ComfortNCT05576701
Laughter Therapy Application in Hemodialysis Patients
A study testing Laughter Therapy in people with Comfort and Acceptance Processes, run by Bozok University at 2 sites in Turkey (Türkiye).
Trial summary
Background: A randomized controlled study was conducted on the effects of laughter therapy on increasing the acceptance of the disease, compliance with treatment and comfort levels in patients receiving hemodialysis treatment. Read more about this study
- Who is it for?
- Ages 18 to 85 yearsHealthy volunteers can take part
- Conditions the study is for
- Comfort, Acceptance Processes, Hemolysis
- What is being tested?
- Laughter Therapy
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 42 participants
- Where
- 2 sitesTurkey (Türkiye)
- Study dates
- 1 Aug 2022to 1 Sep 2022
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 85 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Patients who have been treated for HD for more than six months,
- who are over 18 years old
- who agree to participate in the study
Who cannot join
- patients with severe cardiovascular disease,
- who are pregnant,
- with psychiatric disorders,
- who do not regularly attend laughter therapy sessions,
- who have experience in laughter therapy
Trial locations and contacts
2 sites in 1 country.
About this study
Official title: The Effect of Laughter Therapy on Acceptance of Disease, Adherence to Treatment and Comfort Level in Patients Receiving Hemodialysis Treatment: A Randomized Controlled Trial
Background: A randomized controlled study was conducted on the effects of laughter therapy on increasing the acceptance of the disease, compliance with treatment and comfort levels in patients receiving hemodialysis treatment.
Materials and methods: The study was conducted with 42 (experimental group=21, control group=21) patients treated in the hemodialysis unit. Eight sessions of laughter yoga were applied to the hemodialysis patients in the experimental group for four weeks, two days a week. Data were used on the Patient Information Form, the Acceptance Scale, the End Stage Renal Failure - Compliance Scale, and the Hemodialysis Comfort Scale.
Read the detailed description
Kidney Failure is an important public health problem due to its increasing prevalence and high costs worldwide. Especially patients in the end stage of renal failure (ESRD) are faced with a life-threatening chronic disease. These patients need lifelong treatment and care to minimize the negative effects of impaired kidney function and to maintain life.
In the treatment and recovery processes of chronic diseases such as kidney failure, individuals' acceptance of the disease, compliance with the treatment and their comfort level are very important. The stage of acceptance of the disease is when the individual learns to live with the chronic disease by adapting to various complications and changes related to the chronic disease. Not accepting the disease results in submission to the problems brought about by the disease and causes an increase in the sense of dependency and a decrease in the sense of self-efficacy and self-esteem. It is very difficult for patients with end-stage renal disease who receive hemodialysis (HD) treatment among chronic diseases to accept the disease because they are affected by many physical, mental, spiritual and social aspects. It has been reported that patients receiving HD treatment often experience problems in the acceptance process of the disease. In the literature, it has been emphasized that acceptance of the disease is effective in reducing the physical, psychosocial and emotional problems caused by HD treatment. In addition, it has been shown that accepting the disease is effective in increasing the quality of life by reducing symptoms such as fatigue, constipation, loss of appetite, sexual dysfunction and stress in HD patients. On the other hand, it has been determined that individuals with low acceptance level of the disease have increased complaints about the disease and treatment. In studies related to the subject, it has been determined that patients' acceptance of the disease is at different levels.
Another important step in the treatment and recovery processes of chronic diseases is compliance with treatment. Compliance with treatment in the management of HD disease greatly affects the success of treatment. Compliance with treatment in HD patients; It is considered as compliance with fluid-diet-drug intake and participation in hemodialysis sessions. In studies, 55-77% of individuals receiving HD treatment have fluid restriction 30-70% diet restriction, 38-75% of drug intake and participation in 30-69% HD sessions have been found to have problems with it. This situation increases hospitalization, morbidity and mortality rates in individuals receiving HD treatment and creates a heavy burden on the health system. Therefore, it is important to increase patients' acceptance of the disease and their compliance with treatment.
Many physical and psychosocial symptoms occur during the disease and treatment processes, and the care needs of individuals who experience physical, social, economic and psychological problems increase, and there is a significant decrease in the quality of life and comfort. Helping patients with their needs, providing peace and being able to overcome problems gain priority. Therefore, the comfort that defines this situation; plays an important role in the care of individuals with chronic diseases. Comfort; It is defined as meeting the needs of individuals, solving their problems, reaching the desired result and peace by considering them as a whole in terms of physical, psychological, social and environmental aspects. Today, many complications and unmet basic needs of individuals with chronic diseases affect their comfort levels negatively. In the studies conducted, the comfort level of individuals receiving HD treatment is low and moderate. In the literature, problems such as painful invasive procedures, fatigue, decrease in energy, itching, bone/joint pain, numbness or tingling in the feet, sleep problems, dry mouth, decreased sexual desire and arousal experienced by individuals who receive HD treatment can lower their comfort levels. negatively. In order for patients to cope with the problems related to HD treatment, the level of comfort needs to be increased.
