The effect of laughter yoga on well-being, perceived stress, and academic self-efficacy in nursing students: A randomized controlled trial.

Despite rigorous theoretical and clinical training, nursing students face emotional and academic challenges that can harm their well-being. Nonetheless, there is a dearth of research investigating the impact of laughter yoga (LY) on nursing students' well-being, perceived stress, and self-efficacy. The aim of this single-blinded, two-armed randomized controlled trial is to evaluate the effect of LY on nursing students' well-being, perceived stress, and academic self-efficacy (ASE). A total of five sessions of LY were applied to the intervention group. The analysis included a total of 83 nursing students (intervention group n = 41 and control group n = 42). Repeated-measures multivariate analysis of variance (MANOVA) and paired-samples t-test were used for data analysis. Results revealed that the intervention group showed a significant increase in well-being (p < .001) and a decrease in perceived stress after LY (p < .01). However, statistically significant differences between the intervention and control groups were not found in well-being, perceived stress, and ASE (p > .05). These results indicate the potential effects of LY on the students' well-being and perceived stress. Community mental health nurses and educators can use LY to improve well-being in universities.

The impact of laughter yoga as a NIC on health parameters in nurses and nursing students: a systematic review.

BACKGROUND: Laughter yoga is a laughter exercise that combines yoga and breathing exercises (Pranayama). Laughter yoga decreases stress and burnout levels, depression and anxiety, salivary cortisol levels. The aim of the research is to systematically examine the studies on the effect of laughter yoga on health parameters in nurses and nursing students. METHODS: Systematic review of RCTs and quasi-experimental studies. The PRISMA protocol was used as the basis for the conduct of the study. Google Scholar, Medline/PubMed, Cochrane Library, Science Direct, CINAHL Complete and OVID databases were used for study search. Inclusion criteria was based on PICOS. The quality of the studies was assessed using the Joanna Briggs Institute-Meta analysis Statistical Assessment and Review Instrument (JBI-MAStARI). 10 studies were included in the systematic review after those excluded due to reasons not meeting the inclusion criteria. RESULTS: It was determined that the sample size was 50 or more in 80% of the studies. It was determined that the maximum number of laughter yoga sessions was 24 and at least 5 sessions. It has been observed that stress levels evaluated with different measurement tools decrease with the effect of laughter yoga in four studies. In three studies it was found that the level of burnout decreased after laughter yoga. In two studies in which salivary cortisol levels were evaluated also showed that laughter yoga reduced cortisol levels. CONCLUSIONS: It was concluded that stress and burnout levels, depression and anxiety, salivary cortisol levels decreased especially after laughter yoga. In addition, it was concluded that laughter yoga had positive effects on psychological well-being, life satisfaction, subjective happiness increase in and general health in the groups where laughter yoga was practiced.

The Efficacy of Laughter Therapy on Psychological Symptoms in People With Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Studies.

OBJECTIVE: Cancer patients generally have high stress levels, which often leads to depression, anxiety and other psychological problems. Laughter therapy has been used to relieve stress, depression and anxiety in cancer patients, but its efficacy is uncertain. The study aims to summarize evidence on the efficacy of laughter therapy on psychological symptoms of people with cancer. METHODS: A search was conducted in 10 electronic databases for randomized controlled trials (RCTs) reported before May 2023. This systematic review was reported based on the PRISMA 2020 statement. The evaluation of methodological quality and risk of biases were conducted by the Cochrane Risk of Bias Assessment tool version 2, and evidence evaluation was conducted using the GRADE pro online assessment tool. Statistical analysis adopted the Review Manager version 5.4 software. RESULTS: A total of eight studies were included involving 543 participants. Meta-analysis showed that laughter therapy plus routine nursing produced more positive effects than routine nursing in relieving stress (SMD = -1.18, 95% CI -1.73, -0.62, p < 0.0001), depression (SMD = -1.05, 95% CI -1.30, -0.81, p < 0.00001) and anxiety (SMD = -0.81, 95% CI -1.20, -0.43, p < 0.0001). CONCLUSIONS: Laughter therapy could effectively relieve stress, depression and anxiety of cancer patients. Future studies should improve the methodological quality of randomized controlled trials, conduct appropriate follow-up, and report details of follow-up. Additionally, it should perform multi-center and large-sample studies, and combine both subjective and objective outcome indications to enhance the persuasiveness of evidence supporting the effectiveness of laughter therapy. TRIAL REGISTRATION: PROSPERO register: CRD 42023452739.

