@2024 Afarand., IRAN
ISSN: 2252-0805 The Horizon of Medical Sciences 2017;23(4):301-306
ISSN: 2252-0805 The Horizon of Medical Sciences 2017;23(4):301-306
Relationship between Humor and Subjective Well-Being with regard to Mediating Role of Resilience in Caregivers of Patients with Spinal Injury
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Abbasi M. (*)Amirian L. (1)
(*) Psychology Department, Literature & Humanities Faculty, Lorestan University, Khoramabad, Iran
(1) Psychology Department, Literature & Humanities Faculty, Lorestan University, Khoramabad, Iran
Correspondence
Address: Psychology Department, Literature and Humanities Faculty, Lorestan University, 5th Kilometer of Tehran Highway, Khoramabad, Lorestan, IranPhone: +98 (66) 33120097
Fax: +98 (66) 33120097
abbasi.mohammad@hotmail.com
Article History
Received: April 26, 2017Accepted: September 26, 2017
ePublished: November 28, 2017
BRIEF TEXT
Spinal cord Injury is one of the most difficult forms of physical and emotional problems which can reduce the ability to perform the most basic routine of individual, and the involved person is confronted with various disorders in all domains of his life [1, 2].
… [3-6]. Family caregivers who are the main providers of care for a sick or injured family member, usually report lower physical health and higher level of anxiety and depression. Studies have shown that negative emotions such as anger, failure, fear, family conflicts, and burnout are very common in this group of people [7]. … [8-17]. Some researchers have reported that humor as a defensive mechanism is associated with a reduction in symptoms such as depression and anxiety, and improvement of quality of life [18]. … [19-24]. On the other hand, there is a significant and negative relationship between resilience and psychological problems [25, 26]. … [27-32].
Caregivers of people with spinal cord injury due to their specific problems, have stress and responsibilities and are subject to multiple mental and psychological problems. So far, few studies have looked at the psychological characteristics of this group. Accordingly, the purpose of this study was to investigate the relationship between being humorous and subjective well-being with respect to the role of resilience mediation in caregivers with spinal cord injury.
This cross-sectional study is descriptive-correlational.
This research was conducted in the year 2016 among the caregivers of the spinal cord injury patients in Isfahan who had referred to the Borna Scientific-Sport Institute for rehabilitation of their patients.
Of these, 258 were selected through convenience sampling, of which 219 were willing to cooperate in this study.
The following tools were used to collect data: 1-Mental Well-being Scale: To measure mental well-being, the Keyes and Magyar-Mae questionnaire was used [33]. The questionnaire has 45 items and is arranged in three sections: emotional well-being (12 questions), psychological well-being (18 questions), and social well-being (15 questions). The items in this questionnaire are of five degree Likert Scale type. In this questionnaire, questions 1, 2, 3, 8, 9, 11, 12, 13, 17 and 18 are subscales of psychological well-being, and questions 3 to 6, 11, 12, and 14 in the subscale of social well-being and question 5 in the subscale of emotional well-being are scaled reversely. In the present study, the internal consistency coefficient based on Cronbach`s alpha for the whole questionnaire and its subscales including emotional, psychological and social well-being were respectively 0.69, 0.49, 0.66 and 0.71 respectively. Sense of Humor Questionnaire (SHQ): for evaluation of sense of humor of the subjects, this questionnaire was used that has been validated in Iran by Khoshoi [34]. This questionnaire has 25 items that are set up with answers in the seven-point Likert scale (I totally agree, agree, somewhat agree, have no idea, somewhat disagree, disagree, and totally disagree). The total score of the questionnaire is at least 25 and a maximum of 175. Khoshoi has analyzed this questionnaire using the main component analysis of the varimax type. Accordingly, a five-factor structure (pleasure from joke, laughter, verbal joke, humorous social relations and humorous attitude in stressful situation) was explained by 63.73% of the total variance [34]. In the present study, the coefficient of the reliability of the scale was obtained using Cronbach`s alpha of 0.79. 3-Connor-Davidson Resilience Scale (CD-RISC): This scale includes 25 items with five-option answers (totally incorrect, rarely true, sometimes correct, often correct, often corrected and always correct). The minimum score for this test is zero and its maximum is 100. Its validity and reliability have been reported by its creators as desirable [28]. In Samani Jokar & Sahragard [28], the coefficient reliability was obtained 0.87 using Cronbach's alpha method. In the present study, the coefficient of reliability of the scale was calculated 0.77 using Cronbach's alpha. After taking the consent of caregivers of the injured spinal cord patients, the questionnaire was given to them. They were provided with some explanation about the completion of the questionnaire, and after a period of time agreed upon by them, the filled questionnaire was received from them. Throughout the study period, researchers tried to observe all ethical considerations relating to the subjects, including the freedom to choose whether to participate in or not participate in the research that a number of individuals who were selected as samples were discarded from the list due to their disapproval. Also, the subjects were guaranteed that the information obtained from them will remain confidential. During the study, an attempt was made to take action or activity that could endanger the health of participants in the research or others. Data were analyzed using Amos 18 software. To evaluate the pattern of research, the structural equation modeling that is a multi-valued correlation model was used (Fig. 1). A combination of fitness versions was used to determine the adequacy of the proposed pattern of research with the data. The bootstrap test was used to investigate the indirect relationship between humor and mental well-being through resilient mediation.
