Effects of a Humor Therapy Program on Stress Levels in Pediatric Inpatients

Sánchez, Julio César; Echeverri, Luis Felipe; Londoño, Manuel José; Ochoa, Sergio Andrés; Quiroz, Andrés Felipe; Romero, Carmelo García; Ruiz, Joaquín Octavio

doi:10.1542/hpeds.2016-0128

Cited by 82 publications

(30 citation statements)

References 63 publications

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“…Mental stress is known to affect endothelial function (Hirosaki et al, ; Ryu, Shin, & Yang, ; Sanchez et al, ; Takahashi et al, ; Takeda et al, ; Toba et al, ). It was reported that psychological stress induced by performing an arithmetic or speech task inhibited forearm flow response, indicating endothelial dysfunction (Takahashi et al, ; Takeda et al, ; Toba et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…It was reported that psychological stress induced by performing an arithmetic or speech task inhibited forearm flow response, indicating endothelial dysfunction (Takahashi et al, ; Takeda et al, ; Toba et al, ). Previous animal experiments partially elucidated its mechanisms, demonstrating that stress hormones, such as glucocorticoids, endothelin‐1, and inflammatory cytokines, caused endothelial dysfunction through the impairment of NO‐dependent vasodilation (Ryu et al, ; Sanchez et al, ; Toda & Nakanishi‐Toda, ; Tokuda et al, ). A continuous reduction in stress by laughter therapy may improve endothelial dysfunction in older people via a reduction in glucocorticoids, as previous studies showed that serum concentration of glucocorticoids was significantly decreased in participants who viewed a humorous video compared to control participants (Eriksson et al, ; Ryu et al, ; Walter et al, ).…”

Section: Discussionmentioning

confidence: 99%

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Beneficial effect of laughter therapy on physiological and psychological function in elders

et al. 2018

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AimIn the present study we investigated the effect of laughter therapy on physiological and psychological function in older people.DesignAn open‐label trial.MethodsSeventeen older people who regularly attended an elderly day care centre were recruited. Stand‐up comedy as laughter therapy was performed once a week for 4 weeks. Parameters of physiological and psychological function were evaluated before and after laughter therapy.ResultsLaughter therapy intervention resulted in a significant reduction in systolic blood pressure and heart rate, accompanied by a significant increase in plasma concentration of serotonin and a significant decrease in salivary concentration of chromogranin A. Questionnaire surveys of SF‐8, GDS‐15, and Vitality Index demonstrated alleviation of depression and improvement of sociability and activity in older people. Laughter therapy could be expected to become a practical treatment to improve quality of life of older people in an elderly day care centre.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Beneficial effect of laughter therapy on physiological and psychological function in elders

et al. 2018

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“… 25 , 26 Despite this recognition, few studies have investigated the molecular mechanisms that mediate the positive health outcomes of clown intervention. To the best of our knowledge, only 2 studies 27 , 28 conducted with hospitalized children with different acute pathologies receiving clown intervention have used biomarker levels (salivary cortisol) as a variable to assess stress outcome. These studies found lower levels of salivary cortisol following clown intervention compared with preintervention levels.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Clown Intervention on Self-Report and Biomarker Measures of Stress and Fatigue in Pediatric Osteosarcoma Inpatients: A Pilot Study

