Eine ethnografische Untersuchung zur Bedeutung von Humor und Lachen in der akutstationären Pflege und Betreuung chronisch kranker Kinder

Hintergrund: Der Einfluss von Humor und Lachen auf Physis und Psyche des Menschen wurde von medizinischer und psychologischer Forschung sehr umfassend beforscht. Auch für die Pflege existiert bereits ein Konzept zu Humor, welches unter Anderem für verschiedene Zielgruppen mögliche Humorinterventionen beschreibt. Der Schwerpunkt in Forschungen mit Kindern zu Humor liegt dabei etwa in der Erleichterung des Informierens von Eltern oder in Erwartungen von Kindern an Pflegende, welche auch Sinn für Humor haben sollten. Weil aber im deutschsprachigen Raum keine Forschungen für den Bereich der akutstationären Pflege und Betreuung chronisch kranker Kinder existieren, stellte sich die Frage, ob und wie Humor und Lachen außerhalb des Arbeitsbereiches der Klinik Clowns von Kinderkrankenpflegenden genutzt wird. Besonders Kinder mit chronischen Erkrankungen leiden unter verschiedensten Belastungen, welche zu einer existentiellen Krise werden können. Ziele & Methoden: Die Auseinandersetzung mit geeigneten Bewältigungsformen ist essentiell, wobei die Rolle von Humor und Lachen dafür geklärt werden muss. Um die Bedeutung zu klären, welche Pflegende und Kinder Humor und Lachen beimessen, erfolgte mit besagten Personen eine zweimonatige qualitative Untersuchung. Geforscht wurde nach Spradley’s Methode der/des ethnografischen/s Beobachtung sowie Interviews. Erhobenen Daten wurden zusammen mit zusätzlichem Datenmaterial trianguliert und nach der “Domain Analysis“ ausgewertet. Ergebnisse: Wesentliche Ergebnisse der Studie zeigen, dass neben anderen essentiellen Grundbedürfnissen chronisch kranke Kinder auch das Bedürfnis nach Lachen und Spielen haben. Ob dieses Grundbedürfnis befriedigt ist, zeigt sich hauptsächlich in der kindlichen Fröhlichkeit, welche von diversen Faktoren abhängig ist. Pflegende haben aber die Möglichkeit, durch ihr Handeln mit dem Kind durch einen Beziehungsaufbau Voraussetzungen für Humor und Lachen zu schaffen. Sie können ihn meistens so in die Beziehung integrieren, sodass dieser fruchten kann. Kinder stimmten mit diesen Einschätzungen überein und äußerten weitere Wünsche, wie nach Personen zur Ansprache mit mehr Zeit. Wenn dadurch PatientInnen besser gekannt werden, entsteht mehr Nähe und humorvolle Kommunikation tritt nicht nur spontan sondern auch gezielt auf. Es gibt den Pflegenden die Möglichkeit, die Interessen der PatientInnen persönlich anzusprechen. Alle Befragten erklärten als Professionalitätskriterium im Einsatz von Humor das Kennen der Grenzen und das Unterlassen von Humor. Schlussfolgerungen: Humor fand in der Kinderkrankenpflege im untersuchten Setting zwar teilweise gezielt statt. Dennoch ist eine bewusste Auseinandersetzung mit dem Stellenwert von humorvollem Umgang als professionelles Handeln noch kaum vorhanden. Deswegen müssten Inhalte dazu bereits mit in die Ausbildung genommen werden oder im Leitbild von Kinderspitälern verankert werden.Context: The influence of humor and laughter on the human body and mind has been extensively researched, medically as well as psychologically. In the field of nursery a concept of humor exists as well. This concept describes, for instance, potential humor inventions for different target groups. As far as the research with children in the field of humor is concerned, two major aspects are emphasized. Firstly, the facilitation of informing the parents and secondly children’s expectations towards nurses –namely, nurses should have a sense of humor. In the Germanspeaking area no research exists in the field of acute inpatient care and care of chronically ill children. Consequently, the question arose whether and how humor and laughter outside the working area of Clinic Clowns is used by pediatric nurses. Particularly children with chronic diseases suffer from varied stresses, which can cause an existential crisis. Aim & Methods: The discussion of appropriate coping strategies is crucial. However, the role of humor and laughter for this has to be clarified first. In order to clarify the meaning that nurses and children ascribe to humor and laughter, a two-month qualitative study was carried out. This research was based on Spradley's method of ethnographic interviewing and observation. Collected as well as additional data were triangulated and analyzed according to "Domain Analysis". Results: Key findings of the study show that in addition to other essential basic needs of chronically ill children, the need to laugh and play exists and should not be neglected. Whether this basic need is met, is mainly reflected in the child's happiness, which depends on various factors. Through their actions and the resulting relationship building, nurses have the possibility to create a basis for humor and laughter. Across the board, children formulated the assumption that if humor and laughter was integrated in the nurse- child communication, this would improve their relationship. In addition, they expressed other desires, such as their wish to be looked after by persons who have more time at their disposal. More time equals a better developed and more intense relationship. Hence more closeness arises and humorous interaction takes place more selectively. More time provides nurses with the opportunity to address the interests of patients personally. In order to keep professionalism when using humor in hospitals, two important criteria were mentioned by all interviewees: Firstly, being - 5 - aware of boundaries and secondly, refraining from humorous comments when not appropriate. Conclusion: In the investigated setting in children health care, the use of humor partly took place systematically. Nevertheless, a conscious dealing with the importance of humorous use as professional action is still scarcely present. For this reason, contents concerning humorous interaction with child patients should be included in the education of future nursing staff. In addition, such contents should be an important part of children hospitals’ mission statement

