26. You must be joking
Matter for discussion submitted by the RCN Greater Glasgow and Clyde Branch
That this meeting of RCN Congress discusses humour in health, health care and nursing
Report on this debate
May MCreaddie introduced this light-hearted debate with a serious note at the close of Congress 2008.
May referred to research that reveals humour has a positive effect on individuals. However, she cautioned, nurses have a responsibility to respond to humour appropriately and to consider the entire circumstances of the individual.
Other speakers referred to their own experiences of the benefits of humour on the wellbeing of their patients. There were some cautionary tales, however, as some delegates told of misunderstandings arising as a result of inappropriate humour.
All delegates who spoke managed to inject their very own brand of humour which Congress greatly appreciated. Andrew Parker’s fine display of millinery and Bethann Siviter’s tales of transatlantic misinterpretations were especially applauded!
Background
Humour and health research has focussed on investigating the hypothesis that humour may directly or indirectly confer positive health benefits.
Authors of a recent academic review of the purpose and function of humour in health, health care and nursing, identify that nursing has not taken the issue of humour seriously in a way that could potentially improve nurse-patient interactions (McCreaddie and Wiggins, 2008). The authors conducted a review to analyse the academic literature related to humour, nursing and health care. They identify that humour is not about telling a joke, but a contextually-related, complex debate about who we are and how we interact with others. The review concluded that nurses should be underpinning their interactions with an appropriate evidence base.
Direct psychological links between humour and health have focussed predominantly on pain, cardiovascular effects and immunity. Indirect effects have focussed on humour in the role of moderating stress and supporting interpersonal relationships. Whilst McCreaddie and Wiggins concluded that current research does not support the humour/health hypothesis directly, they identified that there can be an indirect impact through interpersonal interactions and support for clients. Nurses, as a result of their ‘real world’ experience of working with both sick and healthy populations, are able to contribute effectively to the expanding body of knowledge of humour research.
Ann Snowden (2003) reviewed the published literature on humour and health promotion across a wide range of disciplines including anthropology, communications, medicine, physiology and psychology. She concluded that, whilst the health-related benefits of humour were becoming popular, with many health care journals reporting health benefits, there was a lack of empirical evidence on when humour supported health benefits and when it did not. These findings were supported by the review of evidence conducted by McCreaddie and Wiggins in 2008.
The American Association of Therapeutic Humour (AATH) includes nurses, neuro-immunologists, cognitive psychologists within its membership, and supports laughter therapy and similar therapeutic interventions to improve client outcomes.
Martin Seligman, a past President of the American Psychological Association and proponent of the positive psychology movement, identified 24 positive values and attributes relating to health, of which humour is one (Seligman et al, 2005). Others have asked if this is entirely appropriate as humour can also be a negative influence.
There are several academic journals available relating to this subject, for example Humor – International Journal of Humor Research, and these indicate a major interest by the nursing profession in investigating interventions related to humour and health.
References and further reading
McCreaddie M and Wiggins S (2008) The purpose and function of humour in health, health care and nursing: a narrative review, Journal of Advanced Nursing, 61 (6), pp. 584-595.
Seligman M E P, Steen T A, Park, N, Peterson C (2005) Positive psychology progress: empirical validation of interventions, American Psychologist, 60 (5), pp. 410-421.
Snowden A (2003) Humour and health promotion, Health Education Journal, 62 (2), pp. 143-152. Available from http://hej.sagepub.com/cgi/content/abstract/62/2/143
Scottish Government (2007) Towards a mentally flourishing Scotland: the future of mental health improvement in Scotland 2008-2011, Edinburgh: Scottish Government (DG Health and Wellbeing). Available from: www.scotland.gov.uk/Resource/Doc/201215/0053753.pdf.
(Accessed 31 January 2008) (Internet).