The samples were 154 males and 65 females aged between 16 and 57 years old. Correlation between all variables was significant and the highest correlation coefficient was between social well-being and psychological well-being and the lowest correlation coefficient was between emotional well-being and humor (p<0.001; Table 1). Fit indices indicated the fitting of data with the proposed model and all the coefficients of direct paths were significant (p<0.05; Table 2; Fig. 2).Also, there was a significant indirect relationship between humor and mental well-being through resilience (p<0.006, β = 0.22). The lower limit of confidence for resilience as mediator was 0.25 in the relationship between humor and mental well-being, and a maximum of 0.36. Given the 95% confidence level for this distance, this mediation relationship (i.e. humor effect on mental well-being through resilience) was significant.
The results of the study showed that there is a positive and significant relationship between humor as independent variable and subjective well-being as a dependent variable. This finding is consistent with previous research results [14, 15]. … [35].In another part of the findings of this research, a positive and significant relationship was found between humor and resilience. This result is consistent with the findings of Turgheh et al. who have shown that resilience in nurses with high humor is higher than in nurses with low humor [36]. On the other hand, the variance of resilience mediator had a significant relationship with mental well-being, which is consistent with the findings of other studies [37-39]. … [40-43].
It is suggested that studies be done longitudinally and with a larger sample size. It is also recommended that in future studies other measurement methods, such as semi-structural interviews, continuous observation, and other qualitative methods be used. According to the findings of this research, caregivers training for people with SCI can help to accept new conditions, as well as improve their mental and psychological state and affect patients with spinal cord injury. Hence, one of the suggestions of this study is that health care administrators help them with the necessary measures to provide the psychological support needed by these patients and their families.
One of the limitations of this study was that the study was done in a period of time, and researches did not control the recent event of caregivers of patients. The data of the present study were collected using questionnaire.
Psychological resilience as the mediator in the relationship between mental well-being and humor plays an important role in improving the psychological state of caregivers of patients with spinal cord injury.
Thanks to all the care givers of the patients with the spinal cord injury for their patience in responding to the questionnaire and cooperating in this research.
Non-declared
For ethical considerations, the purpose of the study was first explained to the participants, and then the written consent was received from the participants in the study. Also, the implementation of the research at the BERA institute of Sport has been approved as 217.95.
Funding for this research was personal.
TABLES and CHARTS
Show attach fileCITIATION LINKS
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[2]Siddall PJ, Mclndoe L, Austin P, Wrigley PJ. The impact of pain on spiritual well-being in people with a spinal cord injury. Spinal Cord. 2016;55(1):105-11.
[3]Lim SW, Shiue YL, Ho CH, Yu SC, Kao PH, Wang JJ, et al. Anxiety and depression in patients with traumatic spinal cord injury: A nationwide population-based cohort study. PLoS One. 2017;12(1). pone.0169623.
[4]Cao Y, Li C, Newman S, Lucas J, Charlifue S, Krause JS. Posttraumatic stress disorder after spinal cord injury. Rehabil Psychol. 2017;62(2):178-85.
