تأثیر آموزش خنده‌درمانی کاتاریا بر کاهش افسردگی و افزایش امید به زندگی در زنان (مطالعۀ موردی: شهر اصفهان)

نوع مقاله : مطالعه پژوهشی اصیل

نویسندگان

1 گروه آموزش تربیت بدنی، دانشگاه فرهنگیان، صندوق پستی 889-14665 تهران، ایران

2 کارشناس ارشد روان‌شناسی ورزشی، گروه علوم ورزشی، دانشگاه آزاد اسلامی اصفهان (خوراسگان)، اصفهان، ایران

چکیده

هدف: ورزش به‌عنوان یک روش غیردارویی می‌تواند به کاهش علائم افسردگی با کارایی قابل‌مقایسه با دارودرمانی و سایر مداخلات روان‌شناختی کمک کند؛ بنابراین این مطالعه با هدف بررسی تأثیر برنامه یوگای خنده بر افسردگی و امید به زندگی زنان شهر اصفهان انجام شد.
مواد و روش ها: این پژوهش نیمه‌تجربی با طرح پیش‌آزمون و پس‌آزمون با گروه کنترل بود. نمونه شامل زنان شرکت‌کننده در کلاس‌های مراکز هلال‌احمر اصفهان بود که به‌صورت نمونه‌گیری تصادفی چندمرحله‌ای به دو گروه آزمایش (15 نفر) و کنترل (15 نفر) تقسیم شدند. گروه آزمایش به مدت هشت هفته (سه جلسه در هفته/هر جلسه 45 دقیقه) در کلاس‌های یوگای خنده شرکت کردند؛ درحالی‌که گروه کنترل فعالیت ورزشی خاصی انجام ندادند. داده‌ها از طریق پرسش‌نامه‌های افسردگی و امید به زندگی جمع‌آوری و با استفاده از آزمون تحلیل کوواریانس تحلیل شدند.
یافته ها: نتایج نشان داد که برنامه آموزش یوگای خنده تأثیر معناداری بر کاهش افسردگی و افزایش امید به زندگی داشت (05/0P<).
نتیجه گیری: به نظر می­رسد برنامه یوگای خنده می‌تواند به‌عنوان یک روش درمانی مؤثر و کم‌هزینه برای بهبود افسردگی و افزایش امید به زندگی در زنان به کار رود.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Effectiveness of Laughter Yoga Intervention on Reducing Depression and Increasing life Expectancy in Women (Case Study: Isfahan city)

نویسندگان [English]

  • FARZANEH DAVARI 1
  • Maryam Amooei 1
  • Mitra Shirvani Jozdani 2
1 Department of Physical Education, Farhangian University, P.O. Box 14665-889, Tehran, Iran
2 MSc in Sports Psychology, Department of Physical Education and Sports Sciences, Isfahan Azad University (Khorasgan), Isfahan, Iran
چکیده [English]

Background and Purpose
Depression is a widespread mental health disorder that differs significantly from normal mood changes and affects various aspects of life, including relationships and social interactions. Globally, approximately 4% of the population experiences depression, with higher prevalence in women (6%) compared to men (4%), and among those over 60 years old (5.7%) (Woodi et al. 2017). Depression is more common in women, with about a 50% higher prevalence, and is a major contributor to suicide, causing over 700,000 deaths annually worldwide, making it the fourth leading cause of death. In Iran, depression rates range between 5.7% and 7.3% across different populations (Montazeri et al., 2013). The disorder manifests differently in men and women, with symptoms like loss of interest, excessive crying, indecisiveness, and low energy being common. Women are more prone to depression due to factors like violence, economic hardship, workplace challenges, and sexual abuse. Additionally, people with mental health disorders, including depression, face significant challenges, such as reduced life expectancy—living 10 to 20 years less than the general population—underscoring the need for targeted interventions (Metrics, & Evaluation, 2021).
Research indicates that both laughter and physical activity have significant benefits for physical and mental health. Laughter, particularly through practices like laughter yoga—which combines yoga stretches and breathing exercises with laughter—has been shown to positively impact various bodily systems. It promotes muscle relaxation, boosts immune response, balances hormones, and enhances mental well-being. Laughter yoga also improves physiological functions such as respiration, digestion, and blood pressure, while reducing stress hormones and stimulating endorphin release, leading to a greater sense of well-being.
Similarly, physical activity is recommended as a low-cost, low-risk strategy for preventing and treating depression, which often results in economic burdens and deteriorating physical health. Regular exercise helps manage weight, improve cardiovascular health, and reduce the risk of chronic diseases like diabetes and hypertension. Importantly, physical activity, and laughter yoga in particular, are effective ways to improve mental health, offering a natural and accessible means to enhance overall well-being.
Research indicates that laughter can boost catecholamine levels and improve cognitive function. While laughter does not reverse aging, it helps maintain alertness and memory, especially in older adults. In stressful situations, laughter reduces stress hormones in the blood, promoting relaxation and health. Recent studies have shown that laughter yoga can significantly enhance mental and physical health, particularly by increasing life expectancy. Given the lack of sufficient research in Iran on the effects of laughter yoga on depression symptoms and life expectancy in women, this study aims to explore this important issue further.
 
