The Effect of Laughter Yoga on Nurses Psychological Resilience and Sleep Quality During the Pandemic Period

March 29, 2022 updated by: Suheyla YARALI, Ataturk University
This study aimed to determine the effects of laughter yoga on the psychological resilience and sleep quality of active nurses during the pandemic period. Initial stage of labor on randomized controlled birth outcomes and maternal satisfaction. A total of 100 nurses, determined by power analysis, were recruited into the randomized controlled, single-blind clinical study. The study included 2 groups (group A nurses who had active contact with patients diagnosed with or at risk of covid-19, group B: nurses who had active contact with patients diagnosed or at risk of covid-19 and participated in laughter yoga practice. Laughter yoga; immune system It has been proven by experimental studies that there is a connection between antibodies and endorphins, that it has a healing effect, that it accelerates the circulatory system as an adverse effect to stress, and that it has a vasodilation effect in the vessels.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The study data were collected by the researchers using online systems with the snowball method due to the pandemic. The inclusion criteria of the study (not having undergone abdominal surgery in the last three months, not having uncontrolled hypertension, not having glaucoma, hernia, epilepsy, not having received a psychiatric diagnosis-treatment, not having received a diagnosis-treatment for sleep problems, having done laughter yoga before) The study consisted of 100 nurses who agreed to participate in the study. Descriptive features form consisting of 13 questions, Connor-Davidson Resilience Scale (CD-RISC) scale and Pittsburgh Sleep Quality Index (PSQI) were used to collect data. Research data were collected in 3 months. During the study, 4 people from the experimental group (3 people did not attend the sessions regularly, 1 person left voluntarily), 6 people from the control group (he left voluntarily) quit the study. Finally, the research was completed with 90 nurses, 46 of which were in the experimental group and 44 in the control group.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
90

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
    • Erzurum
      • Yakutiye, Erzurum, Turkey, 25000
        • Süheyla Yaralı

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • ADULT
  • OLDER_ADULT
  • CHILD

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Not have undergone abdominal surgery in the past three months
  • Not have uncontrolled hypertension
  • Not have epilepsy
  • Not have received a psychiatric diagnosis or treatment
  • Working actively during the pandemic period

Exclusion Criteria:

  • Not attending sessions regularly

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: SUPPORTIVE_CARE
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: SINGLE

