Mallett J, A'Hern R
Royal Marsden NHS Trust, London, U.K.
Int J Nurs Stud. 1996 Oct;33(5):530-50. doi: 10.1016/0020-7489(96)00008-9.
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'.
近年来，人们对在患者护理中运用幽默的兴趣与日俱增。然而，几乎没有研究表明在临床环境中幽默的自然运用情况，尤其是从参与者的角度。本研究采用常人方法论民族志和会话分析方法，调查护士与正在学习并接受血液透析的肾衰竭患者之间幽默的运用情况。据信，该项目在利用视听录像来测量和描述幽默的频率、分布及运用方面具有独特性。研究结果表明，幽默发生率以及患者所产生幽默的比例在不同患者之间存在差异分布，但总体而言，同一患者在不同场合之间并无差异。此外，在一个案例中，每次会话中幽默事例的发生率与时间之间呈现出显著的正相关关系，并且发现另一名患者（D）随着时间推移产生的幽默比例显著更高。对患者D越来越多地运用幽默的进一步探究表明，一个重要方面与患者在“针刺”方面的焦虑和困难有关。这些研究结果对于理解幽默在医疗保健沟通中的作用具有启示意义，特别是在开发正式的“幽默干预措施”方面。
