The effect of humor on elder mental and physical health

doi:10.1016/j.gerinurse.2014.01.005

Geriatric Nursing

Volume 35, Issue 3, May–June 2014, Pages 205-211

https://doi.org/10.1016/j.gerinurse.2014.01.005 Get rights and content

Abstract

A convenience sample of community-dwelling older people attending senior centers was asked to participate in a quasi-experimental study to examine the impact of a humor therapy workshop on physical and mental health. Participants were assessed at baseline and at six months for physical (general health and health quality of life) and mental (general well-being, anxiety, depression and psychological distress) health. The sample consisted of 92 subjects, 42 in the control group and 50 in the workshop. Compared to controls, subjects in the workshop had significantly lower follow-up levels of anxiety and depression and improved general well-being. No differences were observed for general health, health quality of life, or psychological distress. This humor therapy workshop was associated with a positive effect upon mental health. It is recommended that attendance at humor workshops be encouraged and that further investigations into the efficacy of such programs on mental and physical health be investigated.

Introduction

Promoting health and well-being among older people is a growing challenge. The search for effective interventions has led to the therapeutic use of humor as a possible method to promote improved mental and physical health.¹ Humor is generally defined as a positive global mental state, unique to each individual, spanning aspects of cognition, emotion, behavior, and communication. The humor workshop in this study can be seen as a type of humor therapy defined by Goodenough and colleagues² as an intervention that stimulates the discovery, expression or appreciation of the absurdity or incongruity of life's episodes in order to facilitate physical, mental, emotional, social or spiritual healing and coping, thus leading to improved mental and physical health.

Section snippets

Humor and physical and mental health

Several mechanisms have been postulated to explain the association between humor and mental and physical health.³ Evidence supports numerous positive physiological effects on several bodily systems including musculoskeletal, respiratory, cardiovascular, endocrine, immune and nervous systems.4, 5, 6, 7 A second mechanism is the effect of positive emotions such as humor on mental health.³ Laughter therapy was found to significantly decrease levels of depression among a sample of community

Subjects

The target population for this study was community dwelling older adults. The inclusion criterion was attendance at one of four senior centers used in the study. Exclusion criteria were inability to read or write in either Hebrew or English and cognitive impairment (as assessed by the administrator/social worker in charge of the center). See Fig. 1 for the recruitment and drop-out rates for this sample.

Setting

The workshop was presented to the senior administrator responsible for social welfare

Results

The sample consisted of 92 subjects, 42 in the control group and 50 in the humor workshop group (see Fig. 1). Most of the participants were females (n = 67, 74.4% among those who responded) either married (n = 45, 48.9%) or widowed (n = 45, 48.9%). The mean age of the sample was 76.9 (SD – 6.8). Similar numbers of respondents either lived alone (n = 41, 44.6%) or with a spouse (n = 45, 48.9%). Most were not born in Israel (n = 75, 81.3% among those that responded) (see Table 3). Subjects in the

Discussion

This study demonstrates the positive influence of a humor intervention workshop among a community dwelling sample of older people. Improvements in mental health (well being, anxiety and depression) were shown at 6 months, in comparison to a control group. No changes were observed in self-assessed measures of physical health or function.

Conclusion

We found that the implementation of a five month humor workshop, aimed at encouraging the use of humor strategies, among community dwelling older people was associated with positive effects upon subsequent depression, anxiety and general well-being. We encourage similar workshops be added to the programs of community centers and recommend that further research be aimed at investigating the use of humor with other older populations.

Acknowledgments

This study was partially funded by the Israel Ministry of Social Welfare and was supported by the Netanya and Rishon Le Zion municipalities. Thanks go to Mr. Enzo Agada Goren and Mr. Modechai Greenberg for their active participation in the design and data collection of the study. Thanks also go to the “Happy Nation Society” whose members supported the study and dedicated their time and effort to its completion.

