The Advancement In Health Health And Social Care Essay

CHAPTER 1

INTRODUCTION

The field of gerontology is a rapidly growing field particularly in Malaysia due to the advancement in health, science and technology. Such advancement has increased longevity in the population. Therefore, interest in the study of physiology, psychology and sociology of aged population is escalating. Moreover, the number of the elderly among the society and this encourages the Government to give attention to aged population to ensure balance in the development of the country.

Apart from that, besides the facilities such as infrastructure, medicine, and physical health as indicated in National Elderly Policy (NEP), the psychological issues related to the elderly need to be addressed gently. Since then, the Government is committed to the NEP and one of the implementations in NEP is through conducting various studies related to the elderly for the betterment of their quality of life (Masyarakat, 2009).

In view of that, many studies related to the elderly such as their social well-being (Yadollah, Tengku-Aizan, Nurizan, & Rahimah, 2010), nutrition (Suzana, et al., 2007), and care system (Khadijah Alavi, Rahim M. Sail, Idris, & Samah., 2010) have been conducted. These studies have facilitated the Government for better policy making. By conducting such studies, information will be provided to improve the NEP and Older Persons Action Plan.

Consequently, studies related to psychological issues among the elderly such as depression and loneliness have become the focus by researchers (Nurhidayati, 2007). Depressions and other negative emotions among the elderly lead to other psychological problems as well as physical deterioration. Attributable to these issues, the process of aging is accelerated if the persons have negative feelings and challenges in accepting aging as part of life process (Mroczek & Almeida, 2004).

For that reason, it is important to examine feasibility applications to study psycho-gerontology as old age has been correlated with declination of physical and psychological health. Positive aging strengthens the roles and activities in the process of aging explained by the concept of well-being in older persons.

Chida and Steptoe (2008), for instance, observed that positive psychological well-being reduces the risk of mortality and increases longevity. Positive moods such as joy, happiness, optimism, humour, and involvement in enjoyable activities are related to better self-rated health (Benyamini, Idler, Leventhal, & Leventhal, 2000). The ability to control the negative moods will give psychological benefits to the elderly.

In relation to this, positive adjustment to aging process does not mean one can stop himself from physical relapse. Interestingly, Fry (1986) mentioned that humorous experiences help the physical body to react positively to the aging process. Even though the relation between humour and physical aging is a multifaceted issue, humour can always be used as a tool in dealing with certain issues of life including physical issues by turning them to humour instead of mourning about the issues.

In Malay community for instance, Mohamad (1989) stated that basically humour is used to create a distance from difficulties to an imagination or fantasy that is hoped to bring laughter and happiness, as well as to ease the anguish or tedium state of life. Therefore, humour arising from this community is related to factors such as incongruity, absurdity, surprise, and ambiguity (Radzi, 2002).

Thus, this contributes to the good nature of humour that enhances positive environment with laughter and feeling fun in life. The use of humour in Malay culture is embedded indirectly within its traditions (Hassan, 2003). Humour is used as a life sustaining tool and it also helps for better communication. Thus, humour is not limited to having positive effect to psychological well-being and physical health, but it is also said to improve communication in general (Graham, 1995; E. Romero & Pescosolido, 2008; Sparks-Bethea, 2001a).

Moreover, studies on humour showed that humour is considered as an antidote to negative feelings such as depression, stress, and physical pain (B.G Celso, D.J Ebener, & E.J Burkhead, 2003; McGhee, 1991, 1999; Tse, et al., 2010). The ability to react to humour positively can give positive emotional reactions and finally will help the elderly to cope well in life situation (Marten, 2004; Melissa Bekelja Wanzer, Lisa Sparks, & Ann Bainbridge Frymier, 2009).

The ability of people to cope with age and life changes is different as they grow old (Folkman & Moskowitz, 2000; Nahemow, McCluskey-Fawcett, & McGhee, 1986; J. C. Solomon, 1996). The older the person is, the wiser he or she will be; wise person would be able to cope with life event successfully (Lucille Nahemow, 1986). Taking this into consideration, cognitive flexibility is an asset for one to interpret and enjoy humour. Kane, Suls and Tedeschi (1977) emphasised the importance of cognitive aspect in order to experience humour.

