Off-campus UMass Amherst users: To download dissertations, please use the following link to log into our proxy server with your UMass Amherst user name and password.

Non-UMass Amherst users, please click the view more button below to purchase a copy of this dissertation from Proquest.

(Some titles may also be available free of charge in our Open Access Dissertation Collection, so please check there first.)

Sense of humor, childhood cancer stressors, and outcomes of psychosocial adjustment, immune function, and infection

Jacqueline Sue Dowling, University of Massachusetts Amherst


The diagnosis, treatment and side effects of childhood cancer have been described as extremely stressful experiences in the life of a child. Children must learn to cope with painful procedures, fears of mutilation, loss of body parts, treatment side effects, and the uncertainty of treatment outcomes. Anecdotally, children report that a sense of humor helps them cope with the daily experiences of living with cancer, however no research has examined sense of humor and childhood cancer stressors. According to Lazarus and Folkman's (1984) theory of stress, appraisal, and coping, outcomes are influenced by the moderating effect of personal factors. ^ This study investigated the moderating effect of sense of humor on the relationship between cancer stressors and children's psychosocial adjustment to cancer, immune function, and infection. Subjects (N = 43) were selected from a population of school-age children with cancer. Sense of humor was assessed using a modified and tested version of a Multidimensional Sense of Humor Scale (Dowling & Fain, 1999) and its factors of humor appreciation, humor creation, and coping humor. Cancer stressors and psychosocial adjustment were measured using the Childhood Cancer Stressors Inventory and the Children's Adjustment to Cancer Index (Hockenberry-Eaton, Manteuffel, & Bottomley, 1997). Immune function was measured using salivary IgA levels and absolute neutrophil counts. The incidence and severity of infections were assessed over a subsequent month. ^ A moderating effect was observed for incidence of infections. As childhood cancer stressors increase, children with high coping humor scores reported fewer incidence of infections than low scorers. A direct relationship was observed between sense of humor and psychosocial adjustment to cancer, such that children with a high sense of humor had greater psychological adjustment, regardless of the amount of cancer stressors. Additional analysis of a subset of items on the Childhood Cancer Stressors Inventory revealed that coping humor moderated the daily hassles of living with cancer for psychosocial adjustment, SIgA levels, and incidence of infections. Results of this study provide information on one factor, sense of humor, and its influence on childhood cancer stressors, that can help nurses recognize individual differences and develop supportive interventions for the children entrusted to their care. ^

Subject Area

Nursing|Clinical psychology

Recommended Citation

Dowling, Jacqueline Sue, "Sense of humor, childhood cancer stressors, and outcomes of psychosocial adjustment, immune function, and infection" (2000). Doctoral Dissertations Available from Proquest. AAI9978491.