The effect of laughter therapy on self-efficacy and psychological well-being in nursing students.

BACKGROUND: Academic self-efficacy and psychological well-being play a crucial role in the mental health of nursing students and influence whether they decide to remain in the nursing profession. AIMS: This study aimed to determine the effect of laughter therapy on self-efficacy and psychological well-being in nursing students. METHODS: In this randomized controlled study, 208 nursing students were randomly assigned to an experimental (n = 102) and a control (n = 106) group. The experimental group received laughter therapy face-to-face once a week for eight weeks. No intervention was applied to the control group. In both groups, data were collected at the beginning of the study and the end of the eighth week using a Sociodemographic Questionnaire Form, the Academic Self-Efficacy Scale, and the Psychological Well-Being Scale. RESULTS: In the post-study group comparisons, there was a statistically significant difference in the scores for the total Academic Self-Efficacy Scale, the external emotion management and collegiality subscales, and the total Psychological Well-Being Scale (p > 0.05). With regard to all the scale scores, no statistically significant difference was found in the groups in the pre- and post-comparisons (p > 0.05). CONCLUSIONS: It was determined that laughter therapy increased the mean psychological well-being score in the experimental group. It was also found that after the laughter therapy, distraction and loss of interest in lectures decreased, stress and anxiety levels decreased, eating and sleeping habits were regulated, and social media use decreased. Laughter therapy can be used to increase self-efficacy and psychological well-being.

How changes in laughter predict work engagement and workaholism: reciprocal relationships among Japanese employees.

Laughter is related to better well-being in daily life. Previous cross-sectional research among employees showed a positive relationship between laughter and work-related well-being (i.e., work engagement). However, longitudinal and even bidirectional relationships have not been yet explored. This study thus investigated the longitudinal and reciprocal relationships of laughter, with work engagement and workaholism as positive and negative aspects of work-related well-being. Specifically, we conducted two-wave web-based surveys among Japanese employees via an Internet survey company with a one-year interval, and 855 valid data were analyzed. The hypotheses were then tested using structural equation modeling. The results showed that increases in laughter during the previous year were positively and negatively related to future work engagement and workaholism, respectively. In addition, through changes in laughter, the initial work engagement led to future work engagement (gain cycle), whereas initial workaholism led to future workaholism (loss cycle). These findings suggest that laughter and work-related well-being influence each other reciprocally rather than unidirectionally. This underlines the importance of studying reversed as well as regular causal effects in the relationship between laughter and employee well-being.

The Effects of Pets in Cancer Care: A Case Study.

Humans can form an intense bond with their pets through shared love, attachment, and amusement. Through this case study, nurses can develop an increased understanding of how companion pets affect the quality of life of patie.

The effect of laughter yoga and music intervention on depression, anxiety, and stress in the Rafsanjan-Iran aged: a randomized clinical trial study.

OBJECTIVES: This study aimed to compare the effects of laughter yoga and music intervention on depression, anxiety, and stress in aged individuals referred to Rafsanjan health centers. METHOD: In this 3-arm randomized clinical trial, 91 depressed aged participants aged 60-75 years, referred to Rafsanjan health centers, were randomly assigned to intervention and control groups. The study followed a parallel group design with an allocation ratio of 1:1. The laughter yoga intervention was conducted twice a week for eight weeks, and music intervention consisted of 30-min sessions twice a week for eight weeks. The control group received no intervention ('No treatment' concurrent control). Assessments for depressive symptoms (primary outcome), anxiety, and stress were conducted at baseline, post-intervention, and one month after the intervention. RESULTS: A total of 84 patients were analyzed in three groups included the laughter yoga intervention (n = 31), music intervention (n = 25), or control group (n = 28). Repeated measures ANOVA revealed a significant decrease in depressive and anxiety symptoms (p < 0.001) from pre-test to post-test and one-month follow-ups. The greatest impact of the intervention programs on stress was observed immediately after the intervention, but stress increased one month after the intervention programs (p = 0.125). CONCLUSION: Both laughter yoga and music interventions proved effective in improving depression, anxiety, and stress in aged individuals. However, laughter yoga intervention demonstrated a superior effect and better acceptance among elders.

Effectiveness of yoga and laughter yoga in improving psychological resilience of mothers with babies hospitalized in neonatal intensive care unit.

