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Effects of Laughter Therapy on Joint Pain, Functional Status of Knee Joint and Depression in Elderly with Degenerative Knee Arthritis

웃음요법이 퇴행성 슬관절염 노인의 관절통증, 관절기능상태, 우울에 미치는 효과

  • Lee, Yim Sun (Graduate School, College of Nursing, Ewha Womans University) ;
  • Park, Hyo Jung (College of Nursing, Ewha Womans University)
  • 이임선 (이화여자대학교 일반대학원 간호과학과) ;
  • 박효정 (이화여자대학교 간호대학)
  • Received : 2020.06.12
  • Accepted : 2020.09.04
  • Published : 2020.09.30

Abstract

This study examined the effects of laughter therapy in the elderly with degenerative arthritis who had joint pain, joint dysfunction, and depression. Through a single-blind, randomized assignment, an experimental group of 26 subjects and a control group of 26 subjects were recruited among the elderly with degenerative knee arthritis, who were over 65 years of age. From January 8 to March 11 of 2019, a total of 16 laughter therapies were administered two times a week, 60 minutes per session, in eight weeks. The pain threshold (p=.012) and joint function status (p<.001), which represents the pain, joint stiffness, and physical function, and depression (p<.001), in the experimental group improved after the eight weeks laughter therapy compared to the control group. Laughter therapy is a therapeutic intervention that can be delivered through physical or intellectual activities. This therapy is a non-invasive procedure and has the advantage that nurses can practice easily with a little training. It can be used as an intervention within community and clinical settings to relieve pain and improve depression in the elderly with arthritis.

본 연구는 웃음요법이 퇴행성 관절염 노인 환자의 관절 통증, 관절기능 이상, 우울에 주는 효과를 확인하기 위해 시도되었다. 단일맹검, 무작위 배정을 통해 S시의 경로당 및 복지관을 이용중인 65세 이상 퇴행성 슬관절염 노인을 대상으로 실험군 26명, 대조군 26명을 선정하였다. 2019년 1월 8일부터 3월 11일까지 주 2회, 회당 60분, 8주, 총 16회의 웃음요법을 적용하고 그 효과를 VAS, 압통역치, WOMAC, 한국형 노인 우울 단축형 척도로 측정하였다. 연구결과 퇴행성 슬관절염 노인의 통증 역치(p=.012)와 통증, 관절경직, 신체기능을 측정하는 관절기능상태(p<.001), 우울(p<.001)은 대조군에 비해 실험 후 개선되어 웃음요법이 효과가 있음이 확인되었다. 웃음요법은 육체적 또는 지적 활동을 통해 웃음을 경험할 수 있는 치료적 개입으로 침습적인 시술이 이루어지지 않고 약간의 훈련으로 간호사들이 쉽게 적용할 수 있는 장점이 있으므로 웃음요법을 지역사회 및 임상 현장에서 퇴행성 슬관절염 노인의 통증을 완화시키고 우울을 개선하는 중재방법으로 활용할 수 있을 것으로 사료된다.

