process is reported according to PRISMA. RESULTS 148 literature were initially obtained after searching, of which 18 were finally included. Among them, 17 were in English and 1 was in Chinese. There are 16 quantitative studies and 2 qualitative studies published from 2010 to 2022. It is found that the current clown care intervention program has not established a unified intervention standard and effective evaluation program. CONCLUSIONS The results of this scoping review conclude that clown care played a significant role in the nursing home. At first, it can reduce negative emotions, cognitive impairments and physical pain among older adults. In addition, it can improve their quality of life, life satisfaction, etc. It is suggested to learn from the advanced experience of clown care in foreign countries and carry out more clown care among the elderly population in nursing homes in China.
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Affiliation(s)
- Juan Xu
- School of Nursing, Anqing Medical College, Anqing, 246052, Anhui, China.,School of Nursing, Anhui University of Chinese Medicine, Hefei, 230012, Anhui, China
| | - Yu-Xiang Guan
- The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, Anhui, China.
| | - Wen-Tao Liu
- The Chinese Medicine Hospital of Qianshan, Qianshan, 246399, Anhui, China
| | - Ying Zhang
- School of Nursing, Anhui University of Chinese Medicine, Hefei, 230012, Anhui, China
| | - Jing Zheng
- School of Nursing, Anhui University of Chinese Medicine, Hefei, 230012, Anhui, China
| | - Jing Zhang
- School of Nursing, Anhui University of Chinese Medicine, Hefei, 230012, Anhui, China
| | - Chao Wang
- School of Nursing, Anhui University of Chinese Medicine, Hefei, 230012, Anhui, China
| | - Fei Yang
- School of Nursing, Anqing Medical College, Anqing, 246052, Anhui, China
| | - Qing Yang
- School of Nursing, Anqing Medical College, Anqing, 246052, Anhui, China
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Li J, Zhou X, Wang Q. Interventions to reduce loneliness among Chinese older adults: A network meta-analysis of randomized controlled trials and quasi-experimental studies. Appl Psychol Health Well Being 2023; 15:238-258. [PMID: 35621111 DOI: 10.1111/aphw.12375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 05/03/2022] [Accepted: 05/14/2022] [Indexed: 01/26/2023]
Abstract
This meta-analytic study investigates the effectiveness of different interventions in alleviating loneliness among Chinese older adults aged 50 years and above. We searched eight English databases, four Chinese databases, and grey literature. Thirty-four studies, including four randomized controlled trials (RCTs) and 30 quasi-experimental studies, were eventually included in the meta-analysis (n = 3843). Quality appraisal indicated risks of bias in the included studies. The pooled effect size was large and significant (Hedge's g = 0.84, 95% CI [0.54, 1.15]), indicating the effectiveness of interventions in reducing loneliness. However, the effect size may be overestimated due to publication bias. Moderation analyses showed significant differences in effect sizes by study designs and regions of studies. Network meta-analysis (NMA) indicated that hybrid and psychological interventions appeared to be advantageous over others. In addition, group-based delivery modes can add extra benefits to the interventions. This study adds to the knowledge of the effectiveness of current interventions in reducing Chinese older people's loneliness. However, the findings need to be interpreted with caution due to the relatively low study quality, considerable heterogeneity, and publication bias. Despite the limitations, this study offers valuable insights for future research, practice, and policy-making in reducing older people's loneliness.
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Affiliation(s)
- Jia Li
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiaochen Zhou
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Qi Wang
- College of Philosophy, Law & Political Science, Shanghai Normal University, Shanghai, China
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Deng M, Qian M, Lv J, Guo C, Yu M. The association between loneliness and sleep quality among older adults: A systematic review and meta-analysis. Geriatr Nurs 2023; 49:94-100. [PMID: 36470104 DOI: 10.1016/j.gerinurse.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE To systematically review studies and explore the association between loneliness and sleep quality among older adults. METHODS A comprehensive literature search was conducted in 8 databases from their inception to February 28, 2022. Studies that investigated the association between loneliness and sleep quality among older people were obtained. Comprehensive Meta-analysis was used to meta-analyze data in the included studies. RESULTS In total, 16 studies with 23,485 participants were included in this review, and 6 of these studies were included in the meta-analysis. The meta-analysis showed that older adults who were lonely were significantly more likely to suffer from low sleep quality than their counterparts without loneliness (pooled OR = 1.750, 95% CI: 1.511-2.026, p < 0.01). CONCLUSIONS Loneliness is associated with poor sleep quality among older adults. Loneliness reduction measures should be considered as one of the essential elements in sleep management programs for older people with low sleep quality.
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Affiliation(s)
- Mengying Deng
- School of Nursing, Peking University, 38 Xueyuan Rd., Haidian District, Beijing, China
| | - Min Qian
- Department of Nursing, Beijing Ji Shui Tan Hospital and the 4th Medical College of Peking University, Beijing, China
| | - Jinghong Lv
- School of Nursing, Peking University, 38 Xueyuan Rd., Haidian District, Beijing, China
| | - Chenming Guo
- School of Nursing, Peking University, 38 Xueyuan Rd., Haidian District, Beijing, China
| | - Mingming Yu
- School of Nursing, Peking University, 38 Xueyuan Rd., Haidian District, Beijing, China.
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Lee KT, Wang WL, Yang YC. Impact of a magic recreation program on older adults with minor depressive symptoms in a long-term care facility: A pilot randomized controlled trial. Geriatr Nurs 2022; 48:169-176. [PMID: 36257222 DOI: 10.1016/j.gerinurse.2022.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To evaluate a magic recreation program to reduce depressive symptoms in institutionalized older adults. METHODS We conducted a pilot randomized controlled trial in which participants were assigned to either a magic group (n = 6) or a control group with usual activities (n = 6). The magic group received a 6-week magic recreation program. The data were analyzed by generalized estimating equations in terms of intention-to-treat analysis. A sensitivity analysis was conducted by examining the complete case analysis. RESULTS The magic recreation program significantly improved the scores of Patient Health Questionnaire-9 in the magic group (Wald χ 2 = 8.816, p = 0.004, Cohen's d = 1.51, power = 0.9968). The results of the sensitivity analysis were consistent with the results of primary analysis. CONCLUSIONS The 6-week magic recreation program reduced depressive symptoms among institutionalized older adults with minor depressive symptoms.
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Affiliation(s)
- Kuan-Ting Lee
- Department of Family Medicine, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan City 704302, Taiwan; Institute of Physical Education, Health & Leisure Studies, National Cheng Kung University, 1 University Road, Tainan City 701401, Taiwan
| | - Wei-Li Wang
- Department of Family Medicine, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan City 704302, Taiwan; Institute of Physical Education, Health & Leisure Studies, National Cheng Kung University, 1 University Road, Tainan City 701401, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan City 704302, Taiwan; Department of Family Medicine, College of Medicine, National Cheng Kung University, 1 University Road, Tainan City 701401, Taiwan.
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Somech N, Mizrahi T, Caspi Y, Axelrod V. Functional near-infrared spectroscopy imaging of the prefrontal cortex during a naturalistic comedy movie. Front Neurosci 2022; 16:913540. [PMID: 36161175 PMCID: PMC9493198 DOI: 10.3389/fnins.2022.913540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Naturalistic stimulation (i.e., movies and auditory narratives of some minutes' length) has been a powerful approach to bringing more real-life experiences into laboratory experiments. Data-driven, intersubject correlation (ISC) analysis permits examining to what extent activity in a specific brain region correlates across participants during exposure to a naturalistic stimulus, as well as testing whether neural activity correlates with behavioral measures. Notably, most of the previous research with naturalistic stimuli was conducted using functional fMRI (fMRI). Here, we tested whether a naturalistic approach and the ISC are feasible using functional near-infrared spectroscopy (fNIRS) - the imaging method particularly suited for populations of patients and children. Fifty-three healthy adult participants watched twice a 3-min segment of a Charlie Chaplin movie while we recorded the brain activity on the surface of their prefrontal cortex using fNIRS. In addition, an independent group of 18 participants used a continuous scoring procedure to rate the extent to which they felt that different parts of the movie fragment were funny. Our two findings were as follows. First, we found higher-than-zero ISC in fNIRS signals in the prefrontal cortex lobes, a result that was particularly high in the oxygenated channels during the first repetition of the movie. Second, we found a significant negative correlation between oxygenated brain signals and ratings of the movie's humorousness. In a series of control analyses we demonstrated that this latter correlation could not be explained by various non-humor-related movie sensory properties (e.g., auditory volume and image brightness). The key overall outcome of the present study is that fNIRS in combination with the naturalistic paradigms and the ISC might be a sensitive and powerful research method to explore cognitive processing. Our results also suggest a potential role of the prefrontal cortex in humor appreciation.
