Humour interventions for patients in palliative care-a randomized controlled trial.

PURPOSE: The effect of humour on end-of-life patients could be beneficial and is worth investigating. However, data on humour interventions for patients in palliative care are scarce. This study evaluated the effects of a humour intervention in a palliative care setting. METHODS: A two-step intervention was developed based on the humour habits programme by McGhee. Patients were assisted to remember funny episodes from their past and recognize humorous aspects of the present and encouraged to produce humour. The intervention and control group completed questionnaires on life satisfaction, cheerfulness, symptom burden, and perceived stress and if possible gave saliva samples to investigate oxytocin levels. The study was a randomized controlled monocentre study on patients treated in a palliative care ward. Participants had to be conscious and alert enough to complete data collection. Overall, 55 patients were included and randomized to the intervention or control group. RESULTS: Parameters in the control group did not change significantly. In the intervention group, seriousness, bad mood, and stress were reduced. Cheerfulness increased significantly after the intervention. However, the methodologically complex intervention setting was too exhausting for the majority of patients. CONCLUSION: Patients who were able to participate benefited from the effects of the intervention on multiple levels. For future research simple interventions, biomarkers for well-being and assessments by staff or proxies are needed to include patients with reduced cognitive and physical performance status at the end of their lives. TRIAL REGISTRATION: DRKS00028978 German Registry of Clinical Studies.

Report of the intergovernmental panel on climate change: implications for the mental health policy of children and adolescents in Europe-a scoping review.

Climate change is a worldwide challenge. Its consequences do encompass severe threats not only for the existence and somatic health, but also for the mental health of children and adolescents. Mental health can be impaired by three types of consequences. Direct consequences of climate change, such as natural disasters and indirect consequences, such as loss of land, flight and migration, exposure to violence, change of social, ecological, economic or cultural environment. Moreover, the increasing awareness of the existential dimension of climate change in children and adolescents can influence their well-being or challenge their mental health. Consequences of climate change for somatic health may interact with mental health or have psychological sequelae in children and adolescents. Based on the estimates by the United Nations Intergovernmental Panel on Climate Change, we have summarized current data on these differential pathways as to how climate change affects the mental health of children worldwide through selective literature research on Pubmed. Mental health sequelae of direct and indirect consequences of climate change, increased awareness and physical health problems caused by climate change are presented. We give insights into special vulnerabilities of children and adolescents and identify high-risk groups. As the "Fridays for Future" movement has been initiated in northern Europe, we will discuss these results with a focus on children and adolescents in Europe. The results indicate that climate change is a serious threat to children and adolescent mental health. Children´s rights, mental health and climate change should not continue to be seen as separate points; instead, they need to be brought together to address this major challenge determining the future of our children and their descendants.

[What entertainment television can do to convey medical knowledge to students and laypeople-raising awareness of rare diseases]. / Was das Unterhaltungsfernsehen zur Vermittlung von medizinischem Wissen an Studierende und Laien beitragen kann ­ Sensibilisierung für seltene Erkrankungen.

People with complex and rare diseases often have a difficult time in our health system. It can take years to reach a diagnosis and there is often no suitable therapy. Rare diseases are anything but rare among patients: around 4 million people are affected in Germany alone. Nevertheless, rare diseases can often only be diagnosed when they are well enough known and the population is made aware of their existence-this applies to both laypeople and medical professionals. The rather unusual form of imparting knowledge via entertainment television can make an important contribution to disseminate medical knowledge and to raise awareness of medical topics. In specific cases, entertainment television can help to diagnose rare diseases or encourage laypeople to take lifesaving measures, which we try to illustrate in this paper.Series and quiz shows reach more viewers than traditional health programs. They have also proven to be exceptionally effective in student teaching. Since the narrative form focuses on cheering and guessing, instead of simply conveying facts, the medical topics become more emotionally anchored memories and easier to recall. Entertainment television thus offers an innovative approach to increase the health literacy of the population-a potential that could be used more intensively in Germany.

