Abstract
The purpose of this study was to examine the effect of a therapeutic laughter program and the number of program sessions on anxiety, depression, and stress in breast cancer patients. A randomized controlled trial was conducted involving 31 patients who received four sessions of therapeutic laughter program comprised and 29 who were assigned to the no-program control group. Scores for anxiety, depression, and stress were measured using an 11-point numerical rating scale. While no change was detected in the control group, the program group reported reductions of 1.94, 1.84, and 2.06 points for anxiety, depression, and stress, respectively (p < 0.01, p < 0.01, and p < 0.01). Scores decreased significantly after the first therapeutic laughter session (p < 0.05, p < 0.01, and p < 0.01). As the therapeutic laughter program was effective after only a single session in reducing anxiety, depression, and stress in breast cancer patients, it could be recommended as a first-line complementary/alternative therapy.
Highlights
The increase in the survival of cancer patients has created interest in quality of life and the various factors affecting it
Of the 60 patients who participated in the study, 29 in the control group and 31 in the therapeutic laughter program (TLP) group were included in the intention-to-treat analysis (ITT) analysis (Figure 1); for the perprotocol analysis (PP) analysis, 20 from the TLP group who had more than two sessions and 29 in the control group were included
The numerical rating scale (NRS) scores for anxiety displayed a moderate correlation with the Hospital Anxiety Depression Scale (HADS) scores
Summary
The increase in the survival of cancer patients has created interest in quality of life and the various factors affecting it. Breast cancer is the second most frequent cancer in Korean women and occurs most often in middle-aged women in their 40s and 50s [1]. The 5-year survival rate of breast cancer patients has continued to increase since 1993 and it has the second highest survival rate at 91.3% in the last 5 years, beaten only by thyroid cancer [1]. Among the various factors reported to affect quality of life is psychological stress, which leads to depression and anxiety [2]. Psychological stress prevalence is very high among breast cancer patients in Korea, with depression affecting 44% of the cancer patient population [3] and 36% of breast cancer patients undergoing radiation therapy; 21% experience anxiety [4]. Effective interventions to reduce psychological stress are needed urgently
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