THE RELATIONSHIP BETWEEN HUMOR STYLE AND DEATH ANXIETY OF PALLIATIVE CARE PATIENTS

Abstract

Objective: This descriptive and relational study was conducted to examine the relationship between palliative care patients' humor styles and death anxiety. Materials and methods: The study sample consisted of 282 palliative care patients treated in the palliative care clinics of a training and research hospital between January 2021 and August 2021. Personal Information Form, Humor Styles Questionnaire (HSQ), Thorson-Powell Death Anxiety Scale (TPDAS) and Palliative Performance Scale (PPS) were used as data collection instruments. Data analysis was performed in SPSS 25.0 software using mean, standard deviation and percentile, Kolmogorov-Smirnov Goodness-of-Fit Test, Significance test of difference between two means, ANOVA, Post-hoc test, Pearson's Correlation test and regression analysis. The principles of the Declaration of Helsinki were followed in the study, ethics committee approval and institutional permission were obtained. Results: It was found that the mean age of the patients was 49.58±9.56 and 52.1% were hospitalized in the palliative care clinic for 5-10 days. It was determined that the most frequently used humor style by the patients was “Affiliative Humor” (31.7%), and the least used humor style was “Aggressive Humor” (19.5%). The Humor Styles Questionnaire (HSQ) subscale scores of the patients were determined as 31.05±7.11, self-enhancing humor 28.34 ± 6.94, aggressive humor 26.85±7.37, self-defeating humor 23.50± 6.21. The death anxiety scale mean scores of the patients were found to be 81.62±9.12. In addition, a low negative correlation was found between affiliative humor (r=-0.298; p<0.05) and self-enhancing humor (r=-0.318; p<0.05) and death anxiety. A moderate positive correlation was found between aggressive humor (r=0.450; p<0.05) and self-defeating humor (r=0.427; p<0.05) and death anxiety. Conclusion: The result of the study revealed that humor is an important variable associated with death anxiety and the way humor is used by patients differs in death anxiety.

Keywords

• Palliative Care
• Patient
• Humor Style
• Death Anxiety

References

1. [1] Etkind, S.N., Bone, A.E., Gomes, B., Lovell, N., Evans, C.J., Higginson, I.J., Murtagh, F.E.M., “How many people will need palliative care in 2040? Past trends, future projections and implications for services”, BMC Medicine, 15(1), 1–10, 2017. https://doi.org/10.1186/S12916-017-0860-2.
2. [2] Hui, D., Bruera, E., “Models of Palliative Care Delivery for Patients with Cancer”, Journal of Clinical Oncology, 38(9), 865, 2020. https://doi.org/10.1200/JCO.18.02123.
3. [3] Murray, S.A., Kendall, M., Mitchell, G., Moine, S., Amblàs-Novellas, J., Boyd, K., “Palliative care from diagnosis to death”, BMJ, 356, 2017. https://doi.org/10.1136/BMJ.J878.
4. [4] Garg, R., Chauhan, V., Sabreen, B., “Coping Styles and Life Satisfaction in Palliative Care”, Indian Journal of Palliative Care, 24(4), 495, 2018. https://doi.org/10.4103/IJPC.IJPC_63_18.
5. [5] Haun, M.W., Estel, S., Ruecker, G., Friederich, H., Villalobos, M., Thomas, M., Hartmann, M., “Early palliative care for adults with advanced cancer”, Cochrane Database of Systematic Reviews, (6), 2017. https://doi.org/10.1002/14651858.CD011129.PUB2.
6. [6] Corradi, M.L.G., Duim, E., Rodrigues, C.I.S., “Death and End of Life: Perceptions Throughout the Career About Death, Palliative Care, and Educational Process”, Journal of Palliative Care, 2020. https://doi.org/10.1177/0825859720923435.
7. [7] Arab, M., Seyed Bagheri, S.H., Sayadi, A., Heydarpour, N., “Comparison of Death Anxiety, Death Obsession, and Humor Among Nurses Working in Medical-Surgical Departments and Intensive Care Units”, Archives of Neuroscience, e86398, 2019. https://doi.org/10.5812/ans.86398.
8. [8] Anderson, W., Di Tunnariello, N., “Aggressive humor as a negative relational maintenance behavior during times of conflict”, Qualitative Report, 21(8), 1513–1530, 2016. https://doi.org/10.46743/2160-3715/2016.2149.