Material and Methods
This study utilized a quasi-experimental design with a pre-test and post-test control group to investigate the effects of laughter yoga on depression and hope levels among women. The research sample consisted of women attending classes at Red Crescent centers in Isfahan. A multistage random sampling method was used to select one center and a specific class within that center. From this class, 30 women who scored highest on the Beck Depression Inventory-II (BDI-II) and lowest on the Adult Hope Scale (AHS) were chosen and randomly assigned to either the experimental group (15 participants) or the control group (15 participants).
The BDI-II, a widely used self-report instrument, assessed depression levels, while the AHS measured participants' levels of hope based on Snyder’s cognitive model, focusing on agency (motivation) and pathways (planning to achieve goals). Both instruments have demonstrated strong reliability in previous studies.
The intervention involved 24 laughter yoga sessions over eight weeks, with three sessions per week, each lasting 45 minutes. The experimental group participated in these sessions, which included clapping with rhythmic chants, stretching exercises, and playful activities designed to induce laughter. Each session concluded with positive affirmations and meditation to enhance participants' mood and overall sense of well-being. The control group did not engage in any physical activities during this period.
 Results
Results showed that the post-test scores for hope in life were significantly different between the experimental and control groups after controlling for pre-test scores (P= 0.001). The laughter yoga training effectively increased the level of hope in life among women in the post-test phase. The impact of this training on improving hope in life was quantified at 0.546, indicating that approximately 54.6% of the variance in hope in life can be attributed to group membership or the effect of the training.
 Conclusion
This study demonstrates that an eight-week laughter yoga program can significantly reduce symptoms of mild to moderate depression in women. The findings revealed a significant difference between pre-test and post-test depression scores (P=0.002), aligning with previous research that supports laughter yoga as an effective complementary therapy for depression. Studies such as those by Keykha-Hosseinpour (2013) and Eshgh et al. (2011) have similarly shown that physical activity plays a crucial role in improving mental health disorders. Moreover, laughter yoga has been linked to increased levels of mood-enhancing hormones like endorphins and serotonin, which help alleviate depression symptoms.
In addition to mood improvement, laughter yoga can reduce stress hormone levels, particularly cortisol, leading to better sleep quality and decreased anxiety symptoms. Research also suggests that enhancing the immune system through practices like laughter yoga can reduce the risk of depression, as a weakened immune system is often associated with mental health issues. Studies, including those by Tellhed et al. (2019) and Liu et al. (2022), confirm that yoga and related techniques effectively lower stress and anxiety, improving overall quality of life, especially in individuals with chronic conditions.
The study also found that laughter yoga significantly increased hope scores in the experimental group (P=0.001), indicating its positive impact on life satisfaction and mental well-being. Physical activities and exercise have similarly been shown to enhance life expectancy and mental health by fostering social connections and a sense of belonging, which contribute to increased hope. Laughter yoga's stress-reducing and relaxation-inducing effects further enhance hope and life satisfaction.
Physiologically, laughter affects various bodily systems, including the nervous, muscular, respiratory, circulatory, endocrine, and immune systems. It reduces stress hormones like cortisol while increasing happiness-related hormones such as endorphins and serotonin, thus improving mood and reducing depression. Psychologically, laughter directly combats depression by reducing stress, anxiety, and tension while enhancing mood, self-esteem, energy, and vitality. These combined benefits suggest that laughter yoga is a safe, effective, and accessible intervention for improving mental health and quality of life, particularly in women.
Given its efficacy, laughter yoga is recommended as a complementary therapeutic tool in mental health programs, particularly for women. Future research should explore its effects on other populations, such as men, adolescents, students, and patients, using longer intervention periods and multiple control groups to provide more robust evidence. Overall, laughter yoga presents a cost-effective, non-pharmacological approach to enhancing mental health and could be widely promoted to improve public awareness of mental wellness strategies. The study suggests that laughter yoga not only serves as an effective intervention for reducing depression and enhancing hope but also as a comprehensive tool for improving overall mental and social well-being in various communities. Further research will help better understand its mechanisms and optimize its use.
FundingThe present study received no financial support from any institution or organization.
Authors' contributions
First author: Data collection and authorship of the introduction; Second and Third author: conceptualization and presentation of the idea, authorship of the introduction, discussion and methodology, and data analysis. All authors contributed equally to the writing and revision of the article.
Conflicts of Interest
The authors declared no conflict of interest.
Acknowledgments
We sincerely thank and appreciate all the athletes who cooperated in the present research.
 
