Prescribing laughter to increase well-being in healthy adults: an exploratory mixed methods feasibility study of the Laughie

Calls for a practical laughter prescription have been made by the medical community. This research developed the Laughie and evaluated its impact to elicit laughter and increase well-being in healthy adults. The Laughie is a user-created one minute recording of the user’s laughter, operated by re-playing it while laughing simultaneously. A mixed methods preliminary feasibility study was conducted between March and May 2018. Twenty-one participants aged 25–93 (x = 51, SD = 20) created a Laughie and were instructed to laugh with it three times a day for seven days, documenting each trial. Well-being was measured prior to and post-intervention using the World Health Organization (WHO five-item) well-being index. Interviews were analysed using thematic analysis. Evaluation considered the Feasibility, Reach-out, Acceptability, Maintenance, Efficacy, Implementation and Tailorability (FRAME-IT) of the Laughie. The Laughie elicited laughter for most of the one minute in 89% of 420 Laughie trials; immediate well-being increased in 70% of them. Absolute overall WHO well-being scores increased post-intervention by 16%. Laughie evaluation using FRAME-IT showed the Laughie was feasible, acceptable, and tailorable. Four smart laughter techniques that facilitated maintenance/usage were identified. The Laughie was feasible, enjoyable, and effective as a laughter prescription in eliciting laughter. Fourteen participants reported absolute well-being increases of 10% or more. Ten participants found their laughter self-contagious. Smart laughter (laughing in a smart way for a smart reason on a smartphone) is a convenient way to harness the benefits of laughter. FRAME-IT is proposed as a practical planning and evaluation framework

30 days wild: who benefits most?

There is a need to provide interventions to improve well-being that are accessible and cost-effective. Interventions to increase engagement with nature are coming to the fore. The Wildlife Trusts 30 Days Wild campaign shows promise as a large-scale intervention for improving public engagement with nature for well-being. The paper aims to discuss this issue. Design/methodology/approach In total, 273 people fully participated in a repeated measures evaluation comparing baseline measures of nature connection, health, happiness and conservation behaviours with measures post-30 days and 3 months. Findings There were sustained and significant increases for scores in nature connection, health, happiness and conservation behaviours. Those with lower scores at baseline in nature connection, conservation behaviours and happiness showed the most benefit. Older participants and those with higher baseline scores in conservation behaviours were the most likely to sustain their engagement with the campaign. Research limitations/implications Although the design and defined outcomes meet criteria for public health interventions, the self-reported measures, self-selecting sample and attrition are limitations. Originality/value The significant and sustained effects of the campaign on health, happiness and nature connection and conservation make this a promising intervention for improving human’s and nature’s well-being. The large community sample and naturalistic setting for the intervention make these data relevant to future interventions and policy.n/

Laughter and humour interventions for well-being in older adults: A systematic review and intervention classification.

Objectives To assess the potential of laughter and humour interventions to increase well-being in a general population of adults aged 60 plus; and to develop a classification to compare approaches and potential benefits of different intervention types. Design A systematic search of Web of Science, PubMed/MEDLINE, PsychInfo, AMED, and PsychArticles used inclusive terms relating to laughter and humour interventions. A realist synthesis approach enabled heterogeneous interventions to be compared pragmatically. Setting Five laughter interventions, and one humour intervention, using one or more outcome related to well-being, were considered for inclusion after screening 178 primary research papers. The five laughter interventions, representing a sample of 369 participants, were retained. Main outcome measures Well-being related outcome measures reported in each intervention informed efficacy; Joanna Briggs Institute tools appraised design; and a realist approach enabled heterogeneous interventions to be measured on their overall potential to provide an evidence base. Results Well-being related measures demonstrated at least one significant positive effect in all interventions. Confounding factors inherent in the intervention types were observed. Individual participant laughter was not reported. Conclusions Laughter and humour interventions appear to enhance well-being. There is insufficient evidence for the potential of laughter itself to increase well-being as interventions contained a range of confounding factors and did not measure participant laughter. Interventions that isolate, track, and measure the parameters of individual laughter are recommended to build evidence for these potentially attractive and low-risk interventions. The classification proposed may guide the development of both evidence-oriented and population-appropriate intervention designs.Objectives To assess the potential of laughter and humour interventions to increase well-being in a general population of adults aged 60 plus; and to develop a classification to compare approaches and potential benefits of different intervention types. Design A systematic search of Web of Science, PubMed/MEDLINE, PsychInfo, AMED, and PsychArticles used inclusive terms relating to laughter and humour interventions. A realist synthesis approach enabled heterogeneous interventions to be compared pragmatically. Setting Five laughter interventions, and one humour intervention, using one or more outcome related to well-being, were considered for inclusion after screening 178 primary research papers. The five laughter interventions, representing a sample of 369 participants, were retained. Main outcome measures Well-being related outcome measures reported in each intervention informed efficacy; Joanna Briggs Institute tools appraised design; and a realist approach enabled heterogeneous interventions to be measured on their overall potential to provide an evidence base. Results Well-being related measures demonstrated at least one significant positive effect in all interventions. Confounding factors inherent in the intervention types were observed. Individual participant laughter was not reported. Conclusions Laughter and humour interventions appear to enhance well-being. There is insufficient evidence for the potential of laughter itself to increase well-being as interventions contained a range of confounding factors and did not measure participant laughter. Interventions that isolate, track, and measure the parameters of individual laughter are recommended to build evidence for these potentially attractive and low-risk interventions. The classification proposed may guide the development of both evidence-oriented and population-appropriate intervention designs

