Humor and laughter in palliative care: An ethnographic investigation

Abstract

Objective: Humor and laughter are present in most of human interaction. Interactions in health care settings are no exception. Palliative care practitioners know from experience that humor and laughter are common in palliative care despite the seriousness of the care context. Research establishing the significance of humor in care of the dying is limited.Methods: Clinical ethnography conducted in a 30-bed inpatient palliative care unit served as the means of exploring the functions of humor in care of the dying. Clinical ethnography is intended for examination of the human experience of illness or of caregiving in an interpersonal context~Kleinman, 1992!. The method emphasizes the subjective experience and the realm of communication and interaction for both patients and caregivers. Data were collected through participant observation, informal interviews with patients and families, and semistructured interviews with members of the health care team.Results: Humor and laughter were widespread and important in the research setting. An overall attitude of good humor prevailed. Within that atmosphere, humor served myriad functions. Functions were identified in three overarching themes; building relationships, contending with circumstances, and expressing sensibility. Humor among patients, families, and staff most commonly served to build therapeutic relationships, relieve tension, and protect dignity and a sense of worth. Humor was particularly significant in maintaining collegial relationships, managing stressful situations, and maintaining a sense of perspective.Significance of results: Findings established the significance of humor and laughter as humanizing dimensions of care of the dying and contributes to the volume of research supporting evidence-based practice.

Therapeutic Benefits of Laughter in Mental Health: A Theoretical Review

“…; Kant in the 18 th century, Laughter has a great influence on keeping balance in physical health. ; Spencer in the 19 th century, Laughter helps ease tension and recover health (Dean and Gregory 2004;Hyeong Woo 2010). The word, laughter, comes from 'hliehhan' in Old English.…”

Hospice Nurse Communication with Patients with Cancer and their Family Caregivers

“…Both family caregivers and patients express humor and distress, consistent with the literature indicating the dying process can be a time of both joy and sadness. [32][33][34] It is difficult to compare how hospice nurse communication compares to other end-of-life encounters, because little research has been conducted in this area. Timmerman and colleagues 35,36 applied RIAS to initial palliative care consultation sessions with radiation oncologists.…”

A comunicação com o paciente em cuidados paliativos: valorizando a alegria e o otimismo

“…Estudos (12)(13) apontam que o bom humor e a risada proporcionam um modo de aliviar a ansiedade, a tensão e a insegurança, além de servir como mecanismo de coping através do qual o indivíduo lida com questões opressivas. Utilizar o humor como estratégia de defesa ou coping permite ao indivíduo distanciar-se do estresse, mostrar sentimentos que geralmente são difíceis de expressar e lidar, como a impotência e o medo, esquecer as preocupações, evitar conflitos, aliviar a tensão e relaxar.…”

“…O humor é um componente valioso da comunicação e do cuidado compassivo em cuidados paliativos, considerado uma dimensão do cuidado emocional. Contudo, o humor nunca deve ferir a dignidade humana e precisa ser utilizado com muito cuidado e tato em situações de crise, discussões sérias e quando há altos níveis de ansiedade (13) .…”