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
EXPERIMENTAL: laughter yoga practice
Laughter yoga practiced by a researcher with a laughter yoga practitioner certificate
Other: laughter yoga for nurses
The experimental group was divided into three groups as 17-17-16 people. For four weeks, laughter yoga sessions were held between 20.00 and 21.00, 2 days a week for each group. Laughter yoga sessions were held for the 1st group between 20.00-21.00 on Mondays and Thursdays, for the 2nd group between 20.00-21.00 on Tuesdays and Fridays, and for the 3rd group between 20.00-21.00 on Wednesdays and Sundays. The first sessions lasted 45 minutes, every other session 40 minutes.
Other: laughter yoga for nurses-Deep breathing exercises
Deep breathing exercises (5 minutes) Breathing is held for 4-5 seconds after deep inspiration. While the arms are brought to the normal position, exhale slowly and rhythmically. When expressing after deep inspiration, the lips can be pursed as if whistling or exhaled with laughter.
Other: laughter yoga for nurses-Warm-up exercises
Warm-up exercises (10 minutes) Rhythm of 1-2, 1-2-3 is added to increase the energy level even more and synchronize the movements of the group. After a few rhythmic clapping movements, another movement is added. Whisking hands left and right. Then an audible rhythm of ho, ho, ha-ha-ha is added to the clapping gesture. Make eye contact with people in the group and smile at them.
Other: laughter yoga for nurses-Childish games
Childish games (10 minutes) Childlike games are used to help laugh without reason just like a child. The group is motivated by visualizing these games in their minds, raising the arms up in the form of a "Y" letter, and saying "very good (applause), very good (applause), hey" with palms facing the sky.
Other: laughter yoga for nurses-Laughter exercises
Laughter exercises (15 minutes) This section includes a variety of laughter exercises such as greetings, strawberry milk, conductor, bonus, hot soup, lion, aloha, bird, appreciation, laughter lotion, elevator, cream cake, and bursting balloon laughter.
EXPERIMENTAL: Laughter yoga session parts-1
Deep breathing exercises (5 minutes)
Other: laughter yoga for nurses
The experimental group was divided into three groups as 17-17-16 people. For four weeks, laughter yoga sessions were held between 20.00 and 21.00, 2 days a week for each group. Laughter yoga sessions were held for the 1st group between 20.00-21.00 on Mondays and Thursdays, for the 2nd group between 20.00-21.00 on Tuesdays and Fridays, and for the 3rd group between 20.00-21.00 on Wednesdays and Sundays. The first sessions lasted 45 minutes, every other session 40 minutes.
Other: laughter yoga for nurses-Deep breathing exercises
Deep breathing exercises (5 minutes) Breathing is held for 4-5 seconds after deep inspiration. While the arms are brought to the normal position, exhale slowly and rhythmically. When expressing after deep inspiration, the lips can be pursed as if whistling or exhaled with laughter.
Other: laughter yoga for nurses-Warm-up exercises
Warm-up exercises (10 minutes) Rhythm of 1-2, 1-2-3 is added to increase the energy level even more and synchronize the movements of the group. After a few rhythmic clapping movements, another movement is added. Whisking hands left and right. Then an audible rhythm of ho, ho, ha-ha-ha is added to the clapping gesture. Make eye contact with people in the group and smile at them.
Other: laughter yoga for nurses-Childish games
Childish games (10 minutes) Childlike games are used to help laugh without reason just like a child. The group is motivated by visualizing these games in their minds, raising the arms up in the form of a "Y" letter, and saying "very good (applause), very good (applause), hey" with palms facing the sky.
Other: laughter yoga for nurses-Laughter exercises
Laughter exercises (15 minutes) This section includes a variety of laughter exercises such as greetings, strawberry milk, conductor, bonus, hot soup, lion, aloha, bird, appreciation, laughter lotion, elevator, cream cake, and bursting balloon laughter.
EXPERIMENTAL: Laughter yoga session parts-2
Warm-up exercises (10 minutes)
Other: laughter yoga for nurses
The experimental group was divided into three groups as 17-17-16 people. For four weeks, laughter yoga sessions were held between 20.00 and 21.00, 2 days a week for each group. Laughter yoga sessions were held for the 1st group between 20.00-21.00 on Mondays and Thursdays, for the 2nd group between 20.00-21.00 on Tuesdays and Fridays, and for the 3rd group between 20.00-21.00 on Wednesdays and Sundays. The first sessions lasted 45 minutes, every other session 40 minutes.
Other: laughter yoga for nurses-Deep breathing exercises
Deep breathing exercises (5 minutes) Breathing is held for 4-5 seconds after deep inspiration. While the arms are brought to the normal position, exhale slowly and rhythmically. When expressing after deep inspiration, the lips can be pursed as if whistling or exhaled with laughter.
Other: laughter yoga for nurses-Warm-up exercises