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Affiliation(s)
- Noam Somech
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Tamar Mizrahi
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
- Head Injuries Rehabilitation Department, Sheba Medical Center, Ramat Gan, Israel
| | - Yael Caspi
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Vadim Axelrod
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
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Zarei SA, Yahyavi SS, Salehi I, Kazemiha M, Kamali AM, Nami M. Toward reanimating the laughter-involved large-scale brain networks to alleviate affective symptoms. Brain Behav 2022; 12:e2640. [PMID: 35687720 PMCID: PMC9304826 DOI: 10.1002/brb3.2640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/03/2022] [Accepted: 05/03/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The practicality of the idea whether the laughter-involved large-scale brain networks can be stimulated to remediate affective symptoms, namely depression, has remained elusive. METHODS In this study, 25 healthy individuals were tested through 21-channel quantitative electroencephalography (qEEG) setup upon resting state and while submitted to standardized funny video clips (corated by two behavioral neuroscientists and a verified expert comedian, into neutral and mildly to highly funny). We evaluated the individuals' facial expressions against the valence and intensity of each stimulus through the Nuldos face analysis software. The study also employed an eye-tracking setup to examine fixations, gaze, and saccadic movements upon each task. In addition, changes in polygraphic parameters were monitored upon resting state and exposure to clips using the 4-channel Nexus polygraphy setup. RESULTS The happy facial expression analysis, as a function of rated funny clips, showed a significant difference against neutral videos (p < 0.001). In terms of the polygraphic changes, heart rate variability and the trapezius muscle surface electromyography measures were significantly higher upon exposure to funny vs. neutral videos (p < 0.5). The average pupil size and fixation drifts were significantly higher and lower, respectively, upon exposure to funny videos (p < 0.01). The qEEG data revealed the highest current source density (CSD) for the alpha frequency band localized in the left frontotemporal network (FTN) upon exposure to funny clips. Additionally, left FTN acquired the highest value for theta coherence z-score, while the beta CSD predominantly fell upon the salience network (SN). CONCLUSIONS These preliminary data support the notion that left FTN may be targeted as a cortical hub for noninvasive neuromodulation as a single or adjunct therapy in remediating affective disorders in the clinical setting. Further studies are needed to test the hypotheses derived from the present report.
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Affiliation(s)
- Shahab A Zarei
- Institute of Neuroscience, The Center of Excellence in Brain and Intelligence Technology, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Chinese Academy of Sciences, Shanghai, China
| | - Seyedeh-Saeedeh Yahyavi
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,DANA Brain Health Institute, Iranian Neuroscience Society, Fars Chapter, Shiraz, Iran.,Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Salehi
- DANA Brain Health Institute, Iranian Neuroscience Society, Fars Chapter, Shiraz, Iran
| | - Milad Kazemiha
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,DANA Brain Health Institute, Iranian Neuroscience Society, Fars Chapter, Shiraz, Iran.,Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali-Mohammad Kamali
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,DANA Brain Health Institute, Iranian Neuroscience Society, Fars Chapter, Shiraz, Iran.,Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,DANA Brain Health Institute, Iranian Neuroscience Society, Fars Chapter, Shiraz, Iran.,Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, California, USA.,Harvard Alumni for Mental Health, Middle-East Ambassador, Dubai, UAE
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12
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Chamorro-Garrido A, Ramírez-Fernández E, Ortega-Martínez AR. Autobiographical Memory, Gratitude, Forgiveness and Sense of Humor: An Intervention in Older Adults. Front Psychol 2021; 12:731319. [PMID: 34970181 PMCID: PMC8712764 DOI: 10.3389/fpsyg.2021.731319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/16/2021] [Indexed: 12/02/2022] Open
Abstract
Research has shown that happiness and well-being play a fundamental role in the health of older adults. For this reason, programs based on Positive Psychology seek to improve quality of life, preventing and reducing the appearance of emotional disorders. The objective of this study was to verify whether an intervention based on Autobiographical Memory, Forgiveness, Gratitude, and Sense of humor would increase quality of life in institutionalized older adults. We used a quasi-experimental design with pre- and post-intervention measures and follow-on measures at 3, 6, and 12 months. A total of 111 institutionalized older adults participated in the study and were randomly assigned to one of three groups: experimental (n = 36), placebo (n = 39), and control (n = 36). Measurements were taken of depression, subjective happiness, satisfaction with life, psychological well-being, and specific memories. Program duration was 11 weeks, followed by refresher sessions of the activities that had been conducted. The results showed that the intervention was effective, producing lasting increase in the participating adults' well-being, maintained for the following 12 months, in contrast to the other two groups. In conclusion, the proposed intervention proved to be a novel tool that was effective, easily applied, and able to improve quality of life and emotional disorders in older adults.
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13
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Kugler L, Kuhbandner C, Gerum S, Hierl C, Münster T, Offereins B, Lutterbach LS. Evaluation of a Humor Training for Patients with Chronic Pain: A Randomized Clinical Trial. J Pain Res 2021; 14:3121-3133. [PMID: 34675641 PMCID: PMC8504473 DOI: 10.2147/jpr.s313868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Humor and laughter are positively associated with psychological as well as with physical well-being. As there is little research examining to what extent patients suffering from chronic pain could benefit from a humor intervention, the goal of this study was to develop a pain-specific humor training and to evaluate its feasibility and effectiveness as component of regular, multimodal pain therapy. Patients and Methods Patients from inpatient treatment groups for chronic pain in a German hospital were randomly assigned to the training group (final n = 62) and the control group (final n = 65). The training consisted of four sessions that were implemented in the usual therapy throughout two weeks. Outcomes were divided into primary (perceived current pain intensity and depression) and secondary ones (quality of life impairment by pain, cheerfulness, and self-enhancing humor) and were assessed prior to and after intervention. Results Results showed improvements in all outcomes for both groups. For primary outcomes, a trend for a greater reduction in current pain intensity was found for the training group compared to the control group (p = 0.060, η2p = 0.02), as well as, for secondary outcomes, a trend for greater reduction of quality of life impairment by pain (p = 0.079, η2p = 0.02) and a trend for greater increase in self-enhancing humor (p = 0.086, η2p = 0.02). Depression and cheerfulness remained unaffected. Feedback indicated feasibility of the training within multimodal therapy, showing overall acceptance as well as providing specific suggestions for improvement. Conclusion As the first study evaluating a specific humor training for patients with chronic pain within a randomized controlled trial, its results are promising regarding an additional contribution that humor interventions can make towards multimodal pain therapy.
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Affiliation(s)
- Lisa Kugler
- Department of Psychology, University of Regensburg, Regensburg, Germany
| | | | - Sarah Gerum
- Clinic for Anesthesia and Intensive Care Medicine, Hospital Barmherzige Brüder, Regensburg, Germany
| | - Christian Hierl
- Clinic for Anesthesia and Intensive Care Medicine, Hospital Barmherzige Brüder, Regensburg, Germany
| | - Tino Münster
- Clinic for Anesthesia and Intensive Care Medicine, Hospital Barmherzige Brüder, Regensburg, Germany
| | - Bernadette Offereins
- Clinic for Forensic Psychiatry and Psychotherapy, Medbo District Hospital, Regensburg, Germany
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14
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Lysne PE, Palit S, Morais CA, DeMonte LC, Lakdawala M, Sibille KT, Bartley EJ. Adaptability and Resilience in Aging Adults (ARIAA): protocol for a pilot and feasibility study in chronic low back pain. Pilot Feasibility Stud 2021; 7:188. [PMID: 34666839 PMCID: PMC8525058 DOI: 10.1186/s40814-021-00923-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/06/2021] [Indexed: 01/02/2023] Open
Abstract
Background Chronic low back pain (cLBP) is the leading cause of disability among older adults and one of the top reasons for seeking healthcare, resulting in significant decrements in physical functioning. Because older adults are among the fastest growing cohorts in the USA, both the incidence and burden of cLBP are expected to increase considerably, rendering geriatric pain management a top health priority. Resilience is defined as a process allowing individuals to adapt and recover from adverse and stressful conditions, and it has been highlighted as a crucial factor in positive health-related functioning. While a growing body of literature supports the use of resilience-based interventions in chronic pain, research examining their effectiveness in older adults with cLBP remains limited. The primary aims of the study are to assess the feasibility and acceptability of a psychologically oriented resilience intervention among aging adults with cLBP. Methods In this article, we describe the rationale and design of the Adaptability and Resilience in Aging Adults (ARIAA) study, a single-arm intervention in which 60 participants (ages ≥ 60 years) with cLBP will be recruited to participate in a 7-week group-based program aimed at enhancing psychological resilience. Intervention sessions will target positive psychology concepts (e.g., positive affect, pain acceptance, hopeful thinking, pain self-efficacy) and cognitive behavioral techniques that have established benefits in pain management. Primary study outcomes include intervention feasibility and acceptability as measured by treatment engagement, intervention credibility and satisfaction, ability to meet recruitment and retention metrics, and the feasibility of questionnaire and home activity completion. Outcomes will be assessed at baseline, immediately at posttreatment, and at the 3-month follow-up period. Discussion This study will establish the feasibility and acceptability of a novel intervention aimed at enhancing positive, psychological functioning, and resilience in older adults with cLBP. Achievement of these aims will provide a rich platform for future intervention research targeting improvements in pain and disability among geriatric populations and will serve as a foundation for a fully powered trial to examine treatment efficacy of the proposed intervention. Trial registration Clinicaltrials.gov, identifier NCT04068922. Registered 28 August 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00923-y.