[5]Hickman RL, Douglas SL. Impact of chronic critical illness on the psychological outcomes of family members. AACN Adv Crit Care. 2010;21(1):80–91.
[6]Baker A, Barker S, Sampson A, Martin C. Caregiver outcomes and interventions: A systematic scoping review of the traumatic brain injury and spinal cord injury literature. Clin Rehabil. 2017;31(1):45-60. doi:10.1136/bmj.j84.
[7]Coffey NT, Cassese J, Cai X, Garfinkel S, Patel D, Jones R, et al. Identifying and understanding the health information experiences and preferences of caregivers of individuals with either traumatic brain injury, spinal cord injury, or burn injury: a qualitative investigation. J Med Internet Res. 2017;19(5):e159.
[8]Dowell P, Lyons K, Schmidt P, Pahwa R. Impact of off time on quality of life and caregiver burden in parkinson’s disease (P6. 007). Neurology. 2017;88(Suppl 16):P6.007.
[9]Teresi JA, Ocepek-Welikson K, Toner JA, Kleinman M, Ramirez M, Eimicke JP, et al. Methodological issues in measuring subjective well-being and quality-of-life: Applications to assessment of affect in older, chronically and cognitively impaired, ethnically diverse groups using the feeling tone questionnaire. Appl Res Qual Life. 2017;12(2):251-88.
[10]Douma L, Steverink N, Hutter I, Meijering L. Exploring subjective well-being in older age by using participant-generated word clouds. Gerontologist. 2017;57(2):229-39.
[11]Foye C. The Relationship between size of living space and subjective well-being. J Happiness Stud. 2017;18(2):427-61.
[12]González-Carrasco M, Casas F, Malo S, Viñas F, Dinisman T. Changes with age in subjective well-being through the adolescent years: Differences by gender. J Happiness Stud. 2017;18(1):63-88.
[13]Dawson C, Veliziotis M, Hopkins B. Temporary employment, job satisfaction and subjective well-being. Eco Indust Democ. 2014;38(1):69-98.
[14]Heintz S. Putting a spotlight on daily humor behaviors: Dimensionality and relationships with personality, subjective well-being, and humor styles. Pers Individ Dif. 2017;104:407-12.
[15]Fox CL, Hunter SC, Jones SE. Longitudinal associations between humor styles and psychosocial adjustment in adolescence. Eur J Psychol. 2016;12(3):377-89.
[16]Hampes W. The relationship between humor styles and forgiveness. Eur J Psychol. 2016;12(3):338-47.
[17]Fritz HL, Russek LN, Dillon MM. Humor use moderates the relation of stressful life events with psychological distress. Personal Soc Psychol Bull. 2017;43(6):845-59.
[18]Rnic K, Dozois DJA, Martin RA. Cognitive distortions, humor styles, and depression. Eur J Psychol. 2016;12(3):348-62.
[19]McCosker B, Moran CC. Differential effects of self-esteem and interpersonal competence on humor styles. Psychol Res Behav Manag. 2012;5:143-50.
[20]Boerner M, Joseph S, Murphy D. The association between sense of humor and trauma-related mental health outcomes: Two exploratory studies. J Loss Trauma. 2017;22(5):440-52.
[21]Ho SK. The relationship between teacher stress and burnout in Hong Kong: positive humour and gender as moderators. Educ Psychol. 2017;37(3):272-86.
[22]Martínez-Martí ML, Ruch W. Character strengths predict resilience over and above positive affect, self-efficacy, optimism, social support, self-esteem, and life satisfaction. J Posit Psychol. 2017;12(2):110-9.
[23]Tucker RP, Wingate LR, O’Keefe VM, Slish ML, Judah MR, Rhoades-Kerswill S. The moderating effect of humor style on the relationship between interpersonal predictors of suicide and suicidal ideation. Pers Individ Dif. 2013;54(5):610-5.
[24]De Santis JP, Florom-Smith A, Vermeesch A, Barroso S, DeLeon DA. Motivation, managemen t, and mastery: A theory of resilience in the context of HIV infection. J Am Psychiatr Nurses Assoc. 2013;19(1):36-46.
