Palliative care teams frequently use humour as a coping instrument. Humour used within the professional team has to be distinguished from humour in the interaction with patients. Humour among staff members working in palliative settings is widely accepted and the positive effect has been demonstrated. Four humour-workshops were organized for staff working in a palliative care unit. All participants completed the State-Trait-Cheerfulness-Inventory (STCI-S and T) and the Distress-Thermometer. Before and after the last two workshops, saliva samples were collected for analysis of oxytocin concentrations. The humour workshops were performed by two coaches based on a concept for the use of humour and mindfulness in the nursing routine. Overall 31 staff members out of 37 participated. Representatives of all professions were included, 28 women, 3 men, 24 to 59 years old. Saliva samples demonstrated a small but not significant oxytocin increase from a mean of 1.52 pg/ml to 1.80 pg/ml after the intervention (p .26). The mean p value of distress was reduced from 5.24 to 3.90 with an effect of p = .05 and bad mood was reduced from 11.19 to 9.43 (p = .36), seriousness decreased from 15.06 to 12.26 (p .01) and cheerfulness changed from 16.33 to 19.03 (p = .02). Despite the small sample size, the reduction of distress and seriousness and the increase of cheerfulness was significant. The changes in Oxytocin and bad mood proved to not be significant. Feedback from participants confirmed the value of humour in palliative care.
Purpose The effect of humour on end-of-life patients could be beneficial and is worth investigating. However, data on humour interventions for patients in palliative care are scarce. This study evaluated the effects of a humour intervention in a palliative care setting. Methods A two-step intervention was developed based on the humour habits programme by McGhee. Patients were assisted to remember funny episodes from their past and recognize humorous aspects of the present and encouraged to produce humour. The intervention and control group completed questionnaires on life satisfaction, cheerfulness, symptom burden, and perceived stress and if possible gave saliva samples to investigate oxytocin levels. The study was a randomized controlled monocentre study on patients treated in a palliative care ward. Participants had to be conscious and alert enough to complete data collection. Overall, 55 patients were included and randomized to the intervention or control group. Results Parameters in the control group did not change significantly. In the intervention group, seriousness, bad mood, and stress were reduced. Cheerfulness increased significantly after the intervention. However, the methodologically complex intervention setting was too exhausting for the majority of patients. Conclusion Patients who were able to participate benefited from the effects of the intervention on multiple levels. For future research simple interventions, biomarkers for well-being and assessments by staff or proxies are needed to include patients with reduced cognitive and physical performance status at the end of their lives. Trial registration DRKS00028978 German Registry of Clinical Studies.
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