Laughter Yoga Effect Depression, Serotonin Levels With Bariatric Surgery Patient
Condition: Bariatric Surgery; Depression
MeSH terms: Depression; Depressive Disorder
Study type: Interventional

Summary: 
      The goal of this a quasi-trial model with pre and post-test control group is to determine the
      effect of laughter yoga on depression and serotonin levels in patients undergoing bariatric
      surgery.

      The main question's it aims to answer are:

        -  Question 1: Does laughter yoga reduce the level of depression in patients undergoing
           bariatric surgery?

        -  Question 2: Does laughter yoga increase serotonin levels in patients who have undergone
           bariatric surgery? 158 patients who underwent bariatric surgery in the General Surgery
           Service of a university hospital in Malatya/Turkey and 6-24 months after the operation
           participated in the study. Sample size was determined using power analysis and 62
           patients were sampled. 31 patients were determined as the control group and 31 patients
           as the experimental group. 10 sessions of laughter yoga were applied to the patients in
           the experimental group who agreed to participate in the study that met the criteria. No
           intervention was made in the control group.
    

Detailed description: 
      The first stage of the data, identifying the patients, was collected by the researcher in the
      general surgery service of the hospital determined between February-June 2021.The patient
      information and blood samples, which are the second phase of the data, were collected by the
      researcher at the same time intervals in the nursing faculty meeting room of the designated
      university. In order to determine the participants to participate in the research, the
      participants who met the criteria were contacted by phone and an appointment was requested.
      Face-to-face Beck Depression Scale was applied to the patients who attended the appointment
      in the General Surgery service. 158 patients who got 17 points from the Beck Depression Scale
      were determined among the 62 patients who agreed to participate in the study, the first 31
      experimental groups and the second 31 control groups. Before their hospital visit for the
      interview, the patients were reminded that they should be fasting for blood sample collection
      and they should be on a 24-hour serotonin free diet. All participants filled the Patient
      Information Form as a pre-test in the nursing faculty meeting room and gave blood samples for
      serotonin levels. Laughter yoga was applied to the experimental group twice a week, on
      Tuesdays and Fridays, for 2,5 months, for a total of 10 sessions (each session 50 minutes) by
      the researcher after obtaining a laughter yoga practice certificate. Due to the COVID-19
      pandemic that started during this study period, the first and last sessions were applied
      face-to-face, and the other eight sessions of laughter yoga were carried out with an internet
      program that allows online meetings. Expert opinions from laughter yoga leaders for online
      applicability of laughter yoga taked. After 10 sessions were applied to the participants, the
      Beck Depression Scale was re-administered to the participants in the experimental group as a
      post-test and blood samples were taken again to check the serotonin levels. The Beck
      Depression Scale was re-administered 5 weeks after the pretest without any intervention in
      the control group, and blood samples were taken again to determine serotonin levels.
    

Intervention name(s): laughter yoga
Intervention type(s): Other
Intervention description(s): According to the literature and the training received on laughter yoga, the time required for the treatment of depression is 50 minutes. The first 10 minutes includes relaxation, stretching and warm-up exercises. The next 30 minutes includes laughing exercises, and finally, the last 10 minutes includes relaxation exercises.
Steps of laughter yoga sessions:
Clapping hands and warm-up exercises: Participants clap their hands, fingers and palms. Then, sounds like ho-ho and ha-ha are added to the clapping exercises along with the rhythm.
Deep breathing exercises: Breathing exercises should be repeated 3-4 times while standing
Childlike games: Arms are raised, imitating the funny and clumsy behavior of a child.
Laughter exercises: The researcher names the exercise, explains how to do it, and the group performs the exercise together.
Dance and Relaxation
Allocation: Randomized
Intervention model: Sequential Assignment
Intervention model description: A Guasi-experimental Study with a Pretest-Posttest Control Group Design.
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: bariatric surgery; depression; laughter yoga; nursing; serotonin