[25]Mealer M, Jones J, Meek P. Factors affecting resilience and development of posttraumatic stress disorder in critical care nurses. Am J Crit Care. 2017;26(3):184-92.
[26]Poole JC, Dobson KS, Pusch D. Anxiety among adults with a history of childhood adversity: Psychological resilience moderates the indirect effect of emotion dysregulation. J Affect Disord. 2017;217:144-52.
[27]Khalatbary J, Bahari S. Relationship between resilience and satisfaction of life. J Educ Psychol. 2010;1(2):83-94.
[28]Amini F. The relationship between resilience and burnout in nurses. J Res Dev Nurs Midwifery. 2014;11(2):94-102. [Persian]
[29]Asli Azad M, Rajai R, Farhadi T, Aghasi A, Shahidi L. The Relationship between hardiness and resilience dimensions of burnout among caregivers physically handicapped, mentally and diversity of Isfahan. Public Health. 2017;10(2):24-32. [Persian]
[30]Lal S, Ungar M, Malla A, Leggo C, Suto M. Impact of mental health services on resilience in youth with first episode psychosis: A qualitative study. Adm Policy Ment Health. 2017;44(1):92-102.
[31]Jiao M, Gu J, Xu H, Hao C, Lau JT, Mo P, et al. Resilience associated with mental health problems among methadone maintenance treatment patients in Guangzhou, China. AIDS Care. 2017;29(5):660-5.
[32]Khoshouei MS. Relationship of sense of humour and mental disorder of students in Esfahan city. J Tabriz Univ Psychol. 2008;3(9):53-70. [Persian]
[33]Keyes CL, Shmotkin D, Ryff CD. Optimizing well-being: The empirical encoundter of two traditions. J Pers Soc Psychol. 2002;82(6):1007-22.
[34]Khoshouei MS. The relationship between emotional intelligence and sense of humor in university students. J Educ Stud Psychol. 2009;9(2):95-111. [Persian]
[35]Pasandideh M, Zare L. An analysis of well-being psychiatric aspects of tolerance and sense of humour between patients who suffer from coronary artery disease and healthy individuals. Health Psychol. 2017;5(20):88-108. [Persian]
[36]Torgheh M, Aliakbari dehkordi M, Alipour A. Effect of humour on burnout and resiliency of nurses . J Holist Nurs Midwifery. 2015;25(2):57-64. [Persian]
[37]Behzadpoor S, Motahhari ZS, Vakili M, Sohrabi F. The effect of resilience training on increasing psychological well-being of infertile women. J Ilam Univ Med Sci. 2015;23(5):131-42. [Persian]
[38]Shojaee S, Beh-Pajooh A, Shokoohiyekta M. The effectiveness of resilience training on mental health in siblings of children with Down syndrome. J Res Behav Sci. 2013;11(5):436-47.[Persian]
[39]Bazzazian S, Rajabi A. Self-efficacy, social support and quality of life in patients with type II diabetes. J Behave Sci. 2012;3(10):25-39. [Persian]
[40]Temprado MD, Agut S, Collado E. The mediating role of resilience in the relationship between personality and adjustment to disease in patients with a drainage enterostomy. J Health Psychol. 2017;359105316689142.
[41]Khodabakhshi Koolaee A, Navidian A, Baiati Z, Rahmatizadeh M. Effectiveness of supportive psychotherapy on quality of life in patients with type2 diabetes. J Diabetes Nurs. 2015;3(3):31-41. [Persian]
[42]Shi M, Liu L, Wang ZY, Wang L. The mediating role of resilience in the relationship between big five personality and anxiety among Chinese medical Students: A Cross-Sectional Study. PloS one. 2015;10(3):0119916.
[43]Ford TE, Lappi SK, Holden CJ. Personality, humor styles and happiness: Happy people have positive humor styles. Eur J Psychol. 2016;12(3):320-37.
[2]Siddall PJ, Mclndoe L, Austin P, Wrigley PJ. The impact of pain on spiritual well-being in people with a spinal cord injury. Spinal Cord. 2016;55(1):105-11.
