Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Perceptions of Nurses about Potential Barriers to the Use of Humour in Practice: A Literature Review of Qualitative Research

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Perceptions of Nurses about Potential Barriers to the Use of Humour in Practice: A Literature Review of Qualitative Research

Article excerpt

Introduction

The humour-health hypothesis asserts that there is a positive link between humour and good health, which has subsequently led to research interest into the use of humour within healthcare environments (Martin & Lefcourt, 2004). Humour has been recognised as an effective intervention during ill-health, with a low-risk, non-invasive nature in comparison to pharmaceutical alternatives (Bennett & Langacher, 2006; Greenberg, 2003). However, some research indicates that humour may be considered 'trivial' and inappropriate as a form of clinical intervention (Dean & Major, 2008).

Evidence shows that when laughter erupts in response to humour, endogenous hormones (endorphins, serotonin and dopamine) are released (Tremayne, 2014). Dopamine can cause an increase in both positive thinking and creativity, in addition to decreasing depression (Old, 2012). Similarly, laughter has been reported to lower serum cortisol levels while causing an increase in T-cells and natural killer cells, subsequently reducing stress levels (Old, 2012). There is also evidence of analgesic benefits, with humour proving to be an effective method of pain-relief (Gilbert, 2014; Rotton & Shats, 1996). Humour can be a source of indirect, psychological therapy to patients, suggesting holistic benefits (Martin & Lefcourt, 2004). For example, humour has been found to facilitate feelings of well-being and happiness as well as enhancing patients' ability to cope with the stresses of ill-health (Tanay, Roberts, & Ream, 2013; Tremayne, 2014).

Research suggests that humour may also be beneficial to the nursing profession, encouraging a positive working atmosphere (Dean & Gregory, 2005; Pryor, 2010). Humour within healthcare teams can help to build teamwork, encourage open communication and promote a motivated workforce (Branney et al., 2014; Tanay et al., 2013). The Royal College of Nursing (2005) acknowledge that nursing is a stressful profession that can place many physical, mental and emotional demands on nurses. Humour may assist nurses in coping with the long shifts and emotional labour that nursing entails (McCreaddie & Wiggins, 2009). Literature indicates, however, that patients are more likely to initiate humour in comparison to nurses, suggesting a reluctance in using humour as part of nursing communication (McCreaddie & Payne, 2011; Sumners, 1990; Tanay, Wiseman, Roberts, & Ream, 2014).

The aim of this literature review was to identify studies where the perceptions of nurses about potential barriers to the use of humour in practice were investigated. This review particularly focused on nurses working with the adult population (>18 years of age).

Methods

Research question

The literature review sought to answer the following research question: What are the perceptions of nurses about potential barriers to the use of humour in nursing practice?

Planned search strategy

In order to answer this research question, a literature review was undertaken, incorporating a systematic approach when searching the literature to enhance rigour and reliability (Aveyard, 2014). Thematic synthesis was deemed an appropriate method of data abstraction and in the synthesis of results, as it allows the combination of findings from methodological heterogeneous studies, which subsequently allows for identification of common themes (Barnett-Page & Thomas, 2009). Themes can then be used to inform future healthcare practice and/or policy. Moreover, due to the descriptive and inductive nature of this approach, it was deemed a suitable method in the synthesis of results that explore nurse perceptions (Barnett-Page & Thomas, 2009).

In order to ensure all relevant literature on the chosen topic were accessed, a systematic search strategy was developed and used across four electronic databases: PsycINFO, CINAHL, ASSIA and Medline. As the background literature evidenced the impact of humour on both physical and psychological health, databases were searched which covered both medical and psychological material. …

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