Effects of laughter therapy on quality of life in patients with cancer: An open-label, randomized controlled trial

Toshitaka Morishima · Isao Miyashiro · Norimitsu Inoue · Mitsuko Kitasaka · Takashi Akazawa · Akemi Higeno +5 more

78 citations0/0 files storedPLoS ONE

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Humor Studies and Applications Cancer survivorship and care Music Therapy and Health

Abstract

BACKGROUND: Few randomized controlled trials have assessed the effects of laughter therapy on health-related quality of life (QOL) in cancer patients. This study aimed to evaluate these effects as an exploratory endpoint in cancer patients as part of a randomized controlled trial conducted at a single institution in Japan. METHODS: The Initiative On Smile And CAncer (iOSACA) study was an open-label randomized controlled trial conducted in 2017 in which participants aged 40-64 years with cancer were randomly assigned to either an intervention group (laughter therapy) or control group (no laughter therapy). Each participant in the intervention group underwent a laughter therapy session once every two weeks for seven weeks (total of four sessions). Each session involved a laughter yoga routine followed by Rakugo or Manzai traditional Japanese verbal comedy performances. We assessed QOL as a secondary endpoint in this intention-to-treat population using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). The questionnaire was completed at baseline (Week 0) and at Weeks 3 and 7. Mixed-effects models for repeated measures were developed to compare time-dependent changes in each QOL domain from baseline between the intervention and control groups. RESULTS: Four participants retracted consent and one participant was retrospectively excluded from analysis due to unmet inclusion criteria. The analysis was conducted using 56 participants, with 26 in the intervention group and 30 in the control group. Questionnaire completion rates were high (>90%), with similar QOL scores reported at baseline in both groups. The mixed-effects models showed that the intervention group had significantly better cognitive function and less pain than the control group for a short period. CONCLUSION: Laughter therapy may represent a beneficial, noninvasive complementary intervention in the clinical setting. Further studies are needed to verify the hypotheses generated from this exploratory study.

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1989Neuroendocrine and Stress Hormone Changes During Mirthful Laughter 2011Social laughter is correlated with an elevated pain threshold 2003The effect of mirthful laughter on stress and natural killer cell activity.2010Laughter yoga versus group exercise program in elderly depressed women: a randomized controlled trial 1995Humor as a cognitive technique for increasing pain tolerance 2010Response shift, recall bias and their effect on measuring change in health-related quality of life amongst older hospital patients 2005The Impact of Humor on Patients With Cancer 2004Do cheerfulness, exhilaration, and humor production moderate pain tolerance? A FACS study

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