Related Experiment Video
Updated: Apr 30, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
The effects of humor therapy on nursing home residents measured using observational methods: the SMILE cluster
Lee-Fay Low1, Belinda Goodenough1, Jennifer Fletcher1
1Dementia Collaborative Research Centre, Centre for Healthy Brain Aging, School of Psychiatry, University of New South Wales Australia, Sydney, New South Wales, Australia.
Objectives:
To evaluate the effects of humor therapy assessed using observational methods on agitation, engagement, positive behaviors, affect, and contentment.
Design:
Single-blind cluster randomized controlled trial.
Setting:
A total of 35 Sydney nursing homes.
Participants:
All eligible residents within geographically defined areas within each nursing home were invited to participate.
Intervention:
Professional "ElderClowns" provided 9 to 12 weekly humor therapy sessions, augmented by resident engagement by trained staff "LaughterBosses." Controls received usual care.
Measurements:
The Behavior Engagement Affect Measure (BEAM) touchpad observational tool was used to capture real-time behavioral data. The tool assesses the duration in seconds of agitation, positive behavior toward others, engagement, and affect (angry, anxious, happy, neutral, sad).
Results:
Seventeen nursing homes (189 residents) received the intervention and 18 homes (209 residents) received usual care. Over 26 weeks, in comparison with controls, the humor therapy group decreased in duration of high agitation (effect size = 0.168 and 0.129 at 13 and 26 weeks, respectively) and increased in duration of happiness (effect size = 0.4 and 0.236 at 13 and 26 weeks, respectively).
Conclusion:
We confirmed that humor therapy decreases agitation and also showed that it increases happiness. Researchers may consider evaluating impacts of nonpharmaceutical interventions on positive outcomes. Computer-assisted observational measures should be considered, particularly for residents with dementia and when the reliability of staff is uncertain.
Related Concept Videos
Nursing Evaluation
Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
Nursing Assessment
The nurse collects all aspects of the patient's health in the initial assessment, establishing priorities for ongoing focused assessments...
Techniques of therapeutic communication I: Active Listening, Sharing Observations, Validation, and Using Touch
Therapeutic communication is not the same as social interaction. Social interaction has no goal or purpose and consists of casual information sharing, whereas therapeutic communication has a plan or purpose for the conversation. Therapeutic...
Nursing Process for Patient and Caregiver Teaching III: Evaluation and Documentation
Nurses can use several methods to evaluate patient outcomes. For example, oral questions can assess cognitive learning,...
Heart Failure VII: Nursing Interventions