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HOME > J Korean Acad Community Health Nurs > Volume 27(1); 2016 > Article
Original Article
The Effect of Subjective Xerostomia and Salivary pH in Salivary Glands Stimulated by Laughter Therapy in Frail Elderly Women
Sun Young Lim, Kyem Ju Lee, Su Jin Kim
Journal of Korean Academy of Community Health Nursing 2016;27(1):72-80.
DOI: https://doi.org/10.12799/jkachn.2016.27.1.72
Published online: March 31, 2016

1College of Nursing, Korea University, Seoul, Korea.

2Department of Nursing, Baekseok Culture University, Cheonan, Korea.

• Received: January 26, 2016   • Revised: March 16, 2016   • Accepted: March 23, 2016

© 2016 Korean Academy of Community Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to identify the effect of subjective xerostomia and salivary pH in salivary glands stimulated by laughter therapy in frail elderly women.
  • Methods
    The research used a one-group pretest-posttest design. Data were collected from July 2, 2015 to September 30, 2015. A sample of 41 frail female elderly patients was recruited at A Nursing Home in K City, Korea. We measured xerostomia and salivary pH using a questionnaire and BCP test paper (pH 5.6~7.2). Laughter therapy was given once a week for four weeks (3 items). Data were analyzed through descriptive statistics, independent t-test, ANOVA, paired t-test and Cronbach's using the SPSS 18.0 program.
  • Results
    There were significant differences in salivary pH according to oral health (t=-2.06, p<.05). There were significant differences in xerostomia (t=4.41, p<.001) and salivary pH (t=-7.94, p<.001) after salivary glands stimulated by laughter therapy.
  • Conclusion
    Salivary glands stimulated by laughter therapy improved xerostomia and salivary pH of the frail elderly. Therefore, salivary glands stimulated by laughter therapy may be useful in promoting and maintaining oral health among the frail elderly in the rapidly increasing population of old people.
  • Key Words: Frail elder; Xerostomia; Salivary gland
Table 1

Contents of Laughter Therapy Program

Stage Contents Duration (min)
Introduction
Open mind		 Self introduction, 10
Friendship
Various greeting methods
Stretch of laughter muscle
Main stage Part 1: Laughter, what is laughter therapy? 40
  Effects of laughter
Part 2: Stretch of laughter face muscle
Part 3: Applause with laughter
Part 4: Stimulate excercise of salivary gland
  Strengthening exercise (gingiva, tongue, cheek)
  Execute gingiva message
  Execute tongue exercise
  Execute cheek stretching
Finish stage Deep respiration 10
Warm-up (neck exercise, shoulder exercise)
To say feeling
Table 2

The General Characteristics and Oral related Health (N=41)

Characteristics Categories n (%) or M±SD
Age (year) 82.12±5.17
65~69 1 (2.4)
70~79 13 (31.7)
80~89 23 (56.1)
≥90 4 (9.8)
Household type Alone 18 (43.9)
Married children living 23 (56.1)
Smoking Yes 1 (2.4)
No 40 (97.6)
Drinking Yes 6 (14.6)
No 35 (85.4)
Chronic illness Yes 34 (82.9)
No 7 (17.1)
Current drug medication Yes 34 (82.9)
No 7 (17.1)
Water drinking (cups/day) ≤2 2.44±0.89
3~4 6 (14.6)
5~6 16 (39.0)
≥7 14 (34.1)
5 (12.2)
Stress A lot of 19 (46.4)
Less 22 (53.6)
Exercise Yes 15 (36.6)
No 26 (63.4)
Digestion status Not changed 37 (90.2)
Hard to digest 4 (9.8)
Self-rated oral health (tooth and gum) Good 16 (39.0)
Bad 25 (61.0)
Denture Present 25 (61.0)
Absence 16 (39.0)
Natural teeth 2.41±1.22
Nothing 12 (29.3)
<10 13 (31.7)
10~19 3 (7.3)
≥20 13 (31.7)
Table 3

Subjective Xerostomia according to Oral related Health Characteristics by Laughter Therapy (N=41)

Variables Categories Xerostomia t or F p
Pretest Posttest Difference
M±SD M±SD M±SD
Self-rated oral health (tooth and gum) Good 23.43±11.51 18.75±9.50 -4.68±12.83 1.50 .140
Bad 32.84±11.74 22.60±14.34 -10.24±10.62
Denture Present 30.64±12.68 26.87±12.01 -8.60±12.80 -0.35 .724
Absence 26.87±12.01 19.62±11.16 -7.25±10.08
Natural teeth Nothing 29.41±9.85 24.75±13.28 -4.66±11.99 1.95 .138
<10 31.92±11.48 18.00±7.51 -13.92±12.08
10~19 28.33±19.50 27.33±19.42 -1.00±3.60
≥20 26.38±14.56 19.38±14.82 -7.00±10.68
Table 4

Salivary pH according to Oral related Health Characteristics by Laughter Therapy (N=41)

