Clinical trial NCT06917417: The Effect of Laughter Therapy on Marital Adjustment, Life Satisfaction and Maternal Attachment Level in Mothers
Official title: The Effect of Laughter Therapy Given to Mothers in the Postpartum Period on Marital Adjustment, Life Satisfaction and Maternal Bonding Levels in Mothers; A Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Postpartum
Mothers
Keywords: postpartum period
maternal attachment
life satisfaction
laughter therapy
Lead sponsor: Selcuk University
Sponsor class: OTHER
Collaborators: name: Selcuk University Scientific Research Projects Unit
First posted: 2025-04-08
Enrollment: 90
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: After randomisation, a WhatsApp group will be established with the mothers in the laughter therapy group. Before starting the application, the 'Zoom' programme will be downloaded to the phone or computer of the mothers in the laughter therapy group. A WhatsApp group will be formed with at least 5-10 people, and a total of 10 sessions of laughter therapy will be applied with the groups for 5 weeks, 2 sessions per week. No intervention will be made to the control group, and they will be asked to fill in the questionnaire forms simultaneously.
Primary purpose: SUPPORTIVE_CARE

Brief summary: The postnatal period is a fragile period with physical and psychological changes as well as hormonal changes in the mother. Mind-body based complementary practices such as yoga, meditation, relaxation exercises can be used to improve well-being and facilitate adaptation to the changes experienced during this period. Among these practices, laughter yoga is new, simple, cost-effective, non-invasive, widely available online and easily applicable/accessible. In studies, individuals in different populations from children to the elderly have proven that laughter therapy interventions cause improvement in mood and life satisfaction. Looking at the literature, studies on laughter therapy in Turkey are limited and no study has been found on this subject. Therefore, the present study aims to investigate the effect of laughter therapy given to mothers in the postnatal period on partner adjustment, life satisfaction and maternal attachment level in mothers. It is thought that this study will make a very important contribution to the literature.

Detailed description: The postnatal period is a fragile period with physical and psychological changes as well as hormonal changes in the mother. In the transition to parenthood in the postnatal period, expectant parents experience changes that have important effects on the couple's relationship, the baby-parent relationship and the development of the baby. The positive relationship and harmony of the spouses are important in raising a child. Maternal attachment starts in the prenatal period and reaches the highest level in the postnatal period. It is known that inadequate maternal attachment to the baby poses a threat to the healthy development and well-being of the baby. Therefore, it is important to evaluate the psycho-social welfare of the mother in the postnatal period, to evaluate the level of mother-infant attachment and to make effective midwifery interventions.

Studies in the literature have documented the positive role of laughter in improving quality of life. In addition, it was determined that laughter therapy intervention during pregnancy increased the mental well-being of pregnant women and positively affected prenatal attachment levels. Laughter therapy can be used for both preventive and therapeutic purposes. Poor mental health of the mother poses a danger to the baby and the mother. Studies on laughter therapy are limited in Turkey. In order to increase evidence-based data, there is a need to investigate the potential effectiveness of laughter therapy interventions in terms of mothers' health. It is thought that this study will make a very important contribution to the literature.

Eligibility criteria: Inclusion Criteria:

* At least primary school graduate
* Over 18 years of age
* Volunteer to participate in the research
* Heterosexual
* With a spouse or partner
* At term
* With a single, healthy baby
* Have not had any intra-abdominal surgery
* With a 1-12 month postpartum baby
* Women who can use the Zoom program

Exclusion Criteria:

* Those who do not speak Turkish,
* Those with hearing and visual impairments,
* Those with mental disabilities,
* Those diagnosed with known psychiatric diseases,
* Mothers of babies with disabilities and chronic health problems
* Women with physical illnesses that prevent them from participating in Laughter Yoga sessions (breathing difficulties, persistent cough, vertigo, severe heart disease, hemorrhoids, any type of hernia such as neck, waist or inguinal hernia, severe back pain, urinary incontinence, epilepsy, etc.)
* Women who develop an acute health problem for themselves or their babies, who have had their mothers or babies suddenly hospitalized, who have lost their babies, who have separated from their spouses or partners, who do not attend laughter therapy sessions regularly, and who cannot be reached after the application will be excluded from the study.

