In recent years, humor has played an essential role within the mental and emotional support of healthcare professionals. There have been many situations where we have had to resort to this tool in order to face and cope with those problems which appeared both in our private lives or at work. An anecdote, a funny comment, or some laughs with colleagues or even patients in the middle of all this turmoil, acted as an excellent defence mechanism, an unconscious shelter which helped to reduce stress and anxiety, to relax the atmosphere at work, to improve self-esteem and the relationship with the patient and our colleagues, to encourage teamwork and facilitate understanding and communication. It is known since ancient times that humor is able to provide all these positive effects, among others. Nowadays, the scientific community endorses many of these benefits, which have impact not only on professionals but also on the quality of care, with positive effect on patients and their environment (1,2).

Humor can also become a double-edged sword, because what might be funny and amusing for some might cause rejection or be offensive for others (3). At the beginning of this pandemic, around March / April 2020, mass media and social networks showed our parodies, sketches or dances in a humorous manner; however, others criticised this. They did not understand why healthcare professionals lent themselves to parody in the middle of such a major tragedy. What many of them did not know is that in fact we were taking care of ourselves, in order to be able to care for others. Humor was a helpful tool to face such a hard and painful situation, to try to pull ourselves together, becoming stronger, and thus being able to move forward.

Throughout history there have been many attempts to conceptualise humor, and even today there is no universally accepted model to explain it. This is due to its multidimensional nature, because it involves cognitive, emotional, motor, social and psychophysiological processes (4). Sometimes humor is mistaken for laughter or sense of humor, and envisioned as one single concept, when in fact these are different elements. Humor is a stimulus with cognitive effects which might occur without laughter; laughter is a physiological response to humor or any other stimulus with physical and psychological effects; and the sense of humor is a set of skills and trends associated with humor (3). It is important to highlight that since 1992, the Nursing Intervention Classification (NIC) includes humor as a nursing intervention within Domain 3: behavioural and Class R: Coping Assistance: [5320] Humor “Facilitating the patient to perceive, appreciate and express what is funny, amusing or ludicrous, in order to establish relationships, relieve tension, release anger, facilitate learning, or cope with painful feelings” (5).

Currently there are validated scales to evaluate humor creation, expression and/or appreciation from a sociocultural perspective in the overall population, such as the Coping Humor Scale (CSH) (4), the Multidimensional Sense of Humor Scale (MHSH) (3) or the Humor Styles Questionnaire (HSQ) (4). However, no instrument so far has evaluated humor specifically in the healthcare setting. Th scales available could be used as a measure of humor in the patient, with the objective to determine the types of humor used, how they create and generate it, how they acknowledge and appreciate it, if they use it as a coping mechanism when faced with difficult situations and, ultimately, their attitude towards humor in their daily life. However, from the perspective of the healthcare professional, these scales would only provide data about how they use humor in their personal lives, but not in the professional setting. It is precisely along this line where the research must be focused, to assess how professionals can generate and appreciate humor not only in their personal life, but also in their occupational setting, involving their patients in it.

Nursing is a profession with a major workload and high mental and emotional demands, which in many cases can derive in stressful situations difficult to manage and control. This occupational role involves having to face pain, death, and many other problems faced by other persons in their daily life. In these situations, a poor management of emotions can have direct impact on patient care and safety, increase the likelihood of professional burnout, and even lead to considering leaving the profession. Humor is establishing itself as a strategy which allows professionals to observe daily and occupational facts from a different perspective, much more optimistic. Besides, it can be used as a tool to improve the efficacy of manager leadership. For all this, it is necessary to have a valid and reliable instrument which allows to measure specifically the attitude of professionals towards humor. To learn their attitude towards this construct would not also allow to understand how they use it in their daily lives, but also how they use it in their work setting, both with patients and colleagues. In this way it would be possible to identify the areas to be modified or boosted in order to plan activities for acquiring or strengthening those skills associated with the use of humor in the work setting.

The Multidimensional Scale of Humor in Healthcare Professionals (EMHUPS) has been created precisely to cover the unmet need for instruments to measure humor in the healthcare setting. The EMHUPS scale evaluates the attitude of healthcare professionals towards humor through 35 items classified into eight factors: humor with the patient, humor at work, humor and care, humor in the private setting, training in humor, humor and healthcare setting, demand of training in humor, and humor and leisure. Its application can be extended to all healthcare settings which involve patient care, both in Primary Care and in Specialized Care. This scale has been associated with psychological variables such as anxiety, depression, sleep alterations or psychopathological risk, and there is a negative relationship with the number, severity and intensity of these symptoms. On the other hand, there is a positive association with affiliative and self-affirmative humor, the humor styles considered potentially beneficial for psychological welfare, which intend to improve social relationships and offer an effective way of coping with adversity. Once again, the value of humor in professional self-care stands out. The role played by this strategy in our health must be considered, in the physical, mental, emotional and social levels, as well as its impact on the work environment and its influence on the quality of our patient care.

“Never forget to laugh and make others laugh, because in that way we will be caring for ourselves in order to be able to care for others.”.