It is seen that some complementary methods are used in the literature to increase the health level of patients receiving HD treatment and to ensure that they can lead a quality life. One of these methods is laughter therapy. Laughter therapy; Developed in India in 1995, yoga is a group-based initiative that includes breathing exercises and simulated laughter. It is also a type of exercise done by singing songs, laughing for no reason and playing childish games. Laughter therapy for cardiovascular disease; irritable bowel syndrome, chronic obstructive pulmonary disease, diabetes, cancer. It has been dealt with many diseases such as and Parkinson's and it has been found to have beneficial effects on these diseases. In a randomized controlled experimental study conducted by Bennet et al. in patients receiving HD treatment, it was found that laughter therapy reduced the symptoms of depression. In the study of Sousa et al., it was determined that laughter therapy increases subjective happiness and significantly reduces symptoms of depression. In other studies conducted in patients receiving HD treatment, laughter therapy has positive effects on anxiety, depression, stress, and happiness was determined. There are also studies that show that laughter therapy regulates blood pressure in patients receiving HD treatment. In all these studies, it was observed that laughter therapy is a safe and feasible intervention in patients receiving HD treatment. When the literature is examined, no studies have been found on the effects of laughter therapy on the acceptance of the disease, compliance with the treatment and comfort level, although complementary methods are frequently used in studies on patients. In this direction, it was aimed to evaluate the effects of laughter therapy on acceptance of the disease, compliance with treatment and comfort levels in patients receiving HD treatment.
- Conditions
- Comfort, Acceptance Processes, Hemolysis, Laughter Therapy, Treatment Adherence, Patients
- Being tested
- Laughter Therapy, Control
- Medical subject headings
- Behavior, Hemolysis, Treatment Adherence and Compliance
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Laughter TherapyBehavioural
In this study, laughter therapy was applied to the experimental group three times a week (on Mondays, Wednesdays, and Fridays) for a total of 12 sessions. Each session started with other patients in the HD unit while the patient was receiving HD treatment (1 hour after HD started) and lasted 30-45 minutes. The number of patients who will take part in each laughter session is based on the number of patients attending that session in the hemodialysis unit.
ControlOther
The patients in the control group, on the other hand, did not undergo any intervention other than their routine treatment and care. Laughter therapy was applied for four weeks to HD patients in the control group who wanted the results of the research.
| Study group | Role | What they receive |
|---|---|---|
| Laughter Therapy | Experimental | Laughter therapy consists of group-based interventions that include yoga breathing exercises and stillness. Laughter education is a form of exercise with gratuitous laughter and childlike play. Laughter therapy practices consist of four steps. These; warming exercises, deep exercises, playing childlike games and entertainment (eg greeting laughter, lion laughter, milk waving sounds, quiet laughter, etc.). Laughter therapy sessions in the study were carried out for 4 weeks and three times a week. Laughter therapy has been applied by researchers who have a leader certificate. Receives: Behavioral: Laughter Therapy |
| Control | Active comparator | The patients in the control group, on the other hand, did not undergo any intervention other than their routine treatment and care. The patients were followed for four weeks. Before the study, data collection tools were applied to the patients. Again, after the study started and the study ended, all other data collection tools were applied, except the "Patient Information Form". Receives: Other: Control |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Disease Acceptance Level
This form was used to measure the degree of acceptance of the disease in hemodialysis patients. In the research, it was applied twice in total before the laughter therapy was applied and after the laughter therapy was finished. The total score to be obtained from the scale varies between 8 and 40, and as the score increases, the level of acceptance of the disease increases.
Measured: 4 weeks
Secondary outcomes (1)
Change in compliance level in end-stage renal disease
This form was used to evaluate participation in hemodialysis, medication adherence, fluid compliance, and diet compliance in hemodialysis patients. In the research, it was applied twice in total before the laughter therapy was applied and after the laughter therapy was finished. The range of scores that can be obtained from the scale is between 0-1200, and as the score increases, the compliance of the patients with the treatment also increases.
