Cultural Differences in Therapeutic Humor in Nursing Education

幽默已被醫護人員及護理研究者發現，在臨床照護中對個案身心方面具正向治療性功效。然而以幽默為主題之跨文化研究卻甚為有限，因此，本前驅性研究旨在探討不同文化的護理教師如何將治療性幽默融入課室及臨床教學。藉由此研究，期能說明護理教師對治療性幽默於理論與臨床上之連結性，及對不同文化之治療性幽默概觀。本跨文化研究以開放性問題問卷，收集美國及台灣三個護理學系共40位護理教師（15位來自台灣）提供之資料，以質性研究之內容分析法進行分析。研究結果發現，台灣護理教師指出會在課室中教導治療性幽默之理論及概念，但較少觀察到治療性幽默被實際運用到臨床照護中。其原因可能為台灣社會對疾病的文化價值觀有別於美國在台灣，生病是被嚴肅以待的事，治療性幽默在臨床上的運用需以個案及其家屬之互動模式、輩份角色、及責任關係為前提來考量。相反的，治療性幽默雖並未被放入美國的護理教育課程中；但臨床上，治療性幽默則在與個案互動中自然而然的運用出來。

關鍵字

文化；治療性幽默；護理教育

並列摘要

Humor has been recognized by nurse researchers and practitioners as a constructive therapeutic intervention and has shown positive psychological and physiological outcomes for patient care. Because cross-cultural research on humor is sparse, this preliminary study investigates how nursing faculty members approach teaching therapeutic humor in the classroom and clinical education in different countries. Through an investigation of classroom (didactic) education and clinical practicum with direct patient care, the study may elucidate the linkage between theory and practice as well as how nursing faculty members view therapeutic humor in general. Researching nursing faculty teaching practices and viewpoints of therapeutic humor may help reveal cultural differences in the use of humor in healthcare settings. This cross-cultural study included 40 nursing faculty at three nursing programs: two in the United States and one in Taiwan. A qualitative approach was used to perform content analysis on responses to the open-ended questionnaires. Research findings revealed cultural differences between faculties from the two countries. Taiwanese faculty members indicated that they teach more theory and concepts related to therapeutic humor in the classroom than do nursing faculty members from the United States. However, nursing faculty members in Taiwan reported that they observe and practice less therapeutic humor in clinical settings out of respect for the cultural value of ”reverence of illness” operating within Taiwanese society. Therapeutic humor was family centered and interdependent on relationships, roles, duties, and responsibilities of family members. In contrast, the U.S. faculty members stated that they teach less theory and concepts related to therapeutic humor in the classroom but observe and practice humor more in clinical settings. United States faculty approached teaching therapeutic humor in the classroom on an informal basis because the subject was not part of the required nursing curricula. In clinical settings, therapeutic humor was patient centered and spontaneous in nature.