Healthy ParticipantsNCT06350747
The Effect of Laughter Yoga on Nurses' Perceived Stress, Sleep Quality, and Burnout Levels
A study testing Face-to-Face Laughter Yoga Group and Online Laughter Yoga Group in people with Healthy Participants, run by Manisa Celal Bayar University at 1 site in Turkey (Türkiye).
Trial summary
The planned study aims to contribute to the existing literature by comparatively evaluating the effects of online and face-to-face laughter yoga interventions on nurses, focusing on stress, sleep quality, and burnout. In line with this purpose, the research hypotheses are as follows: H1. Read more about this study
- Who is it for?
- Ages 18 to 80 yearsHealthy volunteers can take part
- Conditions the study is for
- Healthy Participants
- What is being tested?
- Face-to-Face Laughter Yoga Group and Online Laughter Yoga Group
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Apr 2024to 10 Mar 2025
- 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 80 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- working as a nurse
- over 18 years old
Who cannot join
- No uncontrolled hypertension
- No history of abdominal surgery in the last three months
- Not suffering from glaucoma, hernia or epilepsy
- Not receiving psychiatric diagnosis and treatment
- Not receiving sleep-related diagnosis and treatment
- having incontinence
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Manisa Celal Bayar Üniversitesi Hafsa Sultan Hastanesi
Manisa, 45060
About this study
Official title: The Effectiveness of Online and Face-to-Face Laughter Yoga on Nurses' Perceived Stress, Sleep Quality, and Burnout: A Three-Group Randomized Controlled Trial
The planned study aims to contribute to the existing literature by comparatively evaluating the effects of online and face-to-face laughter yoga interventions on nurses, focusing on stress, sleep quality, and burnout. In line with this purpose, the research hypotheses are as follows:
H1. Laughter yoga intervention provided to nurses has a positive effect on their perceived stress levels.
H2. Laughter yoga intervention provided to nurses has a positive effect on their sleep quality.
H3. Laughter yoga intervention provided to nurses has a positive effect on their burnout levels.
H4. There is a significant difference between the effects of online and face-to-face laughter yoga interventions.
Read the detailed description
This study investigated whether laughter yoga can help reduce stress, improve sleep, and prevent burnout among nurses. Nurses often work in challenging conditions with long shifts, which can negatively affect their mental and physical health. In this study, nurses were divided into three groups: one received face-to-face laughter yoga, another participated in laughter yoga online, and the third group did not receive any intervention.
Laughter yoga sessions were conducted twice a week for two weeks and included deep breathing, playful activities, and laughter exercises. Participants completed surveys before and after the sessions to measure their stress levels, sleep quality, and signs of burnout.
The results showed that nurses who participated in the online laughter yoga program experienced better sleep, felt less emotionally exhausted, and had a stronger sense of personal accomplishment. These benefits were not observed in the face-to-face or control groups. Interestingly, the program did not significantly reduce stress levels in any of the groups.
This study suggests that online laughter yoga may be a useful and accessible tool to support the well-being of nurses, especially in healthcare settings where in-person wellness programs are difficult to organize.
- Conditions
- Healthy Participants
- Being tested
- Face-to-Face Laughter Yoga Group, Online Laughter Yoga Group, control group
- Keywords
- burnout level, laughter yoga, nurses, stress, sleep quality
- Medical subject headings
- Sleep Initiation and Maintenance Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Face-to-Face Laughter Yoga GroupBehavioural
In this study, each laughter yoga session lasted approximately 30-40 minutes and consisted of four parts: hand clapping and warm-up exercises, deep breathing exercises, playful games, and laughter exercises. According to Kataria (2011), the first three parts remained consistent across all sessions, while the laughter exercises in the fourth part varied (Kataria 2011). In the first session of each new group, participants were introduced to laughter yoga, its purpose, and objectives, with 10 minutes allocated to this introductory section. As a result, the first session for each group lasted 40 minutes, while the remaining sessions were 30 minutes each. The structure and duration of each session were as follows:
- Section 1: Hand Clapping and Warm-up Exercises - 5 minutes
- Section 2: Deep Breathing Exercises - 10 minutes
- Section 3: Playful Games - 5 minutes
- Section 4: Laughter Exercises - 10 minutes
Online Laughter Yoga GroupBehavioural
In this study, each laughter yoga session lasted approximately 30-40 minutes and consisted of four parts: hand clapping and warm-up exercises, deep breathing exercises, playful games, and laughter exercises. According to Kataria (2011), the first three parts remained consistent across all sessions, while the laughter exercises in the fourth part varied (Kataria 2011). In the first session of each new group, participants were introduced to laughter yoga, its purpose, and objectives, with 10 minutes allocated to this introductory section. As a result, the first session for each group lasted 40 minutes, while the remaining sessions were 30 minutes each. The structure and duration of each session were as follows:
- Section 1: Hand Clapping and Warm-up Exercises - 5 minutes
- Section 2: Deep Breathing Exercises - 10 minutes
- Section 3: Playful Games - 5 minutes
- Section 4: Laughter Exercises - 10 minutes
control groupOther
Participants in the control group will not receive the laughter yoga intervention. They will continue with their usual daily routines and will only complete pre- and post-test assessments.