Warm-up exercises (10 minutes) Rhythm of 1-2, 1-2-3 is added to increase the energy level even more and synchronize the movements of the group. After a few rhythmic clapping movements, another movement is added. Whisking hands left and right. Then an audible rhythm of ho, ho, ha-ha-ha is added to the clapping gesture. Make eye contact with people in the group and smile at them.
Other: laughter yoga for nurses-Childish games
Childish games (10 minutes) Childlike games are used to help laugh without reason just like a child. The group is motivated by visualizing these games in their minds, raising the arms up in the form of a "Y" letter, and saying "very good (applause), very good (applause), hey" with palms facing the sky.
Other: laughter yoga for nurses-Laughter exercises
Laughter exercises (15 minutes) This section includes a variety of laughter exercises such as greetings, strawberry milk, conductor, bonus, hot soup, lion, aloha, bird, appreciation, laughter lotion, elevator, cream cake, and bursting balloon laughter.
EXPERIMENTAL: Laughter yoga session parts-3
Childish games (10 minutes)
Other: laughter yoga for nurses
The experimental group was divided into three groups as 17-17-16 people. For four weeks, laughter yoga sessions were held between 20.00 and 21.00, 2 days a week for each group. Laughter yoga sessions were held for the 1st group between 20.00-21.00 on Mondays and Thursdays, for the 2nd group between 20.00-21.00 on Tuesdays and Fridays, and for the 3rd group between 20.00-21.00 on Wednesdays and Sundays. The first sessions lasted 45 minutes, every other session 40 minutes.
Other: laughter yoga for nurses-Deep breathing exercises
Deep breathing exercises (5 minutes) Breathing is held for 4-5 seconds after deep inspiration. While the arms are brought to the normal position, exhale slowly and rhythmically. When expressing after deep inspiration, the lips can be pursed as if whistling or exhaled with laughter.
Other: laughter yoga for nurses-Warm-up exercises
Warm-up exercises (10 minutes) Rhythm of 1-2, 1-2-3 is added to increase the energy level even more and synchronize the movements of the group. After a few rhythmic clapping movements, another movement is added. Whisking hands left and right. Then an audible rhythm of ho, ho, ha-ha-ha is added to the clapping gesture. Make eye contact with people in the group and smile at them.
Other: laughter yoga for nurses-Childish games
Childish games (10 minutes) Childlike games are used to help laugh without reason just like a child. The group is motivated by visualizing these games in their minds, raising the arms up in the form of a "Y" letter, and saying "very good (applause), very good (applause), hey" with palms facing the sky.
Other: laughter yoga for nurses-Laughter exercises
Laughter exercises (15 minutes) This section includes a variety of laughter exercises such as greetings, strawberry milk, conductor, bonus, hot soup, lion, aloha, bird, appreciation, laughter lotion, elevator, cream cake, and bursting balloon laughter.
EXPERIMENTAL: Laughter yoga session parts-4
Laughter exercises (15 minutes)
Other: laughter yoga for nurses
The experimental group was divided into three groups as 17-17-16 people. For four weeks, laughter yoga sessions were held between 20.00 and 21.00, 2 days a week for each group. Laughter yoga sessions were held for the 1st group between 20.00-21.00 on Mondays and Thursdays, for the 2nd group between 20.00-21.00 on Tuesdays and Fridays, and for the 3rd group between 20.00-21.00 on Wednesdays and Sundays. The first sessions lasted 45 minutes, every other session 40 minutes.
Other: laughter yoga for nurses-Deep breathing exercises
Deep breathing exercises (5 minutes) Breathing is held for 4-5 seconds after deep inspiration. While the arms are brought to the normal position, exhale slowly and rhythmically. When expressing after deep inspiration, the lips can be pursed as if whistling or exhaled with laughter.
Other: laughter yoga for nurses-Warm-up exercises
Warm-up exercises (10 minutes) Rhythm of 1-2, 1-2-3 is added to increase the energy level even more and synchronize the movements of the group. After a few rhythmic clapping movements, another movement is added. Whisking hands left and right. Then an audible rhythm of ho, ho, ha-ha-ha is added to the clapping gesture. Make eye contact with people in the group and smile at them.
Other: laughter yoga for nurses-Childish games
Childish games (10 minutes) Childlike games are used to help laugh without reason just like a child. The group is motivated by visualizing these games in their minds, raising the arms up in the form of a "Y" letter, and saying "very good (applause), very good (applause), hey" with palms facing the sky.
Other: laughter yoga for nurses-Laughter exercises
Laughter exercises (15 minutes) This section includes a variety of laughter exercises such as greetings, strawberry milk, conductor, bonus, hot soup, lion, aloha, bird, appreciation, laughter lotion, elevator, cream cake, and bursting balloon laughter.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Introductory Information Form (questionnaire)