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Humor and laughter can improve mental health by reducing stress, releasing tension,24-27 increasing social interaction,27 and reducing negative emotions while increasing the positive ones.28 The use of humor therapy as a mental health enhancement intervention has been found to significantly reduce depression in the community-dwelling older adults29,30 as well as reduce anxiety and depression, increase satisfaction with life and reduce pain among the older adults living in long-term care facilities.31-34 Hospitalized older adults also experienced increased satisfaction with life with this form of intervention.35
To evaluate a magic recreation program to reduce depressive symptoms in institutionalized older adults.
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In experimental studies with laughter therapy and comic videos, laughter has been shown to lead to the more effective functioning of the respiratory and circulatory system in the body through its stimulation of the hypothalamus, and to reduce muscle tension by stimulating the production of endorphins.12,15–21 It has been reported that using laughter and humor as treatments has positive effects on psychological problems such as depression, anxiety, and stress, as well as on physiological factors such as sleep, blood pressure, temperature, respiration and pain.12,16,17,21–26 The purpose of this study was to determine the effectiveness of comedy video therapy on preoperative anxiety and vital signs in patients about to undergo oncologic surgery.
Cancer, a disease as old as recorded human history, causes patients pain and psychological problems. Watching comedy videos can distract these patients, relieving psychological issues without causing any further harm.
This randomized clinical trial was conducted on patients who were candidates for oncologic surgery at a university hospital in Turkey. The sample of the study consisted of 88 patients. Before surgery, patients in the experimental group (n = 44) watched comedy videos while those in the control group (n = 44) received no intervention. The Patient Introduction and Registration Form and the State and Trait Anxiety Inventory (STAI) were used as data collection tools. Anxiety, measured by the STAI, and vital signs (blood pressure, pulse, respiration, and oxygen saturation) were measured before and after the experimental protocol. Descriptive statistics, chi-square and t-test were used in the analysis of the data.
The pretest of STAI scores and vital signs were similar in both groups (p > 0.05). After video watching, the mean state anxiety score of the patients was 43.36 ± 9.76 in the experimental group and 47.13 ± 5.76 in the control group. The difference between the mean anxiety scores of the two groups was statistically significant (p < 0.05). However, there were no significant differences in vital signs across groups (p > 0.05). Within group pre- versus post-treatment comparisons showed significant reduction in anxiety, diastolic and systolic blood pressures in the video group (p<0.05), while in controls, there was no significant improvement in anxiety and physiologic values.
The results suggest that watching comedy videos has a beneficial effect on pre-operative anxiety and blood pressure in surgical oncology patients.
The effect of exposure to parodies of thin-ideal images on young women's body image and mood
2019, Body Image
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While there is no research to date that has examined the impact of humorous stimuli on body image, there is much research demonstrating the broader psychological benefits of humour. Several studies have shown a significant relationship between humour and depression and anxiety in young adults (e.g., Kuiper & McHale, 2009; Martin, Puhlik-Doris, Larsen, Gray, & Weir, 2003) as well as older adults (e.g., Ganz & Jacobs, 2014). Exposure to humour has also been consistently associated with greater pain tolerance (see Proyer & Wolf, 2017 for a review).
Although social networking services typically promote the thin beauty ideal for women, they also provide an opportunity for users to challenge this dominant ideal in unique and novel ways. This study aimed to experimentally investigate the influence of exposure to humorous, parody images of thin-ideal celebrity Instagram posts on women’s body satisfaction and mood compared to exposure to thin-ideal celebrity posts alone. Participants were 102 women aged 18–30 years who were randomly allocated to view either a set of Instagram images of thin-ideal celebrity posts or humorous parody images of the same celebrity posts. Results indicated that acute exposure to parody images led to increased body satisfaction and positive mood (happiness) compared to exposure to the thin-ideal celebrity images alone. No group differences were found on levels of trait appearance comparison or social media literacy, and the findings were not moderated by trait levels of thin-ideal internalisation. The findings provide preliminary support for the use of humorous, parody images for improving body satisfaction and positive mood in young women and add to the small but growing body of research highlighting potentially positive effects of social media.