et al. 2018

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Background: Pediatric cancer patients experience different psychological processes during hospitalization that may regulate the immune response and affect recovery and response to cancer treatment. In this study, we aimed to examine the feasibility of longitudinal testing of psychophysiological parameters of stress and fatigue in pediatric osteosarcoma patients hospitalized for chemotherapy submitted to clown intervention; and to investigate whether changes in the levels of biomarkers are associated with psychological stress and fatigue levels in these patients after the clown intervention. Methods: A pretest-posttest quasi-experimental pilot study was conducted at the pediatric oncology inpatient unit in a comprehensive cancer care center in Brazil including children and adolescents with osteosarcoma hospitalized for chemotherapy. Eight saliva samples were collected, comprising 4 at baseline (pre-intervention) and 4 after the clown intervention (+1, +4, +9, and +13 hours post-awakening). Salivary cortisol, α-amylase (sAA), cytokines, and matrix metalloproteinase-9 (MMP-9) levels were determined using high-sensitivity enzyme-linked immunosorbent assay (ELISA) kits. Stress and fatigue were measured by Child Stress Scale–ESI and PedsQL Multidimensional Fatigue Scale respectively. Bivariate association analysis between stress and fatigue scores and biomarker levels were investigated using nonparametric statistics. Effect sizes were calculated for each outcome variable. Results: Six pediatric osteosarcoma patients were enrolled with no missing data. No significant effects sizes were observed for psychophysiological outcomes. Effect sizes ranged from 0.54 (cortisol) to 0 (interleukin-1β [IL-1β]). Decreasing overall trends were observed for cortisol levels for all 6 pediatric osteosarcoma patients over time. In addition, a similar pattern of tumor necrosis factor–α (TNF-α) levels over time was found for all 6 patients. Patients with metastatic osteosarcoma showed a linear trend for a decrease in MMP-9 levels between 1 and 9 hours after the clown intervention and restoration to basal levels after 13 hours. Conclusions: The results of this pilot study suggest that it is feasible longitudinally measure psychophysiological outcomes in the pediatric osteosarcoma inpatients for chemotherapy. Clown intervention merits further study as a way to reduce stress as well as fatigue, since that the stress and cytokines measurements are feasible based on our work.

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“…Humor therapy has been proposed as a tool to help patients and caretakers cope with stressors related to medical experiences, 4 such as preparing for hospitalization or surgery 3,5 and managing pain. 6 Magic therapy, an interactive humor-and illusionbased therapy, engages children in an activity to help them overcome medical challenges by establishing a sense of environmental control and improved selfesteem through mastery.…”

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confidence: 99%

A Magic Therapy Program to Alleviate Anxiety in Pediatric Inpatients

Pravder

Leng-Smith

Brash

et al. 2019

Hospital Pediatrics

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OBJECTIVES: Hospitalization generates increased psychological discomfort for children and their caregivers. This anxiety can affect the patient-caretaker response to the health care team and the course of treatment. We aim to evaluate the impacts of a magic therapy program, organized and facilitated by medical students, on alleviating pediatric inpatient and caregiver anxiety. METHODS: Patients aged 5 to 16 years admitted to an inpatient pediatric unit and their caregivers were eligible for inclusion. Patient-caregiver pairs were randomly assigned to a magic therapy intervention group or a control group. Anxiety was measured before and after the intervention by using validated self-report tools. The Facial Image Scale and Venham Picture Test were used to measure anxiety for young patients, the short State-Trait Anxiety Inventory and Facial Image Scale were used for older patients, and the short State-Trait Inventory was used for caregivers. A subset of the intervention group was reevaluated at 1 hour posttherapy. Health professionals were also surveyed regarding their opinions of the program. RESULTS: One hundred patients and 90 caregivers were enrolled. The patient magic group’s standardized anxiety was reduced by 25% (n = 47; P < .001) posttherapy. The caregiver magic group’s anxiety was reduced by 24% (n = 34; P < .001). Data suggest that anxiety reductions lasted through at least 1 hour posttherapy. Physicians (n = 9), nurses (n = 8), and pediatric residents (n = 20) supported program continuance, reported favorable impressions, and suggested patient, caregiver, and staff benefits. CONCLUSIONS: Integration of a magic therapy program into pediatric inpatient care was feasible and successful in decreasing patient and caretaker anxiety. Health care professionals support the program’s continuance.

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Effects of a Humor Therapy Program on Stress Levels in Pediatric Inpatients

Abstract: Humor therapy has beneficial effects on stress and cortisol levels in pediatric inpatients. This supports the implementation and reinforcement of these therapies in pediatric hospitals.

Cited by 82 publications

References 63 publications

Beneficial effect of laughter therapy on physiological and psychological function in elders

Beneficial effect of laughter therapy on physiological and psychological function in elders

The Effect of Clown Intervention on Self-Report and Biomarker Measures of Stress and Fatigue in Pediatric Osteosarcoma Inpatients: A Pilot Study

A Magic Therapy Program to Alleviate Anxiety in Pediatric Inpatients

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