Measured: 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Oct 2022
- Study start1 Aug 2022
- Primary completion1 Sep 2022
- Study completion1 Sep 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for ComfortStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- While the patients were randomized; In order to keep the possibility of being affected by each other at a minimum level, the work was continued with the same application group in the same session group. 72 days in universe, hemodialysis days and sessions at time of day, next Wednesday, Friday = 36 patients); Tuesday, Thursday, evening patient control (n=36 patients are guided by the drawing method.
- Masking
- None (open label)
- Enrolment
- 42 participants (actual)
Sponsor and investigators
- Lead sponsor
- Bozok University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Betül Bal, Bozok University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05576701
- Sponsor's protocol ID
- BBal
- Status last verified
- Feb 2023
- First submitted
- 10 Sep 2022
- Last updated
- 8 Feb 2023
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 8 Feb 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Laughter Therapy on Acceptance of Disease, Adherence to Treatment and Comfort Level in Patients Receiving Hemodialysis Treatment: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT05576701
- Acronym / sponsor ID
- BBal
- Conditions
- Comfort, Acceptance Processes, Hemolysis, Laughter Therapy, Treatment Adherence, Patients
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 42 participants (actual)
- Lead sponsor
- Bozok UniversityUniversity, hospital or other
- Study start
- 1 Aug 2022 (actual)
- Primary completion
- 1 Sep 2022 (actual)
- Study completion
- 1 Sep 2022 (actual)
- First posted
- 12 Oct 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Background: A randomized controlled study was conducted on the effects of laughter therapy on increasing the acceptance of the disease, compliance with treatment and comfort levels in patients receiving hemodialysis treatment.
Materials and methods: The study was conducted with 42 (experimental group=21, control group=21) patients treated in the hemodialysis unit. Eight sessions of laughter yoga were applied to the hemodialysis patients in the experimental group for four weeks, two days a week. Data were used on the Patient Information Form, the Acceptance Scale, the End Stage Renal Failure - Compliance Scale, and the Hemodialysis Comfort Scale.
Detailed description
Kidney Failure is an important public health problem due to its increasing prevalence and high costs worldwide. Especially patients in the end stage of renal failure (ESRD) are faced with a life-threatening chronic disease. These patients need lifelong treatment and care to minimize the negative effects of impaired kidney function and to maintain life.
In the treatment and recovery processes of chronic diseases such as kidney failure, individuals' acceptance of the disease, compliance with the treatment and their comfort level are very important. The stage of acceptance of the disease is when the individual learns to live with the chronic disease by adapting to various complications and changes related to the chronic disease. Not accepting the disease results in submission to the problems brought about by the disease and causes an increase in the sense of dependency and a decrease in the sense of self-efficacy and self-esteem. It is very difficult for patients with end-stage renal disease who receive hemodialysis (HD) treatment among chronic diseases to accept the disease because they are affected by many physical, mental, spiritual and social aspects. It has been reported that patients receiving HD treatment often experience problems in the acceptance process of the disease. In the literature, it has been emphasized that acceptance of the disease is effective in reducing the physical, psychosocial and emotional problems caused by HD treatment. In addition, it has been shown that accepting the disease is effective in increasing the quality of life by reducing symptoms such as fatigue, constipation, loss of appetite, sexual dysfunction and stress in HD patients. On the other hand, it has been determined that individuals with low acceptance level of the disease have increased complaints about the disease and treatment. In studies related to the subject, it has been determined that patients' acceptance of the disease is at different levels.
Another important step in the treatment and recovery processes of chronic diseases is compliance with treatment. Compliance with treatment in the management of HD disease greatly affects the success of treatment. Compliance with treatment in HD patients; It is considered as compliance with fluid-diet-drug intake and participation in hemodialysis sessions. In studies, 55-77% of individuals receiving HD treatment have fluid restriction 30-70% diet restriction, 38-75% of drug intake and participation in 30-69% HD sessions have been found to have problems with it. This situation increases hospitalization, morbidity and mortality rates in individuals receiving HD treatment and creates a heavy burden on the health system. Therefore, it is important to increase patients' acceptance of the disease and their compliance with treatment.
Many physical and psychosocial symptoms occur during the disease and treatment processes, and the care needs of individuals who experience physical, social, economic and psychological problems increase, and there is a significant decrease in the quality of life and comfort. Helping patients with their needs, providing peace and being able to overcome problems gain priority. Therefore, the comfort that defines this situation; plays an important role in the care of individuals with chronic diseases. Comfort; It is defined as meeting the needs of individuals, solving their problems, reaching the desired result and peace by considering them as a whole in terms of physical, psychological, social and environmental aspects. Today, many complications and unmet basic needs of individuals with chronic diseases affect their comfort levels negatively. In the studies conducted, the comfort level of individuals receiving HD treatment is low and moderate. In the literature, problems such as painful invasive procedures, fatigue, decrease in energy, itching, bone/joint pain, numbness or tingling in the feet, sleep problems, dry mouth, decreased sexual desire and arousal experienced by individuals who receive HD treatment can lower their comfort levels. negatively. In order for patients to cope with the problems related to HD treatment, the level of comfort needs to be increased.