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Affiliation(s)
- Paige E Lysne
- Department of Community Dentistry and Behavioral Science, Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Shreela Palit
- Department of Community Dentistry and Behavioral Science, Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Calia A Morais
- Department of Community Dentistry and Behavioral Science, Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Lucas C DeMonte
- Department of Counseling and Higher Education, Northern Illinois University, DeKalb, IL, USA
| | - Maria Lakdawala
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL, USA
| | - Kimberly T Sibille
- Department of Aging and Geriatric Research, Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Emily J Bartley
- Department of Community Dentistry and Behavioral Science, Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.
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15
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Liao YJ, Parajuli J, Jao YL, Kitko L, Berish D. Non-pharmacological interventions for pain in people with dementia: A systematic review. Int J Nurs Stud 2021; 124:104082. [PMID: 34607070 DOI: 10.1016/j.ijnurstu.2021.104082] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
CONTEXT Pain commonly occurs in people living with dementia but is often undertreated. Non-pharmacological interventions are a safer first-line option for pain management, but evidence-based interventions for people living with dementia have not been established. An increasing number of studies have examined the effect of non-pharmacological interventions in pain management. However, the evidence that specifically focuses on people living with dementia has not been systematically reviewed. OBJECTIVES This review aimed to systematically synthesize current evidence on non-pharmacological interventions to manage pain in people living with dementia. METHODS A comprehensive search of the literature was conducted in PubMed, CINAHL, Scopus, and Web of Science databases. Studies were included if they were 1) peer-reviewed original quantitative research, 2) tested the effect of non-pharmacological interventions on pain in people with dementia, and 3) English language. Studies were excluded if they 1) included both pharmacological and non-pharmacological interventions and did not report separate results for the non-pharmacological interventions; 2) enrolled participants with and without dementia and did not have separate results reported for individuals with dementia; 3) tested dietary supplements as the intervention; and 4) were not original research, such as reviews, editorials, commentaries, or case studies. Title, abstract, and full text were screened. Quality assessment was conducted using the Cochrane Risk of Bias tool and Johns Hopkins Level of Evidence. Pain assessment tools, participant characteristics, study designs, intervention condition, and results were extracted. Results were synthesized through grouping the type of the interventions and weighting evidence based on quality and design of the studies. RESULTS A total of 11 articles and 12 interventions were identified. A total of 486 participants were included. Interventions that have shown a positive impact on pain include ear acupressure, music therapy, reflexology, tailored pain intervention, painting and singing, personal assistive robot, cognitive-behavioral therapy, play activity, and person-centered environment program. Nevertheless, a majority of the interventions were only evaluated once. Moreover, most studies had similar sample characteristics and setting. CONCLUSION Overall, the quality of included studies were mostly low to mixed quality and most participants only had mild to moderate baseline pain, which limits detection of the intervention's effect. Hence, these findings need to be duplicated in studies with a greater sample size, a more diverse population (race, gender, and settings), and a more rigorous design to validate the results.
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Affiliation(s)
- Yo-Jen Liao
- Pennsylvania State University, Ross and Carol Nese College of Nursing, 307 Nursing Sciences Building, University Park, PA, 16802, United States.
| | - Jyotsana Parajuli
- Assistant Professor, University of North Carolina at Charlotte, School of Nursing, 9201 University City Blvd, Charlotte, NC, 28223, United States.
| | - Ying-Ling Jao
- Assistant Professor, Pennsylvania State University, Ross and Carol Nese College of Nursing, 307B Nursing Sciences Building, University Park, PA, 16802, United States.
| | - Lisa Kitko
- Associate Professor, Pennsylvania State University, Ross and Carol Nese College of Nursing, 311 Nursing Sciences Building, University Park, PA, 16802, United States.
| | - Diane Berish
- Assistant Research Professor, Pennsylvania State University, Ross and Carol Nese College of Nursing, 304A Nursing Sciences Building, University Park, PA, 16802, United States.
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16
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Studer-Luethi B, Brasser M, Lusti S, Schaerli R. A cross-sectional survey of a public, evidence-based multimodal program for cognitive health in older adults. Arch Public Health 2021; 79:165. [PMID: 34530899 PMCID: PMC8443915 DOI: 10.1186/s13690-021-00670-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/03/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In recent decades, the proportion of older adults in the population has continued to rise, and with it, the need for intervention programs to maintain cognitive functions into old age. Multiple lifestyle factors, including physical, cognitive, and social activities, are crucial to forestalling a decline in cognitive functions. However, Covid-19 curtailed most activities, and therefore, strategies are needed to support older adults in remaining cognitively healthy. This study describes a newly developed and publicly available multimodal program, called "brain coach", to support and stimulate cognitive activity in older adults. The autonomy supportive program integrates into daily life recommendations for evidence-based physical, cognitive, social, mindful, and creative activation exercises. METHODS The study design corresponds to a correlational, analytical, and cross-sectional study with 660 older adults, who participated in the program for at least 3 months and completed an online survey. RESULTS The survey results demonstrate that the average age of the participants was 71 years and 75 % were female. Participants experienced benefits in memory, well-being, attitudes towards the brain, and lifestyle habits. Importantly, time invested in the intervention and participant's positive attitude toward brain health and neuroplasticity, show positive relationships with the experienced benefits. CONCLUSIONS The results reveal the potential of a public program with a multimodal approach to increase cognitive health and promote an active lifestyle. Further research will explore the effects of such a multimodal intervention in a longitudinal randomized controlled trial study.
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17
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Smith R, Wuthrich V, Johnco C, Belcher J. Effect of Group Cognitive Behavioural Therapy on Loneliness in a Community Sample of Older Adults: A Secondary Analysis of a Randomized Controlled Trial. Clin Gerontol 2021; 44:439-449. [PMID: 33100187 DOI: 10.1080/07317115.2020.1836105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Research suggests a link between loneliness, depression, and anxiety. Multiple studies have examined treatment programs for loneliness; however, none have examined the efficacy of Cognitive Behavioral Therapy (CBT) for depression and anxiety in reducing loneliness. METHODS Change in loneliness in sixty-two older adults (≥60 yrs; 65% female) who took part in a previously reported randomized controlled trial for the treatment of comorbid depression and anxiety was examined. Older adults were randomized to a 12-week group CBT or waitlist control condition. Participants who took part in CBT were followed-up three months later. RESULTS Linear Mixed Model analyses indicated that after controlling for baseline cognition, depression, and anxiety, participants who completed CBT experienced a significant decrease in loneliness while the control group did not. This reduction was maintained at follow-up. CONCLUSIONS CBT programs for depression and anxiety are likely to be effective at reducing loneliness. This may be due to shared underlying cognitive and behavioral mechanisms between loneliness, depression, and anxiety such as sensitivity to perceived threat and social withdrawal. Further research is needed to understand if specific loneliness interventions are more effective. CLINICAL IMPLICATIONS CBT may be effective at reducing loneliness among older adults with depression and anxiety.
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Affiliation(s)
- Ronald Smith
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Viviana Wuthrich
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Carly Johnco
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Jessica Belcher
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
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18
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Abstract
Chronic noncancer pain (CNCP) is a significant health burden among adults. Standard behavioral therapies typically focus on targeting negative affect (NA) and yield only modest treatment effects. The aims of this study were to systematically review and investigate the association between positive affect (PA) and pain severity among adults with CNCP. Databases that were searched included MEDLINE (PubMed), PsycINFO, CINAHL, ProQuest Dissertations and Theses, OLASTER, Open Grey, and PsyArXiv (inception to July 23, 2019). We analyzed studies that: (1) used observational, experimental, or intervention study designs; (2) enrolled individuals with CNCP (pain ≥ 12 weeks); and (3) reported full quantitative results on outcomes. Two researchers independently screened articles, extracted data, and assessed the risk of bias. The main meta-analysis was followed by subgroup analyses. All analyses were performed using random-effects models. Formal tests for heterogeneity (Q-statistic; I) and publication bias (p-curve and p-uniform*) were performed. We meta-analyzed 29 studies with 3521 participants. Results demonstrated that PA inversely impacts pain severity in people with CNCP (r = -0.23). Subgroup analyses showed a significant effect for gender and marginally significant effects for age in studies that adjusted for NA. On average, effect sizes for observational studies were larger in studies with a higher proportion of female respondents and in studies that did not adjust for NA. Finally, larger effect sizes were found in intervention studies with older compared with younger samples.