Thus, in studying humour among the elderly, cognitive aspects need to be considered. This is because cognitive decline in the elderly especially in humour comprehension or appreciation could lead to very stressful life (Lucille Nahemow, 1986). However, if the elderly are able to see things that go wrong and able to laugh at it, this could give greater experience for them and make them feel happy despite of the difficulty in humour comprehension.

Therefore, in order to study humour and aging, the intellectual process of humour must be recognised. People who have sense of humour could help other people to age positively (Jose, Parreira, Thorson, & Allwardt, 2007). Fry (1986) further explained the humour physiological aspects that could help the elderly to have greater control on their emotions by stimulating the role of humour in life as they age.

However, studies on humour and its effect to human especially among the elderly are still few in number (Proyer, Ruch, & Mǖller, 2009; Melissa Bekelja Wanzer, et al., 2009; N.G Westburg, 2003). The positive impact of humour for the elderly shows the need to understand the meaning and experience of using humour in depth (Proyer, et al., 2009; Ruch, Proyer, & Weber, 2010).

Research Problem

Humour does contribute to successful aging (Maurer & Kogan, 2008; N.G Westburg, 2003).But, the understanding of humour must be achieved first. Human is given natural instinct such as sense of humour (Del Real, 2006) and will react to humour according to certain condition and situation (Rose, 2008) that will induce laughter (Mueller, 2006). Laughter, as part of human behaviour and concomitantly will effect human lifespan (Provine, 2000).

However, the study of humour at old age is a new endeavour. The studies on humour are prevalently among younger respondents (Bilge & Saltuk, 2007; Chen & Martin, 2007; Erozkan, 2009; Greven, Chamorro-Premuzic, Arteche, & Furnham, 2008; Jordan & Carter, 2002). Thus, the meaning and understanding of humour cannot be generalised to older persons. Therefore, it is appropriate to conduct a study among the elderly to particularly comprehend how humour is defined by them.

Furthermore, there are differences in terms of perception of humour between the young and the old (Ruch, et al., 2010). According to Sparks-Bethea (2001a), what is considered humorous by the young may not be for the old, and vice versa, due to the factors such as cognitive maturity and experiences (Melissa Bekelja Wanzer, et al., 2009). The substantial meanings of humour therefore need to be addressed appropriately.

Humour has multidimensional components (Jose, et al., 2007). Even though there are studies on humour in different aspects of human life, humour is not well-studied between middle life and later life in the lifespan of human being (Seltzer, 1986). Knowing how humour is used will help the researcher to understand how humour affects aging process emotionally and cognitively.

The humour phenomenon within the elderly merits further investigation. To date, very few studies have examined the relationship between humour and the elderly (Abyad, 2009). Character strengths such as humour contribute to a good life and enhance a positive correlation between aging and life satisfaction (Ruch, et al., 2010). Therefore, humour may keep group morale high and it may be used for the benefit of others, including the elderly.

Besides, humour significantly improves life satisfaction among the elderly (Mathieu, 2008). This indicates that humour is resource to enhance the quality of life. According to Goodman (1995), human experience and cognitive maturity help to perceive daily experience in an appropriate manner. Therefore, the present research helps to understand how humour affects the quality of life in real situation.

From the discussion above, even though humour gives positive impact to the elderly, there is a need to investigate the meaning and the experience of using humour among them (Ruch, Proyer, & Weber, 2009; Ruch, et al., 2010). Thus, this study examined how the elderly define humour from their own perspective. In-depth exploration is needed so that the understanding of humour from the eye of the elderly can be utilised for future guideline in the field of psycho-gerontology.

Once the definition of humour has been thoroughly understood, in this study, the researcher worked within two major perspectives, namely the application and related model. From the application point of view, the researcher was able to see how humour or knowledge about humour can be used for practical purposes. This includes the types of humour used for different reasons. The latter i.e., related model is to explore what exactly humour is, how it works, how it is used, and most importantly, the effect of humour.

Finally, the extensive quantitative studies on humour (Martin, 2001; Ruch, 2011) did not really show the meaning of humour in daily activities (Nahemow, et al., 1986). Humour contributes to positive aging (Proyer, et al., 2009; Ruch, et al., 2009) but measuring how positive aging really affects the person is another spectrum of issue. Thus, from this point of view, it is important to look at this issue qualitatively.