 
 
 
 

کلیدواژه‌ها [English]

  • Laughter Yoga
  • ؛ Red Crescent
  • ؛ depression؛ Life
  • Expectancy
  1. Cabral, P., Meyer, H. B., & Ames, D. (2011). Effectiveness of yoga therapy as a complementary treatment for major psychiatric disorders: a meta-analysis. The Primary Care Companion for CNS Disorders, 13(4), 26290.

https://doi.org/10.4088/pcc.10r01068 

  1. Çelik, A. S., & Yarali, S. (2023). The effect of laughter yoga on the psychological resilience and sleep quality of nurses during the pandemic: A randomized controlled trial. Alternative Therapies in Health & Medicine, 29(5), 136-152.
  2. de Castro, F., Cappa, C., & Madans, J. (2023). Anxiety and depression signs among adolescents in 26 low-and Middle-Income Countries: prevalence and association with functional difficulties. Journal of Adolescent Health, 72(1), S79-S87.

https://doi.org/10.1016/j.jadohealth.2022.03.022

  1. Eshgh, Z. M., Naghavi, B., Rashvand, F., Majd, H. A., & Derakhshan, H. B. (2011). Effects of humor therapy on fatigue and depression of multiple sclerosis (MS) patients. Advances in Nursing & Midwifery, 20(70), 7-11.
  2. Evans-Hoeker, E. A., Eisenberg, E., Diamond, M. P., Legro, R. S., Alvero, R., Coutifaris, C., Casson, P. R., Christman, G. M., Hansen, K. R., & Zhang, H. (2018). Major depression, antidepressant use, and male and female fertility. Fertility and Sterility, 109(5), 879-887.

https://doi.org/10.1016/j.fertnstert.2017.07.882

  1. Ewais, T., Begun, J., Kenny, M., Rickett, K., Hay, K., Ajilchi, B., & Kisely, S. (2019). A systematic review and meta-analysis of mindfulness based interventions and yoga in inflammatory bowel disease. Journal of Psychosomatic Research, 116, 44-53.

https://doi.org/10.1016/j.jpsychores.2018.11.010

 

  1. Greene, C. M., Morgan, J. C., Traywick, L. S., & Mingo, C. A. (2017). Evaluation of a laughter-based exercise program on health and self-efficacy for exercise. The Gerontologist, 57(6), 1051-1061.

https://doi.org/10.1093/geront/gnw105

  1. Grensman, A., Acharya, B. D., Wändell, P., Nilsson, G. H., Falkenberg, T., Sundin, Ö., & Werner, S. (2018). Effect of traditional yoga, mindfulness–based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout. BMC Complementary and Alternative Medicine, 18, 1-16.

