1
|
Cosi A, Tieri M, Lombardi L, Ciaravino C, D Ercole S, Tripodi D. Clowntherapy in paediatric dentistry: The psychological approach to the paediatric patient. Eur J Paediatr Dent 2022; 23:242-248. [PMID: 36172903 DOI: 10.23804/ejpd.2022.23.03.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
AIM Anxiety towards dental treatments and visits in children are often cause for the avoidance and/or failure of the treatment itself, as well as a reason for stress in both the patient and the orthodontist. The aim of the research is to understand if the use of clown therapy in dental waiting rooms is efficient in bringing down the level of preoperative anxiety in paediatric dental patients. METHODS Two psychometric tests were used: CFSS-DS (Dental Subscale of the Children's Fear Survey Schedule) and FIS (Facial Image Scale), after the translation of the original versions, to both the patients and their parents. The CFSS-DS is the most used instrument in order to assess dental fear in children, it is composed by 15 questions that outline situations which children and adolescents will have to face while on the dental chair. The FIS is a visual analogical scale that uses faces as indicators of anxiety. CONCLUSION Clowntherapy proves to be an efficient non-pharmacological method to reduce anxiety and dental fear in paediatric patients, offeringa valid and practical support for paediatric dentists.
Collapse
Affiliation(s)
- A Cosi
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - M Tieri
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - L Lombardi
- Department of Psychological, Health, and Territorial Sciences
| | - C Ciaravino
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - S D Ercole
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - D Tripodi
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| |
Collapse
|
2
|
Lopes-Júnior LC, Bomfim E, Olson K, Neves ET, Silveira DSC, Nunes MDR, Nascimento LC, Pereira-da-Silva G, Lima RAG. Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials. BMJ 2020; 371:m4290. [PMID: 33328164 PMCID: PMC7737653 DOI: 10.1136/bmj.m4290] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate evidence from randomised controlled trials and non-randomised controlled trials on the effectiveness of hospital clowns for a range of symptom clusters in children and adolescents admitted to hospital with acute and chronic conditions. DESIGN Systematic review of randomised and non-randomised controlled trials. DATA SOURCES Medline, ISI of Knowledge, Cochrane Central Register of Controlled Trials, Science Direct, Scopus, American Psychological Association PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences Literature. STUDY SELECTION Randomised and non-randomised controlled trials were peer reviewed using the following eligibility criteria: children and adolescents who were admitted to hospital for acute conditions or chronic disorders, studies comparing use of hospital clowns with standard care, and studies evaluating the effect of hospital clowns on symptom management of inpatient children and adolescents as a primary outcome. DATA EXTRACTION AND SYNTHESIS Two investigators independently screened studies, extracted data, and appraised the risk of bias. Methodological appraisal was assessed by two investigators independently using the Jadad scale, the revised Cochrane risk-of-bias tool for randomised controlled trials (RoB 2), and the risk of bias in non-randomised studies (ROBINS-I) tool for non-randomised controlled trials. RESULTS 24 studies (n=1612) met the inclusion criteria for data extraction and analysis. Most studies were randomised controlled trials (n=13). Anxiety was the most frequently analysed symptom (n=13), followed by pain (n=9), psychological and emotional responses and perceived wellbeing (n=4), stress (n=4), cancer related fatigue (n=3), and crying (n=2). Five studies used biomarkers, mainly cortisol, to assess stress or fatigue outcome following hospital clowns. Most of the randomised controlled trials (n=11; 85%) were rated as showing some concerns, and two trials were rated with a high risk of bias. Most non-randomised controlled trials (n=6; 55%) were rated with a moderate risk of bias according to ROBINS-I tool. Studies showed that children and adolescents who were in the presence of hospital clowns, either with or without a parent present, reported significantly less anxiety during a range of medical procedures, as well as improved psychological adjustment (P<0.05). Three studies that evaluated chronic conditions showed favourable results for the intervention of hospital clowns with significant reduction in stress, fatigue, pain, and distress (P<0.05). CONCLUSIONS These findings suggest that the presence of hospital clowns during medical procedures, induction of anaesthesia in the preoperative room, and as part of routine care for chronic conditions might be a beneficial strategy to manage some symptom clusters. Furthermore, hospital clowns might help improve psychological wellbeing in admitted children and adolescents with acute and chronic disorders, compared with those who received only standard care. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018107099.
