Taking medical education into the l9th century: an immodest proposal.
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Over the past few decades, increasing evidence has shown the beneficial effects of humor. The use of caregiver-initiated humor as an intervention in healthcare settings has both physiological and emotional benefits. Little has been written, however, about another very important aspect of humor, patient-initiated humor. When patients use humor to relieve their feelings of stress, uncertainty, or embarrassment, they are trying to communicate with their caregiver. This use of humor by patients is not to "make light" of the situation, but rather a way to reduce their feelings of dehumanization. Humor is an interactive process of sharing and an important aspect of communication. Patients will observe the caregiver for a response. An open, accepting response signals understanding; a negative or null response, however, may serve to isolate the patient. The guidelines discussed in this article for recognizing, interpreting, and responding to patient-initiated humor will help home care and hospice nurses to foster increased open patient/caregiver communication and create a supportive humanistic atmosphere for patient care.
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There has been increasing interest in the use of humour in patient care within recent years. However, little research has been conducted to show the natural utilisation of humour, particularly from the participants' perspective, within the clinical environment. This study uses ethnomethodological ethnography and conversation analysis methods to investigate the use of humour between nurses and patients with renal failure who were learning about, and to, haemodialyse. It is believed that the project is unique in the utilisation of audiovisual video recordings to measure and describe the frequency, distribution and use of humour. Findings indicated that humour rates and the proportion of humour produced by the patients were differentially distributed between patients but, overall, not between the same patients on different occasions. In addition, in one case a significant positive relationship between the rate of humorous instances per session and time was demonstrated and another patient (D) was found to produce a significantly larger proportion of the humour over time. Further exploration of patient D's increasing use of humour revealed that one important aspect was associated with the patients anxiety and difficulties with regard to "needling'. The findings have implications for understanding the role of humour in health care communication, particularly with reference to developing formal "humorous interventions'.
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Effectiveness of melanoma prevention depends on how it is accepted by the population. Humour and alarmism are often used in campaigns, but no information is available about how much they may improve or limit the impact of a campaign. Three different leaflets containing the same information about sun exposure and skin cancers were developed using three different tones of presentation: humoristic (H-leaflet), alarmist (A-leaflet) or neutral information (N-leaflet). In this randomized controlled study, each type of leaflet was mailed to a sample of 300 subjects representative of the sociodemographic population of the South of France. A fourth sample to whom no leaflet was sent was used as a control. Fifteen days after the mailing, the 1200 individuals were interviewed by phone. Four hundred and forty-four of the 900 who received the mail read the leaflet. The percentage of individuals with a good awareness of melanoma was higher in leaflet groups than in controls. The percentage of individuals who read a leaflet was lower in the A-leaflet group and the percentage of individuals knowing what a melanoma is tended to be lower in the H-leaflet group. There was no significant difference between groups with regard to ability for self-assessment of skin sun sensitivity, risk factors and sun exposure. The tone of presentation seems to have a limited impact on the effect of a campaign, but alarmism tends to reduce the number of people reached by the message whereas humour tends to decrease the impact of the message.
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The usage, derivation, and psychological, ethical, and legal aspects of slang terminology in medicine are discussed. The colloquial vocabulary is further described and a comprehensive glossary of common UK terms provided in appendix. This forms the first list of slang terms currently in use throughout the British medical establishment.