EFFECT OF LAUGHTER ON THE PSYCHOLOGICAL WELL-BEING OF HOSPITALIZED PATIENTS Charles Okonkwo, Ph.D. & Alomaja Abayomi Smith, MSc Department of Psychology, Chukwuemeka Odumegwu Ojukwu Univsersity

OVERVIEW: Working Title: Effect of Laughter on the Psychological Well-being off Hospitalized Patients Introduction What Informed our Research Interest Research Questions Conceptual and Theoretical Framework Methodology Findings, Implications, Conclusion and Future Directions Questions and Answers

Introduction: The quality of life of hospitalized patients are usually being affected by a lot of psychological experiences such as pain, distress, anxiety, and depression, which has reduced their quality of life. Laughter therapy is a noninvasive and non- pharmacological alternative treatment for stress and depression, representative cases that have a negative influence on mental health (Yim, 2016). Laughter therapy physiologically reduces the level of stress hormones, increases the level of health promoting-hormones such as endorphins, and strengthens the immune system by increasing the number of T-lymphocytes through activation of natural killer cells, which multiplies white blood cells in the body, as well as raises immunity in the body (Bennett & Lengacher 2009). Laughter is a universal aspect of human non-verbal communication. It occurs naturally and plays a big role in social interactions, however, it is only recently that laughter is becoming the subject of research (Ram, 2015).

Physiological Outcomes of Laughter Exercises and relaxes muscles Improves respiration Stimulates circulation Decreases stress hormones Increases the immune system’s defenses Elevates pain threshold and tolerance Enhances mental functioning (Ripoll & Rodera 2008).

The Psychological Effects of Laughter Reduces stress, anxiety, and tension, and counteracts symptoms of depression Elevates mood, self-esteem, hope, energy, and vigor Enhances memory, creative thinking, and problem solving Improves interpersonal interaction, relationships, attraction, and closeness Increases friendliness and helpfulness and builds group identity, solidarity, and cohesiveness Promotes psychological well-being Improves quality of life and patient care Intensifies fun and is contagious (Arminen &Halonen 2007).  

Conceptual and Theoretical Framework: Categories of Laughter: Genuine or spontaneous laughter Simulated laughter Stimulated laughter Induced laughter; and (5) pathological laughter Spontaneous laughter, unrelated to one’s own free will, is triggered by different (external) stimuli and positive emotions.

Conceptual and Theoretical Framework Continues: Three categories in the theories of laughter: Arousal theory: Concerned with the cognitive aspects of laughter; stress increases arousal, while laughter is able to reduce stress by easing arousal and tension (Apte 1985; Lefcourt and Martin 2012).

Conceptual and Theoretical Framework Continues: Three categories in the theories of laughter: Discrepancy theory: Concerned with the cognitive aspect, which says laughter starts from the dithered process, situation, or thought apart from the knowledge or logic that people commonly known. This theory says people laugh when they realize there is discrepancy between the actual situation and their general knowledge of it (Apte 1985; Lefcourt and Martin 2012).

Conceptual and Theoretical Framework Continues: Three categories in the theories of laughter: Superiority Theory: Laughter occurs when people look down on others more than who they are actually, or when they have a feeling or thought that they are superior to others. The theory says laughter restricts the external environment and raises confidence (MacGhee and Pistolesi 1979).

Research Questions and : Does laughter therapy (watching four, three- minutes comedy skits) improve the psychological well-being of hospitalized patient?

Methodology: Data Collection: STEM Participants: Total (n) = 15 Convenient random selection, via personal permission One private and one public hospital STEM Participants: Total (n) = 15 Females = 59.9% Males = 40.1%

Methodology Continues: Measures: Modified version, 20-item Psychological Well-being Scale (Ryff, 1972) E.g.: “I am satisfied with state in life?” Cronbach’s alpha = .96 Content Validity = .77 Four Three-Minute Comedy Skits

Before the laughter therapy After the laugh therapy 62/15=4.133 Table 1.1:Psychologycal Well-being, before and after laughter treatment S/N Before the laughter therapy After the laugh therapy Differences Person -1 58 52 6 Person -2 68 76 -8 Person -3 57 62 -5 Person -4 65 66 -1 Person -5 67 70 -3 Person -6 63 7 Person -7 60 2 Person -8 59 64 Person -9 -6 Person -10 Person -11 56 Person -12 53 -4 Person -13 61 Person -14 72 74 -2 Person -15 79 80 N=15 955 973

Descriptive Statistics Paired Samples Statistics Mean N Std. Deviation Std. Error Mean   Before Treatment 63.6667 15 6.96590 1.79859 After Treatment 64.8667 7.70776 1.99013

Hypothesis: H0: = 0 (There is no mean difference in the before and after comedy skits on hospitalized patients) H1: = 0 There is a change)

Findings in Relation to Hypothesis We observed a mean difference of MD = -1.200 with SD = 4.738, obtained a t = -.981, with df = 14, as such accepted the null hypothesis Thus, the treatment effect was not statistically significant, t (14) =-.981, P >.05. In other words, hospitalized patients did not improve significantly on their psychological well-being after watching the four 3-minutes comedy skits.

Findings and Implications Eventhough, the treatment effect was not statistically significant, t (14) =-.981, P >.05. There was a mean difference, indicating that the after treatment effect the patients showed improvement in their psychological well-being.

Conclusion and Future Directions There was a mean difference, likely indicating that after the laughter experience the patients showed improvement in their psychological well-being. As such, we advocate that laughter experience be part of treatment given to hospitalized patients. Future Directions: People living with HIV/AIDS

Questions and Answers