Collapse
Affiliation(s)
- Luís Carlos Lopes-Júnior
- Federal University of Espírito Santo, Avenida Marechal Campus, 1468 Maruípe, Vitória, 29.043-900, ES, Brazil
| | - Emiliana Bomfim
- University of Saskatchewan, College of Medicine, Saskatoon, SK, Canada
| | | | | | | | | | | | | | | |
Collapse
|
3
|
Siddiqui SA, Singh MV. Therapeutic Clowning in Pediatric Practice: A Novel Concept to Think About in India. Indian Pediatr 2020. [PMID: 32893831 PMCID: PMC7605477 DOI: 10.1007/s13312-020-2015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Shahid Akhtar Siddiqui
- Department of Pediatrics, SN Children Hospital, MLN Medical College, Allahabad, Uttar Pradesh, India.
| | - Mukesh Vir Singh
- Department of Pediatrics, SN Children Hospital, MLN Medical College, Allahabad, Uttar Pradesh, India
| |
Collapse
|
4
|
Samant R, Balchin K, Cisa-Paré E, Renaud J, Bunch L, McNeil A, Murray S, Meng J. The importance of humour in oncology: a survey of patients undergoing radiotherapy. Curr Oncol 2020; 27:e350-e353. [PMID: 32905157 PMCID: PMC7467787 DOI: 10.3747/co.27.5875] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Humour has long been considered an important coping tool for patients with cancer, but published quantitative data about its significance are limited. The purpose of our study was to survey patients with cancer undergoing radiotherapy regarding their opinions about the use of humour in their care. Methods An anonymous 35-item questionnaire evaluating the patient experience, including the value of humour, was developed by an interdisciplinary team of health care providers (hcps) working within the Radiation Medicine program. This anonymous, voluntary, paper-based survey for self-completion required approximately 10 minutes to finish and was administered during the fall of 2018 and the spring of 2019. Results For the 199 patients who completed the survey [108 women, 89 men (2 respondents did not specify)], median age was 68 years. That group represents approximately 30%-35% of the patients on treatment during the study period. Almost all respondents (86%) indicated that, during their visits to the cancer centre, it was "somewhat important" or "very important" for health care providers (hcps) to use appropriate humour, and 61% of respondents indicated using humour "frequently" or "always" when dealing with their individual cancers. Most respondents (79%) said that humour decreased anxiety, and 86% indicated that laughing was considered "somewhat important" or "very important." Approximately 4% of respondents even listed "sense of humour" as being the most important quality that they looked for in their interactions with their hcps. Conclusions Cancer patients undergoing radiotherapy clearly view humour as being important for coping and dealing with their disease, and oncology hcps should routinely consider incorporating the use of appropriate humour into the care that they provide.
Collapse
Affiliation(s)
- R Samant
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - K Balchin
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - E Cisa-Paré
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - J Renaud
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - L Bunch
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - A McNeil
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - S Murray
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - J Meng
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| |
Collapse
|
5
|
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. Int J Environ Res 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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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.
| |
Collapse
|
6
|
Bressington D, Yu C, Wong W, Ng TC, Chien WT. The effects of group-based Laughter Yoga interventions on mental health in adults: A systematic review. J Psychiatr Ment Health Nurs 2018; 25:517-527. [PMID: 30030938 DOI: 10.1111/jpm.12491] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/03/2018] [Accepted: 07/19/2018] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Laughter yoga is claimed to promote mental health and has become increasingly popular worldwide. There has been no systematic review of laughter yoga intervention studies and thus evidence of its effects on mental health is unclear. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Laughter Yoga interventions improved depressive symptoms in two studies over the short term. There is a lack of good quality evidence to show that laughter yoga is more effective than other group-based interventions in improving mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Well-conducted and clearly reported trials of laughter yoga are needed before the intervention can be considered as an evidence-based intervention to improve mental health. ABSTRACT Introduction Laughter Yoga is claimed to promote mental health and is increasingly popular worldwide. Despite its popularity, there has been no systematic review of Laughter Yoga intervention studies and thus evidence of its effects on mental health is unclear. Aim This review aimed to critically evaluate the effects of group-based Laughter Yoga on improving mental health in adults. Method We conducted a systematic review of experimental studies (published from 1995 to 2017). Study quality was assessed, the effect sizes for individual mental health outcomes were calculated and all reviewed studies were narratively synthesized. Results Six experimental studies with inconsistent results were included in this review. The most promising effect of Laughter Yoga is the improvement of depressive symptoms, indicating significant medium-large effect sizes in two studies over the short term. The overall level of evidence was weak due to poor study quality and risks of bias. Discussion Laughter Yoga shows potential, but currently there is insufficient evidence to support its effectiveness in improving mental health when compared to other group-based interventions. Implications for practice This review highlights the need to conduct rigorous trials of laughter yoga before the intervention can be considered as an evidence-based intervention to improve mental health.
