Intradialytic Laughter Yoga therapy for haemodialysis patients: a pre-post intervention feasibility study.
Study Goal
The researchers aimed to assess the feasibility, psychological and physiological impact of Laughter Yoga in end-stage kidney disease patients undergoing hemodialysis, and estimate sample sizes for future studies.
Results Summary
Laughter Yoga showed non-significant improvements in happiness, mood, and optimism, with reduced stress and fewer intradialytic hypotensive episodes, but no changes in lung function or blood pressure. Nurses reported positive perceptions of the intervention.
Population
End-stage kidney disease patients receiving hemodialysis.
Effective Dosage
30-minute sessions, three times per week.
Duration
Four weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Laughter Yoga | increase | happiness | patients with end stage kidney disease in a dialysis setting | non-significant | non-significant increases | #1 |
Laughter Yoga | increase | mood | patients with end stage kidney disease in a dialysis setting | non-significant | non-significant increases | #2 |
Laughter Yoga | increase | optimism | patients with end stage kidney disease in a dialysis setting | non-significant | non-significant increases | #3 |
Laughter Yoga | decrease | stress | patients with end stage kidney disease in a dialysis setting | - | a decrease | #4 |
Laughter Yoga | decrease | Episodes of intradialytic hypotension | patients with end stage kidney disease in a dialysis setting | from 19 pre and 19 during Laughter Yoga to 4 post Laughter Yoga | decreased | #5 |
Laughter Yoga | no change | lung function | patients with end stage kidney disease in a dialysis setting | - | no change | #6 |
Laughter Yoga | no change | blood pressure | patients with end stage kidney disease in a dialysis setting | - | no change | #7 |
BACKGROUND: Laughter 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. METHODS: Pre/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. RESULTS: One 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. CONCLUSIONS: This 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 REGISTRATION: Australian New Zealand Clinical Trials Registry - ACTRN12614001130651 . Registered 23 October 2014.