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Laughter really is among the best medicines, says Air Force nurse

Image of Military personnel laughing. Click to open a larger version of the image. Air Force 1st Lt. Nick Wendt, 492nd Fighter Squadron weapon systems officer, laughs after exiting an aircraft at Łask Air Base, Poland, April 23 (Photo by: Air Force Senior Airman Madeline Herzog).

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| Stress | Nursing in the Military Health System

Most people have heard the phrase "laughter is the best medicine," but Air Force Col. Jacqueline Killian has the scientific proof to back it up.

Killian, a senior nurse scientist for the 711th Human Performance Wing, at Wright-Patterson Air Force Base, Ohio, focused her 2015 Ph.D. research at the Uniformed Services University of the Health Sciences in Bethesda, Maryland on using laughter yoga as an intervention to mitigate the effects of stress on students at USU.

Laughter yoga, she said, is not what people may think of when they think of traditional yoga. Laughter yoga, popularized by Dr. Madan Kataria in the 1990s and early 2000s, is a combination of laughter exercises interspersed with pranayama, or the practice of breath control in yoga.

"The yogic aspect doesn't have to do with yoga poses, it has to do with yogic breathing," Killian said.

Killian monitored the students, all military officers, and graduate students from programs throughout USU, before, during, and after the introduction of laughter yoga, and the results spoke, or perhaps laughed, for themselves.

"I asked participants before, at the two-week mark, and one month out about their perceived stress levels and resilience," said Killian. "I also used the Positive and Negative Affect scale and monitored for depression and anxiety."

The Positive and Negative Affect Schedule is one of the most widely used scales to measure mood or emotion. The scale is comprised of 20 items, with 10 items measuring positive affect (e.g., excited, inspired) and 10 items measuring negative affect (e.g., upset, afraid). Each item is rated on a five-point scale, ranging from 1 (very slightly or not at all) to 5 (extremely), to measure the extent to which the affect has been experienced over a specific time.

She also asked the participants open-ended questions to find out what they thought may be changing because of the laughter yoga. That was the most surprising part for her.

"Some of them reported that they were sleeping better, that they were drinking less alcohol or caffeine, or that they were exercising more," Killian said. "Some reported that family members or colleagues even commented about how much better their attitude was or how much happier they seemed. It was almost like participating in the laughter yoga gave them permission to take care of themselves better."

Among the other results the participants reported were decreased stress levels and increased resilience.

"Over time, once we analyzed the data, we found that just participating in laughter yoga four times, twice a week for two weeks, actually did decrease their perceived stress levels and their negative affect, and it improved their resilience scores and their positive affect, said Killian.

Military personnel laughing
Air Force Staff Sgt. David Brown, 15th Air Support Operations Squadron joint terminal attack controller, laughs after finishing a speed drill during Draco Spear at Moody Air Force Base, Georgia in August 2018 (Photo by: Air Force Senior Airman Janiqua Robinson).

Killian explained that laughter has the dual benefits of being free and easy. It also isn't time-consuming.

"Laughter is a super easy thing to do. We can all laugh, but I think we get stuck focusing on lists of things we have to do, bills we have to pay, tasks that are required at work. We have this constant list of things in our minds that don't allow our minds to rest," she said. "If we just took a minute to try to laugh, even if you're fake laughing, it engages the diaphragm, which is where our vagus nerve sits."

This, she said, is where the science of laughing and its health benefits come into play.

"The vagus nerve activates your parasympathetic nervous system, the 'rest and digest' part of your nervous system, which is the opposite of the 'fight or flight' part of your nervous system so, essentially, you're telling your body to relax when you laugh," said Killian. "If you do that once or twice a day, share a laugh with a friend or a coworker, you immediately feel a sensation of relaxation in your body, whether you're conscious of it or not. It counteracts the chronic stress response."

That means there’s a physiological reason that you feel better when you laugh.

"It's good for your respiratory system, your autonomic nervous system and your mind," Killian said.

Not only is laughter free and easy, Killian said, but it also gets easier with time.

"The great thing about laughing is the more we do it, the easier it is to do," she said.

As National Nurses Week comes to close, Killian said stress management, including using laughter, is extremely important for nurses.

"We do what we can to try to get health care staff to take a little bit of time for self-care and to use their leave so they can recharge their batteries, so to speak, so they can get the rest that is needed, and to spend time with family," she said. "Hopefully now, with vaccination numbers increasing and the hospitalization rate decreasing, we can try to give nurses, health care workers and support personnel some time back to recover."

She said health care, especially within the military, has the potential to be even more stressful because of the obligation that providers feel they have to others.

"As military health care providers, we're programmed to take care of others, almost to our own detriment. Sometimes, we don't take time to take care of ourselves," said Killian. "Nurses Week is a time when we can appreciate the work that nurses and medical technicians do for our communities and remind them that we appreciate them, and we want them to take care of themselves. They are a limited and extremely valuable resource that we celebrate this month.

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