It is seen that some complementary methods are used in the literature to increase the health level of patients receiving HD treatment and to ensure that they can lead a quality life. One of these methods is laughter therapy. Laughter therapy; Developed in India in 1995, yoga is a group-based initiative that includes breathing exercises and simulated laughter. It is also a type of exercise done by singing songs, laughing for no reason and playing childish games. Laughter therapy for cardiovascular disease; irritable bowel syndrome, chronic obstructive pulmonary disease, diabetes, cancer. It has been dealt with many diseases such as and Parkinson's and it has been found to have beneficial effects on these diseases. In a randomized controlled experimental study conducted by Bennet et al. in patients receiving HD treatment, it was found that laughter therapy reduced the symptoms of depression. In the study of Sousa et al., it was determined that laughter therapy increases subjective happiness and significantly reduces symptoms of depression. In other studies conducted in patients receiving HD treatment, laughter therapy has positive effects on anxiety, depression, stress, and happiness was determined. There are also studies that show that laughter therapy regulates blood pressure in patients receiving HD treatment. In all these studies, it was observed that laughter therapy is a safe and feasible intervention in patients receiving HD treatment. When the literature is examined, no studies have been found on the effects of laughter therapy on the acceptance of the disease, compliance with the treatment and comfort level, although complementary methods are frequently used in studies on patients. In this direction, it was aimed to evaluate the effects of laughter therapy on acceptance of the disease, compliance with treatment and comfort levels in patients receiving HD treatment.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- While the patients were randomized; In order to keep the possibility of being affected by each other at a minimum level, the work was continued with the same application group in the same session group. 72 days in universe, hemodialysis days and sessions at time of day, next Wednesday, Friday = 36 patients); Tuesday, Thursday, evening patient control (n=36 patients are guided by the drawing method.
| Arm | Type | Receives |
|---|---|---|
| Laughter Therapy | Experimental | Behavioral: Laughter TherapyLaughter therapy consists of group-based interventions that include yoga breathing exercises and stillness. Laughter education is a form of exercise with gratuitous laughter and childlike play. Laughter therapy practices consist of four steps. These; warming exercises, deep exercises, playing childlike games and entertainment (eg greeting laughter, lion laughter, milk waving sounds, quiet laughter, etc.). Laughter therapy sessions in the study were carried out for 4 weeks and three times a week. Laughter therapy has been applied by researchers who have a leader certificate. |
| Control | Active comparator | Other: ControlThe patients in the control group, on the other hand, did not undergo any intervention other than their routine treatment and care. The patients were followed for four weeks. Before the study, data collection tools were applied to the patients. Again, after the study started and the study ended, all other data collection tools were applied, except the "Patient Information Form". |
Who may qualify
- Ages
- 18 to 85 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Patients who have been treated for HD for more than six months,
- who are over 18 years old
- who agree to participate in the study
Key exclusion criteria (5 listed)
- patients with severe cardiovascular disease,
- who are pregnant,
- with psychiatric disorders,
- who do not regularly attend laughter therapy sessions,
- who have experience in laughter therapy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Laughter TherapyIn this study, laughter therapy was applied to the experimental group three times a week (on Mondays, Wednesdays, and Fridays) for a total of 12 sessions. Each session started with other patients in the HD unit while the patient was receiving HD treatment (1 hour after HD started) and lasted 30-45 minutes. The number of patients who will take part in each laughter session is based on the number of patients attending that session in the hemodialysis unit. | Behavioural | Laughter Therapy |
| ControlThe patients in the control group, on the other hand, did not undergo any intervention other than their routine treatment and care. Laughter therapy was applied for four weeks to HD patients in the control group who wanted the results of the research. | Other | Control |
Primary outcome
Change in Disease Acceptance Level
Time frame: 4 weeks
This form was used to measure the degree of acceptance of the disease in hemodialysis patients. In the research, it was applied twice in total before the laughter therapy was applied and after the laughter therapy was finished. The total score to be obtained from the scale varies between 8 and 40, and as the score increases, the level of acceptance of the disease increases.
1 secondary outcome
Change in compliance level in end-stage renal disease
Time frame: 4 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Feb 2023.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Laughter Therapy in people with Comfort and Acceptance Processes, run by Bozok University at 2 sites in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Feb 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Disease Acceptance Level (time frame: 4 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Feb 2023.