https://doi.org/10.1186/s12906-018-2141-9

  1. Hallam, K. T., Peeters, A., Gupta, A., & Bilsborough, S. (2023). Moving minds: Mental health and wellbeing benefits of a 50-day workplace physical activity program. Current Psychology, 42(15), 13038-13049. \

https://doi.org/10.1007/s12144-021-02525-6

  1. Hannerz, H., Borgå, P., & Borritz, M. (2001). Life expectancies for individuals with psychiatric diagnoses. Public Health, 115(5), 328-337.

https://doi.org/10.1038/sj.ph.1900785

  1. Hatami, F., Tahmasbi, F., & Torabi Mehrabani, M. (2024). The effect of physical activity on anxiety due to corona-virus outbreak and cognitive function in adolescent girls. Sport Psychology Studies, 1, 1-20. In Persian https://doi.org/10.22089/spsyj.2024.14951.2404
  2. Hendriks, T., De Jong, J., & Cramer, H. (2017). The effects of yoga on positive mental health among healthy adults: a systematic review and meta-analysis. The Journal of Alternative and Complementary Medicine, 23(7), 505-517. https://doi.org/10.1089/acm.2016.0334
  3. Kaplan, H. I., & Sadock, B. (1998). Synopsis of psychiatry; Ch 15 mood disorders. Baltimore: Williams and Wilkins.
  4. Kessler, R. C. (2006). The epidemiology of depression among women. In Women and depression: A handbook for the social, behavioral, and biomedical sciences (pp. 22-37). Cambridge: Cambridge University Press.

https://doi.org/10.1017/cbo9780511841262.004

  1. Keykhahoseinpoor, A., Rahnama, N., & Chitsaz, A. (2013). Effects of eight weeks laughter yoga training on motor function, balance, and flexibility in subjects with Parkinson's disease. Journal of Research in Rehabilitation Sciences, 9(1), 39-47.
  2. Ko, H. J., & Youn, C. H. (2011). Effects of laughter therapy on depression, cognition and sleep among the community‐dwelling elderly. Geriatrics & Gerontology International, 11(3), 267-274.

https://doi.org/10.1111/j.1447-0594.2010.00680.x

  1. Laursen, T. M., Musliner, K. L., Benros, M. E., Vestergaard, M., & Munk-Olsen, T. (2016). Mortality and life expectancy in persons with severe unipolar depression. Journal of Affective Disorders, 193, 203-207.

https://doi.org/10.1016/j.jad.2015.12.067

  1. Liu, W., Liu, J., Ma, L., & Chen, J. (2022). Effect of mindfulness yoga on anxiety and depression in early breast cancer patients received adjuvant chemotherapy: a randomized clinical trial. Journal of Cancer Research and Clinical Oncology, 148(9), 2549-2560.

https://doi.org/10.1007/s00432-022-04167-y

  1. Liu, X., Wang, S., & Wang, G. (2022). Prevalence and risk factors of postpartum depression in women: A systematic review and meta‐analysis. Journal of Clinical Nursing, 31(19-20), 2665-2677.

https://doi.org/10.1111/jocn.16121

  1. Metrics, I. O. H., & Evaluation. (2021). Global health data exchange (GHDx). Retrieved from https://ghdx.healthdata.org/.
  2. Montazeri, A., Mousavi, S. J., Omidvari, S., Tavousi, M., Hashemi, A., & Rostami, T. (2013). Depression in Iran: A systematic review of the literature (2000-2010). Payesh, 12(6), 567-594.
  3. Mora-Ripoll, R. (2011). Potential health benefits of simulated laughter: A narrative review of the literature and recommendations for future research. Complementary Therapies in Medicine, 19(3), 170-177.

https://doi.org/10.1016/j.ctim.2011.05.003

  1. Morse, D. R. (2007). Use of humor to reduce stress and pain and enhance healing in the dental setting. Journal of the New Jersey Dental Association, 78(4), 32-36.
  2. Namazinia, M., Mazlum, S. R., Mohajer, S., & Lopez, V. (2023). Effects of laughter yoga on health-related quality of life in cancer patients undergoing chemotherapy: a randomized clinical trial. BMC Complementary Medicine and Therapies, 23(1), 192.