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19
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A brain-inspired cognitive support model for stress reduction based on an adaptive network model. COGN SYST RES 2021. [DOI: 10.1016/j.cogsys.2020.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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20
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Berger P, Bitsch F, Falkenberg I. Humor in Psychiatry: Lessons From Neuroscience, Psychopathology, and Treatment Research. Front Psychiatry 2021; 12:681903. [PMID: 34122193 PMCID: PMC8193079 DOI: 10.3389/fpsyt.2021.681903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
Humor is a ubiquitous human characteristic that is socially motivated at its core and has a broad range of significant positive effects on emotional well-being and interpersonal relationships. Simultaneously, however, impairments in humor abilities have often been described in close association with the occurrence and course of neuropsychiatric disorders, such as schizophrenia, social anxiety, or depression. In the past decade, research in the neuroimaging and psychiatric domain has substantially progressed to (i) characterize impaired humor as an element of psychopathology, and (ii) shed light on the neurobiological mechanisms underlying the role of humor in neuropsychiatric diseases. However, (iii) targeted interventions using concepts of positive psychology have revealed first evidence that a systematic training and/or a potential reactivation of humor-related skills can improve rehabilitative outcome in neuropsychiatric patient groups. Here, we sought to integrate evidence from neuroscience, as well as from psychopathology and treatment research to shed more light on the role of humor in psychiatry. Based on these considerations, we provide directions for future research and application in mental health services, focusing on the question of how our scientific understanding of humor can provide the basis for psychological interventions that foster positive attitudes and well-being.
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Affiliation(s)
- Philipp Berger
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Florian Bitsch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg, Germany
| | - Irina Falkenberg
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg, Germany
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21
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ÇAKAR M, KINACI E, ATAOĞLU S. Ağrı Yönetiminde Alternatif Bir Yaklaşım: Kahkaha Terapisi. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2020. [DOI: 10.33631/duzcesbed.773239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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22
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Quan NG, Lohman MC, Resciniti NV, Friedman DB. A systematic review of interventions for loneliness among older adults living in long-term care facilities. Aging Ment Health 2020; 24:1945-1955. [PMID: 31602993 DOI: 10.1080/13607863.2019.1673311] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES This study aimed to review loneliness interventions for older adults living in long-term care (LTC) facilities over the past 10 years, to categorize interventions by type, and to compare effectiveness of loneliness interventions in these settings. METHODS Systematic review followed PRISMA guidelines. Articles matching search criteria were collected from PubMed, PsycINFO, and Web of Science from 2009 to 2019. The inclusion criteria were as follows: 1) English language, 2) intervention studies with a quantitative measure that compares pre-trial to post-trial changes, 3) loneliness as a primary or secondary outcome 4) subjects age >65, and 5) subjects living in a LTC facility, such as a nursing home, assisted-living, or hospice. RESULTS A total of 15 intervention studies qualified for systematic review. Most of these interventions were psychological therapies and leisure/skill development interventions. Approximately, 87% of studies reported significant decreases in loneliness following intervention. Laughter therapy, horticultural therapy, and reminiscence therapy were associated with the greatest decreases in loneliness. DISCUSSION Results suggest that, although less common than interventions in the community, there are several effective interventions to reduce loneliness among older adults living in LTC facilities. Lack of standardized measures and high-quality studies limits comparisons between intervention types and generalizability to different populations.
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Affiliation(s)
- Nicolas G Quan
- Biological Sciences, University of South Carolina, Columbia, SC, USA
| | - Matthew C Lohman
- Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Nicholas V Resciniti
- Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Daniela B Friedman
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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23
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Ramírez-Maestre C, Esteve R, López-Martínez AE, Miró J, Jensen MP, de la Vega R. Beyond pain intensity and catastrophizing: The association between self-enhancing humour style and the adaptation of individuals with chronic pain. Eur J Pain 2020; 24:1357-1367. [PMID: 32383261 DOI: 10.1002/ejp.1583] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/29/2020] [Accepted: 05/01/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Many questions regarding the process by which self-enhancing humour style has an effect on chronic pain individuals' adjustment remain unanswered. The aim of the present study was to analyse the association of self-enhancing humour style with adjustment in a sample of individuals with chronic pain, over and above the role of catastrophizing and pain intensity. Adjustment was assessed using measures of depression, pain interference and flourishing. We also examined the indirect association between self-enhancing humour style and adjustment via pain acceptance. METHODS The study included 427 patients with heterogeneous chronic pain conditions. The study hypotheses were tested using three multiple linear regression analyses, one for each of the criterion variables. RESULTS Consistent with the study hypothesis, both direct and indirect associations were found between self-enhancing humour style and depressive symptoms, pain interference and flourishing via pain acceptance. CONCLUSIONS Self-enhancing humour style could potentially help individuals with chronic pain to gain perspective and distance themselves from the situation through the acceptance of pain-related negative emotions. SIGNIFICANCE Very few studies have investigated the relationship between humour styles and adjustment in chronic pain samples. The results of the current study support the idea that adaptive dispositional traits, such as patient's self- enhancing humour style, play a role in the adaptation of individuals with chronic pain. Given that the association between self-enhancing humour style and adjustment evidenced an indirect association through pain acceptance, training in the use of humour, as individuals with self-enhancing humour style do, might be a useful addition to ACT treatment.
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Affiliation(s)
- Carmen Ramírez-Maestre
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Rosa Esteve
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Alicia E López-Martínez
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Jordi Miró
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Catalonia, Spain
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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De Francisco S, Torres C, De Andrés S, Millet A, Ricart MT, Hernández-Martínez-Esparza E, Abades M, Trujols J. Effectiveness of Integrative Laughter Therapy to Reduce Anxiety, Improve Self-Esteem and Increase Happiness: A Naturalistic Study at a Day Hospital for Addictive Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214194. [PMID: 31671508 PMCID: PMC6862057 DOI: 10.3390/ijerph16214194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 10/28/2019] [Indexed: 12/21/2022]
Abstract
Little is known about the effectiveness of laughter therapy as an adjunctive treatment for patients with addictive disorders. This study aims to evaluate the benefits of integrative laughter therapy (ILT) on levels of self-esteem, anxiety, and happiness in patients treated for addiction at a day hospital (DH). A prospective, naturalistic study with a pre-post design was conducted. All 185 participants received the standard, multicomponent treatment at the DH (treatment as usual; TAU). The participants were also invited to attend weekly ILT sessions. Upon completion of the 2-month DH treatment program, patients were classified according to their attendance at the ILT sessions: patients who attended ≥80% constituted the experimental group (TAU + ILT group) while those who attended <80% were considered controls. Although both groups achieved statistically significant increases in self-esteem and happiness with a decrease in trait anxiety, the improvement on these variables was significantly greater in the TAU + ILT group. Subject to the limitations inherent to quasi-experimental research, the findings of the present study suggest that the addition of an ILT module to the standard treatment in a DH for addictive disorders may yield greater improvement in self-esteem, anxiety, and happiness compared to TAU.
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Affiliation(s)
- Seyla De Francisco
- Escola Universitària d'Infermeria de l'Hospital de la Santa Creu i Sant Pau (EUI Sant Pau), Universitat Autònoma de Barcelona (UAB), 08025 Barcelona, Spain.
- Unitat de Conductes Addictives, Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
| | - Cristina Torres
- Unitat de Conductes Addictives, Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
| | - Sandra De Andrés
- Unitat de Conductes Addictives, Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain.
| | - Ana Millet
- Unitat de Conductes Addictives, Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
| | - M Teresa Ricart
- Escola Universitària d'Infermeria de l'Hospital de la Santa Creu i Sant Pau (EUI Sant Pau), Universitat Autònoma de Barcelona (UAB), 08025 Barcelona, Spain.
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain.
| | - Elvira Hernández-Martínez-Esparza
- Escola Universitària d'Infermeria de l'Hospital de la Santa Creu i Sant Pau (EUI Sant Pau), Universitat Autònoma de Barcelona (UAB), 08025 Barcelona, Spain.
| | - Mercedes Abades
- Escola Universitària d'Infermeria de l'Hospital de la Santa Creu i Sant Pau (EUI Sant Pau), Universitat Autònoma de Barcelona (UAB), 08025 Barcelona, Spain.
| | - Joan Trujols
- Unitat de Conductes Addictives, Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain.
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25
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Mota de Sousa LM, Antunes AV, Alves Marques-Vieira CM, Lopes Silva PC, Pedro Severino SS, Guerreiro José HM. Efecto del uso del humor en el bienestar, depresión y sentido del humor en pacientes en hemodiálisis. ENFERMERÍA NEFROLÓGICA 2019. [DOI: 10.4321/s2254-28842019000300004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objetivo: Evaluar si la visualización de películas de humor durante las sesiones de hemodiálisis mejora el bienestar subjetivo y el sentido del humor, al tiempo que disminuye los niveles de estrés / ansiedad y depresión, en pacientes con hemodiálisis.
