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NCT Number: NCT07235735

The Effect of Laughter Yoga on Individual and Organizational Outcomes in Nurse Managers

The goal of this clinical trial is to learn if laughter yoga can improve both individual and organizational outcomes in nurse managers. The main questions it aims to answer are:

* Does laughter yoga lower burnout and stress levels in nurse managers? * Does laughter yoga improve work-life quality and job performance? * Does laughter yoga help nurse managers make better decisions and solve problems more effectively? * Does laughter yoga lower compassion fatigue and support positive approaches to workplace conflict? Researchers will compare a laughter yoga group with a control group to see if there are meaningful differences.

Participants will:

* Join structured laughter yoga sessions for a defined period (weekly sessions). * Complete surveys before and after the program about stress, burnout, work-life quality, decision-making, problem solving, job performance, compassion fatigue, and conflict approaches. * Continue their usual work while attending sessions.

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Key information

About this study

Nurse managers play a vital role in healthcare systems by ensuring the quality of nursing services, supporting staff, coordinating care, and solving organizational problems. However, the combination of administrative responsibilities, staff shortages, and high expectations often leads to stress, burnout, compassion fatigue, and difficulties in maintaining work-life balance. These conditions not only affect the individual health and well-being of nurse managers but also reduce team motivation, patient care quality, and overall organizational performance.

Laughter yoga is a mind-body practice that combines intentional laughter with breathing exercises. It does not rely on humor or jokes; instead, participants engage in guided group exercises that promote spontaneous and prolonged laughter. Scientific evidence suggests that laughter yoga can lower stress hormones, increase endorphins, improve mood, and strengthen social bonds. Although laughter yoga has been studied in various populations, there is a lack of randomized controlled trials (RCTs) specifically focusing on nurse managers and their professional challenges.

This randomized controlled trial aims to fill this gap by evaluating the individual and organizational outcomes of laughter yoga among nurse managers working in university and state hospitals.

The expected contribution of this study is to provide new evidence on a cost-effective, non-pharmacological intervention that can be easily integrated into hospital settings. If laughter yoga proves effective, it can be adopted as a sustainable strategy to support nurse managers' mental health, enhance their leadership capacity, and indirectly improve patient care and organizational outcomes.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Currently working as a nurse manager
  • Having at least six months of managerial experience
  • Continuing to serve as a nurse manager throughout the study period

Exclusion criteria

  • Having previously received laughter yoga training
  • Use of medications affecting general health components during the study (e.g., for depression, anxiety)
  • Being pregnant
  • Experiencing an acute stressful life event, such as the death of a close relative
  • Having undergone abdominal surgery within the past 6 months

Treatment and study plan

Laughter Yoga Program

Behavioral

This intervention consists of a structured Laughter Yoga Program designed for nurse managers. Each session includes breathing exercises, warm-up activities, guided and simulated laughter exercises (such as clapping, chanting, role-play laughter), and a short relaxation/meditation phase. Sessions are conducted in small groups by a certified facilitator. The program is delivered twice weekly for 8 weeks, with each session lasting approximately 30-45 minutes. The intervention is intended to reduce burnout, stress, and compassion fatigue, while improving decision-making, problem-solving, job performance, and work-life balance.

Other names: Laughter Therapy;, Laughter Exercises

Primary outcomes

  1. Perceived Stress (Perceived Stress Scale - PSS)

    Time frame: Baseline, 8 weeks, 3 months.

    Developed by Cohen & Williamson, adapted to Turkish by Eskin in 2013. 14 items, single-factor measure of stress.

    Scale Range: 0-56. Interpretation Higher scores = greater perceived stress (worse outcome).

  2. Burnout Levels (Maslach Burnout Inventory - MBI)

    Time frame: Baseline, immediately post-intervention (8 weeks), and follow-up (3 months after intervention).

    Developed by Maslach & Jackson in 1986, adapted to Turkish by Ergin in1992. 22 items, three subscales: Emotional Exhaustion, Depersonalization, and Personal Accomplishment.

    Scale Range: Emotional Exhaustion (0-54), Depersonalization (0-30), Personal Accomplishment (0-48).

    Interpretation: Higher Emotional Exhaustion and Depersonalization scores = worse outcome; higher Personal Accomplishment scores = better outcome.

Secondary outcomes

  1. Problem Solving Inventory

    Time frame: Baseline, 8 weeks, 3 months

    Problem Solving Inventory, Developed by Heppner & Peterson in1982; adapted to Turkish by Şahin in 1993

    Description: 31 items, six subscales: Problem-Solving Confidence, Approach-Avoidance, Personal Control, Planfulness, Impulsivity, Reflective Style.

    Scale Range: 31-186. Interpretation: Higher scores = less effective problem solving (worse outcome); lower scores = better problem-solving skills.

  2. Work Performance

    Time frame: Baseline, 8 weeks, 3 months.

    Work Performance Job Performance Scale - Goodman and Svyantek in 1999; Turkish adaptation was made in 2014 by Bağcı.

    Description: 25 items, two subscales: Task Performance and Contextual Performance.

    Scale Range: 25-125. Interpretation: Higher scores = better work performance.

  3. Compassion Fatigue

    Time frame: Baseline, 8 weeks, 3 months

    Developed by Dennis Portnoy and adapted Turkısh by Özdemir and Kutlu in 2022. The form consists of 40 items. The scale, which has no sub-dimensions, is evaluated based on the total number of items. The scale is a 3-point Likert-type scale: 1 = Very true, 2 = Partly true, and 3 = Rarely true. Those who answered "Very true" to 15 or more items in total are considered to have high levels of compassion fatigue.Cronbach alpha is 0,87

  4. Decision-Making Styles scale

    Time frame: Baseline, 8 weeks, 3 months.

    Developed by Scott and Bruce in 1995; adapted to Turkish by Yılmaz Kuşaklı in 2023

    24 items, five subscales: Rational, Intuitive, Dependent, Avoidant, Spontaneous.

    Scale Range: 24-120. Interpretation: Higher scores in each subscale = more frequent use of that decision-making style

Study contacts

Contact information is provided by the study sponsor or research team.

Handan ALAN, Assoc.Prof.

CONTACT

[email protected]

+905321709457

Serpil SUBAŞI ÇAĞLAR, PhDCandidate

CONTACT

[email protected]

+905321709457

Sponsors and collaborators

Lead sponsor

Zonguldak Bulent Ecevit University

Other

Registry information

Official study title

The Effect of Laughter Yoga on Individual and Organizational Outcomes in Nurse Managers: A Longitudinal Study

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Nov 19, 2025
Registry last updated
Nov 19, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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