Effect of Laughter Therapy on Mood Disturbances, Pain, and Burnout in Terminally Ill Cancer Patients and Family Caregivers.

Abstract

Humor has been commonly used in palliative care and identified as a coping strategy of palliative care patients and family caregivers. However, the use of humor or laughter in palliative care settings is still limited. The aim of this study was to examine the effect of laughter therapy involving spontaneous laughter on mood disturbances and pain in terminally ill patients with cancer and mood disturbances and the levels of burnout in family caregivers. This quasi-experimental study used a nonequivalent control group pretest-posttest design. The laughter therapy developed was provided for 20 to 30 minutes a day for 5 consecutive days. Twenty-six pairs of terminally ill cancer patients and family caregivers in the intervention group and 23 pairs in the comparison group from the hospice ward of a tertiary teaching hospital participated in this study. The data were collected using structured questionnaires and analyzed using descriptive statistics and 2-way repeated-measures analysis of variance. There were significant decreases in mood disturbances in the patients ( P < .001) and family caregivers ( P < .001), pain in the patients ( P < .001), and levels of burnout in the caregivers ( P < .001) in the intervention group. Laughter therapy can be an alternative intervention to support both terminally ill patients with cancer and their family caregivers experiencing multidimensional distress in palliative care settings. The appropriate use of laughter or humor therapy needs to be encouraged as a support tool in palliative care. Palliative care teams must be properly trained to provide spontaneous laughter therapy or planned humor therapy.