Effects of Laughter Therapy on Postpartum Mothers' Stress, Sleep, and Breastfeeding

February 27, 2025 updated by: Havva Tokgöz Kekeç, Selcuk University

The Effect of Laughter Therapy Given to Mothers in The Postpartum Period on Their Perceived Stress, Sleep Quality and Breastfeeding Self-Efficacy Level; Randomized Controlled Trial

Postnatal period is an important developmental transition period for women. Stress in the postnatal period is one of the most common mental health problems and most mothers report experiencing stress in the perinatal period. In addition, stress and negative mental health also threaten breastfeeding self-efficacy. The postnatal period is an important stage in terms of early initiation and maintenance of breastfeeding. Breastfeeding self-efficacy is a mother's perceived confidence in her ability to breastfeed her newborn baby. Therefore, midwives are expected to assess women and identify women in need of supportive interventions and consciously contribute to their treatment. Another common problem in the postnatal period is poor sleep quality. It was determined that an increase in sleep quality and perceived social support positively affected breastfeeding self-efficacy of postpartum women. In addition, poor sleep quality poses a threat for negative mental health outcomes for women in the postpartum period. Previous studies reflect mothers' desire for non-pharmacological interventions and a high degree of satisfaction with these therapies. Laughter therapy, one of the main non-pharmacological interventions, is recognised as a universal approach to reduce stress and anxiety. The postnatal period is a fragile period with physical and psychological changes as well as hormonal changes in the mother. Poor mental health of the mother poses a danger to the well-being of the mother and the baby. Mothers in the postpartum period need low-cost, easily accessible preventive interventions to prevent these problems. In this context, the aim of this study is to determine the effect of laughter therapy given to mothers in the postpartum period on perceived stress, sleep quality and breastfeeding self-efficacy level in mothers.

Study Overview

Status

Enrolling by invitation

Conditions

Intervention / Treatment

Detailed Description

The postnatal period is an important developmental transition period for women and mothers experience various difficulties. Therefore, midwives are expected to assess women and identify women in need of supportive interventions and consciously contribute to their treatment. Previous studies reflect mothers' desire for non-pharmacological therapies and a high degree of satisfaction with these therapies. Laughter therapy, one of the main non-pharmacological interventions, is recognised as a universal approach to reduce stress and anxiety. Laughter therapy is a new, simple, cost-effective, non-invasive, non-invasive, widely available online, easily accessible and effective method. Laughter therapy has been applied to many different patient populations and healthy individuals in a variety of settings, and studies have reported benefits such as improved sleep quality, decreased depression, pain and stress hormones, improved mood and life satisfaction, increased prenatal attachment and breastfeeding self-efficacy. These benefits document the positive role of laughter therapy in improving the quality of life of individuals. Laughter therapy is a type of cognitive-behavioural therapy that can improve physical, psychological and ultimately quality of life. Laughter therapy can be used for both preventive and therapeutic purposes. In contrast, the negative effects of laughter and humour are negligible.

In conclusion, laughter is a human and universal value. Using laughter effectively to improve well-being and facilitate adaptation to the changes experienced in this period can significantly improve quality of life. Mothers in the postpartum period need low-cost, easily accessible preventive interventions to prevent these problems. However, to achieve this, health professionals need to be aware of the most appropriate evidence-based interventions. The number of studies investigating the effect of laughter therapy on women's health is limited in Turkey. In order to increase evidence-based data, there is a need to investigate the potential effectiveness of laughter therapy interventions in terms of women's health. In this context, the aim of this study was to determine the effect of laughter therapy given to mothers in the postnatal period on perceived stress, sleep quality and breastfeeding self-efficacy level. It is thought that the results of this study will guide midwives to be aware of the effectiveness of laughter therapy and to plan interventions to improve the quality of life of mothers.

Study Type

Interventional

Enrollment (Estimated)

120

Phase

  • 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
    • Selçuklu
      • Konya, Selçuklu, Turkey, 42250
        • Selcuk University Faculty of Medicine Hospital

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • At least primary school graduate
  • Over the age of 18
  • Those who volunteer to participate in the research
  • Heterosexual
  • Having a single and healthy baby
  • Postpartum 1-12 month old baby
  • Women who can use Zoom program

Exclusion Criteria:

  • Those who do not speak Turkish,
  • Those with hearing and visual impairments,
  • Those with mental disabilities,
  • Those diagnosed with a known psychiatric disease,
  • Mothers who do not breastfeed
  • Mothers who have babies with disabilities and chronic health problems
  • Women with physical conditions that prevent them from participating in laughter yoga sessions (respiratory distress, persistent cough, vertiligo, severe heart disease, hemorrhoids, any type of hernia such as neck, waist or inguinal hernia, severe back pain, urinary incontinence, epilepsy, etc.),
  • Women who use medication or use another non-pharmacological method to reduce stress.