Time Frame: up to 2 weeks
The form prepared by the researchers consists of a total of 13 questions, including some demographic characteristics (age, education level, marital status, etc.) and professional characteristics (working years, frequently worked shifts, clinic/unit worked during the epidemic period, etc.) of the nurses.
up to 2 weeks
Connor-Davidson Resilience Scale (CD-RISC)-pre-test
Time Frame: up to 5 weeks
The scale consists of 25 items and has a 5-point Likert type scoring ranging from 'never true' (0) to 'always true' (4). Scale; It consists of three sub-dimensions, namely perseverance and personal competence, tolerance to negative phenomena, and spiritual inclination, and the total score to be taken from the scale is minimum 0 and maximum 100 points. High scores obtained from the scale indicate high levels of psychological resilience. According to the factor structure, perseverance and personal competence with items 1, 5, 10, 11, 12, 15, 16, 17, 18, 19, 21, 22, 23, 24, 25; Resilience levels can be determined by examining tolerance to negative events with items 4, 6, 7, 8, 13, 14, and moral tendency with items 2, 3, 9, 20. The Cronbach's alpha coefficient of the scale was stated as 0.89. In this study, the Cronbach's alpha coefficient of the scale was calculated as 0.92.
up to 5 weeks
Pittsburgh Sleep Quality Index (PSQI)-pre-test
Time Frame: up to 5 weeks
In the form consisting of a total of 24 questions, scores of 7 components are obtained. PSQI; It consists of seven sub-components that evaluate subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping pills, and dysfunction during the day. The response of each is scored between 0-3 according to symptom frequency. The sum of the scores of the seven components gives the total PSQI score. The total score obtained varies between 0-21, and high values indicate poor sleep quality and high sleep disturbance level. A total score of 6 or above indicates that the sleep quality is clinically significantly worse. The Cronbach Alpha internal consistency coefficient of the scale was found to be 0.80. In this study, the Cronbach's alpha coefficient of the PSQI Scale was calculated as 0.83.
up to 5 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Connor-Davidson Resilience Scale (CD-RISC)-post-application testing
Time Frame: up to 5 weeks
The scale consists of 25 items and has a 5-point Likert type scoring ranging from 'never true' (0) to 'always true' (4). Scale; It consists of three sub-dimensions, namely perseverance and personal competence, tolerance to negative phenomena, and spiritual inclination, and the total score to be taken from the scale is minimum 0 and maximum 100 points. High scores obtained from the scale indicate high levels of psychological resilience. According to the factor structure, perseverance and personal competence with items 1, 5, 10, 11, 12, 15, 16, 17, 18, 19, 21, 22, 23, 24, 25; Resilience levels can be determined by examining tolerance to negative events with items 4, 6, 7, 8, 13, 14, and moral tendency with items 2, 3, 9, 20. The Cronbach's alpha coefficient of the scale was stated as 0.89. In this study, the Cronbach's alpha coefficient of the scale was calculated as 0.92.
up to 5 weeks
Pittsburgh Sleep Quality Index (PSQI)-post-application testing
Time Frame: up to 5 weeks
n the form consisting of a total of 24 questions, scores of 7 components are obtained. PSQI; It consists of seven sub-components that evaluate subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping pills, and dysfunction during the day. The response of each is scored between 0-3 according to symptom frequency. The sum of the scores of the seven components gives the total PSQI score. The total score obtained varies between 0-21, and high values indicate poor sleep quality and high sleep disturbance level. A total score of 6 or above indicates that the sleep quality is clinically significantly worse. The Cronbach Alpha internal consistency coefficient of the scale was found to be 0.80. In this study, the Cronbach's alpha coefficient of the PSQI Scale was calculated as 0.83.
up to 5 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ataturk University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 24, 2021

Primary Completion (ACTUAL)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 15, 2021

Study Completion (ACTUAL)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
August 31, 2021

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
March 18, 2022

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 18, 2022

First Posted (ACTUAL)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 29, 2022

Study Record Updates

Last Update Posted (ACTUAL)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 6, 2022

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 29, 2022

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2022

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • suheylasy

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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