Material y Método: Se realizó un estudio pre-post intervención con un grupo de control no equivalente, en pacientes con enfermedad renal crónica en hemodiálisis, en dos unidades de hemodiálisis de Diaverum Clinics. El estudio incluyó a 34 pacientes en el grupo de intervención y 33 pacientes en el grupo de control. La intervención consistió en la visualización de películas de humor durante diez sesiones de hemodiálisis en un período de cuatro semanas. El grupo control vio películas neutrales.
Los datos se recogieron mediante un cuestionario de información sociodemográfica y de salud (edad, sexo, nacionalidad, educación, ocupación, estado civil, duración de la sesión de diálisis, presencia de hipertensión y diabetes); la escala subjetiva de felicidad; la escala de satisfacción general con la vida; la escala de depresión, ansiedad y estrés (DASS-21) y la escala multidimensional de sentido del humor. Se emplearon pruebas t-Student y pruebas t para muestras pareadas. La respuesta al cambio se evaluó utilizando: el porcentaje de cambio, el efecto pico y el efecto base, el tamaño del efecto y la media de respuesta estandarizada.
Resultados: Los niveles de felicidad subjetiva y de sentido del humor aumentaron en el grupo de intervención, pero no hubo aumento significativo en la satisfacción general con la vida. Solo los niveles de depresión disminuyeron significativamente en el grupo de intervención.
Conclusiones: La visión de las películas de humor como una intervención de enfermería mejoró los niveles de felicidad subjetiva y de sentido del humor, al tiempo que disminuyó la percepción de los síntomas depresivos.
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26
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Newman N, Kogan S, Stavsky M, Pintov S, Lior Y. The impact of medical clowns exposure over postoperative pain and anxiety in children and caregivers: An Israeli experience. Pediatr Rep 2019; 11:8165. [PMID: 31579203 PMCID: PMC6769359 DOI: 10.4081/pr.2019.8165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 06/05/2019] [Indexed: 12/27/2022] Open
Abstract
While postoperative pain management was shown to reduce unwanted physiological and emotional outcomes, pediatric postoperative pain management remains suboptimal. Medical-clowns were shown to be beneficial in many medical contexts including reduction of stress, anxiety and pain. This study was set to assess the effectiveness of medical-clowns on pediatric postoperative pain reduction. Children age 4 or above, planned for elective hernia repair surgery were recruited. Children were randomly divided to a control or medicalclown escorted groups. Demographical and clinical data were collected using questionnaires and electronic sheets. Children escorted by clowns reported lower levels of pain upon admittance, discharge and 12- hours post-surgery. Statistically significant reduction of parental distress and significantly higher serum cortisol levels were observed in the clown-therapy group. Although small, our study supports the possibility that preoperative medical-clown therapy might be a cheap, safe and yet beneficial method for postoperative pain reduction.
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Affiliation(s)
- Nitza Newman
- Pediatric Surgery Department, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva
| | - Slava Kogan
- Joyce and Irwing Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva.,Soroka Clinical Research Center, Soroka University Medical Center, Beer-Sheva
| | - Moshe Stavsky
- Joyce and Irwing Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva.,Soroka Clinical Research Center, Soroka University Medical Center, Beer-Sheva
| | - Shay Pintov
- The Medical School for International Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Yotam Lior
- Joyce and Irwing Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva.,Soroka Clinical Research Center, Soroka University Medical Center, Beer-Sheva
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27
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Laughter-inducing therapies: Systematic review and meta-analysis. Soc Sci Med 2019; 232:473-488. [DOI: 10.1016/j.socscimed.2019.02.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 01/24/2019] [Accepted: 02/11/2019] [Indexed: 01/09/2023]
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28
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Martín-María N, Caballero FF, Miret M, Tyrovolas S, Haro JM, Ayuso-Mateos JL, Chatterji S. Differential impact of transient and chronic loneliness on health status. A longitudinal study. Psychol Health 2019; 35:177-195. [PMID: 31237442 DOI: 10.1080/08870446.2019.1632312] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective: Loneliness is associated with worse health status outcomes. Yet, the present study is one of the first to identify how patterns of loneliness (transient and chronic) are associated with health over time. Design: A total of 2,390 individuals were interviewed in 2011-2012 and 2014-2015 in a follow-up study conducted over a nationally representative sample of Spain. After confirming a longitudinal relationship between loneliness and health status, a growth curve mixture modeling was used to examine health trajectories. Main outcome measures: The three-item UCLA Loneliness Scale was used to assess loneliness. Health status was measured with self-reported questions regarding ten domains (vision, mobility, and self-care, among others), and seven measured tests (including grip strength, walking speed and immediate and delayed verbal recall). Results: A quarter of participants were lonely at baseline. Both the group of transient and chronic loneliness showed a negative significant relationship with health status at follow-up, (β = -0.063 and β = -0.075 respectively, p < 0.001). Nevertheless, the health status did not change across time in any group. Conclusion: People experiencing chronic loneliness had the worst health status. Different patterns of loneliness could benefit from the appropriate interventions.
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Affiliation(s)
- Natalia Martín-María
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine, Public Health and Microbiology, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública. CIBERESP, Madrid, Spain
| | - Marta Miret
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Stefanos Tyrovolas
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Josep Maria Haro
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Somnath Chatterji
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
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29
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Bartley EJ, LaGattuta NR, Robinson ME, Fillingim RB. Optimizing resilience in orofacial pain: a randomized controlled pilot study on hope. Pain Rep 2019; 4:e726. [PMID: 31041425 PMCID: PMC6455683 DOI: 10.1097/pr9.0000000000000726] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/25/2019] [Accepted: 01/30/2019] [Indexed: 12/26/2022] Open
Abstract
Introduction: Over recent years, there has been growing interest in the role of positive, psychological resources that promote resilience and optimal functioning in chronic pain. Although multiple factors comprise resilience, hope is a strength-based motivational state known to contribute to positive psychosocial adjustment and adaptive pain coping. Emerging evidence supports the viability of therapeutic approaches that foster resilience; however, interventions designed to target hope in the context of pain have been remarkably understudied. Objectives: The objectives of this pilot study were to test the feasibility and preliminary efficacy of a resilience-oriented hope intervention for clinical pain, as well as psychosocial outcomes and experimental pain sensitivity in individuals with orofacial pain. Methods: Twenty-nine participants with temporomandibular disorder were randomized to a 3-session intervention intended to increase hope or a control intervention (EDU) involving education about pain and stress. Before and after the intervention, participants attended 2 laboratory sessions whereby they completed psychosocial questionnaires and sensitivity to heat, cold, and pressure pain was assessed. Hope was measured using the Adult State Hope Scale. Results: Compared with EDU, the Hope group exhibited an increase in state hope, lower heat pain sensitivity, higher pressure pain thresholds at the temporomandibular joint, and reductions in pain catastrophizing. Conclusion: Although preliminary, results suggest that a resilience-based hope intervention may be beneficial in reducing pain sensitivity and catastrophizing and could serve as a target for pain management.
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Affiliation(s)
- Emily J Bartley
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA.,Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA
| | - Natalie R LaGattuta
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michael E Robinson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA.,Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA.,Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA
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Abstract
AIMS There has recently been an increased interest in mental health indicators for the monitoring of population wellbeing, which is among the targets of Sustainable Development Goals adopted by the United Nations. Levels of subjective wellbeing and suicide rates have been proposed as indicators of population mental health, but prior research is limited. METHODS Data on individual happiness and life satisfaction were sourced from a population-based survey in Hong Kong (2011). Suicide data were extracted from Coroner's Court files (2005-2013). Area characteristic variables included local poverty rate and four factors derived from a factor analysis of 21 variables extracted from the 2011 census. The associations between mean happiness and life satisfaction scores and suicide rates were assessed using Pearson correlation coefficient at two area levels: 18 districts and 30 quantiles of large street blocks (LSBs; n = 1620). LSB is a small area unit with a higher level of within-unit homogeneity compared with districts. Partial correlations were used to control for area characteristics. RESULTS Happiness and life satisfaction demonstrated weak inverse associations with suicide rate at the district level (r = -0.32 and -0.36, respectively) but very strong associations at the LSB quantile level (r = -0.83 and -0.84, respectively). There were generally very weak or weak negative correlations across sex/age groups at the district level but generally moderate to strong correlations at the LSB quantile level. The associations were markedly attenuated or became null after controlling for area characteristics. CONCLUSIONS Subjective wellbeing is strongly associated with suicide at a small area level; socioeconomic factors can largely explain this association. Socioeconomic factors could play an important role in determining the wellbeing of the population, and this could inform policies aimed at enhancing population wellbeing.
