Volume 20, Issue 2 (10-2023)
J Res Dev Nurs Midw 2023, 20(2): 14-18 |
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Oflaz B, Kendirkıran G. The relationship between nursıng students' humor styles and perceived care behaviors. J Res Dev Nurs Midw 2023; 20 (2) :14-18
URL: http://nmj.goums.ac.ir/article-1-1573-en.html
URL: http://nmj.goums.ac.ir/article-1-1573-en.html
1- Istanbul Metropolitan Municipality, Social Services Department, Social Services Directorate, Istanbul, Turkey , burcuoflazz@gmail.com
2- Halic University - Faculty of Health Sciences, Department of Nursing, Turkey
2- Halic University - Faculty of Health Sciences, Department of Nursing, Turkey
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Introduction
Besides being the ability to see events and situations from a positive perspective, humor is defined as a skill that is inherent in humans, can be developed, and involves cognitive, emotional, behavioral, psychophysiological, and social aspects (1-3). The sense of humor differs from society to society and increases productivity as it offers the opportunity to look at events from different angles (4). In health, it is stated that humor can reduce stress and improve the quality of life, transforming fears and other negative emotions into positive emotions expressed through laughter (5).
Care is based on human love between the caregiver and the patient. The individual characteristics, education levels, economic status, cultural characteristics, and religious beliefs of the caregivers, as well as the nurses' professional commitment, motivation, professional knowledge, and skills, directly affect the quality of the care provided (6,7). Humor provides the continuity of care and communication by building a bridge between the patient and the nurse. It also ensures the active participation of the patient in nursing care by creating a sense of trust, helps the individual to experience the death process at the best comfort level, decreases the anxiety levels of the nurses, increases their job satisfaction, and positively affects coping skills (8, 9).
This study aimed to evaluate the relationship between the humor styles of nursing students and their perceived care behaviors.
Methods
The descriptive correlational study was conducted to determine the relationship between nursing students' humor styles and perceived care behaviors.
The sample comprised nursing students studying at the Nursing School of Higher Education at a foundation university in Istanbul between December 2019 and December 2020. The study was conducted following the approval of the ethics board and institutional permission. Due to the coronavirus disease 2019 (COVID-19) pandemic that occurred after the permissions for the study were obtained, the data collection tools were prepared in the form of an e-survey (Google Forms) and delivered to the students online (via mobile phones, e-mails, and social media accounts). The forms were designed so as to be filled out by the students only once. The forms were shared with the students, and the data were collected in line with the principle of confidentiality of the data.
The population consisted of 255 second-year, third-year, and fourth-year students studying at the Nursing School of Higher Education at a foundation university located in Istanbul. The sample was composed of 124 students who agreed to participate and were accessed online due to the interruption of face-to-face education during the pandemic. As a result of the power analysis performed with G*Power v. 3.0.1, a minimum sample size of 124 was found to be sufficient with 90% power, 5% margin of error, and d=0.2935 impact size. The inclusion criteria were (i) volunteering to participate, (ii) not having a vision, auditory, or understanding problem, (iii) being a second, third, or fourth-year student at the Nursing School of Higher Education, and (iv) being 18 years old or above.
Data Collection Tools
Personal Information Form: It is a 20-question form developed in line with the literature review, which inquired about the students' general information (10, 11).
Humor Styles Questionnaire (HSQ): It is a 32-item, 7-point Likert-type scale developed by Martin et al. (2003) to measure individual differences in the daily use of humor (12). The validity and reliability of the scale in Turkish were examined by Yerlikaya (2003). It has 4 subscales, which are Affiliative Humor, Self-Enhancing Humor, Aggressive Humor, and Self-Defeating Humor. A high score obtained from the subscales indicates the usage frequency of that specific humor style (10). Cronbach's alpha values are as follows: Affiliative Humor 0.74, Self-Enhancing Humor 0.78, Aggressive Humor 0.69, and Self-Defeating Humor 0.67. In this study, Cronbach's alpha values were as follows: Affiliative Humor 0.77, Self-Enhancing Humor 0.82, Aggressive Humor 0.74, and Self-Defeating Humor 0.80.
