A longitudinal analysis of humor coping and quality of life in systemic sclerosis

Abstract

A connection between humor and health outcomes is widely assumed but has been understudied, particularly in clinical populations. The use of humor as a coping mechanism has been suggested as a potential predictor of quality of life (QOL) outcomes in chronic disease. This study assessed the relationship between humor and physical/mental health variables in a longitudinal study of individuals with systemic sclerosis (SSc), a progressive rheumatic disease that can be fatal in severe cases. It was hypothesized that humor coping (HC) would be inversely associated with disease severity, pain, disability, and psychological distress. It was also hypothesized that after implementing the appropriate demographic and disease severity controls, HC would predict these outcomes both cross-sectionally and longitudinally. Ninety-three participants with SSc received clinical exams and completed self-report surveys. The exam and measures were repeated ∼1 year later (n = 74). In bivariate correlational analysis, HC was found to be negatively associated with disease severity, pain, disability, and distress, as predicted. However, after controlling for covariates in hierarchical regression analysis, HC did not significantly predict any of the disease-related outcomes, either cross-sectionally or longitudinally. The HC did approach significance as a predictor of disability at Time 1, although the effect was weak. This study contributes to a growing body of evidence that HC may not be directly beneficial to QOL in chronic disease. Although the notion that HC could be an inexpensive and accessible point of intervention among the chronically ill is appealing, results suggest the relationship is associative and small at best, and do not provide evidence supporting the use of humor as a therapeutic strategy.

Keywords:

• chronic disease
• systemic sclerosis
• humor coping
• adjustment

Acknowledgements

The authors thank Ann McKinney, M.A., Renn Upchurch, Ph.D., Helen Greenbergs, Ph.D., Marilyn Duzik, R.N., and Gretchen H. Henstorf, B.A., for their assistance with this study. They also express their gratitude to all participants, who had provided important information about their experiences with SSc.