Humor doesn't retire: Improvisation as a health-promoting intervention for older adults
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One approach to promoting health within the older adult population that has recently emerged is humor therapy. Elder clowns and group-led humor therapy have been shown to decrease chronic pain and provide psychosocial benefits, including improved mental function, decreased depression, and general increased well-being in older adults residing in assisted living and advanced care settings (Berk, 2001; Ganz & Jacobs, 2014; Ko & Youn, 2011; Tse et al., 2010; Walter et al., 2007). However, most studies have only explored passive humor, in which participants are the recipients of humor, for example, being told jokes or reading funny anecdotes.
As our population ages and aging in place continues to remain a priority of older adults, identifying novel ways to promote the wellbeing of older adults and reduce isolation is of the utmost importance. The Second City is a Chicago-based comedy improvisation organization that provides training in improvisation. One of their training courses, Humor Doesn’t Retire, specifically teaches adults 55 and over, on improvisation. This study sought to explore the experiences of older adults enrolled in Humor Doesn’t Retire, and to characterize any benefits that older adult participants perceived following participation in the comedy improvisation course. Qualitative analysis was used to identify and describe common themes that emerged in a survey of open-ended questions regarding benefits of the improvisation course on outlook and mood as well as behavior changes. Results for perceived benefits showed main themes of increased positivity, an increased sense of comfort and ease with the unexpected, a sense of self-development and self-awareness, and a feeling of acceptance by their social group. Participants reported that these changes fed into their behaviors, and resulted in enhanced problem solving abilities, greater facility in social situations, and the tangible outcome of an expanded and closer-knit social circle. As the first study in our knowledge to examine the effect of improvisation comedy on healthy older adults, this exploratory analysis has suggested that improvisation comedy may be a mechanism by which to combat several geriatric syndromes, including depression, stress, and isolation − all of which are detrimental to older adults.
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Particularly, humor had positive effects on the patient's well-being. Humor was defined as a positive global mental state spanning aspects of cognition, emotion, behavior.18 Sense of humor refers to individual differences in personality related to the perception, appreciation, expression, and capacity of to use amusement, laughter, and jocosity also to cope to difficulty.19
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We found that surgical treatment of arteriovenous malformations affected subjective well-being and emotional aspects. Coping ability influenced the QoL and the presence of anxiety and depressive symptoms. We found a significant correlation between depression and humor (r = −.47, P = .03) and between QoL and self-distraction (r = −.48, P = .03) and humor (r = .44, P = .05). In particular, humor was a significant predictor of mental health and physical health.
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Feature ArticleThe effect of humor on elder mental and physical health

Abstract

Introduction

Section snippets

Humor and physical and mental health

Subjects

Setting

Results

Discussion

Conclusion

Acknowledgments

Biol Psychol

Humor as seen from a public health perspective

Scand J Public Health

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

Int Psychogeriatr

Humor, laughter and physical health: methodological issues and research findings

Psychol Bull

Effects of humor and laughter on psychological functioning, quality of life, health status, and pulmonary functioning among patients with chronic obstructive pulmonary disease: a preliminary investigation

Heart Lung

A longitudinal analysis of humor coping and quality of life in systemic sclerosis

Psychol Health Med

Humor theories and the physiological benefits of laughter

Holist Nurs Pract

Effects of laughter therapy on depression, cognition and sleep among the community-dwelling elderly

Geriatr Gerontol Int

Humour as emotion regulation: the differential consequences of negative versus positive humour

Cogn Emot

The role of coping humor in the physical and mental health of older adults

Aging Ment Health

Humor, laughter and happiness in the daily lives of recently bereaved spouses

Omega

Humour, beauty and culture as personal health resources: experiences of elderly Swedish women

Scand J Public Health

Feature Article
The effect of humor on elder mental and physical health