Collapse
Affiliation(s)
- Daniel Bressington
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Clare Yu
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wandy Wong
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Tsz C Ng
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wai Tong Chien
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR
| |
Collapse
|
7
|
Meiri N, Ankri A, Ziadan F, Nahmias I, Konopnicki M, Schnapp Z, Itzhak Sagi O, Hamad Saied M, Pillar G. Assistance of Medical Clowns Improves the Physical Examinations of Children Aged 2-6 Years. Isr Med Assoc J 2017; 19:786-791. [PMID: 29235739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND A good physical exam is necessary to help pediatricians make the correct diagnosis and can save unnecessary imaging or invasive procedures. Distraction by medical clowns may create the optimal conditions for a proper physical examination. METHODS Children aged 2-6 years who required physical examination in the pediatric emergency department were recruited and randomly assigned to one of two groups: physical exam by a pediatrician in the presence of caregivers vs. physical exam with the assistance of a medical clown. Outcome measures consisted of the level of child's discomfort, anxiety, and the quality of the physical examination. RESULTS Ninety three children participated. Mean age was 3.3 ± 3.6 years (range 2-6). The duration of the physical exam was similar between the clown and control groups (4.6 ± 1.4 minutes vs. 4.5 ± 1.1 minutes (P = 0.64). The duration of discomfort was shorter in the clown group (0.2 ± 0.6 minutes) than the control group(1.6 ± 2.0 minutes, P = 0.001). In the medical clown group, 94% of pediatricians reported that the medical clown improved their ability to perform a complete physical examination. A trend of less hospitalization in the medical clown group was also noticed (11.3% in the medical clown group vs. 18.3% in the control group, P = 0.1); however, further study is required to verify this observation. CONCLUSIONS Integration of a medical clown in physical examination improves the overall experience of the child and the caregivers and helps the pediatrician to perform a complete physical examination.
Collapse
Affiliation(s)
- Noam Meiri
- Department of Pediatric Emergency Medicine, Carmel Medical Center, Haifa, associated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Amichi Ankri
- Department of Pediatric Emergency Medicine, Carmel Medical Center, Haifa, associated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Faten Ziadan
- Department of Pediatric Emergency Medicine, Carmel Medical Center, Haifa, associated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Itay Nahmias
- Department of Pediatric Emergency Medicine, Carmel Medical Center, Haifa, associated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Muriel Konopnicki
- Department of Pediatric Emergency Medicine, Carmel Medical Center, Haifa, associated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Zeev Schnapp
- Department of Pediatric Emergency Medicine, Carmel Medical Center, Haifa, associated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Omer Itzhak Sagi
- Department of Pediatric Emergency Medicine, Carmel Medical Center, Haifa, associated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Mohamad Hamad Saied
- Department of Pediatric Emergency Medicine, Carmel Medical Center, Haifa, associated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Giora Pillar
- Department of Pediatric Emergency Medicine, Carmel Medical Center, Haifa, associated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
8
|
Ben-Pazi H, Cohen A, Kroyzer N, Lotem- Ophir R, Shvili Y, Winter G, Deutsch L, Pollak Y. Clown-care reduces pain in children with cerebral palsy undergoing recurrent botulinum toxin injections- A quasi-randomized controlled crossover study. PLoS One 2017; 12:e0175028. [PMID: 28414728 PMCID: PMC5393564 DOI: 10.1371/journal.pone.0175028] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 03/19/2017] [Indexed: 12/04/2022] Open
Abstract
Objective We investigated the impact of clown-care on pain in 45 children with cerebral palsy who underwent recurrent Botulinum-toxin injections (age 7.04± 4.68 years). Participants were randomized to receive either clown (n = 20) or standard (n = 25) -care. Methods Pain Visual-Analogue-Scale (range 1–5) was reported before and after procedures. Pain assessment was lower for children undergoing Botulinum-toxin injections with clown-care (2.89± 1.36) compared to standard-care (3.85± 1.39; p = 0.036) even though pain anticipated prior to procedures was similar (~3). Findings Children who underwent the first procedure with clown-care reported lower pain even after they crossed-over to the following procedure which was standard (p = 0.048). Carryover effect was more prominent in injection-naïve children (p = 0.019) and during multiple procedures (p = 0.009). Prior pain experience correlated with pain in subsequent procedures only when first experience was standard-care (p = 0.001). Conclusions Clown-care alleviated pain sensation during Botulinum-toxin injections and initial clown-care experience reduced pain during subsequent injections even though clowns were not present. Trial registration clinicaltrials.gov ID # NCT01377883.
Collapse
Affiliation(s)
- Hilla Ben-Pazi
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
- * E-mail:
| | - Avraham Cohen
- Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Naama Kroyzer
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | | | - Yaakov Shvili
- Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Gidon Winter
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Lisa Deutsch
- Biostatistical Consulting (L.D), BioStats, Modien, Israel
| | - Yehuda Pollak
- School of Education, The Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
9
|
Sánchez JC, Echeverri LF, Londoño MJ, Ochoa SA, Quiroz AF, Romero CR, Ruiz JO. Effects of a Humor Therapy Program on Stress Levels in Pediatric Inpatients. Hosp Pediatr 2017; 7:46-53. [PMID: 27908974 DOI: 10.1542/hpeds.2016-0128] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Disease and hospitalization generate stress, which can affect the response to treatment. Humor has been used in many hospitals to decrease stress. The aim of this study was to evaluate the impact of a humor therapy program on stress levels in pediatric inpatients. METHODS In the first phase, an intervention and a control group were studied over 2 consecutive 3-month periods; the interventions were performed by a team of artists trained in humor therapy. Salivary cortisol levels were measured by enzyme-linked immunosorbent assay, and the Weisz test, a pictorial chart that determines subjective stress perception, and the Parker test, which assesses objective stress, were applied. In the second phase, salivary cortisol levels were measured and the Weisz test was administered before and after the interventions. RESULTS A total of 306 patients were recruited into this study: 198 in the first phase (94 in the intervention group and 104 in the nonintervention group) and 108 in the second phase. There were no differences between groups regarding age, sex, or medical diagnosis. The children in the intervention group presented lower cortisol levels, lower scores on the Parker test, and higher scores on the Weisz test than children in the nonintervention group. In the second phase, the children showed lower salivary cortisol levels and higher scores on the Weisz test after the intervention. CONCLUSIONS Humor therapy has beneficial effects on stress and cortisol levels in pediatric inpatients. This supports the implementation and reinforcement of these therapies in pediatric hospitals.