Effects of humorous interventions on the willingness to donate organs: a quasi-experimental study in the context of medical cabaret.

BACKGROUND: It has been shown that fears and misconceptions negatively affect the willingness to donate organs. Empirical studies have examined health communication strategies that serve to debunk these fears. There are promising indications that humor has the potential to influence health-related attitudes and behaviors. This study examines empirically whether medical cabaret, as a specific format for delivering health-related information in a humorous way, affects the willingness to donate organs. METHODS: A quasi-experimental study was conducted among the audience of a medical cabaret live show. Participants in two intervention groups and one control group were interviewed just before the start of the live show (t0) and about 6 weeks later (t1). Intervention group 1 (I1) witnessed a ten-minute sequence by the cabaret artist about organ donation. Participants in I2 witnessed the sequence and, in addition, received an organ donor card. Descriptive statistics and t-tests were used to investigate changes in attitudes and the willingness to donate organs from t0 to t1. RESULTS: A significant increase in the willingness to donate organs and an improvement in general attitude was observed in the intervention groups. Moreover, significantly more participants in I2 carried an organ donor card after the intervention. Some fears could be reduced, while understanding of the reasons for organ donation could be increased via the intervention. CONCLUSIONS: The study confirms that medical cabaret is able to affect respondents' attitudes and behaviors even in the context of organ donation. Medical cabaret can enhance the willingness to donate organs and dispel negative concerns.

GET.HAPPY2 - User perspectives on an internet-based self-management positive psychology intervention among persons with and without depression: Results from a retrospective survey.

OBJECTIVE: Previous research suggests that online positive psychology interventions (PPI) are frequently used by individuals with symptoms of depression. We aimed to investigate differences in the way depressed and nondepressed users react to the content of an existing online PPI, originally designed for the general public. METHOD: In a retrospective online survey, we assessed discontinuation parameters, aspects of satisfaction with the program, and negative reactions among users of an online PPI. RESULTS: Bivariate and multivariate analyses showed that, overall, reactions between depressed and nondepressed individuals were similar. Differences were observed concerning reasons for using and for discontinuing the program, the perception of exercises, and negative reactions. CONCLUSIONS: Although satisfaction with the program was high, it did not seem to fully meet users' expectations and might be more difficult to complete during episodes of depression. Implications of this study for the adaptation of online PPIs addressing depressed individuals are discussed.

Evaluation of a Study Protocol of the Application of Humor Interventions in Palliative Care Through a First Pilot Study.

Background: Humor and laughter might have an alleviating effect on pain threshold and enhance coping and building relationships. However, randomized controlled studies in palliative care have struggled with high percentages of attrition and missing values. Objectives: We aimed to evaluate a study protocol through a pilot study for the evaluation of a multistage humor intervention with psychological and physiological outcome parameters that may be applied successfully in a palliative care environment. Design: This pilot study utilized a pre-post design. The inclusion of a control group for the final study setting recruiting 120 patients is planned. Setting/Subjects: The study was a monocenter study in a clinic for palliative care in Germany. All patients were eligible for recruitment. Seven patients were recruited for the pilot study. Measurements: Interventions were developed using a humor training for psychiatric patients. Quantitative sensory testing for pain threshold testing and questionnaires on humor as a character trait, pain intensity, life satisfaction, and symptom burden were planned to be evaluated before and after three humor interventions. Results: The feasibility of the original study design was re-evaluated after pilot testing. Only two out of the seven patients were able to complete two interventions, requiring modification. Fewer questionnaires, less complex physiological testing, and reduction from three to two interventions were then planned. Conclusion: The initial planned research methodology must be adjusted for patients with high symptom burden. In the experimental group of the final study setting, the effects of one to two interventions will be evaluated measuring oxytocin levels in saliva and using standardized questionnaires to determine cheerfulness, life satisfaction and symptom burden, as well as assessing as-needed medication. Trial registration: DRKS00028978 German Registry of Clinical Studies.