Women who develop an acute health problem in themselves or their babies, who have a sudden hospitalisation of the mother or baby, mothers who lose their babies, women who do not attend all of the laughter therapy sessions and women who cannot be reached after the application will be excluded from the study.

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 Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: laughter therapy group
After randomization is achieved, a WhatsApp group will be established with the mothers in the laughter therapy group. Before starting the application, the "Zoom" program will be downloaded to the phones or computers of the mothers in the laughter therapy group. Afterwards, an online application will be carried out in groups via Zoom, by determining a common day and time according to the working hours of the mothers and the researcher. Groups will be formed with at least 5-10 people, and laughter therapy will be applied to the groups for 4 weeks, 2 sessions per week, for a total of 8 sessions.
Behavioral: Laughter Therapy
A laughter yoga session; It is approximately 30 minutes and consists of four parts. These sections; hand clapping and warm-up exercises, deep breathing exercises, childish games and laughter exercises. In each laughter yoga session, the first three parts are the same, but the laughter exercises in the fourth part vary. In the first session of each new group, the introduction of laughter yoga, its purpose and objectives will be discussed. 10 minutes will be allocated for this section in the first session of each group. Therefore, the first session is planned to be 40 minutes in each group and all subsequent sessions are planned to be 30 minutes.
No Intervention: control group
No intervention will be made to the control group, they will be asked to fill out the survey forms simultaneously.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Perceived Stress Scale
Time Frame: 1st Time: Day 1, 2nd Time: Day 30, 3rd Time: Day 60
It was developed by Cohen, Kamarck & Mermelste (1983), and in the reliability study, the Cronbach Alpha value was found to be 0.86. The Cronbach Alpha value of the "Perceived Stress Scale", which was adapted into Turkish by Bilge, Öğce, Genç and Oran (2007) and whose validity and reliability studies were conducted, was found to be 0.81. Three items of the scale, prepared in a 5-point Likert type (0 never, 4 very often), are reverse-worded (items 4, 5, 6), and five items are literal (items 1, 2, 3, 7, and 8). A total score of 0-32 is taken from the scale. It has two subscales: perceived stress (items 1, 2, 3, 7, 8) and perceived coping (items 4, 5, and 6). The scale is evaluated on both total score and subscale scores. A high total score means a high perceived stress level. High scores from the subscales are a negative situation.
1st Time: Day 1, 2nd Time: Day 30, 3rd Time: Day 60

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pittsburgh Sleep Quality Index (PSQI)
Time Frame: 1st Time: Day 1, 2nd Time: Day 30, 3rd Time: Day 60
The PSQI was developed by Buysse et al. (1989) (20) and its Turkish validity and reliability was performed by Ağargün et al. (1996). The PSQI provides information about sleep quality in the last month and the type and severity of sleep disturbance. In the scale consisting of 24 questions in total, 18 questions are scored. The scale consists of 7 sub-dimensions that provide information about the individual's 'Subjective Sleep Quality', 'Sleep Latency', 'Sleep Duration', 'Habitual Sleep Efficiency', 'Sleep Disorder', 'Sleep Medication Use' and 'Daytime Dysfunction'. Each sub-dimension is evaluated on a 0-3 point scale (item 0=no distress, 3=serious distress). The total score of all sub-dimensions gives the total score of the scale (min- max=0-21). Sleep quality is classified as good between 0-4 points and poor sleep quality between 5-21 points.
1st Time: Day 1, 2nd Time: Day 30, 3rd Time: Day 60

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Breastfeeding Self-Efficacy Scale
Time Frame: 1st Time: Day 1, 2nd Time: Day 30, 3rd Time: Day 60
In 2003, a 14-item short form of the 33-item scale developed by Dennis and Faux was developed to assess mothers' breastfeeding self-efficacy levels. Tokat Aluş and Okumuş (2010) conducted a Turkish reliability and validity study of the short form of the Breastfeeding Self-Efficacy Scale and found that it was suitable for Turkish culture. The Breastfeeding Self-Efficacy Short Form Scale is a 5-point Likert-type scale (1=Never sure and 5=Always sure). The minimum score that can be obtained from the scale is 14 and the maximum score is 70. The higher the score, the higher the breastfeeding self-efficacy. The average administration time of the scale is 5-7 minutes.
1st Time: Day 1, 2nd Time: Day 30, 3rd Time: Day 60

Collaborators and Investigators

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

Sponsor

Selcuk University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

February 10, 2025

Primary Completion (Estimated)

April 15, 2025

Study Completion (Estimated)

May 30, 2025

Study Registration Dates

First Submitted

February 16, 2025

First Submitted That Met QC Criteria

February 27, 2025

First Posted (Actual)

March 25, 2025

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

February 27, 2025

Last Verified

February 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 2024/616
  • Researcher (Other Identifier: Bahçeşehir University)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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