Caring Assessment Questionnaire (CARE-Q): The scale was developed by Patricia Jean Larson (1981), and the Turkish validity and reliability of the scale were explored by Eskimez and Acaroğlu (2019). The subscales of the 50-item scale measuring care behaviors are “Accessibility (6 items)”, “Explains and Facilitates (6 items)”, “Comforts (9 items)”, “Anticipates (5 items)”, “Trusting Relationship (16 items)”, and “Monitors and Follows Through (8 items)” (11). The Cronbach's alpha value is 0.97. In this study, the Cronbach's alpha was 0.94.
Data analysis
Statistical analyses were performed in IBM SPSS Statistics v. 24 (IBM Corp., Armonk, NY, USA) by using frequency tables and descriptive statistics, independent samples t-test, analysis of variance (ANOVA), Mann-Whitney-U test, Kruskal-Wallis H test, Bonferroni correction, and Spearman correlation analysis.
Results
Of the 124 nursing students, 86.3% were female and 97.6% were single. The mean age of the students was 20.80±1.94 years. Moreover, 49.2% of the students were second-year students, 15.3% were third-year students, and 35.5% were fourth-year students (Table 1). It was found that 72.6% of the students were "very satisfied" with receiving occupational education. It was also determined that 65.3% of the students would choose nursing again if provided with the opportunity, 60.5% had not participated in any scientific activity within the last year, 96% did not read humorous magazines, and 82.3% supported the view that "providing care is the primary duty of the nurse."
The students' mean score on the Affiliative Humor subscale was 44.95±7.26, their Self-Enhancing Humor subscale mean score was 36.50±9.85, the mean score on the Aggressive Humor subscale was 17.22±7.22, and the Self- Defeating Humor subscale mean score was 26.86±9.99. The total mean score of the students on the CARE-Q was 6.38±0.51. Their mean score on the subscale of Accessibility was 6.31±0.55, their mean score on the subscale of Explains and Facilitates was 6.24±0.70, their mean score on the subscale of Comforts was 6.19±0.63, the Anticipates subscale mean score was 6.25±0.86, the Trusting Relationship subscale mean score was 6.45±0.60, and their mean score on the subscale of Monitors and Follows Through was 6.67±0.52 (Table 2).
The mean scores that the male students obtained from the subscales of Aggressive Humor and Self-Defeating Humor on the Humor Styles Questionnaire were found to be significantly higher (p<0.05). The mean score of those who had participated in a scientific activity within the last year was significantly higher on the subscale of Affiliative Humor (p<0.05). In addition, the mean score of those who were partially satisfied with the education they received was significantly higher on the Self-Enhancing Humor and Self-Defeating Humor subscales of the Humor Styles Questionnaire (p<0.05) (Table 3).
The female students' mean scores on the subscales of Explains and Facilitates and Anticipates and their CARE-Q total mean scores were determined to be significantly higher (p<0.05). The mean score of those who were 22 years old and above on the Monitors and Follows Through subscale of CARE-Q was significantly higher (p<0.05). Accessibility, Comforts, and Trusting Relationship subscale mean scores and the CARE-Q total mean score of those who would not choose nursing as an occupation again if given the opportunity were significantly higher (p<0.05). Comforts and Anticipates subscale mean scores and the CARE-Q total mean score of those who did not read humorous magazines were significantly higher (p<0.05). Finally, Accessibility, Explains and Facilitates, Comforts, Anticipates, and Monitors and Follows Through subscale mean scores and the CARE-Q total mean score of those who agreed with the view that "providing care is the main duty of the nurse" were significantly higher (p<0.05) (Table 4).
A significant negative relationship was found between the Aggressive Humor sub-dimension and Accessibility, Explains and Facilitates, Comforts, Anticipates, Trusting Relationship, Monitors and Follows Through, and CARE-Q total score, and a positive relationship was found in the other subscales (Table 5).
Discussion
The highest score among the subscales of the Humor Styles Questionnaire was obtained on the Affiliative Humor subscale. It is known that positive use of humor positively affects the individual's psychology and improves his/her well-being. In addition, positive use of humor positively contributes to students' achievement by increasing their motivation and helping them cope with stress more easily (12-14).
In the study conducted by Bulut et al. (2017), the students' positive humor mean score was higher compared to their negative humor mean score (15). This result suggests that the students used humor in their lives in a positive way and that they had a positive perspective of the challenges they encountered.