Keywords

References

  1. D. Pereira, B. Peleteiro, J. Araujo, J. Branco, R. A. Santos, E. Ramos, "The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review", Osteoarthritis Cartilage, Vol. 19, pp. 1270-1285, 2011. DOI: https://doi.org/10.1016/j.joca.2011.08.009
  2. K. H. Chung, Y. H. Oh, E. Y. Kang, K. R. Kim, Y. K. Lee, & M. A. Oh, 2017 National survey of older Koreans, Policy Report, Korea Institute for Health and Social Affairs, Korea, pp. 39-43.
  3. S. O. Yang, S. H. Lee, "A Survey on the customized visiting nurse's assessment and management of chronic musculoskeletal pain in older adults", J Korean Acad Community Health Nurs. Vol. 21, No. 3, pp. 311-320, 2011. DOI: https://doi.org/10.12799/jkachn.2010.21.3.311
  4. The Korean Orthopaedic Association. Knee Osteoarthritis [Internet]. Seoul: The KoreanOrthopaedic Association. 2011 [cited 2018 November10]. Available from:: http://www.koa.or.kr/info/index_10_1.php
  5. C. S. Kim, S. H. Jang, Y. Y. Cho, "The effect of laughter therapy on arthralgia, depression, and sleep of elderly housebound women with osteoarthritis", Journal of Korean Biological Nursing Science, Vol. 17, No. 2, pp. 123-131, 2015. DOI: http://doi.org/10.7586/jkbns.2015.17.2.123
  6. Y. J. Ko, M. Y. Hyun, "Effects of laughter therapy on pain, depression, and quality of life of elderly people with osteoarthritis", Journal of Korean Academic Psychiatric and Mental Health Nursing, Vol. 22, No. 4, pp. 359-367, 2013. DOI: https://doi.org/10.12934/jkpmhn.2013.22.4.359
  7. C. S. Kim, K. S. Yoo, S. H. Hong, "The effects of foot reflexology on arthralgia, ankylosis, depression and sleep in community-dwelling elderly women with osteoarthritis", Journal of Korean Academic of Community Health Nursing, Vol. 25, No. 3, pp. 207-216, 2014. DOI: http://doi.org/10.12799/jkachn.2014.25.3.207
  8. M. S. Song, Y. K. Yoo, N. C. Kim, "Effects of aquatic exercise on joint angle, pain, stiffness, and physical function in elderly women with osteoarthritis", J Korean Gerontol Nurs, Vol. 17, No. 2, pp. 89-97, 2015. DOI: https://doi.org/10.17079/jkgn.2015.17.2.89
  9. H. K. Oh, S. H. Ahn, R. Y. Song, "Comparing effects of tai chi exercise on pain, activities of daily living, and fear of falling in women with osteoarthritis and rheumatoid arthritis", J Muscle Joint Health, Vol. 18, No. 2, pp. 137-146, 2011. DOI: http://doi.org/10.5953/JMJH.2011.18.2.137
  10. M. J. Jang, Y. M. Lim, H. J. Park, "Effects of auricular acupressure on joint pain, range of motion, and sleep in the elderly with knee osteoarthritis", J Korean Acad Community Health Nurs, Vol. 3, No. 1, pp. 79-89, 2019. DOI: https://doi.org/10.12799/jkachn.2019.30.1.79
  11. E. J. Lee, Y. J. Lee, J. H. Choi, H. J. Jo, J. Y. Kang, "The association between osteoarthritis and depression in Korean adults over 45 years-old: Korean National Health and Nutrition Examination Survey 2010-2012", Korean Journal of Family Practice, Vol. 6, No. 2, pp. 111-117, 2016. DOI: https://doi.org/10.21215/kjfp.2016.6.3.211
  12. E. O. Park, "Effects of visiting laughter therapy on depression and insomnia among the vulnerable elderly", Journal of Korean Academic of Community Health Nursing, Vol. 24, No.2, pp. 205-213, 2013. DOI: http://doi.org/10.12799/jkachn.2013.24.2.205
  13. M. Takeda, H, Ryota, K. Takashi, O, Masayasu, T. Shinji, M. Takashi, S. Golam, T. Toshihisa, "Laughter and humor as complementary and alternative medicines for dementia patients", BMC complementary and alternative medicine, Vol. 10, No. 28, pp. 1-7, 2010. DOI: http://doi.org/10.1186/1472-6882-10-28