The Engage-Disengage Model as an Inclusive Model for the Promotion of Healthy and Successful Aging in the Oldest-old

Theories relating to healthy and successful aging do not specifically cater for the oldest-old. This predominantly theoretical research considers the relevance of existing healthy and successful aging theories in the oldest-old. It explores a small sample of interviews of independently living oldest-old using Differential Qualitative Analysis. The Activity Theory and the Disengagement Theory were particularly relevant to investigate differences. The Engage-Disengage model was conceived as a pragmatic holistic model to address specific challenges facing the oldest-old. Engage-Disengage reflects attainable healthy and successful aging in the oldest-old according to individual abilities (intrinsic physical and mental capacities), values, and external resources (social, material, and environmental)

Differential qualitative analysis: a pragmatic qualitative methodology to support personalised healthcare research in heterogenous samples

Differential qualitative analysis (DQA) was developed as a pragmatic qualitative health methodology for the exploration of individual differences, behaviours, and needs within heterogeneous samples. Existing qualitative methodologies tend to emphasise the identification of general principles, an approach that can lead to standardised treatment, care, and medicine. DQA emphasises the identification of individual variation, in order to inform personalised healthcare. DQA comprises an accessible three-stage approach: first individual profiles are explored and differentiated into research-relevant subgroups; then each subgroup is analysed, and findings identified; finally, the data is analysed in its entirety and overall and subgroup findings are presented. DQA was developed as a new qualitative approach to: (1) emphasise the identification of person and patient-centered findings; (2) facilitate the analysis of sample heterogeneity, including variation in responses and intervention outcomes; (3) provide a convenient, pragmatic, systematic, and transparent methodology; (4) bridge the qualitative-quantitative divide with a mutually accessible approach. DQA may be particularly relevant for mixed methods research, early-stage interventions, and research exploring personalised and patient-centred care, and integrative medicine.N/

The Effect of Self-Compassion on Job Burnout and Hours Worked in Employees’ Working from Home

Working from home (WFH) has been associated with increased levels of job burnout; a psycho-physiological outcome of experiencing intense or extended periods of work-related stress. Individuals with higher levels of self-compassion have been shown to mitigate the effects of stress by reducing the negative affect associated with stressful situations. The objective of this study was to analyse the effect of self-compassion on job burnout and number of working hours in full time employees WFH. Fifty-eight full time WFH participants (37 females, 21 males; age M = 34, SD = 8 years) completed online self-report questionnaires. Multivariate regression analysis revealed that SC did not predict job burnout and number of working hours for this sample of WFH employees. The obtained evidence suggests that self-compassion was not enough to mitigate job burnout or number of working hours, therefore employers should not rely on employees to manage workloads and hours effectively but assist in developing schedules to reduce the negative impact of job burnout on their mental health.N/

Prescribing laughter to ameliorate mental health, sleep, and wellbeing in university students: A protocol for a feasibility study of a randomised controlled trial

© 2020 Objectives: This research is the first study to investigate the potential effects of a laughter prescription on both psychological health and objective sleep parameters in university students. The primary objective is to evaluate the feasibility of prescribing laughter to inform a larger randomised controlled trial. Secondary objectives are to assess if a two-week laughter prescription improves subjective and objective sleep outcomes, wellbeing, and/or psychological health outcomes. Trial design: To assess the feasibility of a randomised controlled trial for laughter prescription in relation to sleep, psychological health, and wellbeing. Forty university students will be recruited and randomised to one of two conditions (control/experimental). Methods: Wrist actigraphy and sleep diaries will be used to estimate sleep outcomes during a one-week baseline testing phase and across the two-week intervention. The experimental group will be shown how to record a Laughie (a 1-min recording of their joyful laughter on their smartphone) and prescribed to laugh with it three times daily for 14 days (the control group will only track sleep). All participants will complete the WHO (Five) Well-being Index, and Hospital Anxiety and Depression Scale pre- and post-intervention. The CONSORT checklist, and the Feasibility, Reach-out, Acceptability, Maintenance, Efficacy, Implementation, and Tailorabilty (FRAME-IT) framework will guide intervention planning and evaluation. Participant interviews will be analysed using Differential Qualitative Analysis (DQA). Results: The feasibility of a two-week laughter prescription in university students and its impact on sleep, wellbeing, and/or psychological health outcomes will be assessed. Conclusions: Zayed University Research Ethics Committee approved the study in July 2019. The research will be completed following protocol publication. Trial registration: ClinicalTrials.gov. ID: NCT04171245. Date of registration: 18 October 2019