Collapse
Affiliation(s)
- Julio C Sánchez
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Luis F Echeverri
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Manuel J Londoño
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Sergio A Ochoa
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Andrés F Quiroz
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - César R Romero
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Joaquín O Ruiz
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia
| |
Collapse
|
10
|
Rimon A, Shalom S, Wolyniez I, Gruber A, Schachter-Davidov A, Glatstein M. Medical Clowns and Cortisol levels in Children Undergoing Venipuncture in the Emergency Department: A Pilot Study. Isr Med Assoc J 2016; 18:680-683. [PMID: 28466619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Medical clowns are increasingly used for diminishing pain and anxiety during painful procedures being performed on children in the hospital setting. Cortisol levels rise as a response to emotional distress. OBJECTIVES To investigate whether medical clown-assisted interventions to reduce child's distress during venipuncture have an effect on cortisol levels. METHODS During a 1 year period, children requiring blood work or intravenous access in the pediatric emergency department were prospectively randomized to either the presence or absence of a medical clown during the procedure. The child's distress was evaluated using the Faces Pain Scale - revised (FPS-R) for the 4-7 year age group and the visual analog scales (VAS) for those aged 8-15 years. Serum cortisol levels were measured in blood samples obtained by venipuncture. RESULTS Fifty-three children aged 2-15 years were randomly assigned to the study group (with medical clown, n=29) or to the control group (without medical clown, n=24). Combined pain scores of the study group and control group were 2.2 and 7.5 respectively (P < 0.001). No difference in mean cortisol levels was found between the study group and the control group at all ages (16.4 µg/dl vs. 18.3 µg/dl, P = 0.65). CONCLUSIONS In this pilot study, medical clowns reduced the distress from venipuncture in children. No effect on cortisol levels was observed.
Collapse
Affiliation(s)
- Ayelet Rimon
- Pediatric Emergency Medicine, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shelly Shalom
- Pediatric Emergency Medicine, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ido Wolyniez
- Pediatric Emergency Medicine, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Anita Schachter-Davidov
- Pediatric Endocrinology Service, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Miguel Glatstein
- Pediatric Emergency Medicine, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
11
|
Tener D, Ofir S, Lev-Wiesel R, Franco NL, On A. Seriously clowning: Medical clowning interaction with children undergoing invasive examinations in hospitals. Soc Work Health Care 2016; 55:296-313. [PMID: 27123686 DOI: 10.1080/00981389.2016.1141826] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This qualitative study examined the subjective experience of children undergoing an invasive examination in the hospital when accompanied by a medical clown. In-depth semi-structured interviews were conducted with nine such children and nine of their accompanying parents. The children were patients in two outpatient departments (Pediatric Gastroenterology and a Center for the Sexually Abused) in a hospital in Israel. Interviews were coded thematically using an Atlas.ti software program. Analysis of the interviews indicated that the intervention of the clown positively changed the children's perceptions of the hospital, of experiencing the examination, and of their life narrative. Medical clowns thus appear to be a central, meaningful, and therapeutic source for children undergoing invasive examinations in hospital, as well as for their parents. Therefore, it may be advisable to incorporate medical clowns as an integral part of medical teams performing invasive procedures and to include the clowns in all stages of the hospital visit.