In this study, the Aggressive Humor and Self-Defeating Humor subscale mean scores of the male participants were found to be significantly higher. Similar results were obtained in previous studies, in which aggressive and self-defeating humor styles were found to be higher in men (16-18). The use of humor by students who have a self-defeating humor style to make others happy while ignoring their own needs and thoughts and criticizing themselves through humor can increase unhealthy social interactions and increase the individual's inclination towards negative emotions such as stress, anxiety, and sorrow (1,8).
In this study, Self-Enhancing Humor and Self-Defeating Humor subscale mean scores of the students who were partially satisfied with the education they received were significantly higher compared to those who were very satisfied. During nursing education, students encounter numerous stressors such as intense course periods, internships in hospital environments, being involved in the care of patients in the terminal stage, and seeing various technological equipment and materials for the first time and using them (13).
In this study, the Affiliative Humor subscale mean scores of those who had participated in a scientific activity in the last year were found to be significantly higher than those who had not. If nursing students follow scientific studies and publications, it helps them improve their awareness of conducting scientific research and critical perspectives; still, it is known that critical thinking skill, which is included in the basic components of humor, provides a solution-oriented and multilateral perspective in the face of problems (19, 20).
While nurses' correct determination of the patient's care needs and internalization of nursing care affect the quality of patient care, the development of appropriate care perception both during the education process and after graduation increases care awareness (21). Therefore, determining nursing students' perception of care is important in terms of the development of a professional occupation perception (22). In this study, the students' mean score on the CARE-Q was found to be 6.38±0.51. The content of the Monitors and Follows Through subscale, which had the highest mean score in line with the literature, consists of occupational technical practices, such as how to administer intravenous (IV) drugs, how to use tools and equipment such as catheters and aspirators, and how to provide the best physical care to the patient (23). In this study, the lowest mean score was obtained by the students on the Comforts subscale. The content of this subscale is composed of factors such as taking precautions for the comfort of the patient, staying with the patient, listening and talking to him/her, being tolerant towards choosy patients, and touching the patient when she/he needs relaxation (11). This situation suggests that the students avoided using therapeutic methods such as communicating with the patients and touching them, mostly developed their psychomotor skills, and perceived more technical care behaviors as important (24).
The Explains and Facilitates (p<0.001) and Anticipates (p<0.05) subscale scores and the CARE-Q total mean score (p<0.05) of the female participants were significantly higher compared to the male participants. Clinical decision-making and critical thinking skills are included in the Anticipates subscale, while the Explains and Facilitates subscale consists of care behaviors such as informing the patient about the care and treatment process and being honest about the patient's medical condition by providing necessary training (11).
The Monitors and Follows Through subscale mean score in the 21 years and above age group was significantly higher (p<0.05). In the study conducted by Eskimez and Acaroğlu (2019), an opposite result was found (11). It was reported that although there were no significant differences between the students in different years of study in terms of the CARE-Q mean score, as the year of study increased, the CARE-Q mean score decreased. In a study conducted by Birimoglu and Ayaz (2015), it was stated that the students' characteristics, such as age, sex, and year of study, did not affect their perceived care (24). It is believed that the nursing students' perceived care behaviors improved due to their education and increased hospital practices, along with an increase in their year of study, and differed according to the year of study.
It is well-known that students' voluntary choice of an occupation is important in terms of professional development (24, 25). It was determined that although the students' perceived nursing care was high, they would not choose nursing as an occupation again. However, based on the literature, there are studies in which the perceived care behaviors of students who willingly chose the profession were determined to be higher (11, 24).
The mean scores of the Comforts and Anticipates subscales and the CARE-Q total mean score of the students who did not read humorous magazines were significantly higher than those who did. No study was found in the literature that examined this issue, so it would be useful to conduct studies that examine the effects of the types of magazines and books that the students read on their care behaviors.
The mean scores of the Accessibility, Explains and Facilitates, Comforts, Anticipates, and Monitors and Follows Through subscales and the CARE-Q total score of the students who agreed with the view that "providing care is the primary duty of the nurse" were higher compared to those who did not (p<0.05). This result is in compliance with the literature, suggesting that the nursing students were aware of the importance of the role of caregiving as a nursing role and saw caregiving as the primary duty of the nurse (11, 24).