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31
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Pérez-Aranda A, Hofmann J, Feliu-Soler A, Ramírez-Maestre C, Andrés-Rodríguez L, Ruch W, Luciano JV. Laughing away the pain: A narrative review of humour, sense of humour and pain. Eur J Pain 2018; 23:220-233. [PMID: 30176100 DOI: 10.1002/ejp.1309] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 08/24/2018] [Accepted: 08/25/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVE The link between humour and sense of humour with pain has been a topic of research for decades. The purpose of the present article was to review the different studies that have been conducted to date on the association between humour and sense of humour with pain. DATABASES AND DATA TREATMENT The literature search was conducted using the PubMed, Science Direct and ProQuest databases. Forty-one studies were reviewed, and the results are summarized and structured into three sections: experimental pain, chronic pain and pain in children. RESULTS For experimental pain, the findings support the idea that humorous distractions, such as watching a comedy clip, increase pain tolerance, although most of the studies indicate that other non-humorous distractions produce similar effects. Regarding chronic pain, humour has been studied as a way of coping with pain and the emotional distress produced by chronic pain conditions. The results of correlational studies show significant associations between the use of humour and main variables such as anxiety and catastrophizing. Finally, concerning pain in children, similar findings to those described for the previous sections have been reported, with a notable presence of studies on clinic clown interventions, which promote emotional well-being among children and their parents, although their effectiveness in pain reduction is controversial. CONCLUSIONS The study of the link between humour and pain is still on an early stage, and overcoming the limitations of previous studies is required to strengthen the promising results that have been observed up to date. SIGNIFICANCE This review summarizes all main findings regarding humour, sense of humour and pain up until the first half of 2018 and offers a list of aspects to be considered in further studies regarding the link of humour and pain to contribute to a more systematic research.
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Affiliation(s)
- Adrián Pérez-Aranda
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Teaching Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Jennifer Hofmann
- Department of Psychology, University of Zurich, Zurich, Switzerland.,Department of Personality and Assessment, University of Zurich, Zurich, Switzerland
| | - Albert Feliu-Soler
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Teaching Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Carmen Ramírez-Maestre
- Department of Personality, Evaluation and Psychological Treatment, University of Malaga, Malaga, Spain
| | - Laura Andrés-Rodríguez
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Teaching Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Willibald Ruch
- Department of Psychology, University of Zurich, Zurich, Switzerland.,Department of Personality and Assessment, University of Zurich, Zurich, Switzerland
| | - Juan V Luciano
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Teaching Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
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32
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Shropshire M, Stapleton SJ, Dyck MJ, Kim M, Mallory C. Nonpharmacological interventions for persistent, noncancer pain in elders residing in long-term care facilities: An integrative review of the literature. Nurs Forum 2018; 53:538-548. [PMID: 30242833 DOI: 10.1111/nuf.12284] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 06/05/2018] [Accepted: 07/10/2018] [Indexed: 11/28/2022]
Abstract
Elders residing in long-term care facilities experience ongoing moderate to severe pain, relief from and increased comfort remain relevant healthcare concerns. However, persistent, noncancer pain may not have been properly addressed due to insufficient attention to research that exists to support the utilization and efficacy of nonpharmacological intervention(s) for elders in long-term care facilities. Our aim of this integrated review was to evaluate the current state of the science on nonpharmacological intervention(s) for pain that are currently utilized in elders who reside in long-term care facilities. Exercise, massage, heat therapy, and relaxation/rest were identified as significant nonpharmacological interventions for persistent pain in elder residents living in long-term care facilities.
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Affiliation(s)
- Michele Shropshire
- Mennonite College of Nursing, Illinois State University, Normal, Illinois
| | | | - Mary J Dyck
- Mennonite College of Nursing, Illinois State University, Normal, Illinois
| | - Myoungjin Kim
- Mennonite College of Nursing, Illinois State University, Normal, Illinois
| | - Caroline Mallory
- College of Health and Human Services, Indiana State University, Terre Haute, Indiana
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33
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Kuru Alıcı N, Zorba Bahceli P, Emiroğlu ON. The preliminary effects of laughter therapy on loneliness and death anxiety among older adults living in nursing homes: A nonrandomised pilot study. Int J Older People Nurs 2018; 13:e12206. [DOI: 10.1111/opn.12206] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 05/04/2018] [Accepted: 06/14/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Nilgün Kuru Alıcı
- Faculty of Nursing; Department of Public Health Nursing; Hacettepe University; Ankara Turkey
| | - Pınar Zorba Bahceli
- Department of Nursing; Selcuk University Faculty of Health Sciences Konya; Turkey
| | - Oya Nuran Emiroğlu
- Faculty of Nursing; Department of Public Health Nursing; Hacettepe University; Ankara Turkey
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34
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Yanguas J, Pinazo-Henandis S, Tarazona-Santabalbina FJ. The complexity of loneliness. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:302-314. [PMID: 29957768 PMCID: PMC6179015 DOI: 10.23750/abm.v89i2.7404] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 03/28/2018] [Indexed: 12/20/2022]
Abstract
Loneliness is a prevalent and global problem for adult populations, and a number of different studies have linked it to multiple chronic conditions, including: heart disease, lung disease, cardiovascular disease, hypertension, atherosclerosis, stroke, and metabolic disorders, such as obesity and metabolic disease. Is a major predictor of psychological problems, such as depression, psychological stress, and anxiety. Loneliness is linked to overall morbidity and mortality in adult populations. But limited interventions have demonstrated long-term effectiveness in reducing loneliness in adults with these same chronic conditions. Our research of the extant literature addresses the following question: What evidence exists regarding the relationships between loneliness and health? We focus on recent findings with respect to the links between loneliness and health.
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Affiliation(s)
- Javier Yanguas
- Scientific Director of the Elderly Program. "la Caixa" Banking Foundation. (Spain). President of the Department of Social and Behavioral Sciences at the IAGG-EU.
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35
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Ibrahim MM, Patwardhan A, Gilbraith KB, Moutal A, Yang X, Chew LA, Largent-Milnes T, Malan TP, Vanderah TW, Porreca F, Khanna R. Long-lasting antinociceptive effects of green light in acute and chronic pain in rats. Pain 2017; 158:347-360. [PMID: 28092651 DOI: 10.1097/j.pain.0000000000000767] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Treatments for chronic pain are inadequate, and new options are needed. Nonpharmaceutical approaches are especially attractive with many potential advantages including safety. Light therapy has been suggested to be beneficial in certain medical conditions such as depression, but this approach remains to be explored for modulation of pain. We investigated the effects of light-emitting diodes (LEDs), in the visible spectrum, on acute sensory thresholds in naive rats as well as in experimental neuropathic pain. Rats receiving green LED light (wavelength 525 nm, 8 h/d) showed significantly increased paw withdrawal latency to a noxious thermal stimulus; this antinociceptive effect persisted for 4 days after termination of last exposure without development of tolerance. No apparent side effects were noted and motor performance was not impaired. Despite LED exposure, opaque contact lenses prevented antinociception. Rats fitted with green contact lenses exposed to room light exhibited antinociception arguing for a role of the visual system. Antinociception was not due to stress/anxiety but likely due to increased enkephalins expression in the spinal cord. Naloxone reversed the antinociception, suggesting involvement of central opioid circuits. Rostral ventromedial medulla inactivation prevented expression of light-induced antinociception suggesting engagement of descending inhibition. Green LED exposure also reversed thermal and mechanical hyperalgesia in rats with spinal nerve ligation. Pharmacological and proteomic profiling of dorsal root ganglion neurons from green LED-exposed rats identified changes in calcium channel activity, including a decrease in the N-type (CaV2.2) channel, a primary analgesic target. Thus, green LED therapy may represent a novel, nonpharmacological approach for managing pain.
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Affiliation(s)
- Mohab M Ibrahim
- Departments of Anesthesiology and.,Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Amol Patwardhan
- Departments of Anesthesiology and.,Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | | | - Aubin Moutal
- Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Xiaofang Yang
- Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Lindsey A Chew
- Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | | | - T Philip Malan
- Departments of Anesthesiology and.,Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Todd W Vanderah
- Departments of Anesthesiology and.,Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Frank Porreca
- Departments of Anesthesiology and.,Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Rajesh Khanna
- Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
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36
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Bermeja AI, Ausín B. [Programs to combat loneliness in the institutionalised elderly: A review of the scientific literature]. Rev Esp Geriatr Gerontol 2017; 53:155-164. [PMID: 29100718 DOI: 10.1016/j.regg.2017.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 04/04/2017] [Accepted: 05/12/2017] [Indexed: 11/29/2022]
Abstract
Loneliness is a problem that affects a very high percentage of older people, and can lead to physical and/or mental illness. This article aims to present a systematic review of programs to combat loneliness directed towards the institutionalised elderly. Experimental and quasi-experimental articles published between 2000 and 2016 were included in the review. An analysis was carried out on the quality of the methodological evidence of each of the articles. The programs analysed included animal-assisted, contacts with families through videoconferencing, gardening and/or horticulture workshops, reminiscence therapies, humour therapies, and cognitive interventions. The results show that intervention programs are effective to reduce the feeling of loneliness. The methodological limitations of the studies are discussed and future research is recommended.
