Paul McGhee, PhD

The Impact of Other Mind-Body Approaches on Patient Outcomes

• "Have you ever been treated by a doctor for this condition?"
  "No, they always make me pay."

Sign in a doctor's office: "Amnesia patients must pay in advance."

We saw in last month's article that research on the impact of hospital humor programs upon patient outcomes is just beginning. A great deal of research has been conducted using other mind-body approaches, however. In one analysis of 191 different studies (involving 8600 patients), a wide range of mind/body interventions before and after surgery (e.g., guided imagery, hypnosis, relaxation procedures, biofeedback and giving information) were found to be effective in improving surgery outcomes. "These interventions have been shown to work for virtually every imaginable kind of surgery--from back surgery to coronary-bypass operations to cancer resections."1

Since most health management systems are concerned about length of hospital stays, it is important to note that one analysis of 13 different studies showed that "psychosocial interventions reduced hospitalization by an average of 2.4 days . . ."2 A different analysis of 102 studies showed that 79% of them revealed a shorter length of hospital stay because of the mind-body procedure used.3

The most effective of the various procedures used over the past two decades involve what have been called "psychoeducational interventions." These involve providing patients health-related information about their condition and surgical procedure, as well as some kind of skill or exercise that helps them reduce pain or cope better.

In one analysis of 102 different studies, such interventions were found to have a significant positive impact on recovery rate, pain reduction, psychological well-being and satisfaction with care. This was found for abdominal, thoracic, orthopedic, gynecological, cancer, and eye-ear-nose-throat patients.4 An especially strong effect was found for the ability of these mind-body procedures to reduce medical complications and reduce the number of days after discharge before resuming normal activities.

In a 1998 review of all the research in this area, Henry Dreher concluded that in addition to providing preparatory information about the upcoming surgery, the provision of coping and rehabilitation skills plays a key role in the gains shown.5 Relaxation techniques alone showed only mixed success, in spite of the fact that they are one of the most popular approaches used in many healthcare settings.

As we have already seen, humor is a powerful coping skill, and muscle relaxation occurs as a result of laughter. So, although research on the effect of humor on patient outcomes is now in its infancy, there is every reason to be optimistic about the results of this research when it is completed.

Within hospitals, nurses have tremendous power to boost the spirits of their patients. And this, in turn, helps patients mobilize their own natural healing resources. If you are a nurse, you can use humor to help your patients cope. The catch is, of course, that you must first improve your own humor skills. Many nurses are already transferring the benefits of my 8-Step Humor Skills Program to their patients. (See my web site, www.LaughterRemedy.com.) One nurse told me that her favorite line is, "I was going to tell you a joke, but I can see you're in stitches already."

Patients say that humor and shared laughter help raise their spirits, and take their minds off their illness and problems. In some cases, patients regularly exposed to hospital humor also leave the hospital earlier than they would normally be expected to (according to informal reports by hospital staff). I know of a cancer center in Florida where the patients have such a good time while undergoing treatments that they often go back for visits long after their disease is in remission.

One physician in a hospital I spoke at observed that patients with spinal cord injuries who were able to laugh about their circumstances were much better at absorbing and dealing with the humiliation and frustration they often felt. They also had fewer complications than patients who were unable to find a light side of their condition. This doctor is convinced that humor and laughter play an important role in their recovery.

Many hospital staff are convinced that while humor helps both staff and patients relieve some of the tension that builds up, it also adds a more human touch to the hospital experience. The important point for you to consider is that if many health care experts now see enough therapeutic value in humor to build it into hospital settings, it's certainly worthwhile to improve your sense of humor so that you can get this therapeutic effect into your own life every day. It will help you remain healthy, and support your recovery when you do get sick.

[Excerpt from Dr. McGhee's book, Health, Healing and the Amuse System: Humor as Survival Training. Published by Kendall/Hunt, 1999. To order a copy by e-mail, see www.kendallhunt.com. Click on orders. ISBN number is 7872-5797-4.]


Pun Fun

1. A father looked outside and saw his own children pressing their hands into the cement of a newly laid sidewalk. He ran to the door and angrily gave the kids a real tongue-lashing. His wife asked, "How could you do that? Don't you love your children?" He answered, "In the abstract, yes; but not in _________."
CLUE: Find another word for what sidewalks are made of.

2. A photographer went to a haunted castle determined to get a photo of a ghost that was said to appear only once particular night every year. Not wanting to frighten off the ghost, he waited in the dark until midnight, when the apparition appeared. The ghost turned out to be very friendly, and agreed to pose for one photo. The happy photographer adjusted the flash on the camera and took the picture. He discovered later in his studio that the photo was underexposed and completely blank. So the ________ was willing, but the _______ was weak.
CLUE: This joke alludes to a familiar phrase in the last line. Once you think of the phrase, you should get the punchline.


References
1. Dreher, D. Mind-body interventions for surgery: Evidence and exigency. Advances in Mind-Body Medicine, 1998, 14, 207-222.
2. Mumford, E., et al. The effects of psychological intervention on recovery from surgery and heart attacks: An analysis of the literature. American Journal of Public Health, 1982, 72, 141-151.
3. Devine, E.C. Effect of psychoeducational care for adult surgical patients: A meta-analysis of 191 studies. Patient Education and Counseling, 1992, 19, 129-142.
4. Devine, E.C. & Cook, T.D. Clinical and cost-savings effects of psychoeducational interventions with surgical patients: A meta-analysis. Research in Nursing and Health, 1986, 9, 89-105.
5. Dreher, 1998.


Answers to Pun Fun

1. the concrete
2. spirit . . . flash (flesh)