[3]Lim SW, Shiue YL, Ho CH, Yu SC, Kao PH, Wang JJ, et al. Anxiety and depression in patients with traumatic spinal cord injury: A nationwide population-based cohort study. PLoS One. 2017;12(1). pone.0169623.
[4]Cao Y, Li C, Newman S, Lucas J, Charlifue S, Krause JS. Posttraumatic stress disorder after spinal cord injury. Rehabil Psychol. 2017;62(2):178-85.
[5]Hickman RL, Douglas SL. Impact of chronic critical illness on the psychological outcomes of family members. AACN Adv Crit Care. 2010;21(1):80–91.
[6]Baker A, Barker S, Sampson A, Martin C. Caregiver outcomes and interventions: A systematic scoping review of the traumatic brain injury and spinal cord injury literature. Clin Rehabil. 2017;31(1):45-60. doi:10.1136/bmj.j84.
[7]Coffey NT, Cassese J, Cai X, Garfinkel S, Patel D, Jones R, et al. Identifying and understanding the health information experiences and preferences of caregivers of individuals with either traumatic brain injury, spinal cord injury, or burn injury: a qualitative investigation. J Med Internet Res. 2017;19(5):e159.
[8]Dowell P, Lyons K, Schmidt P, Pahwa R. Impact of off time on quality of life and caregiver burden in parkinson’s disease (P6. 007). Neurology. 2017;88(Suppl 16):P6.007.
[9]Teresi JA, Ocepek-Welikson K, Toner JA, Kleinman M, Ramirez M, Eimicke JP, et al. Methodological issues in measuring subjective well-being and quality-of-life: Applications to assessment of affect in older, chronically and cognitively impaired, ethnically diverse groups using the feeling tone questionnaire. Appl Res Qual Life. 2017;12(2):251-88.
[10]Douma L, Steverink N, Hutter I, Meijering L. Exploring subjective well-being in older age by using participant-generated word clouds. Gerontologist. 2017;57(2):229-39.
[11]Foye C. The Relationship between size of living space and subjective well-being. J Happiness Stud. 2017;18(2):427-61.
[12]González-Carrasco M, Casas F, Malo S, Viñas F, Dinisman T. Changes with age in subjective well-being through the adolescent years: Differences by gender. J Happiness Stud. 2017;18(1):63-88.
[13]Dawson C, Veliziotis M, Hopkins B. Temporary employment, job satisfaction and subjective well-being. Eco Indust Democ. 2014;38(1):69-98.
[14]Heintz S. Putting a spotlight on daily humor behaviors: Dimensionality and relationships with personality, subjective well-being, and humor styles. Pers Individ Dif. 2017;104:407-12.
[15]Fox CL, Hunter SC, Jones SE. Longitudinal associations between humor styles and psychosocial adjustment in adolescence. Eur J Psychol. 2016;12(3):377-89.
[16]Hampes W. The relationship between humor styles and forgiveness. Eur J Psychol. 2016;12(3):338-47.
[17]Fritz HL, Russek LN, Dillon MM. Humor use moderates the relation of stressful life events with psychological distress. Personal Soc Psychol Bull. 2017;43(6):845-59.
[18]Rnic K, Dozois DJA, Martin RA. Cognitive distortions, humor styles, and depression. Eur J Psychol. 2016;12(3):348-62.
[19]McCosker B, Moran CC. Differential effects of self-esteem and interpersonal competence on humor styles. Psychol Res Behav Manag. 2012;5:143-50.
[20]Boerner M, Joseph S, Murphy D. The association between sense of humor and trauma-related mental health outcomes: Two exploratory studies. J Loss Trauma. 2017;22(5):440-52.
[21]Ho SK. The relationship between teacher stress and burnout in Hong Kong: positive humour and gender as moderators. Educ Psychol. 2017;37(3):272-86.
[22]Martínez-Martí ML, Ruch W. Character strengths predict resilience over and above positive affect, self-efficacy, optimism, social support, self-esteem, and life satisfaction. J Posit Psychol. 2017;12(2):110-9.
[23]Tucker RP, Wingate LR, O’Keefe VM, Slish ML, Judah MR, Rhoades-Kerswill S. The moderating effect of humor style on the relationship between interpersonal predictors of suicide and suicidal ideation. Pers Individ Dif. 2013;54(5):610-5.