| Study group | Role | What they receive |
|---|---|---|
| Control Group | Other | Participants in this group did not receive any intervention during the study period. They only completed the pre- and post-intervention assessments. After study completion, they were offered a single optional laughter yoga session. Receives: Other: control group |
| Face-to-Face Laughter Yoga Group | Experimental | Participants in this group attended four sessions of laughter yoga conducted in person by certified instructors. Sessions lasted approximately 40 minutes and were held twice a week for two weeks in groups of 5-6 nurses.This intervention included hand clapping and warm-up exercises, deep breathing, playful games, and laughter exercises. Delivered in-person, each session lasted 30-40 minutes and followed a standardized format developed by Dr. Madan Kataria. Receives: Behavioral: Face-to-Face Laughter Yoga Group |
| Online Laughter Yoga Group | Experimental | Participants in this group received the same laughter yoga intervention as the face-to-face group, but it was delivered online via Zoom. Sessions were held in the evening hours twice a week over two weeks.This intervention followed the same structure as the face-to-face program, including clapping, breathing, and laughter exercises. Sessions were conducted in real time via Zoom by certified laughter yoga instructors. Receives: Behavioral: Online Laughter Yoga Group |
What is being measured
The primary outcome is the main question the study is designed to answer.
Perceived Stress Scale
ASQ is designed to measure how stressful some situations in a person's life are perceived. A total score of 0-32 is taken from the scale. It has two subscales: perceived stress (items 1, 2, 3, 7, 8) and perceived coping (items 4, 5, and 6). The scale is evaluated on both total score and subscale scores. A high total score means a high perceived stress level. High scores from the subscales are a negative situation.
Measured: two week and three week after intervention
Jenkins Sleep Scale
It is used in clinical studies to evaluate patients' sleep problems. Patients are asked 4 questions about their sleep problems in the last month and asked to tick the boxes that apply to them. 0 (almost never), 1 (1-3 days per month), 2 (4-7 days per month), 3 (8-14 days per month), 4 (15-21 days per month), 5 (23-31 days per month) It is evaluated as . An increase in the score indicates that the person's sleep quality decreases.
Measured: two week and three week after intervention
Maslach Burnout Scale
This measurement tool consists of a total of 22 items and three subscales. Among these subscales, the emotional exhaustion subscale consists of 9 items, the depersonalization subscale consists of 5 items, and the personal accomplishment subscale consists of a total of 8 items. Scale items are scored as "1: never" and "7: always". It was decided to arrange the scale as a five-degree scale, with the answer options being "0 never" and "4 always". The high level of burnout reflects the high score on the emotional exhaustion and depersonalization subscales and the low score on the personal accomplishment subscale. Moderate levels of burnout reflect moderate scores for all three subscales, while low levels reflect low scores on the emotional exhaustion and depersonalization subscales and high scores on the "personal accomplishment" subscale.
Measured: two week and three week after intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Apr 2024
- Study start1 Apr 2024
- Primary completion10 Feb 2025
- Study completion10 Mar 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Healthy ParticipantsStudies 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
- pretest-posttest with control group
- Masking
- None (open label)
- Enrolment
- 40 participants (actual)
Sponsor and investigators
- Lead sponsor
- Manisa Celal Bayar University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Özge Topsakal, Manisa Celal Bayar University
- Investigators
- Özge TOPSAKAL, Principal investigator, Manisa Celal Bayar University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06350747
- Sponsor's protocol ID
- CelalBayarU-SBF-OT-02
- Status last verified
- May 2025
- First submitted
- 30 Mar 2024
- Last updated
- 20 May 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Topsakal O, Erdenilgen O, Yilmaz R, Donmez P. Online vs. face-to-face laughter yoga to support nurses' well-being: A pilot randomized trial. Work. 2026 Jul 30:10519815261472875. doi: 10.1177/10519815261472875. Online ahead of print.