9. [9] Greene, D.S., King, N.D., “Humor and A1C: the interaction between humor and diabetes control”, Humor, 2021. https://doi.org/10.1515/HUMOR-2020-0124.
10. [10] Lurie, A., Monahan, K., “Humor, Aging, and Life Review: Survival Through the Use of Humor”, Social Work in Mental Health, 13(1), 82–91, 2015. https://doi.org/10.1080/15332985.2014.884519.
11. [11] Sim, I.O., “Humor intervention program for children with chronic diseases”, Applied Nursing Research, 28(4), 404–412, 2015. https://doi.org/10.1016/j.apnr.2015.09.001.
12. [12] Boerner, M., Joseph, S., Murphy, D., “The Association Between Sense of Humor and Trauma-Related Mental Health Outcomes: Two Exploratory Studies”, Journal of Loss and Trauma, 22(5), 440–452, 2017. https://doi.org/10.1080/15325024.2017.1310504.
13. [13] Cundall, M.K., Kelly, S., eds “Cases on Applied and Therapeutic Humor”, IGI Global, USA, 2021. https://doi.org/10.4018/978-1-7998-4528-7.
14. [14] Cai, C., Yu, L., Rong, L., Zhong, H., “Effectiveness of humor intervention for patients with schizophrenia: A randomized controlled trial”, Journal of Psychiatric Research, 59, 174–178, 2014. https://doi.org/10.1016/J.JPSYCHIRES.2014.09.010.
15. [15] Lambert South, A., Elton, J., Lietzenmayer, A.M., “Communicating death with humor: Humor types and functions in death over dinner conversations”, Death Studies, 1–10, 2020. https://doi.org/10.1080/07481187.2020.1716883.
16. [16] Vrabel, J.K., Zeigler-Hill, V., Shango, R.G., “Spitefulness and humor styles”, Personality and Individual Differences, 105, 238–243, 2017. https://doi.org/10.1016/j.paid.2016.10.001.
17. [17] Naderi, F., Bakhtiar, P.S., Shokouhi, M., “The comparison of death anxiety, optimism and sense of humor among female nurses”, Woman and Culture, 1(3), 41–50, 2010.
18. [18] Kuiper, N.A., “Humor Styles Questionnaire”, Encyclopedia of Personality and Individual Differences, 2087–2090, 2020. https://doi.org/10.1007/978-3-319-24612-3_39.
19. [19] Yerlikaya, E.E., “Mizah Tarzları Ölçeği’nin (Humor Styles Questionnaire) uyarlama çalışması / The adaptation of Humor Styley Questionnaire into Turkish language”, Master Thesis, Çukurova University, Institute of Social Sciences, Adana, 2003.
20. [20] Thorson, J.A., Powell, F.C., “A revised death anxiety scale”, Death Studies, 16(6), 507–521, 1992. https://doi.org/10.1080/07481189208252595.
21. [21] Karaca, F., Yıldız, M., “Thorson-Powell Ölüm Kaygısı Ölçeğinin Türkçe Çevirisinin Normal Populasyonda Geçerlik ve Güvenirlik Çalışması”, Tabula Rasa, 1(1), 43–55, 2001.
22. [22] Panichelli, C., Albert, A., Donneau, A-F., D’Amore, S., Triffaux, J-M., Ansseau, M., “Humor Associated with Positive Outcomes in Individual Psychotherapy”, American Journal of Psychotherapy, 71(3), 95–103, 2018. https://doi.org/10.1176/APPI.PSYCHOTHERAPY.20180021.
23. [23] Lin, SS-H., Hong, C-C., Tsai, L-T., Liu, E.T., “Depressogenic traits and depression: Are humor styles mediators?”, Humor, 34(1), 113–134, 2021. https://doi.org/10.1515/HUMOR-2020-0001.
24. [24] Greengross, G., “Sex and gender differences in humor: Introduction and overview”, Humor, 33(2), 175–178, 2020. https://doi.org/10.1515/HUMOR-2020-0005.
25. [25] Martin, R.A., Puhlik-Doris, P., Larsen, G., Gray, J., Weir, K., “Individual differences in uses of humor and their relation to psychological well-being: Development of the Humor Styles Questionnaire”, Journal of Research in Personality, 37(1), 48-75, 2003. https://doi.org/10.1016/S0092-6566(02)00534-2.
26. [26] Saffarinia, M., “Predicting Dimensions of Psychological Capital Based on Humor Styles among Medical Students”, Iranian Journal of Health Psychology, 4(1), 69–79, 2021.
27. [27] Wellenzohn, S., Proyer, R.T., Ruch, W., “Humor-based online positive psychology interventions: A randomized placebo-controlled long-term trial”, Journal of Positive Psychology, 11(6), 584–594, 2016. https://doi.org/10.1080/17439760.2015.1137624.