[24]De Santis JP, Florom-Smith A, Vermeesch A, Barroso S, DeLeon DA. Motivation, managemen t, and mastery: A theory of resilience in the context of HIV infection. J Am Psychiatr Nurses Assoc. 2013;19(1):36-46.
[25]Mealer M, Jones J, Meek P. Factors affecting resilience and development of posttraumatic stress disorder in critical care nurses. Am J Crit Care. 2017;26(3):184-92.
[26]Poole JC, Dobson KS, Pusch D. Anxiety among adults with a history of childhood adversity: Psychological resilience moderates the indirect effect of emotion dysregulation. J Affect Disord. 2017;217:144-52.
[27]Khalatbary J, Bahari S. Relationship between resilience and satisfaction of life. J Educ Psychol. 2010;1(2):83-94.
[28]Amini F. The relationship between resilience and burnout in nurses. J Res Dev Nurs Midwifery. 2014;11(2):94-102. [Persian]
[29]Asli Azad M, Rajai R, Farhadi T, Aghasi A, Shahidi L. The Relationship between hardiness and resilience dimensions of burnout among caregivers physically handicapped, mentally and diversity of Isfahan. Public Health. 2017;10(2):24-32. [Persian]
[30]Lal S, Ungar M, Malla A, Leggo C, Suto M. Impact of mental health services on resilience in youth with first episode psychosis: A qualitative study. Adm Policy Ment Health. 2017;44(1):92-102.
[31]Jiao M, Gu J, Xu H, Hao C, Lau JT, Mo P, et al. Resilience associated with mental health problems among methadone maintenance treatment patients in Guangzhou, China. AIDS Care. 2017;29(5):660-5.
[32]Khoshouei MS. Relationship of sense of humour and mental disorder of students in Esfahan city. J Tabriz Univ Psychol. 2008;3(9):53-70. [Persian]
[33]Keyes CL, Shmotkin D, Ryff CD. Optimizing well-being: The empirical encoundter of two traditions. J Pers Soc Psychol. 2002;82(6):1007-22.
[34]Khoshouei MS. The relationship between emotional intelligence and sense of humor in university students. J Educ Stud Psychol. 2009;9(2):95-111. [Persian]
[35]Pasandideh M, Zare L. An analysis of well-being psychiatric aspects of tolerance and sense of humour between patients who suffer from coronary artery disease and healthy individuals. Health Psychol. 2017;5(20):88-108. [Persian]
[36]Torgheh M, Aliakbari dehkordi M, Alipour A. Effect of humour on burnout and resiliency of nurses . J Holist Nurs Midwifery. 2015;25(2):57-64. [Persian]
[37]Behzadpoor S, Motahhari ZS, Vakili M, Sohrabi F. The effect of resilience training on increasing psychological well-being of infertile women. J Ilam Univ Med Sci. 2015;23(5):131-42. [Persian]
[38]Shojaee S, Beh-Pajooh A, Shokoohiyekta M. The effectiveness of resilience training on mental health in siblings of children with Down syndrome. J Res Behav Sci. 2013;11(5):436-47.[Persian]
[39]Bazzazian S, Rajabi A. Self-efficacy, social support and quality of life in patients with type II diabetes. J Behave Sci. 2012;3(10):25-39. [Persian]
[40]Temprado MD, Agut S, Collado E. The mediating role of resilience in the relationship between personality and adjustment to disease in patients with a drainage enterostomy. J Health Psychol. 2017;359105316689142.
[41]Khodabakhshi Koolaee A, Navidian A, Baiati Z, Rahmatizadeh M. Effectiveness of supportive psychotherapy on quality of life in patients with type2 diabetes. J Diabetes Nurs. 2015;3(3):31-41. [Persian]
[42]Shi M, Liu L, Wang ZY, Wang L. The mediating role of resilience in the relationship between big five personality and anxiety among Chinese medical Students: A Cross-Sectional Study. PloS one. 2015;10(3):0119916.
[43]Ford TE, Lappi SK, Holden CJ. Personality, humor styles and happiness: Happy people have positive humor styles. Eur J Psychol. 2016;12(3):320-37.