Therefore, according to Forssen (2007), qualitative studies on humour are needed especially to understand the use of humour in depth. The use of qualitative methods in the study of humour may adequately unpack certain issues in life that cannot be revealed quantitatively. Thus, this current study is hoped to be able to scrutinise how the elderly use humour as part of aging process.

Research Objectives

This current study has a general objective and some specific objectives. The general objective is to investigate the meaning of humour among the elderly. This is because the meaning of humour is still vague especially to find the meaning of humour in Malay culture. Furthermore, the meaning of humour is not the same between the young and the old (L. Nahemow, 1986).

The specific objectives are to examine the concept of humour from the perspective of the elderly and how important it is to them, and to understand the application and implication of humour in positive aging.

Thus, this study investigated the experience on the use of humour among the elderly. In other words, the researcher wants to scrutinise the understanding and experience of using humour in everyday life of the elderly. Aging is a process that everyone has to go through in life and positive aging is significant to ensure that the process of aging is not perceived as a disadvantage but is considered as reinforcement to live life to the fullest. As there is no way to stop aging process, positive aging is articulated by the study of humour in the elderly.

Research Questions

The study aims to explore the meaning and experience on the use of humour among the elderly. Therefore, the research questions are divided into two main topics of this study namely meaning of humour and experience in humour. More specifically, for the first main topic, the research questions are as follows: (i) What is the real understanding about humour?; (ii) What is the purpose of using humour?; and (iii) What is the situation when humour is used?. For the second main topic, the research questions are as follows: (i) How humour is used daily activities?; (ii) In what condition humour is used?; (iii) What is the effect of humour?; and (iv) What are the sources of humour production?.

Significance of the Research

This study is aimed to see how the elderly understand the meaning of humour and how humour is used based on their experiences. The information obtained from this study can crystallise the meaning of humour especially in improving the well-being of the elderly. The fact that humour plays an important role in human life (B.G Celso, et al., 2003; Jose, et al., 2007), the present research on humour is hoped to encourage positive aging.

In addition to this, this study identified how humour is used by the elderly to positively adapt with aging process. This study seeks to see the practical functions of humour and its effects to the elderly. In general, the findings of this study can be utilised by academicians, policy makers, professional helps, and others. Some of other benefits of this study are as follows:

An appropriate model for programmes in relation to the elderly will be developed by adopting humorous component to improve their psychological well-being;

The model developed will be able to be a reference for individuals and professional helps such as nurses, counsellors, social workers, and non-government organisation to use humour in their services;

The model can be used as therapeutic guidelines for the elderly or caregivers;

The knowledge on humour and older persons can become a reference in the field of gerontology especially from Malaysian perspective;

The findings can be used for value-added information to the policy makers such as the Welfare Department in improving the services for the elderly in Malaysia;

To educate the public about the concept of humour among the elderly and at what level humour can be used to improve their daily activities.

In conclusion, this study is important to have better comprehension on the use of humour to the elderly and actions that can be implemented once the real meaning and understanding of humour are clear.

Limitations

The limitations of this study were:

The respondents of this study were selected using purposive sampling. Respondents were drawn from specific area i.e., Putrajaya and cannot be regarded as representing the whole region.

Since this is a qualitative study, the number of respondents was limited. The number of respondents interviewed would totally depend on the saturation of information obtained.

The study was conducted at Putrajaya and it cannot be generalised to the Malay population in Malaysia. Generalisation is limited to the respondents and their family members who reside in Putrajaya.

In-depth interviews were utilised to obtain as much information as possible from the respondents. Therefore, the interaction between the researcher and the respondents was important. The respondents were expected to communicate openly and to feel comfortable throughout the interviews. But, it was not easy to make the respondents feel comfortable.

The realm of humour is basically subjective and may be different across socio-culture, education as well as interpretation. Thus, this study is meant to look into the respondents’ subjectivity on the understanding of humour.

Research Framework

The term "well-being", "subjective well-being" or "psychological well-being" is often used interchangeably (M.H Abel, 2002). Positive aging strengthens the roles and activities in the process of aging are explained by the concept of well-being in older persons. Consistent with the aim of this present study, positive moods such as humour can facilitate the psychological well-being (Chida & Steptoe, 2008).

