Abstract
BackgroundLaughter Yoga consists of physical exercise, relaxation techniques and simulated vigorous laughter. It has been associated with physical and psychological benefits for people in diverse clinical and non-clinical settings, but has not yet been tested in a haemodialysis setting. The study had three aims: 1) to examine the feasibility of conducting Laughter Yoga for patients with end stage kidney disease in a dialysis setting; 2) to explore the psychological and physiological impact of Laughter Yoga for these patients; and 3) to estimate the sample size required for future research.MethodsPre/post intervention feasibility study. Eighteen participants were recruited into the study and Laughter Yoga therapists provided a four week intradialytic program (30-min intervention three times per week). Primary outcomes were psychological items measured at the first and last Laughter Yoga session, including: quality of life; subjective wellbeing; mood; optimism; control; self-esteem; depression, anxiety and stress. Secondary outcomes were: blood pressure, intradialytic hypotensive episodes and lung function (forced expiratory volume). Dialysis nurses exposed to the intervention completed a Laughter Yoga attitudes and perceptions survey (n = 11). Data were analysed using IBM SPSS Statistics v22, including descriptive and inferential statistics, and sample size estimates were calculated using G*Power.ResultsOne participant withdrew from the study for medical reasons that were unrelated to the study during the first week (94 % retention rate). There were non-significant increases in happiness, mood, and optimism and a decrease in stress. Episodes of intradialytic hypotension decreased from 19 pre and 19 during Laughter Yoga to 4 post Laughter Yoga. There was no change in lung function or blood pressure. All nurses agreed or strongly agreed that Laughter Yoga had a positive impact on patients’ mood, it was a feasible intervention and they would recommend Laughter Yoga to their patients. Sample size calculations for future research indicated that a minimum of 207 participants would be required to provide sufficient power to detect change in key psychological variables.ConclusionsThis study provides evidence that Laughter Yoga is a safe, low-intensity form of intradialytic physical activity that can be successfully implemented for patients in dialysis settings. Larger studies are required, however, to determine the effect of Laughter Yoga on key psychological variables.Trial registrationAustralian New Zealand Clinical Trials Registry - ACTRN12614001130651. Registered 23 October 2014.
Highlights
Laughter Yoga consists of physical exercise, relaxation techniques and simulated vigorous laughter
Despite the many psychological benefits of laughter it is unclear if these benefits translate into a positive intervention for people with end stage kidney disease (ESKD) [12]
Intradialytic hypotensive (IDH) episodes There were 19 Intradialytic hypotension (IDH) episodes recorded in the month preceding the Laughter Yoga (LY), 19 IDH episodes recorded during, and four recorded post LY intervention
Summary
The questionnaire included measures of general life satisfaction, subjective wellbeing, mood, optimism, control, self-esteem, depression, stress and anxiety These measures were chosen because they are theoretically consistent with psychological wellbeing and have recently been explored with a non-clinical sample that undertook a laughter yoga intervention [11]. Three psychological variables that were considered most amenable to change following an intervention such as LY (i.e., associated with relaxation and positive mood) were depression, anxiety and stress, all measured using the DASS [19] These variables represent more transient, temporary states, that are more susceptible to change by intervention, compared to other psychological variables such as self-esteem and subjective wellbeing which are inherently stable over time [22, 23].
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