Intermediality in the visualization of peace: contradicting narratives about peace and violence in Timor-Leste

Visuals can be effective tools for educating an audience about peacebuilding and the need to engage with a nation's violent past. However, research on visuality has pointed to the ambivalence visuals can develop through audiencing and the dominant political discourse. Building on this, this article argues that ambivalence can also occur between narratives by different media although the same institution produced them, and that such inherent contradictions can limit the institution's effectiveness. The analysis centers upon a case study of the East Timorese Commission for Reception, Truth and Reconciliation (CAVR) that compares the commission's documentary dalan ba dame (“road to peace”) with its final report about peace and the human rights violations committed in the territory between 1975 and 1999. While the commission's final report stresses the individual responsibility of members of the Indonesian military and formulates the need for an institution-based liberal peace, the documentary communicates the message that all parties to the conflict are guilty of committing crimes and that peace has already been created, mitigating the need to further engage with the violent past. The analysis identifies the media's different formats and their different agendas as reasons for the creation of these contradicting messages. Based on an assessment of the dissemination of both media and their reception within the political discourse in Timor-Leste, the implications of these conflicting narratives for educating an international audience are discussed. Since the final report is difficult to access due to its length and its legal language, the documentary remains the more accessible medium to educate an international audience about the nation's violent past. However, due to the narrative it conveys, the documentary's ability to mobilize an international audience is limited. Thus, the article argues for considering three aspects when designing visuals for peace education: the intermediality of visuals with other media and its potential effects concerning the communication of a specific message, the reception of the message by the target audience, and the reception of the message by broader audiences when the visual is distributed online

Review: Bräuchler, Birgit (ed.), Reconciling Indonesia. Grassroots Agency for Peace

Review of the edited volume: Bräuchler, Birgit (ed.) (2009), Reconciling Indonesia. Grassroots Agency for Peace, London/New York: Routledge, ISBN-13: 978-0415487047, 272 pages

Review: Bräuchler, Birgit (ed.), Reconciling Indonesia. Grassroots agency for peace

Review of the edited volume: Bräuchler, Birgit (ed.) (2009), Reconciling Indonesia. Grassroots Agency for Peace, London/New York: Routledge, ISBN-13: 978-0415487047, 272 pages