Exploring experiences of care-workers participating in laughter therapy

Abstract

The study seeks to explore the experiences of care workers participating in laughter therapy. Community care workers play a vital role in the support of the HIV/AIDS infected and affected members of the community. However, the nature of this type of work contributes to high levels of emotional distress such as depression, anxiety and stress. The purpose of the study is 1) to explore the effects of working with orphans and vulnerable children (OVC) on the care workers and their experiences of participating in laughter therapy; and 2) the effects of laughter therapy on care workers’ levels of depression and stress. Given that laughter has been found to have several positive effects, many variations of this intervention have been developed. For the purpose of this study, a specific type of laughter therapy was used, namely that of Aerobic Laughter Therapy (ALT). The study was part of a project run by InHappiness Institution and was conducted at Nanga Vhutshilo in Soweto. The care workers at the centre provide care services for orphans and vulnerable children (OVC) affected by the HIV/AIDS epidemic. Purposive sampling was utilised to recruit seven care workers from the centre who participated in a laughter intervention. The study was phenomenological in nature and utilized both qualitative and quantitative methodology. Quantitative data was collected through two questionnaires administered before and after the laughter therapy intervention: The Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS). The Wilcoxon Signed-Rank Test was used to compare pre- and post- results of the scale scores for each participant. Results showed a significant difference between the pre- and post-intervention assessment scores for both Anxiety and Depression (-2.226 (p<0.05) and -1.876 (p<0.05) respectively). In addition, the Wilcoxon signed rank test showed that the post-intervention total scores for PSS were significantly lower than the pre-intervention assessment total scores (-1.863). The significantly lower post-intervention assessment scores show that the laughter therapy intervention produced a positive change with regards to anxiety, depression and stress in the participants. Qualitative data was collected through pre and post –intervention face- to- face semi-structured interviews and were analysed using Interpretative Phenomenological Analysis (IPA). The three themes that emerged from data analysis of the pre-intervention interviews were: motivation to become a care worker, work stresses and coping mechanisms. The five themes that emerged from the post-intervention interviews were: Initial reactions and expectations, effects on interpersonal relationships, improved effective coping ability, collective participation and laughter as a change agent. The study revealed that care workers experience high levels of stress, and anxiety. These emotions manifested in emotional distress in the form of frustrations, exhaustion and feelings of being overwhelmed. Emotional distress was found to be related to care workers’ personal involvement with their clients and high levels of emotional investment in them. Furthermore the study revealed the cyclic link that identification not only contributed to employment in such contexts, but it served to increase levels of personal involvement. Such personal involvement subsequently caused care workers to experience high levels of emotional distress when unable to meet the needs of the community in this respect. Findings from this study support laughter, with specific reference to Aerobic Laughter Therapy (ALT), as a positive therapeutic intervention that can possibly improve behaviour with regards to coping with difficult situations and providing a buffer against the negative effects of stress. However, the sample used in this study was not sufficient to conclusively make a generalised finding.