This randomized controlled study aimed to determine the effectiveness of yoga and laughter yoga approaches in enhancing psychological resilience of mothers with babies hospitalized in the neonatal intensive care unit. The Mothers were randomized into three groups as yoga, laughter yoga, and control groups. The mothers received a total of 10 yoga/laughter yoga sessions for 45 minutes twice a week as home-based exercises. Depression, anxiety, stress, and psychological resilience outcomes were evaluated at baseline and after 5th and 10th sessions. The study was completed with 60 mothers including 20 mothers in the yoga group, 19 mothers in the laughter yoga group, and 21 mothers in the control group. There were statistically significant differences between the groups in terms of depression, anxiety, stress, and psychological resilience after 5th and 10th sessions. Yoga and laughter yoga was effective for increasing psychological resilience and alleviating depression, anxiety, stress.

Laughter-Induced Seizures: A Rare Type of Reflex Epilepsy.

This research explores the rare occurrence of laughter-induced seizures, a form of reflex epilepsy documented in only one previous case in the literature. The patient, free from prior medical or neuropsychiatric history, exhibited seizures triggered solely by laughter. Electroencephalography and neuroimaging revealed normal results. Despite declining medical therapy, lifestyle modifications enabled seizure management. The study emphasizes the dearth of data on laughter-induced seizures, prompting the consideration of multimodal strategies for treatment. Further research is imperative to unveil the precise pathophysiology and establish standardized therapeutic approaches for this uncommon epileptic manifestation.

Hearing laughter: a prescription for anxiety relief.

Anxiety can have adverse effects on cognition such as impairing test performance or restricting working memory. One way of reducing anxiety is through humor, and the present research investigated if the perception of laughter, which is often seen as a reaction to humor, could impact self-reported anxiety. Participants completed the STAI battery containing subscales for both state and trait anxiety before and after one of three manipulations: a laughter sounds rating task, a neutral sounds rating task, or a working memory span task. Results showed that perceiving laughter decreased both state and trait anxiety, taking a working memory test increased state anxiety, and perceiving neutral sounds had no effect on either type of anxiety. These findings are interpreted as evidence that the positive emotions induced by hearing laughter help to regulate anxiety by undoing arousal, even when negative emotions are not present.

Pathological Laughter: The First Manifestation of Intracerebral Haemorrhage Linked to Phenylephrine Overuse.

A 42-year-old woman presented to the emergency department with sudden-onset uncontrollable laughter, 'fou rire prodromique' (prodrome of crazy laughter), and left leg weakness. Imaging revealed a right cerebral haemorrhage of the premotor cortex corresponding to the leg cortical representation. A history of excess phenylephrine use for sinusitis and migraine was subsequently obtained. The patient's neurological recovery was good, enabling a return to her pre-stroke employment. The neurological causes of pathological laughter and the brain networks involved are discussed in this report. The role of sympathomimetics in the causation of cerebral haemorrhage potentially via the initiation of a reversible cerebral vasoconstriction syndrome is highlighted. The use of over-the-counter substances should be part of medication history in such cases.

Efficacy and Safety of Laughter Yoga in Cancer Patients: A Scoping Review of Randomized Controlled Trials.

The use of laughter yoga as a complementary and alternative medicine (CAM) strategy has recently gained interest as a potential supportive intervention for cancer patients. In this review, we aimed to assess the impact of laughter yoga on the quality of life of cancer patients, with a focus on evidence from randomized controlled trials (RCTs). Our analysis indicates that laughter yoga can significantly improve the quality of life of cancer patients by improving emotional and physical functioning and reducing symptoms of depression and stress. These findings suggest that laughter yoga is a promising CAM practice for enhancing cancer patients' psychological and physical health. Future research should aim to extend these studies to more extensive and more diverse populations to validate and expand upon these findings.

Mapping the differential impact of spontaneous and conversational laughter on brain and mind: an fMRI study in autism.

Spontaneous and conversational laughter are important socio-emotional communicative signals. Neuroimaging findings suggest that non-autistic people engage in mentalizing to understand the meaning behind conversational laughter. Autistic people may thus face specific challenges in processing conversational laughter, due to their mentalizing difficulties. Using fMRI, we explored neural differences during implicit processing of these two types of laughter. Autistic and non-autistic adults passively listened to funny words, followed by spontaneous laughter, conversational laughter, or noise-vocoded vocalizations. Behaviourally, words plus spontaneous laughter were rated as funnier than words plus conversational laughter, and the groups did not differ. However, neuroimaging results showed that non-autistic adults exhibited greater medial prefrontal cortex activation while listening to words plus conversational laughter, than words plus genuine laughter, while autistic adults showed no difference in medial prefrontal cortex activity between these two laughter types. Our findings suggest a crucial role for the medial prefrontal cortex in understanding socio-emotionally ambiguous laughter via mentalizing. Our study also highlights the possibility that autistic people may face challenges in understanding the essence of the laughter we frequently encounter in everyday life, especially in processing conversational laughter that carries complex meaning and social ambiguity, potentially leading to social vulnerability. Therefore, we advocate for clearer communication with autistic people.

