Is kidney dialysis a laughing matter?
For 11,000 Australians kidney dialysis is not something to laugh about. However a good chuckle might well be the best thing for them.
In an Australian first, Deakin University's Associate Professor Paul Bennett is leading a research team that is measuring the impact Laughter Yoga has on the health and wellbeing of patients on dialysis.
"Patients fronting up for dialysis for five hours a day, three times a week are often feeling down and experience lethargy, cramps, low blood pressure, anorexia and needle pain, so laughing is probably the last thing they feel like doing," Associate Professor Bennett said.
"However Laughter Yoga has the potential to improve their mood and general wellbeing. Through this new study we will be measuring the impact Laughter Yoga has on the lung function, mood and wellbeing of patients undergoing treatment at the Monash Health's Moorabbin Dialysis Centre."
Laughter Yoga is based on the theory that voluntary laughter provides the same physiological and psychological benefits as spontaneous laughter including decreasing anxiety and improving mood and blood pressure.
During the sessions patients are taken through 30 minutes of simulated laughing with controlled breathing and short exercises that involve clapping, neck and shoulder stretches, all designed for the limited mobility the patients have while hooked up to dialysis machines.
The patients are guided by Laughter Yoga therapists Merv Neal (of Laughter Yoga Australia) and Ros Ben-Moshe (of Laughlife Wellbeing Programs and La Trobe University).
"We often need laughter the most when we least feel like laughing, so Laughter Yoga is a process created by a doctor in India that allows us to laugh for absolutely no reason," Neal said.
"It is a process that enables people to go through a simulated laughter in the body which then triggers the mind into thinking the body is having a good time so it releases the happy hormones and the laughter becomes real.
"It is very much an aerobic workout too; it gets the blood pumping and oxygen circulating."
Neal said that with the dialysis patients he has also noticed it provides a sense of joy and community in an otherwise isolating environment.
"There is nothing joyful about a dialysis unit as much as the staff make it as good as they possibly can, so for these people to break out and show positive emotion has been profound," Neal said.
"What Laughter Yoga provides is a sense of community. It provides an emotional, mental, physical and spiritual connection within the group. One patient has told me that they love the sense of community in that it brings everyone together because the dialysis unit is a very isolating place in lots of ways.
"It is also bringing the staff in with the patients so it is just as liberating for them being able to bring joy to the workplace and they are finding it a great connection with each other and the patients in a way they have never experienced before."
For 83 year-old Barbara Blackburn, Laughter Yoga has provided a welcome break during treatment.
"I have been on dialysis for 14 years," Blackburn said.
"It makes you feel very tired and when you are on the machine you get very cold.
"It [the Laughter Yoga] has been a good community thing. It's drawing everybody together. The staff are doing it too; I have a lot of laughs watching them do it. It's been very beneficial. I think it will improve our outlook and our lung function."
Ben-Moshe added that there was a universal and inclusive nature to laughter.
"It [the group of dialysis patients] is a very socially and culturally diverse group and some participants have very limited English, yet the universal nature of laughter means that they can all join in. There are not too many activities that are so inclusive," she said.
Associate Professor Bennett (an Alfred Deakin Postdoctoral Research Fellow with the Centre for Nursing Research — a Deakin University Monash Health Partnership) is hoping to detect improved measures of wellbeing, mood, anxiety and lung function in this group.
"These measures are always poorer in the dialysis group than in non-dialysis groups leading to a poorer overall quality of life for people on dialysis," he said.
"Following this study I would like to move on to multi-site national and international trials with the ultimate aim to see Laughter Yoga implemented in all dialysis units throughout Australia and worldwide."
The study is funded by the Graham Burnley Memorial Scholarship through the medical technology company Gambro and administered by the Renal Society of Australasia.