Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-26T02:50:47.213Z Has data issue: false hasContentIssue false

Humor and laughter in palliative care: An ethnographic investigation

Published online by Cambridge University Press:  04 April 2005

RUTH ANNE KINSMAN DEAN
Affiliation:
Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada
DAVID M. GREGORY
Affiliation:
Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada

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.

Type
Research Article
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Amenta, M.A. (1984). Traits of hospice nurses compared with those who work in traditional settings. Journal of Clinical Psychology, 40, 415420.Google Scholar
American Nurses' Association (1995). Nursing's Social Policy Statement. Washington, D.C.
Apte, M. (1985). Humor and laughter: An anthropological approach. Ithaca, NY: New York University Press.
Astedt-Kurki, P. & Isola, A. (2001). Humour between nurse and patient, and among staff: Analysis of nurses' diaries. Journal of Advanced Nursing, 35, 452458.Google Scholar
Astedt-Kurki, P., Isola, A., Tammentie, T., et al. (2001). Importance of humour to client-nurse relationships and clients' well-being. International Journal of Nursing Practice, 7, 119125.Google Scholar
Astedt-Kurki, P. & Liukkonen, A. (1994). Humour in nursing care. Journal of Advanced Nursing, 20, 183188.Google Scholar
Beck, C.T. (1997). Humor in nursing practice: A phenomenological study. International Journal of Nursing Studies, 34, 346352.Google Scholar
Berger, P.L. (1997). Redeeming laughter: The comic dimension of human experience. New York: Walter De Gruyter.
Burson-Tolphin, A. (1993). A “travesty tonight”: Satiric skits in medicine. Literature and Medicine, 12, 81110.Google Scholar
Chochinov, H.M. (2002). Dignity-conserving care: A new model for palliative care. Journal of the American Medical Association, 287, 22532261.Google Scholar
Coser, R.L. (1959). Some social functions of laughter: A study of humor in a hospital setting. Human Relations, 12, 171182.Google Scholar
Coser, R.L. (1960). Laughter among colleagues. Psychiatry, 23, 8195.Google Scholar
Dunn, B. (1993). Use of therapeutic humour by psychiatric nurses. British Journal of Nursing, 2, 468473.Google Scholar
Emerson, J.P. (1973). Negotiating the serious import of humor. In People in places: The sociology of the familiar, Birenbaum, A. & Sagarin, E. (eds.), pp. 269280. London: Nelson.
Fine, G.A. (1993). The sad demise, mysterious disappearance, and glorious triumph of symbolic interactionism. Annual Review of Sociology, 19, 6187.Google Scholar
Fox, R.C. (1959). Experiment perilous. Glencoe, IL: Free Press.
Gelkopf, M., Kreitler, S., & Sigal, M. (1993). Laughter in a psychiatric ward. Journal of Nervous and Mental Disease, 181, 283289.Google Scholar
Goldberg, D. (1997). Joking in a multi-disciplinary team: Negotiating hierarchy and the allocation ‘cases’. Anthropology & Medicine, 4, 229244.Google Scholar
Griffiths, L. (1998). Humour as resistance to professional dominance in community mental health teams. Sociology of Health and Illness, 20, 874895.Google Scholar
Herth, K. (1990). Contributions of humor as perceived by the terminally ill. American Journal of Hospice Care, 7, 3640.Google Scholar
Herth, K. (1993). Humor and the older adult. Applied Nursing Research, 6, 146153.Google Scholar
Jacobs, B.B. (2001). Respect for human dignity: A central phenomenon to philosophically unite nursing theory and practice through consilience of knowledge. Advances in Nursing Science, 24, 1735.Google Scholar
Kleinman, A. (1992). Local worlds of suffering: An interpersonal focus for ethnographies of illness experience. Qualitative Health Research, 2, 127134.Google Scholar
Langley-Evans, A. & Payne, S. (1997). Light-hearted talk in a palliative day care context. Journal of Advanced Nursing, 26, 10911097.Google Scholar
Lefcourt, H.M., Davidson, K., Shepherd, R., et al. (1997). Who likes “Far Side” humor? Humor, 10, 439452.Google Scholar
Lefcourt, H.M. & Martin, R.A. (1986). Humor and life stress. New York: Springer.
Major, J.E. (1998). Critical care nurses' use of humor. Unpublished master's thesis, Winnipeg, Canada: University of Manitoba.
Martin, R.A. (2001). Humor, laughter, and physical health: Methodological issues and research findings. Psychological Bulletin, 127, 504519.Google Scholar
Podilchak, W. (1992). Fun, funny, fun-of humor and laughter. Humor, 5, 375396.Google Scholar
Rasmussen, B.H., Norberg, A., & Sandman, P.O. (1995). Stories about becoming a hospice nurse. Cancer Nursing, 18, 344354.Google Scholar
Rosenberg, L. (1991). A qualitative investigation of the use of humor by emergency personnel as a strategy for coping with stress. Journal of Emergency Nursing, 17, 197203.Google Scholar
Shibles, W. (2002). Humor reference guide: A comprehensive classification and analysis. Retrieved June 3, 2002, from University of Wisconsin–Whitewater Web site: http://facstaff.uww.edu/shiblesw/humorbook/hpreface.html.
Smith, A.C. & Kleinman, S. (1989). Managing emotions in medical school: Students' contacts with the living and the dead. Social Psychology Quarterly, 52, 5669.Google Scholar
Smith, M.C. (1999). Caring and the science of unitary human beings. Advances in Nursing Science, 21, 1428.Google Scholar
Sumners, A.D. (1990). Professional nurses' attitudes towards humour. Journal of Advanced Nursing, 15, 196200.Google Scholar
Thornton, J. & White, A. (1999). A Heideggerian investigation into the lived experience of humour by nurses in an intensive care unit. Intensive and Critical Care Nursing, 15, 266278.Google Scholar
Waskul, D.D. & van der Riet, P. (2002). The abject embodiment of cancer patients: Dignity, selfhood, and the grotesque body. Symbolic Interaction, 25, 487513.Google Scholar
Wright, D.J. (2002). Researching the qualities of hospice nurses. Journal of Hospice and Palliative Nursing, 4, 210216.Google Scholar
Yoels, W.C. & Clair, J.M. (1995). Laughter in the clinic: Humor as social organization. Symbolic Interaction, 18, 3958.Google Scholar
Ziv, A. (1984). Personality and Sense of Humor. New York: Springer.