PubMed | The Cancer Council Australia
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2016
20552 Background: The use of humour has been reported as a strategy for countering existential ambivalence or normalising difficult situations such as serious illness and its treatment, and as part of coping with them. Its use has also been associated with reduced anxiety and depression. We therefore expected that humour would be used as part of communication about end-of-life issues.Taped semi-structured interviews with 51 patients (27 females and 24 males) with all stages of cancer who were being interviewed to obtain their views of end-of-life decision- making in order to inform policy (Olver et al., Psycho-Oncol 2002, 11(3): 181-187, Eliott et al, Qual Health Res 2007; 17(4): 442-455) were analysed for the use of humour in discussing sensitive issues. Reading and rereading and a qualitative software package were employed to sort the interviews into categories, and for this study speech associated with laughter was analysed.When specifically referring to humour patients indicated its importance for them to lighten the atmosphere but also indicated that the use of humour was a desirable attribute of their doctors. There were 5 broad categories where patients used laughter. The most common was when they were uncertain about an answer (e.g. the ideal timing of discussing do not resuscitate orders with patients). The others included when embarrassed at discussing personal or family issues or physical symptoms, or when making rash generalisations. Patients laughed when they purposely told amusing anecdotes or used colloquialisms for sensitive concepts like death, as well as laughing in response to humour expressed by the interviewer. The topics discussed that were most associated with patients use of humour were death, euthanasia, funerals (particularly their own), hope, religion, and when patients described complementary and alternate therapies.Patients utilise humour to help discuss issues that they find stressful or embarrassing such as those associated with end- of-life decision-making and it is important to create an empathetic environment in which this can occur to assist them in expressing their views. No significant financial relationships to disclose.