This framework incorporates well-being in the daily activities of the elderly and their own definition of humour based on their own experience. The framework is used as a functional framework to acquaint with better understanding of humour by the elderly. Finally, based on this framework, further analysis related to the humour theories will be discussed.

Positive Psychology

Positive Aging

Well-Being

Humour

Figure 1: Humour overlaps with positive psychology and positive aging as part of well-being.

Figure 1 explains how positive aging is related to humour as introduced by Ruch (2001). The explanation by Ruch (2001) is straightforward. In positive psychology, humour is one of the characteristics and values based on the (Values Action Inventory of Strengths (VIA), which is categorised as transcendence value. Figure 1 also reveals that the researcher views positive psychology as an umbrella to explain the development of positive aging as the concept of humour introduced by Ruch (2001).

Positive psychology values subjective experiences that include the well-being and satisfaction, hope and optimism, flow and happiness (Seligman & Csikszentmihalyi, 2000). As a big umbrella, positive psychology also explains the concept of positive aging in the perspective of gerontology.

In relation to this, positive aging, under the umbrella of positive psychology, explains how the elderly live their life in optimum way and how the positive aging is congruent to their goals to make them satisfied with their living. This is the indicator of positive aging and the outcome is thus positive well-being.

Furthermore, Figure 1 also elucidates how humour intersects between positive aging and well-being as the outcome. Humour is useful for the elderly in maintaining their well-being. For instance, humour helps to increase interpersonal relations and experiences that strengthen psychological well-being (Kuiper & McHale, 2009). This explains the role of humour as a tool for the elderly to accomplish the state of positivism or positive aging, and finally to maintain their well-being and "live the life to the fullest" state.

Thus, humour can make people feel better thus resulting in the feeling of dominance and supremacy (superiority theory). Gruner (1997) argued that aggression or superiority is the essential property of humour. Humour can be used as a form of exaggeration (incongruity theory) especially when odd is involved and as justification for reasoning (G. Ritchie, 2011).

Finally, humour is also used as catharsis (Monro, 1988) to remove psychological restrain (relief theory). Therefore, the use of humour will give psychological benefits to the elderly as human continuously search for meaningful pursuit in life. As one of the core outcome variables in positive psychology, well-being can be achieved by being humorous (Ruch, et al., 2009).

At a macro level, systematic explanations on some implications of humour theories help to understand the concept of humour even better. Three major theories of humour namely the Incongruity Theory, Superiority Theory, and Relief Theory are seen as giving more positive states and reduce the negative ones.

Moreover, the framework also helps the researcher not only to describe, discuss, and analyse the instances of humour, but it also helps the researcher to build up a diagram to illustrate types of humour and their occurrences among the elderly. Furthermore, within this framework, the researcher aims to build up a model postulating humour entities that interact with the well-being of the elderly. Consequently, the framework will also provide a theoretical research to see the way humour is used.

Next, Figure 2 provides a model on the research framework of the major aspects of humour explored for this study. It shows the inter-relationship between the aspects of well-being in the perspectives of social gerontology and humour, which have meaningful process and impact to the elderly due to the dynamic relations.

Based from Figure 2, positive psychology is the general foundation to positive aging, which is subsequently related to positive well-being. This is in support with the claimed made by Lucille Nahemow (1986) that one of the important factors in well-being is humour across the life-span; thus, a study on humour among the elderly needs to be conducted (Ruch, et al., 2010). Therefore, the in-depth exploration on humour will be expanded from this point.

In conclusion, the use of research framework in this research will help to ensure the credibility of the research. The framework therefore offers the organisation of the knowledge to be more systematic and structured. Other than that, the framework also explains the rationale of the research outcome/findings.

Figure 2: Research framework of the present study.

Summary

This chapter describes the aspect of humour in general. The study of humour has been largely conducted in the West (Kalliny, Cruthirds, & Minor, 2006 ). The phenomenon of humour is universal (Flugel, 1954) and should be studied in the Eastern part of the world as well.

Besides, the subjectivity of humour is also strongly influenced by socio-cultural and personal interpretation. Even though research on humour has benefited both psychological and physical health of human (McRoberts & Larson-Casselton, 2006), the research on the elderly has rarely been studied. Thus, this study was conducted to examine how humour is viewed by the elderly and how humour would benefit them.