Collapse
Affiliation(s)
- Dafna Tener
- a The Paul Baerwald School of Social Work and Social Welfare , The Hebrew University of Jerusalem , Jerusalem , Israel
| | - Shoshi Ofir
- b The Baruch Padeh Medical Center , Poriya , Israel
| | - Rachel Lev-Wiesel
- c The Emili Sagol Creative Arts Therapies Research Center , University of Haifa , Haifa , Israel
| | | | - Avi On
- e Pediatric GI Unit , Baruch Padeh Medical Center, The Faculty of Medicine in the Galilee, Bar-Ilan University , Safed , Israel
| |
Collapse
|
12
|
Chuchuen U, Pampiansil P, Busarakumtragul P. Effects of Laughing Training on Stress Levels in Thai Private Office Workers. J Med Assoc Thai 2015; 98 Suppl 9:S130-S134. [PMID: 26817221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Laughing is a kind of well known alternative medicine used to treat stressful persons or depressive patients to relax. The laughing program used in this study was initially designed by Thai psychiatrists. It consists of deep diaphragmatic breathing exercises, voice expression, facial expression exercises and aerobic exercises, which are expected to promote good health. OBJECTIVE To evaluate the effects of the laughing training on stress levels in Thai private office workers. MATERIAL AND METHOD Thirty-eight subjects whose age 25-60 years were recruited to enroll in this program. They were randomly divided into two groups: 20 people for the experimental group and 18 persons for the control group. The experimental subjects participated in laughing program for 3 days/week, 60 minutes/day for 8 consecutive weeks. The program took place from June to July 2013. The level of stress was assessed using the Suanprung stress test-60 (SPST-60). The data were analyzed by descriptive statistics, t-test dependent and t-test independent with p < 0.05 considered significant. RESULTS After they joined the laughing program, no significant difference was found in the mean scores of the level of stress between the control and experimental groups. However, the sensitivities to the arousal events in the experimental group had a tendency to decrease. CONCLUSION Laughing training may be used as a tool to promote better health. There was no significant difference in the stress levels after the program was ended except a decrement tendency in the sensitivities to the arousal events. For further study, duration and intensity of the course may be adjusted for a more effective training program.
Collapse
|
13
|
Füeßl HS. [Laughter is the best medicine - but it has its risks!]. MMW Fortschr Med 2015; 157:34. [PMID: 26049344 DOI: 10.1007/s15006-015-3212-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
14
|
Weiß J. [Thinking outside the box -- simply laugh: the World Laughter Day]. Z Gastroenterol 2015; 53:376. [PMID: 26167553 DOI: 10.1055/s-0034-1397741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
15
|
Barkmann C, Siem AK, Wessolowski N, Schulte-Markwort M. Clowning as a supportive measure in paediatrics - a survey of clowns, parents and nursing staff. BMC Pediatr 2013; 13:166. [PMID: 24112744 PMCID: PMC3851858 DOI: 10.1186/1471-2431-13-166] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 09/30/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Hospital clowns, also known as clown doctors, can help paediatric patients with the stress of a hospitalization and to circumvent the accompanying feelings of fear, helplessness and sadness, thus supporting the healing process. The objectives of the present study were to clarify the structural and procedural conditions of paediatric clowning in Germany and to document the evaluations of hospital clowns, parents and hospital staff. METHODS A nationwide online survey of hospital clowns currently active in paediatric departments and an accompanying field evaluation in Hamburg hospitals with surveys of parents and hospital staff were conducted. In addition to items developed specifically for the study regarding general conditions, procedures, assessments of effects and attitudes, the Work Satisfaction Scale was used. The sample included n = 87 hospital clowns, 37 parents and 43 hospital staff members. RESULTS The online survey showed that the hospital clowns are well-trained, motivated and generally satisfied with their work. By their own estimate, they primarily boost morale and promote imagination in the patients. However, hospital clowns also desire better interdisciplinary collaboration and financial security as well as more recognition of their work. The Hamburg field study confirmed the positive results of the clown survey. According to the data, a clown intervention boosts morale and reduces stress in the patients. Moreover, there are practically no side effects. Both parents and hospital staff stated that the patients as well as they themselves benefited from the intervention. CONCLUSIONS The results match those of previous studies and give a very positive picture of hospital clowning, so that its routine use and expansion thereof can be recommended. Furthermore, the intervention should be subject to the rules of evidence-based medicine like other medical treatments.
Collapse
Affiliation(s)
- Claus Barkmann
- Forschungsgruppe Epidemiologie und Evaluation, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik (W29), Universitätsklinikum Hamburg-Eppendorf Martinistraße 52, Hamburg, D-20246, Germany.
| | | | | | | |
Collapse
|
16
|
Chang C, Tsai G, Hsieh CJ. Psychological, immunological and physiological effects of a Laughing Qigong Program (LQP) on adolescents. Complement Ther Med 2013; 21:660-8. [PMID: 24280475 DOI: 10.1016/j.ctim.2013.09.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 06/12/2013] [Accepted: 09/03/2013] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES One objective of this study was to assess the effects of laughter on the psychological, immunological and physiological systems of the body. Another objective was to introduce the Laughing Qigong Program (LQP), as a method of standardization for simulated laughter interventions. DESIGN A randomized, prospective, experimental study of the LQP was conducted in a group of adolescents (n=67) in Taiwan. During study-hall sessions, experimental subjects (n=34) attended the LQP for eight-weeks. Simultaneously, control subjects (n=33) read or did their homework. All subjects were tested before and after the intervention on the following: Rosenberg Self-Esteem scale (RSE), Chinese Humor Scale (CHS) and Face Scale (FS) as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR), and heart rate variability (HRV) as physiological markers of the body's response to stress. Mood states (FS) were measured before/after each LQP session. RESULTS Mood states (p=.00) and humor (p=.004; p=.003) improved in the experimental group; no significant changes were found in the controls (p=69; p=60). The immunological marker of stress, cortisol levels, decreased significantly for those who participated in the LQP (p=.001), suggesting lower levels of stress after completion of the program. CONCLUSIONS The LQP is a non-pharmacological and cost-effective means to help adolescents mitigate stresses in their everyday life.
