看護ケア領域における笑いの有効性に関する文献学的考察

A Literature Review on the Effects of Laughter in Nursing Care

要旨

　目的：国内において報告されてきた笑いの効果を身体面，精神面の二方向から概観し，看護の場で笑いを用いる有効性を提示することを目的とした．

　方法：引用文献の検索には，医学中央雑誌刊行会から，“笑い”or“ユーモア”をキーワードとして1980年以降，2009年5月までで検索を行い，29件採用した．また，国際誌はPubMedを用い，2000年以降，2009年5月までの文献からキーワード“laughter”and“effect”で検索し，20件を採用した．

　結果：笑いの身体面の効果としては，笑い体験によるNK細胞活性ならびにアレルギー反応などの免疫系に関して効果があったという報告が最も多く，その他疼痛緩和，血糖上昇抑制作用があることが報告されていた．また笑いの精神的効果として，ストレスコーピング，不安ならびに緊張の緩和などの効果が報告されていた．

　結論：笑いは，身体面と精神面両方での効果が期待できる．しかし，看護ケアとして笑いの効果を検討した研究は少なく，今後，看護師による笑いに関する介入研究の成果が期待される．

Abstract

　Object：To demonstrate the efficacy of using laughter in clinical and nursing practice, the present study was designed to overview the effects of laughter previously reported in Japan regarding both physical and mental aspects through a literature review.

　Method：Literature search was performed of the Igaku Chuo Zasshi Publishing database using “laughter” or “humor” as the keyword for publications during the period of 1980 to May 2009, and 29 articles were retrieved. For international journals, PubMed was used with the keywords “laughter” and “effect” and the target period of 2000 to May 2009, and 20 papers by Japanese authors were identified.

　Results：As the physical effects of laughter, many researchers reported enhancement of the NK cell activity and its effects on the immune system. There were also studies on the alleviation of pain, improvement of various symptoms in allergic patients, reduction of the increase in blood glucose after eating, and improvement of cerebral activity. As the mental effects of laughter, there were a lot of studies on efficacy in coping with stress. In addition, humor have benefits in relation to interpersonal skills, and a relaxation effect.

　Conclusion：While there have been many experiments involving healthy people or specific disease, the efficacy of laughter in patients with acute/chronic disease as well as its preventive effects are expected to be explored in future research on laughter as a means of nursing care in clinical practice.