Effects of Laughter Therapy on Stress Response and Pain of Military Personnel with Low Back Pain in Hospital

웃음요법이 군병원 요통환자의 스트레스 반응과 통증에 미치는 영향

  • Yu, Jeong-A (Department of Nursing, Armed Forces Nursing Academy) ;
  • Kim, Keum-Soon (Department of Nursing, Seoul National University)
  • Published : 2009.04.30


Purpose: This study was to determine the effects of laughter therapy on stress response and pain of military patients with low back pain. Method: The subjects in the experimental group received 3-sessions of laughter therapy on 3 consecutive days. The primary outcome measures were state anxiety, depression, blood pressure, pulse rate and pain. Result: After 3 sessions of laughter therapy, the scores of state anxiety(p=.046), depression(p=.028) and pulse rate(p=.003) were significantly lower and diastolic blood pressure(p=.038) was significantly higher in the experimental group than those in the control group. The level of pain(p=.711) was not different significantly between two groups. Conclusion: Laughter therapy could be an effective strategic intervention for military patients with low back pain to reduce the level of anxiety and depression. Further studies are needed to determine long-term effects of laughter therapy and its effects on cardiovascular system and pain.



  1. Baek, N. J. (2003). A study of psychometric characteristics and pain behaviors in low back pain patients. Unpublished master's thesis, Seoul National University, Seoul.
  2. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archf Gen Psychiatry, 4(6), 561-571. https://doi.org/10.1001/archpsyc.1961.01710120031004
  3. Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck depression inventory: Twenty years of evaluation. Clin Psychol Rev, 8(1), 77-100.
  4. Bennett, H. J. (2003). Humor in medicine. South Med J, 96(12), 1257-1261. https://doi.org/10.1097/01.SMJ.0000066657.70073.14
  5. Bennett, M. P., & Lengacher, C. (2008). Humor and laughter may influence health: III. Laughter and health outcomes, e-CAM, 5(1), 37-40.
  6. Choi, E. S., & Kim, S. D. (2001). An analysis of the concept of pain. Korean J Women Health Nurs, 7(3), 284-292.
  7. Dersh, J., Polatin, P. B., Leeman. G., & Gatchel, R. J. (2004). The management of secondary gain and loss in medicolegal settings: Strengths and weakness. J Gccup Rehabil. 4(4), 267-279.
  8. Fernandez, E., & Turk, D. C. (1992). Sensory and affective components of pain: Separation and synthesis. Psychol Bull, 112(2), 205-217. https://doi.org/10.1037/0033-2909.112.2.205
  9. Han, H. M., Yeom, T. H., Shin, Y. W., Kim, K. H., Yoon, D. I, & Jung, K. J. (1986). A standardization study of Beck depression inventory in Korea. J Korean Neuropsychiatr Assoc, 25(3), 487-500.
  10. Huskinsson, E. C., & Scott, J. (1976). Graphic representation of pain. Pain, 2(2), 175-184. https://doi.org/10.1016/0304-3959(76)90113-5
  11. Hyun, H. S. (2007) A study on stress and symptoms of stress in soldiers in the army. J Korean Acad Nurs, 38(2), 238-247. https://doi.org/10.4040/jkan.2008.38.2.238
  12. Jeon, J. K. (1992). A clinical study of lumbago patients. J Korean Acad Rehabil Med, 4(1), 59-67.
  13. Kim, K. R., Jang, Y. S., Kim, E. H., Seo, Y. S., Kim, D. H., & Shin, D. H. (1998). A study of psychogenic symptoms in chronic low back pain patients. J Korean Acad Fam Med, 19(1), 16-28.
  14. Kim, K. H., & Lee, M. H. (1999). Effects of humor intervention program on anxiety, depression and coping of humor in hemodialysis patients. J Korean Acad Rehabil Med, 2(1), 95-108.
  15. Kim, J. A. (1989). The effect of supportive nursing care on depression, mood and satisfaction in military patients with low back pain. J Korean Acad Nurs, 20(3), 324-340.
  16. Kim, J. A. (1994). Effects of music therapy on pain and depression of musculoskeletal trauma. J Korean Rheum Assoc, 1(1), 48-70.
  17. Kim, J. T., & Shin, D. K. (1978). A study based on the standardization of the ST AI for Korea. New Med J, 21(11), 69-75.
  18. Kim, H. J. (1995). Effect of humor video tape on an anxiety, depression and coping of the impaired mobility patients. Unpublished master's thesis, Seoul National University, Seoul.
  19. Kwon, H. J., Rho, E. S., Kwon, S. S., Kim, K. H., Yeoum, S. G., Song, M. S., & Cho, J. Y (2003). A grounded theory approach to the experience of hospitalization. J Korean Acad Psychiatr Ment Health Nurs, 12(2), 172-181.
  20. Lee, K. H. (1989). An exploratory study on the factors contributing to the development of the low back pain in military enlisted men. Unpublished master's thesis, Yonsei University, Seoul.
  21. Martin, R. A. (2001). Humor, laughter, and physical health: Methodological issues and research findings. Psychol Bull, 127(4), 504-519. https://doi.org/10.1037/0033-2909.127.4.504
  22. Shacham, S., Dar, R., & Cleeland, C. S. (1984). The relationship of mood state to the severity of clinical pain. Pain, 18(2), 187-197. https://doi.org/10.1016/0304-3959(84)90886-8
  23. Spielberger, C. D. (1972). Conceptual and methodological issues in anxiety research. In C. D. Spielberger (Ed.). Anxiety; Current trends in theory and research(Vol. 2). New York: Academic Press.
  24. Stuber, M., Hilber, S. D., Mintzer, L. L., Castaneda, M., Glover, D., & Zeltzer, L. (2007). Laughter, humor and pain perception in children; A pilot study. Retrieved July 10, 2008, from http://ecam.oxfordjournals.org/cgi/content/full/nem097v1.
  25. Suh, M. J .. & Kim, K. S. (1994). Effects of humor nursing intervention on the stress response for the cancer patient undergoing chemotherapy. Korean J Stress Res, 2(2), 193-206.
  26. Yang, M. S. (2008). The effects of laughter therapy on pain and state anxiety of spinal surgery patients. Unpublished master's thesis, Chonbuk University, Jeonju.
  27. You, J. E., & Jung, E. H. (2001). The effects of traditional physical therapy on pain reduction and depression level of patients with chronic low back pain. J Korean Soc Phys Ther, 13(3), 677-638.
  28. Yu, S. J., Lee, J. E., & Lee, K. R. (2005). The effect of laughter therapy on vital sign and emotional state in homes for the aged. J Korean Acad Psychiatr Ment Health Nurs, 14(1), 55-63.
  29. Yoon, H. S., & Lee, E. O. (1994). Reliability and validity of the behavioral observation method for assessing low back pain in patients with spinal diseases. J Korean Rheum Assoc. 1(1), 97-115.