Collapse
Affiliation(s)
- Chueh Chang
- National Taiwan University, Institute of Health Policy and Management, Taiwan.
| | | | | |
Collapse
|
17
|
Parnowska D, Braniecka A, Radomska A. [Sense of humour in schizophrenia--ability of humour reception and possibilities of its application in therapeutic interventions]. Psychiatr Pol 2013; 47:945-956. [PMID: 25011239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The existing research on sense of humour in schizophrenia is focused on two main areas, mainly, assessment of patients' abilities to understand and appreciate humour and denoting the possibilities of its application in therapeutic programs concentrating on the improvement of patients' functionality and preventing illness relapses. The vast majority of the conclusions from the above mentioned research corroborate the opinion on the usefulness of developing and reinforcing sense of humour in schizophrenia, emphasizing its beneficial effect on the patients' quality of life, above all, in terms of reducing aggression, anxiety and depression as well as improving general life satisfaction and social functioning. At the same time numerous research indicate low reception of humour in schizophrenia which can negatively influence its effective usage in therapeutic interventions. Further constraint with regard to the therapy can constitute an intensified fear for being laughed at, which has been confirmed in numerous empirical reports. Therefore, it seems that addressing humorous therapeutic interventions to the above mentioned group of patients requires especially careful planning taking into consideration its cognitive and affective limitations in the perception of humour and intensified fear for being laughed at.
Collapse
|
18
|
Takayanagi K, Shimura T, Iwabuchi K, Fujiwara H, Ohnishi J, Ishii K, Murakami K. Laughter education for implementation of the smile-sun method to promote natural healing in public and healthcare facilities. Jpn Hosp 2012:57-61. [PMID: 22988739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
19
|
Abstract
Humour research in healthcare has tended to focus on rehearsed as opposed to spontaneous humour. This paper reports an empirical example of spontaneous humour in healthcare interactions: a negative case analysis from a constructivist grounded theory study. Twenty Clinical Nurse Specialist (CNS)-patient interactions and CNS pre- and postinteraction audio diaries provided the baseline data corpus. Follow-up interviews, field notes, focus groups and observations serviced theory generation with a constant comparison approach to data collection and analyses. Interpretative and illustrative frameworks incorporating humour theories, non-laughter humour support, discursive features and prosodical features of speech were applied to all data. This paper is based upon the negative case comprising a 90-minute follow-up interview and 10 hours of field note observations. The negative case - a CNS working with female drug users' sexual and reproductive health needs - contradicted emerging findings from the baseline data corpus. First, the negative case had greater awareness of humour, deliberately initiated humour and recognised parameters and exclusion zones. Second, a good patient personal was evident in the baseline data corpus but the negative case worked with 'bad' patients. Accordingly, a specific type of humour - harsh humour - was evident in the negative case. Harsh humour used areas of potential discord (e.g. drug use) as a focus of humour creation and maintenance. The deliberate initiation of harsh humour enabled the negative case and her colleagues to achieve their aims by engaging effectively with unpredictable, reluctant and recalcitrant patients. The negative case demonstrates how humour can be used to therapeutically enhance healthcare interactions with disenfranchised individuals. Humour is not superficial but integral to the accomplishment of key aspects of interactions. Health and social care workers should consider the potential for therapeutic humour to engage and maintain all patients - disenfranchised or otherwise - in healthcare interactions.
Collapse
Affiliation(s)
- May McCreaddie
- Nursing and Midwifery, University of Stirling, Stirling, UK.
| |
Collapse
|
20
|
Abstract
BACKGROUND Positive effects of humor on older patients with depressive symptoms have been repeatedly reported. Empirical evidence, however, is rare. We investigated the effects of a standardized humor therapy group in a clinical context especially for older depressed patients. PATIENTS AND METHODS For this purpose, an experimental group with treatment (52 patients participating in the humor group) was compared to a control group with no specific treatment (38 patients); all 90 participants had clinical depressive symptoms according to ICD-10 classification. Questionnaires (among them GDS, SF-12, State-Trait Cheerfulness Inventory, Satisfaction with Life Scale) were administered at two time points (pre- and post-treatment). RESULTS From pre- to post-measurement, significant improvements could be shown only in the experimental group for resilience and satisfaction with life (p<0.05). Analyses of the subgroups with at least medium to severe depression showed further significant effects for cheerfulness, seriousness, bad mood, and satisfaction with life (p<0.05). These severely affected patients seemed to profit best from humor therapy. CONCLUSION Our results indicate the efficacy of this specific therapeutic intervention for older depressed patients.