A positive and significant relationship was found between CARE-Q subscale scores, total score, Affiliative Humor, and Self-Enhancing Humor; a negative and significant relationship was also observed with the aggressive humor subscale. Individuals who have an aggressive humor style (which is a negative humor style) mostly use humor in their relations with others to attack, ridicule, and insult others (3, 5). In the study, a positive, very weak, and significant relationship was found between the students' Self-Defeating Humor mean score and their mean score on the Comforts subscale (p<0.05). Those who have a self-defeating humor style decreased self-respect and efforts to be accepted in society underly these entertaining behaviors exhibited by individuals by making jokes insulting themselves. Mayor-Silva et al. (2022) conducted a study on the quarantines during the pandemic for health sciences students. According to them, the participants who stated conscientiousness as a personality factor further developed positive humor (26). Humor reduces stress by ensuring the positive perception of stressful situations in the face of negative emotions rather than as a threat and provides a holistic approach to problems (27). It is stated that humor and health are interrelated, and studies have been conducted on the beneficial effects of laughter and humor interventions for adult patients (28).
Limitations
The results of this study cannot be generalized because it was conducted on nursing students of a single university. The coincidence of the study with the pandemic is another limitation.
Conclusion
The majority of the participants were female, single, second-year students, satisfied with vocational education, would choose nursing again if they had the opportunity, had not participated in scientific events in the last year, did not follow humorous magazines, and stated that providing care was the primary duty of the nurse.
The perceived care behaviors among the students is important in terms of adopting the caregiving role and professional development. As individuals approach problems in a solution-oriented way, thanks to humor, they can cope with professional problems more easily.
Nursing education professionals should determine the perceived care behaviors of students who have just started nursing education and increase their awareness on this issue, providing help and support to the patient/healthy individual, care, spiritual motivation and support for healing, emotional satisfaction created by the profession with a humorous approach when necessary, art and lifelong learning. It should help them adopt the profession by explaining the processes. Considering the place of therapeutic humor among curative care methods, it is recommended that humor be introduced to students during the education process and added to the curriculum.
Acknowledgement
We thank the institutional managers and the participants for their valuable time and insights. We want to thank Prof Dr Necmiye Sabuncu for her supports, guidance, and ideas. This study was presented as a master's thesis by Burcu Oflaz, under the supervision of Gülcan Kendirkıran (assistant professor) at Halic University Graduate Education Institute, Department of Nursing, and was orally presented at the VI. International X. National Psychiatric Nursing Congress.
Funding sources
No funding was received for the research.
Ethical statement
The research conforms to the provisions of the Declaration of Helsinki. Written permission from the Halic University School of Nursing and ethical approval was obtained from the Halic University Non-Interventional Clinical Research Ethics Committee to conduct the study (Date: 24/12/2020, Issue: 244), and permission to utilize the scale was obtained from its authors. After the necessary permissions were obtained, the written consent of all participants was received before the study began, written consent was obtained from all participants by reading and approving the approval text in the form prepared on Google Forms.
Conflicts of interest
The authors declare that there are no conflicts of interest.
Author contributions
BO: Conceptualization, Data curation, Formal Analysis, Investigation, Methodology, Validation, Visualization, Resources, Writing – original draft
GK: Conceptualization, Data curation, Formal Analysis, Investigation, Methodology, Validation, Visualization, Supervision, Writing – original draft, Writing – review and editing
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Besides being the ability to see events and situations from a positive perspective, humor is defined as a skill that is inherent in humans, can be developed, and involves cognitive, emotional, behavioral, psychophysiological, and social aspects (1-3). The sense of humor differs from society to society and increases productivity as it offers the opportunity to look at events from different angles (4). In health, it is stated that humor can reduce stress and improve the quality of life, transforming fears and other negative emotions into positive emotions expressed through laughter (5).
Care is based on human love between the caregiver and the patient. The individual characteristics, education levels, economic status, cultural characteristics, and religious beliefs of the caregivers, as well as the nurses' professional commitment, motivation, professional knowledge, and skills, directly affect the quality of the care provided (6,7). Humor provides the continuity of care and communication by building a bridge between the patient and the nurse. It also ensures the active participation of the patient in nursing care by creating a sense of trust, helps the individual to experience the death process at the best comfort level, decreases the anxiety levels of the nurses, increases their job satisfaction, and positively affects coping skills (8, 9).
