Psychological Effects of a Laughter Yoga and Staff Interaction Program for Older Adults Using Day Care Services After a Major Earthquake

A Non-Randomized Controlled Trial

Abstract

Background: After large-scale disasters, older adults are at increased risk of social isolation and depressive symptoms. Day care services may function as important community-based settings for preventive psychosocial interventions. This study examined the psychological effects of a combined program incorporating laughter yoga and positive staff interaction among older adults using day care services during the post-disaster recovery phase.

Methods: A non-randomized controlled trial was conducted between October 2013 and February 2014 at a public long-term care day service center in I City, M Prefecture, Japan. Participants were 25 older adults (intervention group: n = 14; control group: n = 11). The intervention group participated in a program consisting of facial muscle exercises, laughter yoga sessions, positive verbal interaction with staff, and cool-down activities, delivered at 1–2 week intervals for a total of 8 sessions. Psychological outcomes were assessed before and after the intervention using the Geriatric Depression Scale-15 (GDS-15), the Short Form-8 Health Survey (SF-8™), and the Sense of Coherence Scale-13 (SOC-13). Non-parametric tests were applied due to the small sample size and non-normal data distribution. Effect sizes (Cohen's d) were calculated to evaluate the magnitude of change.

Results: The intervention group showed a significant reduction in depressive symptoms as measured by the GDS-15 compared with the control group (mean change −4.00 vs. −1.91, p = 0.02, d = 1.02). Significant improvements were also observed in three SF-8™ subscales—bodily pain, vitality, and social functioning—with medium to large effect sizes. The physical component summary score (PCS) demonstrated an improvement trend, whereas no significant changes were found in the mental component summary score (MCS) or SOC-13. Correlation analyses revealed that improvements in depressive symptoms were significantly associated with changes in mental health–related quality of life and sense of coherence.

Conclusions: The combined laughter yoga and positive interaction program was associated with reduced depressive symptoms and improvements in selected aspects of health-related quality of life among socially vulnerable older adults after a major disaster. This low-cost, feasible intervention may serve as a practical psychosocial support model in post-disaster community care settings.