Study protocol for a randomized controlled trial of humor therapy in residential care: the Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE)

Goodenough, Belinda; Low, Lee‐Fay; Casey, Anne-Nicole; Chenoweth, Lynn; Fleming, Richard; Spitzer, Peter; Bell, Jean-Paul; Brodaty, Henry

doi:10.1017/s1041610212000683

Cited by 25 publications

(15 citation statements)

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“…The Study protocol details have been reported previously 16. Ethics approval was obtained from the University of New South Wales Human Research Ethics Committee (approval number 08345).…”

Section: Methodsmentioning

confidence: 99%

The Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) study: cluster randomised trial of humour therapy in nursing homes

et al. 2013

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ObjectivesTo determine whether humour therapy reduces depression (primary outcome), agitation and behavioural disturbances and improves social engagement and quality-of-life in nursing home residents.DesignThe Sydney Multisite Intervention of LaughterBosses and ElderClowns study was a single-blind cluster randomised controlled trial of humour therapy.Setting35 Sydney nursing homes.ParticipantsAll eligible residents within geographically defined areas within each nursing home were invited to participate.InterventionProfessional ‘ElderClowns’ provided 9–12 weekly humour therapy sessions, augmented by resident engagement by trained staff ‘LaughterBosses’. Controls received usual care.MeasurementsDepression 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.RandomisationSites were stratified by size and level of care then assigned to group using a random number generator.ResultsSeventeen 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).ConclusionsHumour therapy did not significantly reduce depression but significantly reduced agitation.Trial registrationAustralian New Zealand Clinical Trials Registry -ACTRN12611000462987.

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“…The Study protocol details have been reported previously 16. Ethics approval was obtained from the University of New South Wales Human Research Ethics Committee (approval number 08345).…”

Section: Methodsmentioning

confidence: 99%

The Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) study: cluster randomised trial of humour therapy in nursing homes

et al. 2013

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“…Apart from the health sector, humor interventions have also been investigated in the field of positive psychology (Ruch and McGhee, 2014 ; Ruch and Hofmann, 2017 ). Some studies in medical settings were conducted with older people in nursing homes (Mathieu, 2008 ; Goodenough et al, 2012 ; Low et al, 2013 ), cancer patients (Itami, 2000 ; Venter et al, 2008 ), veterans (Steinhauser et al, 2000 ), and patients suffering from depression (Shahidi et al, 2011 ). Positive correlations have been reported on humor and laughter in relation to life satisfaction outside the health care setting (Wild et al, 2003 ; Ruch et al, 2010 ), and there is some evidence of a relationship between humor and health (Martin, 2001 , 2004 ).…”

Section: Introductionmentioning

confidence: 99%

Humor Assessment and Interventions in Palliative Care: A Systematic Review

et al. 2018

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Background: The central goal of palliative care is to optimize the quality of life of patients suffering from life-limiting illnesses, which includes psychosocial and spiritual wellbeing. Research has demonstrated positive correlations between humor and laughter with life satisfaction and other aspects of wellbeing, and physiological symptoms can be improved by humorous stimuli.Objectives: The aim of this review is to evaluate humor interventions and assessments that have been applied in palliative care and to derive implications for future research.Methods: A systematic review of four databases identified 13 included studies. Criteria for inclusion were peer-reviewed English-language studies on humor interventions or assessments in a palliative care context.Results: Two studies on humor interventions and 11 studies on humor assessment were included in the systematic review. Most of these studies were about the patients' perspective on humor in palliative care. Findings showed that humor had a positive effect on patients, their relatives, and professional caregivers. Humor was widely perceived as appropriate and seen as beneficial to care in all studies.Conclusions: Even though humor interventions seem to be potentially useful in palliative care, descriptions evaluating their use are scarce. Overall, research on humor assessment and interventions in palliative care has remained limited in terms of quantity and quality. More research activities are needed to build a solid empirical foundation for implementing humor and laughter as part of regular palliative care activities.

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“…The same can be said about studies investigating the influence of humor on geriatric patients with mental diseases. Recently, Nauert (2011) referenced an as yet unpublished result by a research group (for study protocol, see Goodenough et al, 2012) reportedly showing a 20% decrease in agitation in patients with dementia. Happiness and positive behaviors rose but only for the duration of the program.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a standardized humor group in a clinical setting: a feasibility study for older patients with depression

Konradt

Hirsch

Jonitz

et al. 2012

Int J Geriat Psychiatry

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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)

Abstract: SMILE is the first large rigorous study of humor therapy in aged care.

Cited by 25 publications

References 30 publications

The Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) study: cluster randomised trial of humour therapy in nursing homes

The Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) study: cluster randomised trial of humour therapy in nursing homes

Humor Assessment and Interventions in Palliative Care: A Systematic Review

Evaluation of a standardized humor group in a clinical setting: a feasibility study for older patients with depression

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