Skip to main content
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 2005 Feb;81(952):126–130. doi: 10.1136/pgmj.2004.019406

Use of humour in primary care: different perceptions among patients and physicians

M Granek-Catarivas 1, S Goldstein-Ferber 1, Y Azuri 1, S Vinker 1, E Kahan 1
PMCID: PMC1743193  PMID: 15701747

Abstract

Purpose: (1) To explore the frequency with which humorous behaviour and statements occur in family medicine practice in Israel, and (2) to quantitatively assess the correlation between the subjective perceptions of humour in medical encounters between patients and physicians.

Method: In a cross sectional study, two populations (doctors and patients) were surveyed with paired structured questionnaires completed immediately after primary care practice visits. Two hundred and fifty consecutive encounters from 15 practices were sampled. The physician questionnaire was self administered, and patient questionnaire was administered by a trained research assistant.

Results: A mean of 16.7 questionnaires was completed per physician (range 6–20). The physicians reported having used some humour in only 95 encounters (38%), whereas almost 60% of patients agreed with the statement, "The doctor used some humour during the visit". At the same time, for specific encounters, the agreement between patients' perception and physicians' perceptions on the use of humour, although not completely by chance (p = 0.04), is low (κ = 0.115). Patient characteristics (age, education, gender, family status, mother tongue, self perceived heath status, stress, mood, and expectations) were not related to the degree of agreement between the patients' and physicians' perceptions.

Conclusion: Humour was used in a large proportion of encounters, independently of patient characteristics. Patients seem to be more sensitised to humour than physicians, probably because of their high stress level during medical encounters. Cultural differences may also play a part. Physicians should be made aware of this magnifying effect, and the issue should be discussed in medical schools.

Full Text

The Full Text of this article is available as a PDF (64.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ackerman M. H., Henry M. B., Graham K. M., Coffey N. Humor won, humor too: a model to incorporate humor into the healthcare setting (revised) Nurs Forum. 1994 Apr-Jun;29(2):15–21. doi: 10.1111/j.1744-6198.1994.tb00155.x. [DOI] [PubMed] [Google Scholar]
  2. Beck Rainer S., Daughtridge Rebecca, Sloane Philip D. Physician-patient communication in the primary care office: a systematic review. J Am Board Fam Pract. 2002 Jan-Feb;15(1):25–38. [PubMed] [Google Scholar]
  3. Berk L. S., Tan S. A., Fry W. F., Napier B. J., Lee J. W., Hubbard R. W., Lewis J. E., Eby W. C. Neuroendocrine and stress hormone changes during mirthful laughter. Am J Med Sci. 1989 Dec;298(6):390–396. doi: 10.1097/00000441-198912000-00006. [DOI] [PubMed] [Google Scholar]
  4. Black D. W. Laughter. JAMA. 1984 Dec 7;252(21):2995–2998. [PubMed] [Google Scholar]
  5. Buchanan T. W., al'Absi M., Lovallo W. R. Cortisol fluctuates with increases and decreases in negative affect. Psychoneuroendocrinology. 1999 Feb;24(2):227–241. doi: 10.1016/s0306-4530(98)00078-x. [DOI] [PubMed] [Google Scholar]
  6. Hampes W. P. Relation between humor and empathic concern. Psychol Rep. 2001 Feb;88(1):241–244. doi: 10.2466/pr0.2001.88.1.241. [DOI] [PubMed] [Google Scholar]
  7. Hassed C. How humour keeps you well. Aust Fam Physician. 2001 Jan;30(1):25–28. [PubMed] [Google Scholar]
  8. Kimata H. Effect of humor on allergen-induced wheal reactions. JAMA. 2001 Feb 14;285(6):738–738. doi: 10.1001/jama.285.6.738. [DOI] [PubMed] [Google Scholar]
  9. Levinson W., Roter D. L., Mullooly J. P., Dull V. T., Frankel R. M. Physician-patient communication. The relationship with malpractice claims among primary care physicians and surgeons. JAMA. 1997 Feb 19;277(7):553–559. doi: 10.1001/jama.277.7.553. [DOI] [PubMed] [Google Scholar]
  10. Spitzer P. The clown doctors. Aust Fam Physician. 2001 Jan;30(1):12–16. [PubMed] [Google Scholar]
  11. Wender R. C. Humor in medicine. Prim Care. 1996 Mar;23(1):141–154. doi: 10.1016/s0095-4543(05)70267-0. [DOI] [PubMed] [Google Scholar]
  12. Wright F. The use of the self in group leadership: a relational perspective. Int J Group Psychother. 2000 Apr;50(2):181–198. doi: 10.1080/00207284.2000.11490997. [DOI] [PubMed] [Google Scholar]
  13. Yates S. Finding your funny bone. Incorporating humour into medical practice. Aust Fam Physician. 2001 Jan;30(1):22–24. [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES