Struthers J
Isle of Man Centre for Nurse Education, 4th Floor, Hillary House, Prospect Hill, Douglas IM1 1EQ, Isle of Man.
J Adv Nurs. 1999 May;29(5):1197-204. doi: 10.1046/j.1365-2648.1999.01004.x.
Community psychiatric nurses' (CPNs') accounts of interactions with clients often reflect benefits of using humour appropriately. This is despite the use of humour as a specific therapeutic form of communication generally being ignored during CPNs' professional development. With the growth in community care, mental health nurses are required to function more autonomously within the client's home environment, thus the contextual nature of the nurse's use of humour may have to be adjusted accordingly. How nurses makes this adjustment of their use of humour appears to be left to their own experiences. Yet inappropriate use of humour may be costly to the nurse-client relationship. The research described in this paper used a descriptive qualitative methodology to explore the perceptions of seven CPNs working in Scotland in relation to their use of humour during client interactions. As this study did not specifically access clients, ethical permission was not required from the local research and ethics committee. This did not excuse the author from recognizing ethical considerations of the subjects in relation to sharing information about being volunteers, their rights of withdrawal and the risks and benefits of the study. Confidentiality and anonymity were also maintained by the use of pseudonyms. Data collected through critical incident analysis and interviews were subjected to content analysis. Findings confirm the paradoxical nature of humour. Humour, when used appropriately, assisted the development of trust and changing the client's restrictive perceptions. Damaging effects were reported, however, if the humour was misinterpreted or perceived by the client as demeaning their experience. Although the CPNs had not received any formal education about the use of humour, recommendations centred on raising student nurses' and CPNs' awareness about their own use of humour.
社区精神科护士（CPNs）对与客户互动的描述往往反映了恰当地运用幽默的益处。尽管在CPNs的专业发展过程中，将幽默作为一种特定的治疗性沟通形式通常被忽视。随着社区护理的发展，心理健康护士需要在客户的家庭环境中更自主地工作，因此护士运用幽默的情境性质可能需要相应调整。护士如何进行这种幽默运用的调整似乎取决于他们自己的经验。然而，不恰当的幽默运用可能会对护患关系造成代价。本文所述的研究采用描述性定性方法，探讨了在苏格兰工作的七名CPNs对其在与客户互动中运用幽默的看法。由于这项研究没有专门接触客户，因此无需获得当地研究与伦理委员会的伦理许可。但这并不免除作者在分享有关志愿者信息、他们的退出权利以及研究的风险和益处时认识到对受试者的伦理考量。通过使用化名也保持了保密性和匿名性。通过关键事件分析和访谈收集的数据进行了内容分析。研究结果证实了幽默的矛盾性质。当幽默被恰当地运用时，有助于建立信任并改变客户的限制性观念。然而，如果幽默被误解或被客户视为贬低他们的经历，则会产生破坏性影响。尽管CPNs没有接受过任何关于幽默运用的正规教育，但建议集中在提高学生护士和CPNs对自己幽默运用的认识上。