  14. S. Y. Park, Y. S. Lee, H. H. Chung, S. M. Choi, "Effects of a laughter therapy on depression, anxiety, fatigue and quality of sleep in gastrointestinal cancer patients post-treatment: a randomized controlled trial", Journal of Korean Biological Nursing Science, Vol. .21, No. 3, pp. 188-198, 2019. DOI: https://doi.org/10.7586/jkbns.2019.21.3.188
  15. K. I. Lee, Y. Eun, "Effect of laughter therapy on pain, depression and sleep with elderly patients in long term care facility", Journal of Muscle and Joint Health, Vol. 18, No. 1, pp. 28-38, 2011. DOI: https://doi.org/10.5953/JMJH.2011.18.1.028
  16. E. A. Cho, H. E. Oh, "Effects of laughter therapy on depression, quality of life, resilience and immune responses in breast cancer survivors", J Korean Acad Nurs. 2011;41(3):285-293. DOI: http://doi.org/10.4040/jkan.2011.41.3.285
  17. E. S. You, Y. H. Choi, "The effects of laughter therapy on pain and anxiety among patients with postmastectomy", Journal of East-West Nursing Research, Vol. 18, No. 1, pp. 47-52, 2012. DOI: https://doi.org/10.14370/jewnr.2012.18.1.047
  18. M. H. Kim, M. J. Kim, "Effects of laughter therapy on recovery status from facial paralysis, pain and stress in bell's palsy patients", Journal of Korean Clinical Nursing Research, Vol. 20, No. 2, pp. 211-222, 2014. DOI: https://doi.org/10.22650/JKCNR.2014.20.2.211
  19. K. S. Kim, J. A. Yu, J. A. Kim, Y. S. Lee, I. O. Lee, " Effects of Tai-Chi exercise and self-help management program applying laughter therapy in patients with osteoarthritis", J Muscle Jt Health, Vol. 17, No. 1, pp. 68-78, 2010. https://doi.org/10.5953/JMJH.2010.17.1.068
  20. L. Arendt-Nielsen, H. Nie, M. B. Laursen, B. S. Laursen, Madeleine, O. H. Simonsen, T. Graven-Nielsen, "Sensitization in patients with painful knee osteoarthritis", Pain, Vol. 149, No. 3, pp. 573-581, 2010. DOI: https://doi.org/10.1016/j.pain.2010.04.003
  21. N. Bellamy, W. W. Buchanan, C. H. Goldsmith, J. Campbell, L. W. Stitt, "Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee." The Journal of rheumatology, Vol. 15, No. 12, pp. 1833-1840, 1988.
  22. S. C. Bae, H. S. Lee, H. R. Yun, T. H. Kim, D. H. Yoo, & S. Y. Kim, "Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and Lequesne osteoarthritis indices for clinical research", Osteoarthritis Cartilage, Vol. 9, pp. 746-750, 2010. DOI: https://doi.org/10.1053/joca.2001.0471
  23. J. I. Sheikh, J. A. Yesavage, "Geriatric Depression Scale (GDS): recent evidence and development of a shorter version", Clinical Gerontologist: The Journal of Aging and Mental Health, Vol. 5, pp. 165-173, 1986. https://doi.org/10.1300/J018v05n01_09
  24. B. S. Kee, A preliminary study for the standardization of geriatric depression scale short form-Korea version. J Korean Neuropsychiatr Assoc, Vol. 35, No. 2, pp. 298-307, 1995.
  25. J. S. Kang, "A meta-analysis of lauhgter therapy in Korean Jorunal", Asia-pacific Journal of Multimedia Service Convergent with Art, Humanities and Sociology, Vol.7, No.1, pp. 489-501, 2017. DOI: http://doi.org/10.14257/AJMAHS.2017.01.08
  26. J. E. Yim, "Therapeutic benefits of laughter in mental health: a theoretical review", The Tohoku Journal of Experimental Medicine, Vol.239, No. 3, pp. 243-249, 2016. DOI: https://doi.org/10.1620/tjem.239.243
  27. H. J. Ko, C. H. Youn, "Effects of laughter therapy on depression, cognition and sleep among the community-dwelling elderly", Geriatric Gerontology International, Vol. 1, No. 3, pp. 267-274, 2011. DOI: http://doi.org/10.1111/j.1447-0594.2010.00680.x