A Study to Assess the effectiveness of Laughter Therapy on Stress among Senior Citizens residing in selected old age homes at Rajkot District

Maheshwari Damor¹, Ivin Manoj A.², Jeenath Justin Doss K.³

¹Ⅱ Year M.Sc. Nursing MHN, Shri Anand Institute of Nursing Opp. Ghanteshwar Park,

B/H Shainik Society, Jamnagar Road, Rajkot.

²Guide, Shri Anand Institute of Nursing Opp. Ghanteshwar Park, B/H Shainik Society, Jamnagar Road, Rajkot.

³Principal, Shri Anand Institute of Nursing Opp. Ghanteshwar Park, B/H Shainik Society, Jamnagar Road, Rajkot.

*Corresponding Author E-mail: maheshwaridamor1412@gmail.com

ABSTRACT:

The present study was to assess the effectiveness of laughter therapy on level of stress among senior citizen residing in ‘Sadbhavna old age home’ at Rajkot. The objective of the study was to assess the effectiveness of laughter therapy on level of stress among senior citizen residing in selected old age homes. A Quasi-experimental one group pre-test and post-test group design was chosen for the study without randomization. The samples were selected for the study by adopting purposive sampling technique. The sample selected for the present study was decided to be 30. The data collected by structured interview with Rating scale – Perceived stress scale administrated to assess the level of stress among senior citizens residing in selected age homes. The tool was used to collect the data which consist of two parts. Part -I: Consist of demographic variables of senior citizens. Part-II : Rating scale – Perceived stress scale. The content of the Rating scale- Perceived stress scale were checked and evaluated by 5 experts. The experts were five nursing experts specialized in Mental Health Nursing. The data collected were analysed through descriptive (mean, frequency and percentage) and inferential statistics (‘t’ test and Chi- square) to test the hypothesis. Study shows that pre-test level of stress among selected 30 samples of senior citizen with stress residing in old age homes, reported 08(26.67%) High perceived stress, 19(63.33%) Moderate stress and 03(10%) reported on low stress. The pre test reported 08 (26.67%) high perceived stress and 19(63.33%) Moderate stress and 03(10%) reported on low stress. After the laughter therapy on stress among senior citizens 23(76.67%) reported Moderate level, 07(23.33) reported low level of stress and there was nil reported on high perceived stress. It also revealed that the mean score of pre test was and post test was 15.33. The Mean difference was 11.7. The standard deviation of pre test was 4.82 and post test was3.04. Degree of freedom (df) was 29. The obtained ‘t’ value 11.23. Hence it was highly significant p<0 With regard to association with stress with their selected demographic variables Age, Gender, Marital status, Source of income, Presence of any physical problem, Pattern of communication with the family member, and Practice of any relaxation therapies had the significant association with the level of stress among senior citizen residing in selected old age homes. The study shows that the calculated Chi-square value is more than the tabulated value at the level of 0.05 for the demographic variables such as Gender, Presence of any physical problem, use of any relaxation therapy exercise. For the other demographic variables such as Age, Marital status, source of income and patterns of communication with family the Chi-square value is less than the tabulated value at the level of 0.05., thus stated hypothesis H2 is accepted which shows there is significant association between effectiveness of laughter therapy on level of stress among senior citizen mnemonic and selected demographic variables.

KEYWORDS: Evaluate, Effectiveness, laughter therapy, senior citizens.

INTRODUCTION:

“Technology is a useful servant but a dangerous master’’ - Christian lou’s lang.

BACKGROUND OF THE STUDY:

Aging is a natural process. Old age is an inevitable one. Old age is a crucial phase where physiological, psychological and socio cultural changes make elderly to develop stress. The concept of ‘old’ has changed drastically over the years. Our prehistoric ancestors probably had a life span of 40 years, with the average individual living around 18 years. Old age is viewed both as a stage in life span of an individual and also a segment of a population in society. Public considers people who are 50 – 75 years of age as old. Developmental psychologist consider 60 years as the demarking line between middle and old age, whereas social researchers set the boundary of old age as 65. Gerontology is the study of aging has becoming a field of specialization. Gerontologist divided the aged into 3 groups the young old (60 – 70 years), old old (75-85 years), and very old (85 and above). Old Age has now become a prevalent social problem in our society.¹

In our modern society, where money is the scale of everything, the old age people are measured as an economic liability and a social burden. In addition, old age is inevitable and thus of concern to each of us. It is strange that no one wants to grow old but everyone wants to live long. But old age is observed as an ineluctable, undesirable, problem-ridden stage of life that we all are compelled to live, marking time until our final exit from life itself. Old age is a period of multiple sickness and general disability. This unbending situation may lead to stress among old age. Exposure to stress among old age can also contribute to behaviours such as smoking, over-consumption of alcohol, retirement from job, family situation, less-healthy eating habits, etc. In India by the year 2010, 24.9% of old age females reported that most days were quite a bit or extremely stressful, compared with 22.0% of males. In Tamil Nadu daily mental illness rates were highest in the old age people above 60 years and with that about 30% were reporting stress. Laughter therapy is defined as a new kind of therapy that involves giggling, chuckling and a great sense of humour.²

NEED FOR THE STUDY:

According to World health organization, (2010) globally rate of growth of aging population is exceeded in general population and this would increase 1.2 billion people over 60 years. A quarter century after number of people over 60s will be doubled. 80% of older persons will live in developing countries and this would increase to 1,594 million by the year 2050. WHO also projected that elderly population in developed nation will close from 12% to 19% by 2026 and then developing countries will account for ¾ of the world’s elderly population. ³