Laughter in everyday life: an event-based experience sampling method study using wrist-worn wearables.

Laughter is a universal, nonverbal vocal expression of broad significance for humans. Interestingly, rather little is known about how often we laugh and how laughter is associated with our personality. In a large, event-based, experience sampling method study (N = 52; k = 9,261 assessments) using wrist-worn wearables and a physical analogue scale, we analyzed belly laughs and fit of laughter events in participants' everyday life for 4 weeks. Additionally, we assessed associations with laughter frequency such as personality, happiness, life satisfaction, gelotophobia (i.e., fear of being laughed at), and cheerfulness. Validating our new measurement approach (i.e., wearables, physical analogue scale), laughter events elicited higher happiness ratings compared to reference assessments, as expected. On average, participants reported 2.5 belly laughs per day and on every fourth day a fit of laughter. As expected, participants who were happier and more satisfied with their life laughed more frequently than unhappier, unsatisfied participants. Women and younger participants laughed significantly more than men and older participants. Regarding personality, laughter frequency was positively associated with openness and conscientiousness. No significant association was found for gelotophobia, and results for cheerfulness and related concepts were mixed. By using state-of-the-art statistical methods (i.e., recurrent event regression) for the event-based, multi-level data on laughter, we could replicate past results on laughing.

Intraoperative changes in large-scale thalamic circuitry following laser ablation of hypothalamic hamartomas.

BACKGROUND AND OBJECTIVES: Gelastic seizures due to hypothalamic hamartomas (HH) are challenging to treat, in part due to an incomplete understanding of seizure propagation pathways. Although magnetic resonance imaging-guided laser interstitial thermal therapy (MRgLITT) is a promising intervention to disconnect HH from ictal propagation networks, the optimal site of ablation to achieve seizure freedom is not known. In this study, we investigated intraoperative post-ablation changes in resting-state functional connectivity to identify large-scale networks associated with successful disconnection of HH. METHODS: Children who underwent MRgLITT for HH at two institutions were consecutively recruited and followed for a minimum of one year. Seizure freedom was defined as Engel score of 1A at the last available follow-up. Immediate pre- and post- ablation resting-state functional MRI scans were acquired while maintaining a constant depth of general anesthetic. Multivariable generalized linear models were used to identify intraoperative changes in large-scale connectivity associated with seizure outcomes. RESULTS: Twelve patients underwent MRgLITT for HH, five of whom were seizure-free at their last follow-up. Intraprocedural changes in thalamocortical circuitry involving the anterior cingulate cortex were associated with seizure-freedom. Children who were seizure-free demonstrated an increase and decrease in connectivity to the pregenual and dorsal anterior cingulate cortices, respectively. In addition, children who became seizure-free demonstrated increased thalamic connectivity to the periaqueductal gray immediately following MRgLITT. DISCUSSION: Successful disconnection of HH is associated with intraoperative, large-scale changes in thalamocortical connectivity. These changes provide novel insights into the large-scale basis of gelastic seizures and may represent intraoperative biomarkers of treatment success.

Evolution of laughter from play.

In this hypothesis, I discuss how laughter from physical play could have evolved to being induced via visual or even verbal stimuli, and serves as a signal to highlight incongruity that could potentially pose a threat to survival. I suggest how laughter's induction could have negated the need for physical contact in play, evolving from its use in tickling, to tickle-misses, and to taunting, and I discuss how the application of deep learning neural networks trained on images of spectra of a variety of laughter types from a variety of individuals or even species, could be used to determine such evolutionary pathways via the use of latent space exploration.

Impact of Laughter Yoga on Test Anxiety and Education Stress of 8th Grade Students: An Experimental Study.