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Affiliation(s)
- Ana Isabel Bermeja
- Facultad de Psicología, Universidad Complutense de Madrid, Madrid, España
| | - Berta Ausín
- Facultad de Psicología, Universidad Complutense de Madrid, Madrid, España.
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37
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Humor doesn't retire: Improvisation as a health-promoting intervention for older adults. Arch Gerontol Geriatr 2017; 75:1-5. [PMID: 29156247 DOI: 10.1016/j.archger.2017.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/11/2017] [Accepted: 10/13/2017] [Indexed: 11/22/2022]
Abstract
As our population ages and aging in place continues to remain a priority of older adults, identifying novel ways to promote the wellbeing of older adults and reduce isolation is of the utmost importance. The Second City is a Chicago-based comedy improvisation organization that provides training in improvisation. One of their training courses, Humor Doesn't Retire, specifically teaches adults 55 and over, on improvisation. This study sought to explore the experiences of older adults enrolled in Humor Doesn't Retire, and to characterize any benefits that older adult participants perceived following participation in the comedy improvisation course. Qualitative analysis was used to identify and describe common themes that emerged in a survey of open-ended questions regarding benefits of the improvisation course on outlook and mood as well as behavior changes. Results for perceived benefits showed main themes of increased positivity, an increased sense of comfort and ease with the unexpected, a sense of self-development and self-awareness, and a feeling of acceptance by their social group. Participants reported that these changes fed into their behaviors, and resulted in enhanced problem solving abilities, greater facility in social situations, and the tangible outcome of an expanded and closer-knit social circle. As the first study in our knowledge to examine the effect of improvisation comedy on healthy older adults, this exploratory analysis has suggested that improvisation comedy may be a mechanism by which to combat several geriatric syndromes, including depression, stress, and isolation - all of which are detrimental to older adults.
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38
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Alparslan Ö, Bozkurt G. The effect of a clown model implemented in hospital on the anxiety and depression level of ill children and their mothers. Arts Health 2017. [DOI: 10.1080/17533015.2017.1334679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Özgür Alparslan
- Faculty of Health Sciences, Department of Midwifery, Gaziosmanpasa Universitesi , Tokat, Turkey
| | - Gülçin Bozkurt
- Faculty of Health Sciences, Department of Midwifery, Istanbul University , Istanbul, Turkey
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39
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Nimrod G, Berdychevsky L. Laughing off the Stereotypes: Age and Aging in Seniors’ Online Sex-Related Humor. THE GERONTOLOGIST 2017; 58:960-969. [DOI: 10.1093/geront/gnx032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- Galit Nimrod
- Department of Communication and the Center for Multidisciplinary Research in Aging, Ben-Gurion University of the Negev, Israel
| | - Liza Berdychevsky
- Department of Recreation, Sport and Tourism, University of Illinois at Urbana–Champaign
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40
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Kuru N, Kublay G. The effect of laughter therapy on the quality of life of nursing home residents. J Clin Nurs 2017; 26:3354-3362. [PMID: 27982486 DOI: 10.1111/jocn.13687] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2016] [Indexed: 12/20/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the effect of Laughter therapy on the quality of life of nursing home residents. BACKGROUND By improving the quality of life of residents living in nursing homes and allowing them to have a healthier existence, their lives can be extended. Therefore, interventions impacting the quality of life of older adults are of critical importance. DESIGN Quasi-experimental design. METHOD The study was conducted between 2 March - 25 May 2015. The experimental group was composed of 32 nursing home residents from one nursing home, while the control group consisted of 33 nursing home residents from another nursing home in the capital city of Turkey. Laughter therapy was applied with nursing home residents of the experimental group two days per week (21 sessions in total). A socio-demographic form and the Short-Form Health Survey (SF-36) were used for data collection. RESULTS After the laughter therapy intervention, general and subscales (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional and spiritual health) quality-of-life scores of residents in the experimental group significantly increased in comparison with the pretest. CONCLUSION Laughter therapy improved the quality of life of nursing home residents. Therefore, nursing home management should integrate laughter therapy into health care and laughter therapy should be provided as a routine nursing intervention. RELEVANCE TO CLINICAL PRACTICE The results indicated that the laughter therapy programme had a positive effect on the quality of life of nursing home residents. Nurses can use laughter therapy as an intervention to improve quality of life of nursing home residents.
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Affiliation(s)
- Nilgun Kuru
- Department of Public Health Nursing, Hacettepe University Faculty of Nursing Ankara, Ankara, Turkey
| | - Gulumser Kublay
- Department of Public Health Nursing, Hacettepe University Faculty of Nursing Ankara, Ankara, Turkey
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Cottrell L. Joy and happiness: a simultaneous and evolutionary concept analysis. J Adv Nurs 2016; 72:1506-17. [DOI: 10.1111/jan.12980] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Laura Cottrell
- Faculty of Nursing Level 3; Edmonton Clinic Health Academy; University of Alberta; Alberta Canada
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Leow JBY, Pont L, Low LF. Effect of humour therapy on psychotropic medication use in nursing homes. Australas J Ageing 2016; 35:E7-E12. [DOI: 10.1111/ajag.12319] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jerome BY Leow
- Faculty of Medicine; University of New South Wales; New South Wales Australia
| | - Lisa Pont
- Sydney Nursing School; The University of Sydney; New South Wales Australia
| | - Lee-Fay Low
- Faculty of Health Sciences; The University of Sydney; Sydney New South Wales Australia
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Duff MC, Gallegos DR, Cohen NJ, Tranel D. Learning in Alzheimer's disease is facilitated by social interaction. J Comp Neurol 2014; 521:4356-69. [PMID: 23881834 DOI: 10.1002/cne.23433] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 07/02/2013] [Accepted: 07/12/2013] [Indexed: 11/11/2022]
Abstract
Seminal work in Gary Van Hoesen's laboratory at Iowa in the early 1980s established that the hallmark neuropathology of Alzheimer's disease (AD; neurofibrillary tangles) had its first foothold in specific parts of the hippocampal formation and entorhinal cortex, effectively isolating the hippocampus from much of its input and output and causing the distinctive impairment of new learning that is the leading early characteristic of the disease (Hyman et al., 1984). The boundaries and conditions of the anterograde memory defect in patients with AD have been a topic of intense research interest ever since (e.g., Graham and Hodges, 1977; Nestor et al., 2006). For example, it has been shown that patients with AD may acquire some new semantic information through methods such as errorless learning, but learning under these conditions is typically slow and inefficient. Drawing on a learning paradigm (a collaborative referencing task) that was previously shown to induce robust and enduring learning in patients with hippocampal amnesia, we investigated whether this task would be effective in promoting new learning in patients with AD. We studied five women with early-stage AD and 10 demographically matched healthy comparison participants, each interacting with a familiar communication partner. AD pairs displayed significant and enduring learning across trials, with increased accuracy and decreased time to complete trials, in a manner indistinguishable from healthy comparison pairs, resulting in efficient and economical communication. The observed learning here most likely draws on neural resources outside the medial temporal lobes. These interactive communication sessions provide a potent learning environment with significant implications for memory intervention.
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Affiliation(s)
- Melissa C Duff
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, 52242; Department of Neurology, Division of Behavioral Neurology and Cognitive Neuroscience, University of Iowa, Iowa City, Iowa, 52242
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Shune S, Duff MC. Verbal play as a discourse resource in the social interactions of older and younger communication pairs. JOURNAL OF INTERACTIONAL RESEARCH IN COMMUNICATION DISORDERS 2014; 5:193-216. [PMID: 25485072 PMCID: PMC4256531 DOI: 10.1558/jircd.v5i2.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Verbal play, or the playful manipulation of elements of language, is a pervasive component of social interaction, serving important interpersonal functions. We analyzed verbal play in the interactional discourse of ten healthy younger pairs and ten healthy older pairs as they completed a collaborative referencing task. A total of 1,893 verbal play episodes were coded. While there were no group differences in verbal play frequency, age-related differences in the quality and function of these episodes emerged. While older participants engaged in more complex, extended, and reciprocal episodes that supported the social nature of communicative interactions (e.g., teasing), younger participants were more likely to engage in verbal play episodes for the purpose of successful task completion. Despite these age-related variations in the deployment of verbal play, verbal play is a robust interactional discourse resource in healthy aging, highlighting an element of human cognition that does not appear to decline with age.
