The effect of a laughter-based intervention on airway patency in children with tracheostomy

Abstract

Background Many children with tracheostomy are vulnerable to the complications of tracheostomy and airway disorders. One of the methods of taking care of the airways is coughing, which is physiologically very similar to laughter. Laughter is used as complementary medicine in nursing care and improves communication with patients and reduces their anxiety. Objective The purpose of this study was to investigate the effect of laughter on airway patency in children with tracheostomy hospitalized in the selected hospitals of medical universities in Tehran, Iran. Methods After obtaining the informed consent from the parents, 80 children with tracheostomy aged 6 to 12 years who have a GCS above 11, at least 72 hours have passed since the tracheostomy surgery, are breathing spontaneously, and didn’t have received anesthetic and are not suffering from an acute or special disease, were included in the study. Then they were randomly assigned into intervention and control groups. The intervention group received the laughter intervention twice a day for two consecutive days and 15 minutes each by watching funny animations and interacting with Puppets simultaneously. For both groups, the variables of airway patency, including O2sat, respiratory rate, and suctioning frequency, were measured three times a day for two consecutive days. Independent t-test, non-parametric Mann-Whitney test, Chi-square test, one-factor analysis of variance with repeated measures, and Friedman's non-parametric test were used to analyze the data, and SPSS software version 19 was used. Results Most of the participants in both groups were boys (63.8%). The most common cause of hospitalization in children was respiratory diseases (75%) and most children (88.8%) were breathing spontaneously. The average amount of O2sat increased significantly after the fifth and sixth sessions by causing laughter in the intervention group (p < 0.05). The intervention group significantly decreased respiratory rate (p < 0.05). There was no significant difference between the two groups in terms of the suctioning frequency until the fifth session (p < 0.05). However, in the sixth session, the suctioning frequency in the intervention group is significantly lower than in the control group (p < 0.05). Conclusion The results of the present research have shown that laughter causes a significant effect on airway patency in children with tracheostomy hospitalized in the selected hospitals of medical universities in Tehran. The results of the present study emphasize the non-invasive care of the airways of children with a tracheostomy. Due to their inability to communicate verbally and reduced sensory stimulation due to hospitalization, these children can benefit from laughing for therapeutic and supportive purposes.