Care for Joy: Evaluation of a Humor Intervention and Its Effects on Stress, Flow Experience, Work Enjoyment, and Meaningfulness of Work.

The media increasingly speak of a care crisis. Systematic support is needed to prepare nursing apprentices for the high demands of their profession and to reduce the number of nurses who finally quit. Particularly in stressful jobs like nursing, humor as a coping strategy can have a beneficial effect on perceived stress and overall work enjoyment. In this study, we used a humor intervention among nursing staff in training and evaluated its effects on humor, stress, work enjoyment, the meaningfulness of work, and flow experience. The sample consists of 104 nurses in training. The intervention group received a 3-h humor intervention, while the control group received no intervention. Positive and negative affect were measured immediately before and after the intervention. Humor was measured before the intervention (t0) and again 6 months later (t1); at t1, we again measured humor and also stress, work meaningfulness, work enjoyment, and flow experience. Our analyses showed a beneficial change in positive and negative affect right after the intervention. By means of repeated measures ANOVA we could further confirm an effect of the intervention on reported humor 6 months later. Humor mediated positive effects of the humor intervention on perceived meaningfulness of work, work enjoyment, and on the frequency of flow at work. Also, we found a significant negative relationship between humor and stress measured at t1. The results of this study confirm the effectiveness of humor interventions in promoting humor, and, through this, the meaningfulness of work, work enjoyment, and the frequency of flow experience. Implications of the use of humor interventions in the nursing profession are discussed.

Increasing the willingness to participate in organ donation through humorous health communication: (Quasi-) experimental evidence.

Increasing people's willingness to donate organs after their death requires effective communication strategies. In two preregistered studies, we assessed whether humorous entertainment education formats on organ donation elicit positive effects on knowledge, fears, attitudes, and behavioral intentions-both immediately after the treatment and four weeks later. We test whether perceived funniness mediates expected effects on attitudes and intentions. Study 1 is a quasi-experiment which uses a live medical comedy show (N = 3,964) as an entertainment education format, which either contained or did not contain information about organ donation. Study 2, a lab experiment, tests humor's causal effect in a pre-post design with a control group (N = 144) in which the same content was provided in either a humorous or non-humorous way in an audio podcast. Results showed that humorous interventions per se were not more effective than neutral information, but that informing people about organ donation in general increased donation intentions, attitudes, and knowledge. However, humorous interventions were especially effective in reducing fears related to organ donation. The findings are discussed regarding the opportunities for sensitive health communication through entertainment education formats, psychological processes that humor triggers, and humor's role in health communication formats.

GET.HAPPY - Acceptance of an internet-based self-management positive psychology intervention for adult primary care patients with mild and moderate depression or dysthymia: A pilot study.

INTRODUCTION: A growing number of internet interventions have been shown to help in alleviating symptoms of depression. So far, only little research has focused on other methods than CBT. The present study aimed to investigate the level of satisfaction with a positive psychology online training among patients with mild and moderate depression or dysthymia. Secondary outcome measures included changes in symptom severity, health related quality of life, and negative effects. METHODS: A total of 81 participants were allocated to the intervention. They were asked to complete online questionnaires and were called by one of the study psychologists at baseline, at post-treatment, and at follow-up (3 months after completion of the intervention). Shorter questionnaires were administered after each module. RESULTS: Overall satisfaction was promising. While participants seemed to be very satisfied with many aspects of the program itself, they were slightly less satisfied with its impact on the problems they sought to solve. Overall, negative effects attributed to the program were small with one exception. At post-treatment, 22.6% of the participants felt that they or their problems were not taken seriously by the program. Symptom severity decreased over time with mild to moderate effect sizes. There was a moderate increase in satisfaction with mental health at both post-treatment and follow-up. CONCLUSIONS: The online program investigated here may be a useful resource-oriented addition to the standard treatment of depression.