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Affiliation(s)
- Samantha Shune
- Communication Disorders and Sciences, The University of Oregon, Eugene, OR, USA
| | - Melissa Collins Duff
- Departments of Communication Sciences and Disorders & Neurology, University of Iowa, Iowa City, IA, USA
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Leef BL, Hallas D. The Sensitivity Training Clown Workshop: enhancing therapeutic communication skills in nursing students. Nurs Educ Perspect 2013; 34:260-4. [PMID: 24187731 DOI: 10.5480/1536-5026-34.4.260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this study was to examine the long-term effectiveness of the Sensitivity Training Clown Workshop (STCW) provided to 131 baccalaureate nursing students. BACKGROUND The STCW was designed and implemented through a collaboration between the artistic director of the Big Apple Circus and nurse faculty to help students understand emotions, learn peripheral awareness skills, and become engaged with patients. METHOD Forty participants responded to an 18-month follow-up evaluation survey. RESULTS The majority of participants reported applying lessons learned in the workshop in their current practice, regardless of their area of nursing employment. CONCLUSION The STCW is an effective method of educating nursing students for pediatric practice. The techniques used in the workshop are applicable to other practice settings.
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Affiliation(s)
- Betty L Leef
- New York University College of Nursing, New York, New York, USA.
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Low LF, Brodaty H, Goodenough B, Spitzer P, Bell JP, Fleming R, Casey AN, Liu Z, Chenoweth L. The Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) study: cluster randomised trial of humour therapy in nursing homes. BMJ Open 2013; 3:bmjopen-2012-002072. [PMID: 23315520 PMCID: PMC3549213 DOI: 10.1136/bmjopen-2012-002072] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To determine whether humour therapy reduces depression (primary outcome), agitation and behavioural disturbances and improves social engagement and quality-of-life in nursing home residents. DESIGN The Sydney Multisite Intervention of LaughterBosses and ElderClowns study was a single-blind cluster randomised controlled trial of humour therapy. SETTING 35 Sydney nursing homes. PARTICIPANTS All eligible residents within geographically defined areas within each nursing home were invited to participate. INTERVENTION Professional 'ElderClowns' provided 9-12 weekly humour therapy sessions, augmented by resident engagement by trained staff 'LaughterBosses'. Controls received usual care. MEASUREMENTS Depression scores on the Cornell Scale for Depression in Dementia, agitation scores on the Cohen-Mansfield Agitation Inventory, behavioural disturbance scores on the Neuropsychiatric Inventory, social engagement scores on the withdrawal subscale of Multidimensional Observation Scale for Elderly Subjects, and self-rated and proxy-rated quality-of-life scores on a health-related quality-of-life tool for dementia, the DEMQOL. All outcomes were measured at the participant level by researchers blind to group assignment. RANDOMISATION Sites were stratified by size and level of care then assigned to group using a random number generator. RESULTS Seventeen nursing homes (189 residents) received the intervention and 18 homes (209 residents) received usual care. Groups did not differ significantly over time on the primary outcome of depression, or on behavioural disturbances other than agitation, social engagement and quality of life. The secondary outcome of agitation was significantly reduced in the intervention group compared with controls over 26 weeks (time by group interaction adjusted for covariates: p=0.011). The mean difference in change from baseline to 26 weeks in Blom-transformed agitation scores after adjustment for covariates was 0.17 (95% CI 0.004 to 0.34, p=0.045). CONCLUSIONS Humour therapy did not significantly reduce depression but significantly reduced agitation. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry -ACTRN12611000462987.
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Affiliation(s)
- Lee-Fay Low
- Dementia Collaborative Research Centre, Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Dementia Collaborative Research Centre, Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Belinda Goodenough
- Dementia Collaborative Research Centre, Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Peter Spitzer
- Humour Foundation, Chatswood, New South Wales, Australia
| | - Jean-Paul Bell
- Arts Health Institute, Newcastle, New South Wales, Australia
| | - Richard Fleming
- NSW & ACT Dementia Training Study Centre, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anne-Nicole Casey
- Dementia Collaborative Research Centre, Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Zhixin Liu
- Dementia Collaborative Research Centre, Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Lynn Chenoweth
- Health and Ageing Research Unit, University of Technology, Sydney, New South Wales, Australia
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Van Malderen L, Mets T, Gorus E. Interventions to enhance the Quality of Life of older people in residential long-term care: a systematic review. Ageing Res Rev 2013; 12:141-50. [PMID: 22504403 DOI: 10.1016/j.arr.2012.03.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 03/22/2012] [Accepted: 03/30/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE In residential long-term care (LTC), a growing interest exists in the older residents' Quality of Life (QoL). The Active Ageing-concept (AA) extended this focus, since AA has the aim to enhance QoL by optimising the opportunities for health, participation and security. In LTCs, AA can be outlined by 9 determinants. This systematic review aimed at identifying interventions to improve the QoL of LTC-residents. These interventions were organised according to the AA-determinants. METHODS PubMed, Web of Science, Psychinfo and Sociological Abstracts were screened systematically. Articles were excluded when they only concerned a specific group of LTC-residents. RESULTS Thirty five relevant articles, encompassing 3910 subjects were found. These concerned interventions concentrating on one or more of the 9 AA-determinants. The largest proportion of interventions regarded the physical activity level or the psychological factors of the residents. Overall, no systematic effects on QoL could be found and a low methodological quality was generally present. CONCLUSION Currently, studies aimed at enhancing the QoL of older LTC-resident are limited and often directed to physical and psychological interventions. The lack of a systematic effect on QoL is possibly related to the fact that these interventions were often not multidimensional, whereas QoL is a multidimensional concept.
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Study protocol for a randomized controlled trial of humor therapy in residential care: the Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE). Int Psychogeriatr 2012; 24:2037-44. [PMID: 22578664 DOI: 10.1017/s1041610212000683] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Humor therapy is a non-pharmacological intervention with potential to improve mood and quality of life for institutionalized older persons, including those with dementia. The primary aims of the Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) are to examine the effects of humor therapy on residents' mood, quality of life, social engagement, and agitation. METHODS SMILE is a single-blinded cluster-randomized controlled trial where 398 consented residents in 35 residential aged care facilities will be allocated to receive humor therapy or usual care. Residents allocated to the intervention group will engage in humor therapy with professional performers (ElderClowns) and trained facility staff (LaughterBosses) for a minimum of nine two-hour sessions over 12 weeks as well as engaging humorously with LaughterBosses during the course of daily care. The usual care control group will not engage in any formal humor therapy. Researchers, blind to treatment allocation, will assess residents at baseline (week 0), post-intervention (week 13), and follow-up (week 26). The measurement suite includes the Cornell Scale for Depression in Dementia, the Dementia Quality of Life Scale, the Multidimensional Observation Scale for Elderly Subjects, the Cohen-Mansfield Agitation Inventory, and the Neuropsychiatric Inventory. Observations of residents' engagement will be recorded at each humor therapy session. CONCLUSIONS SMILE is the first large rigorous study of humor therapy in aged care.
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Shune S, Duff MC. Verbal Play as an Interactional Discourse Resource in Early Stage Alzheimer's Disease. APHASIOLOGY 2012; 26:811-825. [PMID: 23129879 PMCID: PMC3487700 DOI: 10.1080/02687038.2011.650626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND: Verbal play, the creative and playful use of language to make puns, rhyme words, and tease, is a pervasive and enjoyable component of social communication and serves important interpersonal functions. The current study examines the use of verbal play in the communicative interactions of individuals with Alzheimer's disease as part of a broader program of research on language-and-memory-in-use. AIMS: To document the frequency of verbal play in the communicative interactions of individuals with very mild Alzheimer's disease (AD) and their familiar communication partners. To characterize the interactional forms, resources, and functions of playful episodes. METHODS: Using quantitative group comparisons and detailed discourse analysis, we analyzed verbal play in the interactional discourse of five participants with very mild AD and five healthy (demographically matched) comparison participants. Each participant interacted with a familiar partner while completing a collaborative referencing task, and with a researcher between task trials. RESULTS: A total of 1,098 verbal play episodes were coded. Despite being in the early stages of AD, all the AD participants used verbal play. There were no significant group differences in the frequency of verbal play episodes or in the interactional forms, resources, or functions of those playful episodes between AD and healthy comparison pair sessions. CONCLUSIONS: The successful use of verbal play in the interactions of individuals with very mild AD and their partners highlights an area of preserved social communication. These findings represent an important step, both clinically and for research, in documenting the rich ways that individuals with early stage AD orchestrate interactionally meaningful communication with their partners through the use of interactional discourse resources like verbal play. This work also offers a promising clinical tool for tracking and targeting verbal play across disease progression.
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Affiliation(s)
- Samantha Shune
- Department of Communication Sciences and Disorders, University of Iowa
| | - Melissa C. Duff
- Department of Communication Sciences and Disorders, University of Iowa
- Department of Neurology, Division of Behavioral Neurology and Cognitive Neuroscience, University of Iowa
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