PubMed 42530535
Study at a glance
From the registry record, last updated by the sponsor on 20 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effectiveness of Online and Face-to-Face Laughter Yoga on Nurses' Perceived Stress, Sleep Quality, and Burnout: A Three-Group Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT06350747
- Acronym / sponsor ID
- CelalBayarU-SBF-OT-02
- Conditions
- Healthy Participants
- Keywords
- burnout level, laughter yoga, nurses, stress, sleep quality
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 40 participants (actual)
- Lead sponsor
- Manisa Celal Bayar UniversityUniversity, hospital or other
- Study start
- 1 Apr 2024 (actual)
- Primary completion
- 10 Feb 2025 (actual)
- Study completion
- 10 Mar 2025 (actual)
- First posted
- 5 Apr 2024 (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.
The planned study aims to contribute to the existing literature by comparatively evaluating the effects of online and face-to-face laughter yoga interventions on nurses, focusing on stress, sleep quality, and burnout. In line with this purpose, the research hypotheses are as follows:
H1. Laughter yoga intervention provided to nurses has a positive effect on their perceived stress levels.
H2. Laughter yoga intervention provided to nurses has a positive effect on their sleep quality.
H3. Laughter yoga intervention provided to nurses has a positive effect on their burnout levels.
H4. There is a significant difference between the effects of online and face-to-face laughter yoga interventions.
Detailed description
This study investigated whether laughter yoga can help reduce stress, improve sleep, and prevent burnout among nurses. Nurses often work in challenging conditions with long shifts, which can negatively affect their mental and physical health. In this study, nurses were divided into three groups: one received face-to-face laughter yoga, another participated in laughter yoga online, and the third group did not receive any intervention.
Laughter yoga sessions were conducted twice a week for two weeks and included deep breathing, playful activities, and laughter exercises. Participants completed surveys before and after the sessions to measure their stress levels, sleep quality, and signs of burnout.
The results showed that nurses who participated in the online laughter yoga program experienced better sleep, felt less emotionally exhausted, and had a stronger sense of personal accomplishment. These benefits were not observed in the face-to-face or control groups. Interestingly, the program did not significantly reduce stress levels in any of the groups.
This study suggests that online laughter yoga may be a useful and accessible tool to support the well-being of nurses, especially in healthcare settings where in-person wellness programs are difficult to organize.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- pretest-posttest with control group
| Arm | Type | Receives |
|---|---|---|
| Control Group | Other | Other: control groupParticipants in this group did not receive any intervention during the study period. They only completed the pre- and post-intervention assessments. After study completion, they were offered a single optional laughter yoga session. |
| Face-to-Face Laughter Yoga Group | Experimental | Behavioral: Face-to-Face Laughter Yoga GroupParticipants in this group attended four sessions of laughter yoga conducted in person by certified instructors. Sessions lasted approximately 40 minutes and were held twice a week for two weeks in groups of 5-6 nurses.This intervention included hand clapping and warm-up exercises, deep breathing, playful games, and laughter exercises. Delivered in-person, each session lasted 30-40 minutes and followed a standardized format developed by Dr. Madan Kataria. |
| Online Laughter Yoga Group | Experimental | Behavioral: Online Laughter Yoga GroupParticipants in this group received the same laughter yoga intervention as the face-to-face group, but it was delivered online via Zoom. Sessions were held in the evening hours twice a week over two weeks.This intervention followed the same structure as the face-to-face program, including clapping, breathing, and laughter exercises. Sessions were conducted in real time via Zoom by certified laughter yoga instructors. |
Who may qualify
- Ages
- 18 to 80 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- working as a nurse
- over 18 years old
Key exclusion criteria (6 listed)
- No uncontrolled hypertension
- No history of abdominal surgery in the last three months
- Not suffering from glaucoma, hernia or epilepsy
- Not receiving psychiatric diagnosis and treatment
- Not receiving sleep-related diagnosis and treatment
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 |
|---|---|---|