Collapse
Affiliation(s)
- R D Hirsch
- Abteilung für Gerontopsychiatrie und -psychotherapie, LVR-Klinik Bonn, Kaiser-Karl-Ring 20, 53111, Bonn, Deutschland.
| | | | | | | |
Collapse
|
21
|
Strean WB. Laughter prescription. Can Fam Physician 2009; 55:965-967. [PMID: 19826144 PMCID: PMC2762283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- William B Strean
- University of Alberta, Physical Education and Recreation, P-408 VVC, Edmonton, AB T6R 1L5.
| |
Collapse
|
22
|
Vinit F. [The therapeutic clown in the pediatric milieu]. Perspect Infirm 2007; 4:30-33. [PMID: 18323268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
|
23
|
Tan SA, Tan LG, Lukman ST, Berk LS. Humor, as an adjunct therapy in cardiac rehabilitation, attenuates catecholamines and myocardial infarction recurrence. Adv Mind Body Med 2007; 22:8-12. [PMID: 20664127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Catecholamines, especially epinephrine, are implicated in causing arrhythmias, hypertension, and recurrence of myocardial infarction (MI). Diminishing or blocking the effect of catecholamines is useful in cardiac rehabilitation. We have shown previously that a single 1-hour viewing of a humorous video attenuates epinephrine production. DESIGN We hypothesized that daily participation in viewing humor would diminish catecholamine production and improve cardiac rehabilitation. METHODS Forty-eight diabetic patients who had recently experienced an MI were divided into 2 matched groups and followed for 1 year in their cardiac rehabilitation programs. The experimental humor group was asked to view self-selected humor for 30 minutes daily as an adjunct to the standard cardiac therapy. Blood pressure, urinary and plasma epinephrine and norepinephrine levels, and 24-hour Holter recording were monitored monthly in both experimental humor and control groups. RESULTS The patients in the humor group had fewer episodes of arrhythmias, lower blood pressure, lower urinary and plasma epinephrine and norepinephrine levels, less use of nitroglycerin for angina, and a markedly lower incidence of recurrent MI (2/24) than did the control group (10/24). CONCLUSION Humor appears to attenuate catecholamines and MI recurrence and thus may be an effective adjunct in post-MI care.
Collapse
Affiliation(s)
- Stanley A Tan
- Section of Endocrinology, Loma Linda University, Loma Linda, California, USA
| | | | | | | |
Collapse
|
24
|
Walter M, Hänni B, Haug M, Amrhein I, Krebs-Roubicek E, Müller-Spahn F, Savaskan E. Humour therapy in patients with late-life depression or Alzheimer's disease: a pilot study. Int J Geriatr Psychiatry 2007; 22:77-83. [PMID: 16977676 DOI: 10.1002/gps.1658] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Of the disabling disorders of the elderly, depression is the most common affective disorder and Alzheimer's disease (AD) the most common neurodegenerative disorder. Pharmacological treatment strategies for these disorders are often accompanied with severe side effects. Therefore non-pharmacological treatment strategies are of great importance. The aim of the present study was to investigate the impact of humour therapy on quality of life in patients with depression or AD. METHODS Twenty patients with late-life depression and 20 patients with AD were evaluated. Ten patients in each group underwent a humour therapy group (HT) once in two weeks for 60 min in addition to standard pharmacotherapy, which was given as usual to the other group as standard therapy (ST). All patients completed a psychometric test battery at admission and before discharge from the clinic. RESULTS The quality of life scores improved both in HT and ST groups for depressive patients but not for patients with AD irrespective of the therapy group. Depressive patients receiving HT showed the highest quality of life after treatment. In addition, patients with depression in both therapy groups showed improvements in mood, depression score, and instrumental activities of daily living. CONCLUSIONS Although there was no significant effect of humour therapy comparing with standard therapy on quality of life, these findings suggest that humour therapy can provide an additional therapeutic tool. Further studies with higher frequently humour groups are required in order to investigate the impact of humour therapy in gerontopsychiatric treatment.
Collapse
Affiliation(s)
- Marc Walter
- Psychiatric University Clinics, University of Basel, Basel, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
25
|
McCathie M. Spread a lot of happiness. Interview by Maggie Elliot. Ment Health Today 2006:12-3. [PMID: 16821384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
|
26
|
Lindqvist K. Why clown-doctors are needed in paediatric wards. EDTNA ERCA J 2006; 32:117. [PMID: 16898106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
|
27
|
Rhodes B. Send in the clowns. Nurs Manag (Harrow) 2005; 12:13. [PMID: 16252711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
|
28
|
Abstract
Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH) founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient and support to caregivers and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. The diagnosis of cancer is incredibly stressful, and treatments are arduous. Humor may help to ease the pain, show the human side of the health care team, and help everyone cope. Whether the patient uses humor to lighten the mood of a difficult consultation with their physician, or health care workers use it to help cheer each other through the day, humor and laughter can be valuable tools. Humor can soften the isolation experienced by both patients and staff. When used sensitively, respecting the gravity of the situation, humor can build the connection among the caregiver, patient, and family. However, insensitive joking is offensive and distressing, and experience suggests a variable acceptance of humor by patients with life-threatening illnesses, making humor a high-risk strategy, and it can be a pejorative maker of an adversive power differential. The medical literature contains little on humor, and very little research has been conducted on this common aspect of human communication. Through an examination of physician and nurse experiences, the role of humor in medicine is reviewed.
