A comparison of the cardiovascular effects of simulated and spontaneous laughter.

OBJECTIVES: Laughter has long been regarded as beneficial for health, but the mechanisms are not clearly understood. The current study aimed to compare the acute cardiovascular effects of spontaneous and simulated laughter. DESIGN: A mixed factorial experiment was performed to examine changes in cardiovascular variables in response to experimental tasks across conditions. INTERVENTIONS: A sample of 72 participants were randomised to one of three 6 min interventions. Participants in the simulated laughter condition were asked to generate fake laughter, the spontaneous laughter condition viewed a humorous video, and the control condition watched a non-humorous documentary. This was followed by a laboratory stress task. MAIN OUTCOMES MEASURES: Heart rate and heart rate variability (as indexed by rMSSD) were monitored continuously throughout the experiment using ECG. RESULTS: The simulated laughter condition had a significantly higher heart rate (p < .001, ηp2 = .26) and lower rMSSD (p < .001, ηp2 = .13) during the laughter task compared to the other two conditions. Follow-up hierarchical regressions indicated that the difference in heart rate was due to the fact that the simulated condition produced more laughter. The difference in rMSSD, however, was unique to the simulated condition even when controlling for the amount of laughter. The simulated laughter condition had a significantly lower mean HR during the stress task but this was not significant after controlling amount of laughter produced. CONCLUSIONS: Laughter leads to increased heart rate and reduced heart rate variability, which is similar to the effects of exercise. This finding is more pronounced in simulated laughter.

Changes over time in head and neck cancer patients' and caregivers' illness perceptions and relationships with quality of life.

OBJECTIVE: This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months. DESIGN: Forty-two patient-caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor-Partner Interdependence Model. MAIN OUTCOME MEASURE: Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N). RESULTS: Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up. CONCLUSION: Patients' and their caregivers' perceptions of HNC are dynamic over time. Greater discrepancy between patients' and caregivers' illness perceptions at diagnosis predict poorer subsequent patient HRQL.

Illness perceptions and coping predict post-traumatic stress in caregivers of patients with head and neck cancer.

PURPOSE: There is evidence to suggest that caregivers of patients with head and neck cancer (HNC) are susceptible to post-traumatic stress disorder (PTSD) symptoms. The aim of this study was to investigate whether illness perceptions and coping strategies contribute to the development of these symptoms. METHODS: Seventy-eight caregivers completed questionnaires to assess distress, illness perceptions, and coping at diagnosis. Six months later, PTSD symptoms were assessed. Correlation and regression analyses were performed to examine relationships between illness perceptions and coping at diagnosis and PTSD symptoms at 6 months in 48 caregivers. RESULTS: Nineteen percent of caregivers met criteria for estimated PTSD caseness at 6-month follow-up. A regression analysis demonstrated that caregiver perceptions of low treatment benefit and many cancer symptoms, as well as use of avoidant coping techniques, predicted subsequent PTSD. CONCLUSIONS: This preliminary study suggests that caregivers who have perceptions of low benefits from treatment and many patient symptoms, and those using avoidant coping strategies, are at increased risk of experiencing symptoms of PTSD. Psychological interventions that target illness perceptions and coping may help to reduce the prevalence of PTSD in caregivers of patients with HNC.

Gender and ethnic differences in colorectal cancer screening embarrassment and physician gender preferences.

PURPOSE/OBJECTIVES: To examine colorectal cancer (CRC) screening embarrassment among men and women from three ethnic groups and the associated physician gender preference by patient gender and ethnicity. DESIGN: Cross-sectional, purposive sampling. SETTING: Urban community in Brooklyn, NY. SAMPLE: A purpose-derived, convenience sample of 245 European American, African American, and immigrant Jamaican men and women (aged 45-70 years) living in Brooklyn, NY. METHODS: Participants provided demographics and completed a comprehensive measure of CRC screening embarrassment. MAIN RESEARCH VARIABLES: Participant gender and ethnicity, physician gender, and CRC screening embarrassment regarding feces or the rectum and unwanted physical intimacy. FINDINGS: As predicted, men and women both reported reduced fecal and rectal embarrassment and intimacy concern regarding same-gender physicians. As expected, Jamaicans reported greater embarrassment regarding feces or the rectum compared to European Americans and African Americans; however, in contrast to expectations, women reported less embarrassment than men. Interactions indicated that rectal and fecal embarrassment was particularly high among Jamaican men. CONCLUSIONS: Men and women have a preference for same-gender physicians, and embarrassment regarding feces and the rectum shows the most consistent ethnic and gender variation. IMPLICATIONS FOR NURSING: Discussing embarrassment and its causes, as well as providing an opportunity to choose a same-gender physician, may be promising strategies to reduce or manage embarrassment and increase CRC screening attendance.

The many faeces of colorectal cancer screening embarrassment: preliminary psychometric development and links to screening outcome.

OBJECTIVES: Although embarrassment may be among the most easily modified discrete emotional barriers to patients seeking health care or testing, work in the area of colorectal cancer (CRC) has been restricted by the absence of suitable instrumentation. The current report describes the development and validation of a self-report instrument assessing two specific aspects of CRC screening embarrassment and their links to screening outcomes. DESIGN: Convenience sampling was used to recruit 245 European American, African-American, and immigrant Caribbean community-dwelling men and women (aged 45-75 years) living in Brooklyn, New York. METHODS: Participants completed the measure of CRC screening embarrassment, an array of convergent and divergent validity measures including dispositional embarrassment, general medical embarrassment, neuroticism, trait emotion, social desirability, previous treatment avoidance because of embarrassment, relevant health characteristics, and a brief CRC screening history. RESULTS: As expected, CRC screening embarrassment was not unidimensional and had two reliable and distinct components, one concentrated on faecal/rectal embarrassment and the other on embarrassment arising from unwanted intimacy during examinations. In addition to demonstrating patterns of convergent and divergent validity consistent with their separation, multivariate analyses indicated that faecal/rectal embarrassment (but not intimacy concerns) predicted CRC screening frequency. CONCLUSIONS: The current report extends current understanding by identifying the specific sources of embarrassment that may contribute to patients' avoidance of CRC screening. Directions for future study and implications for clinical practice and interventions are discussed.

Worries about modernity predict symptom complaints after environmental pesticide spraying.

OBJECTIVE: Concerns about environmental and technological changes affecting health have been shown to be associated with symptom reports in cross-sectional studies. We aimed to investigate how worries about modernity affecting health, negative affectivity, and prior symptom complaints influence health complaints after environmental spraying in a prospective study. METHODS: Two hundred ninety-two residents of West Auckland completed questionnaires measuring recent symptoms, negative affect, and concerns about the effects of modernity on health before aerial spraying of their neighborhood with Foray 48B. After spraying, 181 residents (62%) returned a follow-up questionnaire measuring symptoms, spray-avoidance behavior, and the perceived effect of the spray program on health. RESULTS: The number of symptoms reported after the spray was most closely related to the number of symptoms reported at baseline (beta = 0.40, p = .0001). Higher levels of modern health worries (beta = 0.23, p = .001) and baseline symptoms (beta = 0.17, p < .05) were associated with a higher number of symptoms being attributed to the spray program. Modern health worries also predicted avoidance behavior during the spraying times (beta = 0.32, p = .001) and the belief that the health of participants and the health of their children and pets was affected by the spray (all p < .01). CONCLUSION: Worries about aspects of modern life affecting health can strongly influence the attribution of symptoms and beliefs about health effects after environmental incidents.