Laughter may indeed be the best medicine!
Some children undergoing surgical experiences are frightened and unsure of the caring of the health care providers, whereas others use humor and laughter to communicate their trust and to reassure family and providers as well. Children are often more resilient than their parents and try to help their parents deal with their stress, using humor and laughter as mechanisms for doing so.
Ron Berk (2004), a professor emeritus of the Johns Hopkins University School of Nursing, created the diagnosis of Mirthium (generic: laughtilyouplotz). On the basis of his review of the literature and personal experiences, he identified the following major benefits of the diagnosis with regard to humor and laughter:
Benefits of humor: reduces negative emotional consequences of stress, anxiety, and tension; decreases depression, loneliness, and anger; improves mood; increases self-esteem; and promotes a sense of empowerment.
Benefits of laughter: increases pain tolerance and pain threshold; improves respiration and breathing; exercises the facial, abdominal, and thoracic muscles; relaxes the muscles/decreases muscle tension; and improves mental functioning (alertness, creativity, and memory).
Although there is some evidence to support the following benefits of humor/laughter, there is much work yet to be done to validate their impact:
Stimulate the production of endorphins, which decrease pain
Lower the heart rate and blood pressure
Decrease the production of stress hormones
Boost immune system function
It would be wonderful if these perceived benefits were proven to be valid, as they would perhaps convince more health care providers to "prescribe" them and more parents to use them in supporting their children before, during, and after surgery.
Humor therapy, also called therapeutic humor, uses the power of smiles and laughter to help patients, families, and health care professionals cope with illness and its treatment. Examples of humor therapy in pediatrics include clowns visiting the units, availability of humor carts with funny materials, laughter yoga classes, and humorous videos and books. One of my favorite authors of such humorous books is Fred Gwynne (1976, 1970, 1980), who wrote such clever books as A Chocolate Moose For Dinner, The King Who Rained, and The Sixteen Hand Horse. These creatively illustrated books help children (and adults) see what commonly used expressions can look like, based on the way the words are spelled; what fun it would be to have books like this to illustrate medical terms and phrases! Of course, there are many other books that can be used to generate laughter in children, such as one I have used frequently: Mouth Sounds: How to Whistle, Pop, Boing, and Honk for All Occasions[horizontal ellipsis]and Then Some (Newman, 2004).
As noted on the Web page at C. S. Mott Children's Hospital (2016), University of Michigan Health System, "humor therapy is completely safe[horizontal ellipsis]Because it is inexpensive, risk-free, and readily available, there is little reason not to try practicing humor therapy."
At the Akron Children's Hospital, Dr. Michael Bigham (2016) "uses humor to build trust and alleviate fear in his critically ill pediatric patients." He has found that his patients' health improves when compassion and laughter are a part of the treatment plan. A colleague, Dr. Sabina Ben-Zion (2016), at the Pediatrics Office in Wadsworth, also uses humor to help children relax when they come to her office for a checkup: "this may be playing peek-a-boo, making funny faces, or pretending I don't know where to check their heart. For example, I ask them if it is on top of their head or at their elbow[horizontal ellipsis]. Kids are full of such joy and humor. It is often what they say that gets me to chuckle." In a study conducted at the National Institutes of Health, researchers found that humorous videos were useful in increasing children's tolerance for moderately painful procedures; based on this finding, it was suggested that "the primary objective is to engage the child and that this can be effective whether or not the child actually laughs out loud." The authors note that "laughter itself may be less important than the emotional involvement in humor. Even the expectation of humor may have a positive effect" (Stuber et al., 2009). Many people find laughing to be spiritually uplifting; in reality, humor can be transcendent. There is evidence throughout our world that God has a sense of humor. I believe that children appreciate God's sense of humor and can laugh about experiences and scenes that we as adults may think we should not laugh about, for fear of being politically incorrect. Thank goodness children do not worry about being politically incorrect; they should be our role models for enjoying life and seeing its humor. In addition, humor can help us to laugh at ourselves; again, children do seem to enjoy laughing at themselves and laughing with us. What a blessing they are to their parents and friends and to us, their health care providers!
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