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Original Article
Effect and Path Analysis of Laughter Therapy on Serotonin, Depression and Quality of Life in Middle-aged Women
Mi Youn Cha, Hae Sook Hong
Journal of Korean Academy of Nursing 2015;45(2):221-230.
DOI: https://doi.org/10.4040/jkan.2015.45.2.221
Published online: April 30, 2015

1Department of Nursing, Uiduk University, Pohang, Korea.

2College of Nursing, Kyungpook National University, Daegu, Korea.

Address reprint requests to: Hong, Hae Sook. College of Nursing, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 700-422, Korea. Tel: +82-53-420-4932, Fax: +82-53-421-2758, hshong@knu.ac.kr
• Received: August 11, 2014   • Revised: August 21, 2014   • Accepted: January 15, 2015

© 2015 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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  • Purpose
    This study was done to examine how laughter therapy impacts serotonin levels, QOL and depression in middle-aged women and to perform a path analysis for verification of the effects.
  • Methods
    A quasi-experimental study employing a nonequivalent control group and pre-post design was conducted. Participants were 64 middle-aged women (control=14 and experimental=50 in 3 groups according to level of depression). The intervention was conducted five times a week for a period of 2 weeks and the data analysis was conducted using repeated measures ANOVA, ANCOVA and LISREL.
  • Results
    Results showed that pre serotonin and QOL in women with severe depression were the lowest. Serotonin in the experimental groups increased after the 10th intervention (p=.006) and the rise was the highest in the group with severe depression (p=.001). Depression in all groups decreased after the 5th intervention (p=.022) and the biggest decline was observed in group with severe depression (p=.007). QOL of the moderate and severe groups increased after the 10th intervention (p=.049), and the increase rate was highest in group with severe depression (p<.006). Path analysis revealed that laughter therapy did not directly affect depression, but its effect was indirectly meditated through serotonin variation (p<.001).
  • Conclusion
    Results indicate that serotonin activation through laughter therapy can help middle-aged women by lessening depression and providing important grounds for depression control.
  • Keywords: Laughter therapy; Middle-aged women; Serotonin; Depression; Quality of life
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Figure 1

Path Analysis of depressions subgroups with control group.

jkan-45-221-g001.jpg
Table 1

Contents of Laughter Therapy Program

jkan-45-221-i001.jpg
Table 2

Homogeneity Test of General Characteristics (N=64)

jkan-45-221-i002.jpg

Cont.=Control group; Exp.=Experimental group; ND=None depression; MD=Moderate depression; SD=Severe depression.

Table 3

Pre-score of Serotonin and QOL of Subjects (N=64)

jkan-45-221-i003.jpg

Cont.=Control group; Exp.=Experimental group; ND=None depression; MD=Moderate depression; SD=Severe depression; QOL=Quality of life.

Table 4

Effect of Laughter Therapy on Serotonin, Depression and QOL within Group (N=64)

jkan-45-221-i004.jpg

*ANCOVA adjusted for pre score; †p<.05; ‡p<.01; §Contrast; Repeated Measures ANOVA of variance of contrast variables. Index 1,2 and 3 Inicate to 1: pre-test, 2: post-test after 5 times, and 3: post-test after 10 times; Cont.=Control group (n=14); Exp.=Experimental group (n=50); ND=None depression (n=15); MD=Moderate depression (n=19); SD=Severe depression (n=16); QOL=Quality of life.

Figure & Data

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        Effect and Path Analysis of Laughter Therapy on Serotonin, Depression and Quality of Life in Middle-aged Women
        J Korean Acad Nurs. 2015;45(2):221-230.   Published online April 30, 2015
        DOI: https://doi.org/10.4040/jkan.2015.45.2.221
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      Effect and Path Analysis of Laughter Therapy on Serotonin, Depression and Quality of Life in Middle-aged Women
      Image
      Figure 1 Path Analysis of depressions subgroups with control group.

      Figure 1

      Effect and Path Analysis of Laughter Therapy on Serotonin, Depression and Quality of Life in Middle-aged Women

      Contents of Laughter Therapy Program

      Homogeneity Test of General Characteristics (N=64)

      Cont.=Control group; Exp.=Experimental group; ND=None depression; MD=Moderate depression; SD=Severe depression.

      Pre-score of Serotonin and QOL of Subjects (N=64)

      Cont.=Control group; Exp.=Experimental group; ND=None depression; MD=Moderate depression; SD=Severe depression; QOL=Quality of life.

      Effect of Laughter Therapy on Serotonin, Depression and QOL within Group (N=64)

      *ANCOVA adjusted for pre score; †p<.05; ‡p<.01; §Contrast; Repeated Measures ANOVA of variance of contrast variables. Index 1,2 and 3 Inicate to 1: pre-test, 2: post-test after 5 times, and 3: post-test after 10 times; Cont.=Control group (n=14); Exp.=Experimental group (n=50); ND=None depression (n=15); MD=Moderate depression (n=19); SD=Severe depression (n=16); QOL=Quality of life.
      Table 1 Contents of Laughter Therapy Program

      Table 2 Homogeneity Test of General Characteristics (N=64)

      Cont.=Control group; Exp.=Experimental group; ND=None depression; MD=Moderate depression; SD=Severe depression.

      Table 3 Pre-score of Serotonin and QOL of Subjects (N=64)

      Cont.=Control group; Exp.=Experimental group; ND=None depression; MD=Moderate depression; SD=Severe depression; QOL=Quality of life.

      Table 4 Effect of Laughter Therapy on Serotonin, Depression and QOL within Group (N=64)

      *ANCOVA adjusted for pre score; †p<.05; ‡p<.01; §Contrast; Repeated Measures ANOVA of variance of contrast variables. Index 1,2 and 3 Inicate to 1: pre-test, 2: post-test after 5 times, and 3: post-test after 10 times; Cont.=Control group (n=14); Exp.=Experimental group (n=50); ND=None depression (n=15); MD=Moderate depression (n=19); SD=Severe depression (n=16); QOL=Quality of life.

      Table 1

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