The Importance of Research in Nursing Practice

Avoiding Liability Bulletin – April 14, 2017

When I was reviewing nursing research on the Web, I came across an interesting study done in 2010 in Hong Kong by several researchers.¹ It studied the “effectiveness of a humor therapy program in relieving chronic pain, enhancing happiness and life satisfaction, and reducing loneliness among older persons with chronic pain.”

Older residents in a nursing home were invited to participate in an 8-week therapy program and this group became the experimental group, which was comprised of 36 residents.  Other residents were not invited and they became the control group.  The number in this group was 34.  So, 70 residents participated.  The groups were comprised of 38 females and 32 males with a mean age of 78.25 for the experimental group and 79.38 for the control group.²

Past research had indicated that nonpharmacological pain management strategies are man, including cognitive-behavioral programs, according to the authors.  One such approach is “distraction”.  And, humor is one of the techniques used to distract patients who experience pain.

Humor has been shown to have many benefits, according to these researchers, including increasing lung capacity, increasing immunoglobulin A, improving pain thresholds, and releasing endorphins.

The humor therapy program was conducted in the multifunction room of the nursing home and was a one hour/week program for 8-weeks.  The program itself involved residents designing and making entries in their respective “My Happy Collection” portfolio; a joke of the day; reading funny jokes and stories; helping residents make humor a higher priority in their lives; playing games.

At the end of the 8-week program, various evaluative procedures and instruments were used to analyze the effects of the program. The study indicated that the humor therapy program reduced pain and loneliness in the residents and happiness and life satisfaction in the older population with chronic pain was enhanced.

In addition, the study also found that although pain levels were high and consistent in some form in the residents in the study, only 32% to 39% of the participants took ordered pain medication to relieve their pain.  According to other studies and literature, older people are reluctant to request pain relief and simply “endure” it as a “normal” part of aging.  In addition, they do not ask for pain medication because they don’t want to be labeled as “complainers”.

Information about loneliness and the life satisfaction of the residents in this nursing home also surfaced in the study.  The participants had a low scores for both, which is consistent with existing literature that nursing home residents experience relational losses (e.g., family, spouse) that lead to social isolation and loneliness.

Although this is only one study, it has major implications for you and your practice, especially if you work with the elderly in nursing homes.

The suggestions include:

1. Research in nursing is essential;
2. Research results in evidence-based practice;
3. If involved in designing and implementing research in your facility, be certain to obtain the approval of your institutional review board or ethics committee;
4. Never force residents/patients to participate in your research–informed consent and voluntary participation is crucial;
5. Maintain the privacy and confidentiality of those residents/patients who do participate in your research project;
6. Utilize the results of research findings in your clinical practice, in this instance by using humor appropriately with residents/patients;
7. Carefully assess a resident/patient’s need for pain medication by proactively asking about his or her level of pain rather than waiting for a request for the medication; and,
8. Apply humor to yourself and use it with your colleagues.

NOTE:  The entire research study can be accessed at http://dx.doi.org/10.4061/2010/343574 .

FOOTNOTES

1. Mimi M. Y. Tse,Anna P.K.Lo, Tracey L.Y.Cheng, and others, (2010) “Humor Therapy: Relieving Chronic Pain and Enhancing Happiness for Older Adults”, Journal of Aging Research. Article ID 343574, 9 pages.
2. Id.

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