This study aimed to evaluate the relationship between the humor styles of nursing students and their perceived care behaviors.
Methods
The descriptive correlational study was conducted to determine the relationship between nursing students' humor styles and perceived care behaviors.
The sample comprised nursing students studying at the Nursing School of Higher Education at a foundation university in Istanbul between December 2019 and December 2020. The study was conducted following the approval of the ethics board and institutional permission. Due to the coronavirus disease 2019 (COVID-19) pandemic that occurred after the permissions for the study were obtained, the data collection tools were prepared in the form of an e-survey (Google Forms) and delivered to the students online (via mobile phones, e-mails, and social media accounts). The forms were designed so as to be filled out by the students only once. The forms were shared with the students, and the data were collected in line with the principle of confidentiality of the data.
The population consisted of 255 second-year, third-year, and fourth-year students studying at the Nursing School of Higher Education at a foundation university located in Istanbul. The sample was composed of 124 students who agreed to participate and were accessed online due to the interruption of face-to-face education during the pandemic. As a result of the power analysis performed with G*Power v. 3.0.1, a minimum sample size of 124 was found to be sufficient with 90% power, 5% margin of error, and d=0.2935 impact size. The inclusion criteria were (i) volunteering to participate, (ii) not having a vision, auditory, or understanding problem, (iii) being a second, third, or fourth-year student at the Nursing School of Higher Education, and (iv) being 18 years old or above.
Data Collection Tools
Personal Information Form: It is a 20-question form developed in line with the literature review, which inquired about the students' general information (10, 11).
Humor Styles Questionnaire (HSQ): It is a 32-item, 7-point Likert-type scale developed by Martin et al. (2003) to measure individual differences in the daily use of humor (12). The validity and reliability of the scale in Turkish were examined by Yerlikaya (2003). It has 4 subscales, which are Affiliative Humor, Self-Enhancing Humor, Aggressive Humor, and Self-Defeating Humor. A high score obtained from the subscales indicates the usage frequency of that specific humor style (10). Cronbach's alpha values are as follows: Affiliative Humor 0.74, Self-Enhancing Humor 0.78, Aggressive Humor 0.69, and Self-Defeating Humor 0.67. In this study, Cronbach's alpha values were as follows: Affiliative Humor 0.77, Self-Enhancing Humor 0.82, Aggressive Humor 0.74, and Self-Defeating Humor 0.80.
Caring Assessment Questionnaire (CARE-Q): The scale was developed by Patricia Jean Larson (1981), and the Turkish validity and reliability of the scale were explored by Eskimez and Acaroğlu (2019). The subscales of the 50-item scale measuring care behaviors are “Accessibility (6 items)”, “Explains and Facilitates (6 items)”, “Comforts (9 items)”, “Anticipates (5 items)”, “Trusting Relationship (16 items)”, and “Monitors and Follows Through (8 items)” (11). The Cronbach's alpha value is 0.97. In this study, the Cronbach's alpha was 0.94.
Data analysis
Statistical analyses were performed in IBM SPSS Statistics v. 24 (IBM Corp., Armonk, NY, USA) by using frequency tables and descriptive statistics, independent samples t-test, analysis of variance (ANOVA), Mann-Whitney-U test, Kruskal-Wallis H test, Bonferroni correction, and Spearman correlation analysis.
Results
Of the 124 nursing students, 86.3% were female and 97.6% were single. The mean age of the students was 20.80±1.94 years. Moreover, 49.2% of the students were second-year students, 15.3% were third-year students, and 35.5% were fourth-year students (Table 1). It was found that 72.6% of the students were "very satisfied" with receiving occupational education. It was also determined that 65.3% of the students would choose nursing again if provided with the opportunity, 60.5% had not participated in any scientific activity within the last year, 96% did not read humorous magazines, and 82.3% supported the view that "providing care is the primary duty of the nurse."
