The effect of laughter yoga on stress and anxiety of nursing students: A systematic review

Objectives Laughter Yoga (LY) is an innovative workout program that integrates simulated laughter with the practice of deep yogic breathing, providing a comprehensive approach to physical well-being. This study aims to examine the impact of laughter yoga on reducing stress and anxiety in nursing students. Design A systematic review is conducted. Data Sources This systematic review used online databases as follow: PubMed, Web of Science, Scopus, and Cochrane Library. A search from the beginning to July 20, 2023, was conducted. Review Methods Medical Subject Headings (MESH) were used for keyword selection along with other target keywords, such as “Laughter Yoga,” “Laughter Therapy,” “Stress,” “Anxiety,” “Angst,” “Hypervigilance,” “Nervousness,” “Anxiousness,” “Pupil Nurse,” and “Nursing Student.” We reviewed and included all English-language publications. The included studies were critically appraised by the Cochrane risk of bias tool. To present the results of the studies, a narrative synthesis is conducted. Results Nine articles with 598 participants met our criteria after reviewing full texts. As a result, nursing students who participated in laughter yoga showed significantly lower stress and anxiety levels. One study evaluated the effectiveness of online laughter yoga, which reduced stress and anxiety after the intervention, although between-group analyses were not significant. It was also found that this intervention leads to the reduction of employment stress. Conclusion Findings support laughter yoga as a cheap and easy way to reduce stress and anxiety in nursing students. It was suggested to design more randomized clinical trials to achieve more certainty. Also, the quality of the primary studies included limited this systematic review.