| Face-to-Face Laughter Yoga GroupIn this study, each laughter yoga session lasted approximately 30-40 minutes and consisted of four parts: hand clapping and warm-up exercises, deep breathing exercises, playful games, and laughter exercises. According to Kataria (2011), the first three parts remained consistent across all sessions, while the laughter exercises in the fourth part varied (Kataria 2011). In the first session of each new group, participants were introduced to laughter yoga, its purpose, and objectives, with 10 minutes allocated to this introductory section. As a result, the first session for each group lasted 40 minutes, while the remaining sessions were 30 minutes each. The structure and duration of each session were as follows: * Section 1: Hand Clapping and Warm-up Exercises - 5 minutes * Section 2: Deep Breathing Exercises - 10 minutes * Section 3: Playful Games - 5 minutes * Section 4: Laughter Exercises - 10 minutes | Behavioural | Face-to-Face Laughter Yoga Group |
| Online Laughter Yoga GroupIn this study, each laughter yoga session lasted approximately 30-40 minutes and consisted of four parts: hand clapping and warm-up exercises, deep breathing exercises, playful games, and laughter exercises. According to Kataria (2011), the first three parts remained consistent across all sessions, while the laughter exercises in the fourth part varied (Kataria 2011). In the first session of each new group, participants were introduced to laughter yoga, its purpose, and objectives, with 10 minutes allocated to this introductory section. As a result, the first session for each group lasted 40 minutes, while the remaining sessions were 30 minutes each. The structure and duration of each session were as follows: * Section 1: Hand Clapping and Warm-up Exercises - 5 minutes * Section 2: Deep Breathing Exercises - 10 minutes * Section 3: Playful Games - 5 minutes * Section 4: Laughter Exercises - 10 minutes | Behavioural | Online Laughter Yoga Group |
| control groupParticipants in the control group will not receive the laughter yoga intervention. They will continue with their usual daily routines and will only complete pre- and post-test assessments. | Other | Control Group |
Primary outcome
Perceived Stress Scale
Time frame: two week and three week after intervention
ASQ is designed to measure how stressful some situations in a person's life are perceived. A total score of 0-32 is taken from the scale. It has two subscales: perceived stress (items 1, 2, 3, 7, 8) and perceived coping (items 4, 5, and 6). The scale is evaluated on both total score and subscale scores. A high total score means a high perceived stress level. High scores from the subscales are a negative situation.
Jenkins Sleep Scale
Time frame: two week and three week after intervention
It is used in clinical studies to evaluate patients' sleep problems. Patients are asked 4 questions about their sleep problems in the last month and asked to tick the boxes that apply to them. 0 (almost never), 1 (1-3 days per month), 2 (4-7 days per month), 3 (8-14 days per month), 4 (15-21 days per month), 5 (23-31 days per month) It is evaluated as . An increase in the score indicates that the person's sleep quality decreases.
Maslach Burnout Scale
Time frame: two week and three week after intervention
This measurement tool consists of a total of 22 items and three subscales. Among these subscales, the emotional exhaustion subscale consists of 9 items, the depersonalization subscale consists of 5 items, and the personal accomplishment subscale consists of a total of 8 items. Scale items are scored as "1: never" and "7: always". It was decided to arrange the scale as a five-degree scale, with the answer options being "0 never" and "4 always". The high level of burnout reflects the high score on the emotional exhaustion and depersonalization subscales and the low score on the personal accomplishment subscale. Moderate levels of burnout reflect moderate scores for all three subscales, while low levels reflect low scores on the emotional exhaustion and depersonalization subscales and high scores on the "personal accomplishment" subscale.
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 20 May 2025.
- Derived from this study: PubMed 42530535Topsakal O, Erdenilgen O, Yilmaz R, Donmez P. Online vs. face-to-face laughter yoga to support nurses' well-being: A pilot randomized trial. Work. 2026 Jul 30:10519815261472875. doi: 10.1177/10519815261472875. Online ahead of print.
- Individual participant dataSharing planned: No
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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.
Özge TOPSAKAL principal investigator
Manisa Celal Bayar University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Face-to-Face Laughter Yoga Group and Online Laughter Yoga Group in people with Healthy Participants, run by Manisa Celal Bayar University at 1 site 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 2 inclusion and 6 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 20 May 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site 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?
Perceived Stress Scale (time frame: two week and three week after intervention). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06350747, which also lists 1 linked publication.
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 20 May 2025.