Health Benefits of Ikigai: A Review of Literature

Recently, the concept of ikigai has attracted international scholarly attention. Originally, researchers have focused on its impact on longevity; however, contemporary approaches to ikigai include career guidance, wellbeing training and clinical practice. That said, much of the existing literature on ikigai has relied on anecdotal episodes, without a clear focus on scientific or clinical literature. In this chapter, we (a) define ikigai, (b) explore the health benefits of ikigai regarding its impact on both physical health and mental health, and (c) discuss how to enhance ikigai and future research, based on scientific findings. Ikigai— originally identified in difficult life experiences among leprosy patients—is defined as an experiential, everyday life phenomena that relates to a reason for your being. Based on a number of meta-analyses and longitudinal studies, evidence suggests a protective benefit and positive correlation between ikigai and better physical health, and an inverse relationship with all-cause mortality. Psychologically, ikigai may be important in developing one's sense of self-understanding, goal attainability, and problem-solving skills. Interventions such as life crafting are deemed helpful to enhance ikigai, although further research (e.g., cross-culture, longitudinal) needs to be conducted to further support the utility of this construct. Our findings can help healthcare workers and researchers to further advance the science of this experiential wellbeing construct.N/

An integrative systematic review of creative arts interventions for older informal caregivers of people with neurological conditions.

We aimed to assess and synthesise the current state of quantitative and qualitative research concerning creative arts interventions for older informal caregivers of people with neurological conditions. A systematic search was employed to identify studies that examined creative arts interventions for older informal caregivers, which were synthesised in this integrative review. We searched the following databases: MEDLINE, PubMed, EBSCO, CINAHL, EMBASE, PsycINFO, Cochrane Library, Scopus, Web of Science, and Google Scholar. We also backwards searched references of all relevant studies and inspected trials registers. Of the 516 studies identified, 17 were included: one was quantitative, nine were qualitative and seven used mixed methods. All included quantitative studies were pilot or feasibility studies employing pre- and post-test design with small sample sizes. Studies varied in relation to the type of creative intervention and evaluation methods, which precluded meta-analysis. Large effect sizes were detected in wellbeing measures following singing and art interventions. The qualitative synthesis highlighted that interventions created space for caregivers to make sense of, accept and adapt to their identity as a caregiver. Personal developments, such as learning new skills, were viewed positively by caregivers as well as welcoming the opportunity to gain cognitive and behavioural skills, and having opportunities to unload emotions in a safe space were important to caregivers. Group creative interventions were particularly helpful in creating social connections with their care-recipients and other caregivers. The current review revealed all creative interventions focused on caregivers of people living with dementia; subsequently, this identified gaps in the evidence of creative interventions for informal caregivers of other neurological conditions. There are encouraging preliminary data on music and art interventions, however, little data exists on other art forms, e.g., drama, dance. Creative interventions may appeal to many caregivers, offering a range of psycho-social benefits. The findings of the current review open the way for future research to develop appropriate and creative arts programmes and to test their efficacy with robust tools.N/

University makes me angry: Investigating stimulus-response (S-R) and cognitive-mediation (C-M) emotion beliefs in undergraduate students

Emotion regulation through cognitive reappraisal is well-studied, but less so are the predispositional and superordinate beliefs that influence reappraisal. Recently, researchers developed the cognitive mediation beliefs questionnaire (CMBQ), which measures two emotion beliefs, namely stimulus-response (S-R) generation beliefs and cognitive mediation (C-M) change beliefs. In working populations S-R generation beliefs are inversely related to cognitive reappraisal tendencies and positive mental health, and positively related to emotion reactivity. C-M change beliefs are positively related to cognitive reappraisal tendencies, and inversely related to emotion reactivity and positive mental health. As yet, there is no evidence for the validity of the CMBQ within student samples, or for the associations between its subscales and cognitive reappraisal, emotion reactivity, and positive mental health. Therefore, in the present study the CMBQ is tested for factorial, convergent (associations with cognitive reappraisal), and concurrent (associations with emotion reactivity and positive mental health) validity in a cohort of 621 undergraduate students in the United Kingdom (U.K.). Results indicate support for the factorial and convergent validity of the CMBQ, with mixed evidence for the concurrent validity of the CMBQ. A CM-SR discrepancy score appeared to provide a promising variable when associated with emotion reactivity and positive mental health. The findings are discussed in terms of practical and research implications of the findings