Table 1. Findings regarding the nursing students' sociodemographic characteristics |
|
Table 2. The nursing students' mean scores on humor styles questionnaire and caring assessment questionnaire
 |
Table 3. Results regarding the comparison between the participants' characteristics and their humor styles questionnaire mean score |
A significant negative relationship was found between the Aggressive Humor sub-dimension and Accessibility, Explains and Facilitates, Comforts, Anticipates, Trusting Relationship, Monitors and Follows Through, and CARE-Q total score, and a positive relationship was found in the other subscales (Table 5).
|
Table 5. The relationship between humor questionnaire scale and caring assessment questionnaire
 |
Table 4. Results regarding the comparison between the participants' characteristics and their caring assessment questionnaire mean score |
Discussion
The highest score among the subscales of the Humor Styles Questionnaire was obtained on the Affiliative Humor subscale. It is known that positive use of humor positively affects the individual's psychology and improves his/her well-being. In addition, positive use of humor positively contributes to students' achievement by increasing their motivation and helping them cope with stress more easily (12-14).
In the study conducted by Bulut et al. (2017), the students' positive humor mean score was higher compared to their negative humor mean score (15). This result suggests that the students used humor in their lives in a positive way and that they had a positive perspective of the challenges they encountered.
In this study, the Aggressive Humor and Self-Defeating Humor subscale mean scores of the male participants were found to be significantly higher. Similar results were obtained in previous studies, in which aggressive and self-defeating humor styles were found to be higher in men (16-18). The use of humor by students who have a self-defeating humor style to make others happy while ignoring their own needs and thoughts and criticizing themselves through humor can increase unhealthy social interactions and increase the individual's inclination towards negative emotions such as stress, anxiety, and sorrow (1,8).
In this study, Self-Enhancing Humor and Self-Defeating Humor subscale mean scores of the students who were partially satisfied with the education they received were significantly higher compared to those who were very satisfied. During nursing education, students encounter numerous stressors such as intense course periods, internships in hospital environments, being involved in the care of patients in the terminal stage, and seeing various technological equipment and materials for the first time and using them (13).
In this study, the Affiliative Humor subscale mean scores of those who had participated in a scientific activity in the last year were found to be significantly higher than those who had not. If nursing students follow scientific studies and publications, it helps them improve their awareness of conducting scientific research and critical perspectives; still, it is known that critical thinking skill, which is included in the basic components of humor, provides a solution-oriented and multilateral perspective in the face of problems (19, 20).
While nurses' correct determination of the patient's care needs and internalization of nursing care affect the quality of patient care, the development of appropriate care perception both during the education process and after graduation increases care awareness (21). Therefore, determining nursing students' perception of care is important in terms of the development of a professional occupation perception (22). In this study, the students' mean score on the CARE-Q was found to be 6.38±0.51. The content of the Monitors and Follows Through subscale, which had the highest mean score in line with the literature, consists of occupational technical practices, such as how to administer intravenous (IV) drugs, how to use tools and equipment such as catheters and aspirators, and how to provide the best physical care to the patient (23). In this study, the lowest mean score was obtained by the students on the Comforts subscale. The content of this subscale is composed of factors such as taking precautions for the comfort of the patient, staying with the patient, listening and talking to him/her, being tolerant towards choosy patients, and touching the patient when she/he needs relaxation (11). This situation suggests that the students avoided using therapeutic methods such as communicating with the patients and touching them, mostly developed their psychomotor skills, and perceived more technical care behaviors as important (24).
The Explains and Facilitates (p<0.001) and Anticipates (p<0.05) subscale scores and the CARE-Q total mean score (p<0.05) of the female participants were significantly higher compared to the male participants. Clinical decision-making and critical thinking skills are included in the Anticipates subscale, while the Explains and Facilitates subscale consists of care behaviors such as informing the patient about the care and treatment process and being honest about the patient's medical condition by providing necessary training (11).
The Monitors and Follows Through subscale mean score in the 21 years and above age group was significantly higher (p<0.05). In the study conducted by Eskimez and Acaroğlu (2019), an opposite result was found (11). It was reported that although there were no significant differences between the students in different years of study in terms of the CARE-Q mean score, as the year of study increased, the CARE-Q mean score decreased. In a study conducted by Birimoglu and Ayaz (2015), it was stated that the students' characteristics, such as age, sex, and year of study, did not affect their perceived care (24). It is believed that the nursing students' perceived care behaviors improved due to their education and increased hospital practices, along with an increase in their year of study, and differed according to the year of study.
It is well-known that students' voluntary choice of an occupation is important in terms of professional development (24, 25). It was determined that although the students' perceived nursing care was high, they would not choose nursing as an occupation again. However, based on the literature, there are studies in which the perceived care behaviors of students who willingly chose the profession were determined to be higher (11, 24).