Collapse
Affiliation(s)
- Richard T Penson
- Department of Medicine, Division of Hematology-Oncology, Massachusetts General Hospital, 02114-2617, USA.
| | | | | | | | | | | | | |
Collapse
|
29
|
Abstract
Using the Stetler model, in-depth literature reviews were performed that demonstrated a positive correlation between humor and comfort levels in patients with cancer. Humor frequently was used for relaxation and as a coping mechanism that aided in promoting general wellness. The literature indicated that various types of humorous material lessened anxiety and discomfort, which allowed for patients' concerns and fears to be discussed openly. The literature also showed that humor had a positive effect on the immune system. Improvements in pain thresholds and elevations in natural killer cell activity consistently appeared in quantitative experimental studies. In addition, measurements of specific neuroendocrine and stress hormone levels revealed biochemical changes that suggested improved physical stress responses and increased feelings of well-being after humorous interventions. This article has implications for nurses because humor can be an effective intervention that impacts the health and well-being of patients with cancer.
Collapse
|
30
|
Gibson L. The gift of laughter. Urol Nurs 2004; 24:527. [PMID: 15658743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Leslie Gibson
- Physicians and Hospitals, Hospice of Florida Suncoast, FL, USA
| |
Collapse
|
31
|
Gibson L. The geriatric gigglers. Urol Nurs 2004; 24:355-6. [PMID: 15446384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Leslie Gibson
- Physicians and Hospitals, Hospice of Florida Suncoast, USA
| |
Collapse
|
32
|
Minier R. [Try a joyful encounter with yourself and others]. Soins Psychiatr 2004:35. [PMID: 14964889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
|
33
|
Le Moal-Sommaire A. [Mossieu Gaga or the humor in madness]. Soins Psychiatr 2004:23-8. [PMID: 14964885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
|
34
|
Bourdeux C. [Laughter and humor, a serious affair?]. Soins Psychiatr 2004:16-7. [PMID: 14964883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
|
35
|
Chaperot C. [Helpful laughter and psychotherapy]. Soins Psychiatr 2004:18-22. [PMID: 14964884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
|
36
|
Lengacher CA, Bennett MP, Kip KE, Keller R, LaVance MS, Smith LS, Cox CE. Frequency of use of complementary and alternative medicine in women with breast cancer. Oncol Nurs Forum 2002; 29:1445-52. [PMID: 12432415 DOI: 10.1188/02.onf.1445-1452] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To estimate the frequency of use of complementary and alternative medicine (CAM) therapies among women diagnosed with breast cancer and to identify demographic and clinical factors associated with CAM use in these patients. DESIGN A descriptive, cross-sectional survey. SAMPLE A convenience sample of 105 predominantly Caucasian women (mean age = 59 years) with a diagnosis of breast cancer was recruited from the Tampa Bay area and a rural midwestern area. METHODS Utilizing the "Use of Complementary Therapies Survey," frequency of CAM use was calculated for 33 individual therapies listed on the survey and among three survey-defined subscales of CAM therapies (i.e., diet and nutritional supplements, stress-reducing techniques, and traditional and ethnic medicines). MAIN RESEARCH VARIABLES Use of CAM therapies and types of treatment in women with breast cancer. FINDINGS Among diet and nutritional supplements, 64% of all participants reported regular use of vitamins and minerals and 33% regularly used antioxidants, herbs, and health foods. Among stress-reducing techniques, 49% of all participants regularly used prayer and spiritual healing, followed by support groups (37%) and humor or laughter therapy (21%). Traditional and ethnic medicine therapies rarely were used with the exception of massage, which 27% of all participants used at least once after diagnosis. More frequent CAM use was observed among study participants who had undergone previous chemotherapy treatment and those with more than a high school education. Also, being less satisfied with their primary physician was associated with patients' more frequent CAM use. CONCLUSIONS CAM use is increasing among women with breast cancer, and frequency of specific use according to type of CAM is higher than what has been reported in other studies. Use increased in patients who had undergone chemotherapy and in those with a high school education. IMPLICATIONS FOR NURSING Oncology nurses are in a key position to identify what treatments patients are using and implement CAM therapies that can be helpful to relieve patient symptoms related to treatment and psychological distress.
Collapse
|
37
|
Fletcher M. Humour on the job. Can Nurse 2001; 97:16-7. [PMID: 11868214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
|
38
|
Moore DB. Make them laugh. Therapeutic humor for patients with grief-related stress or anxiety. Adv Nurse Pract 2000; 8:34-7. [PMID: 11761520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
|