https://doi.org/10.1186/s12906-023-04028-2

  1. Nordentoft, M., Wahlbeck, K., Hällgren, J., Westman, J., Ösby, U., Alinaghizadeh, H., Gissler, M., & Laursen, T. M. (2013). Excess mortality, causes of death and life expectancy in 270,770 patients with recent onset of mental disorders in Denmark, Finland and Sweden. PloS one, 8(1), e55176.

https://doi.org/10.1371/journal.pone.0055176

  1. Ohira, T., & Ichiki, M. (2022). Laughter Is the Best Therapy for Happiness and Healthy Life Expectancy. In Healthy ageing in Asia (pp. 229-240). CRC Press.

https://doi.org/10.1201/9781003043270-20

  1. Öztürk, F. Ö., Bayraktar, E. P., & Tezel, A. (2023). The effect of laughter yoga on loneliness, psychological resilience, and quality of life in older adults: A pilot randomized controlled trial. Geriatric Nursing, 50, 208-214.

https://doi.org/10.1016/j.gerinurse.2023.01.009

  1. Rahimi, C. (2014). Application of the beck depression inventory-II in Iranian University students. Clinical Psychology and Personality, 12(1), 173-188.
  2. Rajabian, M., Andam, R. and Rajabi, M., (2022). The impact of Covid 19 concerns on the depression of athlete students with the modifying role of teammate social connectedness. Sport Psychology Studies11(41), 221-242. In Persian

https://doi.org/10.22089/spsyj.2022.11212.2226

  1. Reimers, C. D., Knapp, G., & Reimers, A. K. (2012). Does physical activity increase life expectancy? A review of the literature. Journal of Aging Research, 2012(1), 243958.

https://doi.org/10.1155/2012/243958

  1. Rezaei, S., Mahfeli, M., Mousavi, S. V., & Poorabolghasem Hosseini, S. (2019). The effect of laughter yoga on the quality of life of elderly nursing home residents. Caspian Journal of Neurological Sciences, 5(1), 7-15.

https://doi.org/10.32598/cjns.5.16.7

  1. Savage, B. M., Lujan, H. L., Thipparthi, R. R., & DiCarlo, S. E. (2017). Humor, laughter, learning, and health! A brief review. Advances in Physiology Education, 41(3), 341-347.

https://doi.org/10.1152/advan.00030.2017

  1. Scheel, T., Gockel, C., & Scheel, T. (2017). Humor in health: How to stay healthy and happy with humor. In Humor at work in teams, leadership, negotiations, learning and health (pp. 95-120). Cham: Springer.

https://doi.org/10.1007/978-3-319-65691-5_7

  1. Sudeck, G., Thiel, A., & Strohacker, K. (2023). Physical activity, subjective well-being and mental health. In Sport and exercise psychology: Theory and application (pp. 649-678). Cham: Springer.

https://doi.org/10.1007/978-3-031-03921-8_26

  1. Talaei, A., Kimiaei, S. A., Borhani Moghani, M., Moharreri, F., Talaei, A., & Khanghaei, R. (2014). Effectiveness of group cognitive behavioral therapy on depression in infertile women. The Iranian Journal of Obstetrics, Gynecology and Infertility, 17(94), 1-9. In Persian
  2. Tellhed, U., Daukantaitė, D., Maddux, R. E., Svensson, T., & Melander, O. (2019). Yogic breathing and mindfulness as stress coping mediate positive health outcomes of yoga. Mindfulness, 10, 2703-2715.

https://doi.org/10.1007/s12671-019-01225-4

  1. Woody, C., Ferrari, A., Siskind, D., Whiteford, H., & Harris, M. (2017). A systematic review and meta-regression of the prevalence and incidence of perinatal depression. Journal of Affective Disorders, 219, 86-92.

https://doi.org/10.1016/j.jad.2017.05.003

  1. Yim, J. (2016). Therapeutic benefits of laughter in mental health: a theoretical review. The Tohoku Journal of Experimental Medicine, 239(3), 243-249.

https://doi.org/10.1620/tjem.239.243

  1. Zarepoor, F., Kamali, M., Alagheband, M., Gheisari, M., & Sarlak, S. (2012). Evaluation of depression and its relationship to exercise in women over 20 years. Journal of Shahid Sadoughi University of Medical Sciences, 20(1), 64-72.  In Persian