Primary outcomes:
measure: Revised Dyadic Adjustment Scale
timeFrame: 1st Time: Day 1, 2nd Time: Day 45, 3rd Time: Day 75
measure: Life Satisfaction Scale
timeFrame: 1st Time: Day 1, 2nd Time: Day 45, 3rd Time: Day 75
measure: Maternal Attachment Inventory
timeFrame: 1st Time: Day 1, 2nd Time: Day 45, 3rd Time: Day 75
measure: Personal Information Form
timeFrame: 1st time: Day 1
Secondary outcomes:
Other outcomes:
Locations:
city: Konya
country: Turkey
facility: Selçuk University Faculty of Medicine Hospital
state: Selçuklu
Study officials:
References:
citation: van der Wal CN, Kok RN. Laughter-inducing therapies: Systematic review and meta-analysis. Soc Sci Med. 2019 Jul;232:473-488. doi: 10.1016/j.socscimed.2019.02.018. Epub 2019 Mar 5.
citation: Spanier GB (1976). Measuring dyadic adjustment: A newscales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family; 38: 15-28.
citation: Scott JK, Nelson JA, Dix T. Interdependence among mothers, fathers, and children from early to middle childhood: Parents' sensitivity and children's externalizing behavior. Dev Psychol. 2018 Aug;54(8):1528-1541. doi: 10.1037/dev0000525. Epub 2018 Jun 21.
citation: Quick AD, Tung I, Keenan K, Hipwell AE. Psychological Well-being across the Perinatal Period: Life Satisfaction and Flourishing in a Longitudinal Study of Black and White American Women. J Happiness Stud. 2023 Mar;24(3):1283-1301. doi: 10.1007/s10902-023-00634-6. Epub 2023 Mar 13.
citation: Pu DF, Rodriguez CM. Spillover and Crossover Effects: Mothers' and Fathers' Intimate Partner Violence, Parent-Child Aggression Risk, and Child Behavior Problems. Child Maltreat. 2021 Nov;26(4):420-430. doi: 10.1177/1077559520985936. Epub 2021 Jan 13.
citation: Namazinia M, Mazlum SR, Mohajer S, Lopez V. Effects of laughter yoga on health-related quality of life in cancer patients undergoing chemotherapy: a randomized clinical trial. BMC Complement Med Ther. 2023 Jun 12;23(1):192. doi: 10.1186/s12906-023-04028-2.
citation: Muller ME. Prenatal and postnatal attachment: a modest correlation. J Obstet Gynecol Neonatal Nurs. 1996 Feb;25(2):161-6. doi: 10.1111/j.1552-6909.1996.tb02420.x.
citation: Küçükkelepçe, DŞ, Ünver H, & Kurt N. (2024). Kahkaha Yogasının Emzirme Öz-Yeterliliği Üzerine Etkisinin İncelenmesi: Randomize Kontrollü Çalışma, Journal of Academic Research in Nursing (JAREN), 10(1).
citation: Kumcağız H, Aydın Avci İ, Caner Ş. (2018). Yaşam doyumu, postpartum depresyon ve özkıyım olasılığı arasındaki ilişki. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 21(1):1-9.
citation: Köker S. (1991). Normal ve Sorunlu Ergenlerin Yaşam Doyumu Düzeyinin Karşılaştırılması. Ankara Üniversitesi Sosyal Bilimler Enstitüsü. Ankara. Yayımlanmamış Yüksek Lisans Tezi.
citation: Ko Y, Park S. A pilot randomized controlled trial of distance laughter therapy for mothers' level of depression, anxiety, and parental stress during the COVID-19 pandemic. PLoS One. 2023 Jul 14;18(7):e0288246. doi: 10.1371/journal.pone.0288246. eCollection 2023.
citation: Kilic S, Can R, Yilmaz SD. Spousal support and dyadic adjustment in the early postpartum period. Women Health. 2024 Feb 7;64(2):121-130. doi: 10.1080/03630242.2024.2304891. Epub 2024 Jan 30.
citation: Kekec HT, Dikmen HA. The relationship of social support perceived by mothers and fathers and dyadic adjustment with maternal and paternal attachment in the postpartum period. Dev Psychobiol. 2023 Jan;65(1):e22358. doi: 10.1002/dev.22358.
citation: Kavlak O, Şirin A. (2009). Maternal Bağlanma Ölçeği'nin Türk toplumuna uyarlanması. Uluslararası İnsan Bilimleri Dergisi; 6:188-202.
citation: Holmes EK, Sasaki T, & Hazen NL. (2013). Smooth versus rocky transitions to parenthood: Family systems in developmental context. Family Relations, 62, 824-837. 10.1111/fare.12041
citation: Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction With Life Scale. J Pers Assess. 1985 Feb;49(1):71-5. doi: 10.1207/s15327752jpa4901_13.
citation: Dağlı, A. ve Baysal, N. (2016). Yaşam Doyumu Ölçeğinin Türkçe'ye uyarlanması: Geçerlik ve güvenirlik çalışması, Elektronik Sosyal Bilimler Dergisi, 15(59), 1250-1262.
citation: Si S Celi K A, Kilinc T. The effect of laughter yoga on perceived stress, burnout, and life satisfaction in nurses during the pandemic: A randomized controlled trial. Complement Ther Clin Pract. 2022 Nov;49:101637. doi: 10.1016/j.ctcp.2022.101637. Epub 2022 Jul 5.
citation: Bayraktaroğlu HT, Çakıcı ET. (2017). Psychometric properties of Revised form Dyadic Adjustment Scale in a sample from North Cyprus. International Journal of Educational Science; 19(2,3): 113-9.
citation: Alves S, Fonseca A, Canavarro MC, Pereira M. Does Dyadic Coping Predict Couples' Postpartum Psychosocial Adjustment? A Dyadic Longitudinal Study. Front Psychol. 2020 Sep 25;11:561091. doi: 10.3389/fpsyg.2020.561091. eCollection 2020.
citation: Ainsworth MDS, Blehar MC, Waters, Wall S. (2015). Patterns of Attachment Erlbaum, Hillsdale.
citation: Agapinar Sahin S, Bekar M. The influence of laughter yoga on pregnancy symptoms, mental well-being, and prenatal attachment: A randomized controlled study. Health Care Women Int. 2023 Jun;44(6):782-801. doi: 10.1080/07399332.2022.2164284. Epub 2023 Jan 10.