Intradialytic Laughter Yoga therapy for haemodialysis patients: a pre-post intervention feasibility study

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.

The effects of group‐based Laughter Yoga interventions on mental health in adults: A systematic review

“…()showed a nonsignificant reduction in depressed mood, whereas Bennett et al. 's () study reported a nonsignificant increase in depressed mood immediately postintervention.…”

“…Six studies (Bennett et al., ; Ellis, Ben‐Moshe, & Teshuva, ; Farifteh et al., ; Shahadi et al. 2010; Weinberg, Hammond, & Cummins, ; Yazdani, Esmaeilzadeh, Pahlavanzadeh, & Khaledi, ) met the criteria for inclusion.…”

“…Bennett et al. 's () single group study also used the DASS and reported a nonsignificant decrease in stress level immediately after 11 sessions of LY in kidney failure patients ( p > 0.05), with a small nonsignificant effect size of −0.19 (95% CI [−1.18, 0.79]). Farifteh et al.…”

Training with an Electric Exercise Bike versus a Conventional Exercise Bike during Hemodialysis for Patients with End-stage Renal Disease: A Randomized Clinical Trial

“…Sample sizes were calculated using G-Power version 3.1 (Franz, Universitat Kiel, Germany), using an alpha value of 0.05 and a power of 80%. 5) All results are given as the mean ± standard deviation, and significance was set at P<0.05.…”

Subjective Wellbeing Assessment in People with Chronic Kidney Disease Undergoing Hemodialysis

“…Dialysis nurses should therefore be encouraged to increase people with CKD's happiness through the integration of laughter yoga [37], the Fordyce's happiness program [38], and the visualization of humor ilms [39], during dialysis sessions. This intervention will improve both people with CKD's wellbeing and health outcomes, such as quality of life, afect, and depressive symptoms.…”