The mean scores of the Comforts and Anticipates subscales and the CARE-Q total mean score of the students who did not read humorous magazines were significantly higher than those who did. No study was found in the literature that examined this issue, so it would be useful to conduct studies that examine the effects of the types of magazines and books that the students read on their care behaviors.
The mean scores of the Accessibility, Explains and Facilitates, Comforts, Anticipates, and Monitors and Follows Through subscales and the CARE-Q total score of the students who agreed with the view that "providing care is the primary duty of the nurse" were higher compared to those who did not (p<0.05). This result is in compliance with the literature, suggesting that the nursing students were aware of the importance of the role of caregiving as a nursing role and saw caregiving as the primary duty of the nurse (11, 24).
A positive and significant relationship was found between CARE-Q subscale scores, total score, Affiliative Humor, and Self-Enhancing Humor; a negative and significant relationship was also observed with the aggressive humor subscale. Individuals who have an aggressive humor style (which is a negative humor style) mostly use humor in their relations with others to attack, ridicule, and insult others (3, 5). In the study, a positive, very weak, and significant relationship was found between the students' Self-Defeating Humor mean score and their mean score on the Comforts subscale (p<0.05). Those who have a self-defeating humor style decreased self-respect and efforts to be accepted in society underly these entertaining behaviors exhibited by individuals by making jokes insulting themselves. Mayor-Silva et al. (2022) conducted a study on the quarantines during the pandemic for health sciences students. According to them, the participants who stated conscientiousness as a personality factor further developed positive humor (26). Humor reduces stress by ensuring the positive perception of stressful situations in the face of negative emotions rather than as a threat and provides a holistic approach to problems (27). It is stated that humor and health are interrelated, and studies have been conducted on the beneficial effects of laughter and humor interventions for adult patients (28).
Limitations
The results of this study cannot be generalized because it was conducted on nursing students of a single university. The coincidence of the study with the pandemic is another limitation.
Conclusion
The majority of the participants were female, single, second-year students, satisfied with vocational education, would choose nursing again if they had the opportunity, had not participated in scientific events in the last year, did not follow humorous magazines, and stated that providing care was the primary duty of the nurse.
The perceived care behaviors among the students is important in terms of adopting the caregiving role and professional development. As individuals approach problems in a solution-oriented way, thanks to humor, they can cope with professional problems more easily.
Nursing education professionals should determine the perceived care behaviors of students who have just started nursing education and increase their awareness on this issue, providing help and support to the patient/healthy individual, care, spiritual motivation and support for healing, emotional satisfaction created by the profession with a humorous approach when necessary, art and lifelong learning. It should help them adopt the profession by explaining the processes. Considering the place of therapeutic humor among curative care methods, it is recommended that humor be introduced to students during the education process and added to the curriculum.
Acknowledgement
We thank the institutional managers and the participants for their valuable time and insights. We want to thank Prof Dr Necmiye Sabuncu for her supports, guidance, and ideas. This study was presented as a master's thesis by Burcu Oflaz, under the supervision of Gülcan Kendirkıran (assistant professor) at Halic University Graduate Education Institute, Department of Nursing, and was orally presented at the VI. International X. National Psychiatric Nursing Congress.
Funding sources
No funding was received for the research.
Ethical statement
The research conforms to the provisions of the Declaration of Helsinki. Written permission from the Halic University School of Nursing and ethical approval was obtained from the Halic University Non-Interventional Clinical Research Ethics Committee to conduct the study (Date: 24/12/2020, Issue: 244), and permission to utilize the scale was obtained from its authors. After the necessary permissions were obtained, the written consent of all participants was received before the study began, written consent was obtained from all participants by reading and approving the approval text in the form prepared on Google Forms.
Conflicts of interest
The authors declare that there are no conflicts of interest.
Author contributions
BO: Conceptualization, Data curation, Formal Analysis, Investigation, Methodology, Validation, Visualization, Resources, Writing – original draft
GK: Conceptualization, Data curation, Formal Analysis, Investigation, Methodology, Validation, Visualization, Supervision, Writing – original draft, Writing – review and editing
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Type of Study: Original Article |
Subject:
Nursing
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