Online vs. face-to-face laughter yoga to support nurses' well-being: A pilot randomized trial

BackgroundLaughter yoga has emerged as a complementary approach with potential benefits for nurses' well-being, particularly among those working in shift-based and demanding clinical settings; however, evidence comparing different delivery formats remains limited.ObjectiveThis study aimed to comparatively evaluate the feasibility and preliminary outcomes of online and face-to-face laughter yoga interventions on perceived stress, sleep quality, and burnout among nurses.MethodsThis three-group pilot randomized controlled trial was conducted at a public hospital between April 2024 and February 2025. A total of 47 nurses were randomly assigned to a face-to-face intervention group, an online intervention group, or a control group. The intervention consisted of four laughter yoga sessions delivered over a two-week period. Data were collected at baseline and postintervention using the Perceived Stress Scale, Jenkins Sleep Scale, and Maslach Burnout Inventory. Statistical analyses included repeated-measures analysis of variance, paired-samples t-tests, and effect size calculations.ResultsNo significant between-group or within-group differences were observed in perceived stress levels. Nurses in the online laughter yoga group demonstrated significant improvements in sleep quality (p = 0.009), emotional exhaustion (p = 0.006), and personal accomplishment (p = 0.006), with large effect sizes. No significant changes were found in the face-to-face or control groups.ConclusionsOnline laughter yoga demonstrated promising preliminary effects on sleep quality and burnout-related symptoms among nurses; however, further studies with larger samples are needed, with efforts to reduce technical barriers such as internet access and connectivity issues.Trial registrationClinicalTrials.gov, TRN: NCT06350747. Registered 18 March 2024. https://clinicaltrials.gov/study/NCT06350747.