Objective: In an exam-based education system, it is of utmost importance to identify levels of test anxiety and educational stress that directly affect success, and to reduce anxiety. A study was conducted to examine the effects of laughter yoga on test anxiety and educational stress in 8th grade students in Turkey. Methods: A cluster sampling, parallel-group randomized controlled trial with pre-test/post-test design studied 64 students (32 in the intervention group and 32 in the control group). The intervention group received laughter yoga sessions twice a week for 6 weeks. The control group received no intervention. Data were collected by a demographic questionnaire, the Westside Test Anxiety Scale, and the Educational Stress Scale. Results: After laughter yoga, the intervention group showed a significant decrease in test anxiety (d = 0.859; p < 0.005) and educational stress scores (d = 0.52875; p < 0.001) compared to the control group. Conclusion: Laughter yoga was associated with decreased test anxiety and educational stress. Laughter yoga activities in schools are recommended to decrease educational stress and test anxiety of students.

Assessment of Medical Clowning in Influencing the Anxiety and Behavior Scores of Children Undergoing Various Dental Treatments and the Stress Levels of the Operator.

Aim: To investigate the potential effectiveness of "medical clowns" on preoperative, intraoperative, and postoperative anxiety of children undergoing various dental treatments and also its effect on the operator's stress levels in a dental setup. Materials and methods: A total of 170 pediatric patients, aged 4-8 years, indicated for preventive therapy, extractions, restorative, and endodontics were included and divided into two groups [group I-audiovisual (A-V) aids; group II-medical clowns], group of 85 patients each after recording Modified yale preoperative scale. Both pre- and postoperatively, Frankl's behavior score was recorded for each patient. During treatment, the face, legs, activity, cry, consolability (FLACC) pain scale, and dental operator's stress level were recorded. Results: Intervention of medical clowns positively influenced children during dental treatment by increasing their pain threshold. The majority of children showed positive Frankl rating scales after dental treatment. Also, the operator's stress was significantly reduced, which led to enhanced treatment outcomes. Conclusion: Humor yields the power of healing, distracts pediatric patients, reduces their anxiety, and alleviates their pain, conferring the patients with a sense of laughter, creativity, and care.Therefore, medical clowns in pediatric dentistry can prove to be serviceable and valuable as a nonpharmacological approach to behavior management. How to cite this article: Aggarwal P, Mathur S, Chopra R. Assessment of Medical Clowning in Influencing the Anxiety and Behavior Scores of Children Undergoing Various Dental Treatments and the Stress Levels of the Operator. Int J Clin Pediatr Dent 2024;17(1):59-66.

The Effects of Laughter Yoga on Happiness and Stress in Nursing Students Going into Clinical Practice for the First Time.

Background: There are numerous difficulties that nursing students must overcome in the nursing practice environment. This circumstance mainly impacts the happiness and stress levels of nursing students who lack clinical practice. Aim: In this study aimed to examine the effect of laughter yoga (LY) on nursing students' happiness and stress levels attending to clinical practice for the first-time. Method: In this randomized controlled trial, a totally 50 nursing students were included from a nursing school in Turkey. Data were collected between December 2022-January 2023 via The Happiness Scale and the Perceived Stress Scale for Nursing Students. A total of eight LY lessons for 4 weeks were practiced to the laughter group (LG). Result: The Happiness Scale's means were compared between the groups before and after the intervention, and the results revealed a significant increase (p < 0.05). There was not a significant difference in the stress scale scores between both the groups following LG and clinical practice (t: -1.780; p = 0.081). However, the stress scores of the LG decreased significantly after the LY sessions were completed (b: 3.595; p = 0.001). Conclusion: LY can be an effective method to be used to help increase happiness and reduce the stress of nursing students for first-time entering clinical practice.

Development of a novel tool to investigate human laughter behaviour and experience.

We present a questionnaire exploring everyday laughter experience. We developed a 30-item questionnaire in English and collected data on an English-speaking sample (N = 823). Based on Principal Component Analysis (PCA), we identified four dimensions which accounted for variations in people's experiences of laughter: laughter frequency ('Frequency'), social usage of laughter ('Usage'), understanding of other people's laughter ('Understanding'), and feelings towards laughter ('Liking'). Reliability and validity of the LPPQ were assessed. To explore potential similarities and differences based on culture and language, we collected data with Mandarin Chinese-speaking population (N = 574). A PCA suggested the extraction of the same four dimensions, with some item differences between English and Chinese versions. The Laughter Production and Perception Questionnaire (LPPQ) will advance research into the experience of human laughter, which has a potentially crucial role in everyday life.