According to National Health Statistics, (2009) there are currently 550 million elderly aged 60 and over in the world and of these 335 million has been living in developing countries, for the last 50 years. The rate of accelerated death in developing countries has visibility decreased and life expectancy at birth has increased by 62 years. In the year 2020 life expectancy at birth will be predicted to reach 70. In India about 7% of elderly population is over the age of 60 and it is expected to increase by 20% by the year 2030. The state of well being varies from 22.1% to 52.1% in the elderly. The prevalence rate of mental morbidity is 89/1000 elderly with geriatric stress accounting for 60/1000. Psychiatric disorder is seldom an isolated event and is associated with a high degree of physical co morbidity. The growing population is one of the most significant characteristics of 20th century and first quarter of 21st century. Along with world population, Indian elderly are also “ageing in old age”. Aging is a lifelong activity from birth we grow older through infancy to childhood to adolescence to adulthood and onwards. The term old is associated with alteration in individual’s biological, psychological, health capabilities and changes in social role; people aged 60 years and over are also considered as persons in third age.⁴

Laughter therapy decreases stress hormones that constrict blood vessels and suppress immune activity and reduces at least four of neuroendocrine hormones associated with stress response. Laughter helps to relieve the stress because while laugh adrenaline level goes down and also triggers the release of endorphins, the body’s natural painkillers and produce a general sense of well being. Laughter therapy is found to lower blood pressure, reduce stress hormones, increase muscle flexion and boost immunes. Therefore the incidence rate gives us a clear picture about the problems of senior citizen. The investigator has personally witnessed the senior citizen suffering from various psychological disturbances. Hence the investigator was interested in administering laughter therapy and to find out the effectiveness to reduce stress among senior citizen and to promote the health status of senior citizens.

The investigators during their clinical experience have come across the senior citizens with certain level of stress while living in old age home. It was noticed that their level of stress can be easily relived by application of laughter therapy. From the findings of literature, the researchers realized the importance of laughter therapy in reducing the level of stress and designed a study to assess the effectiveness of laughter therapy on level of stress among senior citizens living in old age home.⁵

OBJECTIVES OF THE STUDY:

1. To assess the level of stress among senior citizens.

2. To assess the effectiveness of laughter therapy on stress among Senior citizens.

3. To find out the association between the effectiveness of laughter therapy on stress among senior citizens with selected demographic variables.

HYPOTHESES:

H1: There will be a significant difference between the pre test and post test level of stress among the senior citizens.

H2: There will be a significant association between the stress level among senior citizens with selected demographic variables.

MATERIAL AND METHODOLOGY:

RESEARCH APPROACH:

A quantitative research approach will be adopted for this study.

RESEARCH DESIGN:

Quasi – experimental one group pre-test, post-test design.

SETTING: Senior citizens residing in old age home Rajkot.

POPULATION:

· Accessible population: Senior citizens residing in old age home at Rajkot.

· Target population: Senior citizens with moderate or high level of stress.

SAMPLE:

The sample size of the study was 30 senior citizens with stress residing in old age home.

SAMPLING TECHNIQUE:

The researcher study was conducted by non-probability purposive sampling technique.

Data analysis and interpretation:

The collected data was analyzed using both descriptive and inferential statistics.

RESULT:

MAJOR FINDINGS:

The major findings of the study include

A. Findings related to demographic variables of the study

1. The majority of 15 (50%) sample’s age is between 75-84 years

2. The majority of 18 (60%) samples are male.

3. The majority of 18 (60%) samples are widow/widower.

4. The majority of 24 (60%) samples are dependent on their offspring for their source of income.

5. The majority of 15 (50%) samples are having presence of sensory problems.

6. The majority of 18 (60%) samples are having occasional pattern of communication with their family.

7. The majority of 21 (32.5%) samples are not using any relaxation therapy previously.

B. Finding related to Effectiveness of laughter therapy on level of stress among senior citizens.

With regard to effectiveness of laughter therapy on level of stress among senior citizens, the obtained ‘t’ value for the level of knowledge was 11.23 that was highly significant at p<0.001 level.

C. Findings related to association between demographic variables and post test.

With regard to association between the levels of stress with their selected demographic variables such as Gender, Presence of physical problem, use of any relaxation therapy had significant association found. The study shows that the calculated Chi-square value is more than the tabulated value at the level of 0.05 for these demographic variables. This shows there is a significant association between the effectiveness of laughter therapy on level of stress among senior citizens and selected demographic variable

CONCLUSION:

The main conclusion from this present study is that most of the senior citizen residing in selected old age homes had high perceived and moderate level of stress in pre-test and they improved to low and moderate level of stress in post-test. This shows the imperative need to understand the purpose of the laughter therapy on level of stress among senior citizen residing in selected old age homes and it will improve the practice of laughter therapy to improve mental health by reducing stress level.

REFERENCE:

1. Ahuja N. Textbook of Postgraduate Psychiatry. New Delhi: 5th edition. Jaypee Brothers Medical Publishers; 2004.

2. Alligard MR. Nursing Theorists and their work. Philadelphia; 5th Edition, Mosby Company; 2002.

3. Anantharaman RN. Aging in India. Bombay: Tata Institute of Social Science; 1992.

4. Bhatia DC. Community geriatrics. New Delhi: National Institute of Health Care; 1993.

5. Cornelius Katona Gill Livingstone. Stress in Elderly People. U.K: Eayfosa Publishers; 1997.