Variables Categories Salivary pH t or F p
Pretest Posttest Difference
M±SD M±SD M±SD
Self-rated oral health (tooth and gum) Good 6.44±0.81 7.13±0.50 0.68±0.70 -2.06 <.05
Bad 6.12±0.83 7.32±0.47 1.20±0.81
Denture Present 6.12±0.83 7.20±0.50 1.08±0.86 0.79 .434
Absence 6.44±0.81 7.31±0.47 0.87±0.71
Natural teeth Nothing 6.17±0.83 7.25±0.45 1.08±0.79 0.27 .842
<10 6.23±0.83 7.15±0.55 0.92±0.95
10~19 6.00±1.00 7.33±0.57 1.33±0.57
≥20 6.38±0.87 7.31±0.48 0.92±0.75
Table 5

Xerostomia, Salivary pH by Laughter Therapy (N=41)

Variables Pretest Posttest t p
M±SD M±SD
Xerostomia 29.17±12.41 21.09±12.07 4.41 <.001
Salivary pH 6.24±0.83 7.24±0.48 -7.94 <.001

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    • Factors Affecting the Intention to Participate in Healthcare Programs among Elders Living Alone
      Mi Sook Song, Sunjoo Boo
      Journal of Korean Academy of Community Health Nursing.2016; 27(4): 319.     CrossRef

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    The Effect of Subjective Xerostomia and Salivary pH in Salivary Glands Stimulated by Laughter Therapy in Frail Elderly Women
    The Effect of Subjective Xerostomia and Salivary pH in Salivary Glands Stimulated by Laughter Therapy in Frail Elderly Women
    Stage Contents Duration (min)
    Introduction
    Open mind    		 Self introduction, 10
    Friendship
    Various greeting methods
    Stretch of laughter muscle
    Main stage Part 1: Laughter, what is laughter therapy? 40
      Effects of laughter
    Part 2: Stretch of laughter face muscle
    Part 3: Applause with laughter
    Part 4: Stimulate excercise of salivary gland
      Strengthening exercise (gingiva, tongue, cheek)
      Execute gingiva message
      Execute tongue exercise
      Execute cheek stretching
    Finish stage Deep respiration 10
    Warm-up (neck exercise, shoulder exercise)
    To say feeling
    Characteristics Categories n (%) or M±SD
    Age (year) 82.12±5.17
    65~69 1 (2.4)
    70~79 13 (31.7)
    80~89 23 (56.1)
    ≥90 4 (9.8)
    Household type Alone 18 (43.9)
    Married children living 23 (56.1)
    Smoking Yes 1 (2.4)
    No 40 (97.6)
    Drinking Yes 6 (14.6)
    No 35 (85.4)
    Chronic illness Yes 34 (82.9)
    No 7 (17.1)
    Current drug medication Yes 34 (82.9)
    No 7 (17.1)
    Water drinking (cups/day) ≤2 2.44±0.89
    3~4 6 (14.6)
    5~6 16 (39.0)
    ≥7 14 (34.1)
    5 (12.2)
    Stress A lot of 19 (46.4)
    Less 22 (53.6)
    Exercise Yes 15 (36.6)
    No 26 (63.4)
    Digestion status Not changed 37 (90.2)
    Hard to digest 4 (9.8)
    Self-rated oral health (tooth and gum) Good 16 (39.0)
    Bad 25 (61.0)
    Denture Present 25 (61.0)
    Absence 16 (39.0)
    Natural teeth 2.41±1.22
    Nothing 12 (29.3)
    <10 13 (31.7)
    10~19 3 (7.3)
    ≥20 13 (31.7)
    Variables Categories Xerostomia t or F p
    Pretest Posttest Difference
    M±SD M±SD M±SD
    Self-rated oral health (tooth and gum) Good 23.43±11.51 18.75±9.50 -4.68±12.83 1.50 .140
    Bad 32.84±11.74 22.60±14.34 -10.24±10.62
    Denture Present 30.64±12.68 26.87±12.01 -8.60±12.80 -0.35 .724
    Absence 26.87±12.01 19.62±11.16 -7.25±10.08
    Natural teeth Nothing 29.41±9.85 24.75±13.28 -4.66±11.99 1.95 .138
    <10 31.92±11.48 18.00±7.51 -13.92±12.08
    10~19 28.33±19.50 27.33±19.42 -1.00±3.60
    ≥20 26.38±14.56 19.38±14.82 -7.00±10.68
    Variables Categories Salivary pH t or F p
    Pretest Posttest Difference
    M±SD M±SD M±SD
    Self-rated oral health (tooth and gum) Good 6.44±0.81 7.13±0.50 0.68±0.70 -2.06 <.05
    Bad 6.12±0.83 7.32±0.47 1.20±0.81
    Denture Present 6.12±0.83 7.20±0.50 1.08±0.86 0.79 .434
    Absence 6.44±0.81 7.31±0.47 0.87±0.71
    Natural teeth Nothing 6.17±0.83 7.25±0.45 1.08±0.79 0.27 .842
    <10 6.23±0.83 7.15±0.55 0.92±0.95
    10~19 6.00±1.00 7.33±0.57 1.33±0.57
    ≥20 6.38±0.87 7.31±0.48 0.92±0.75
    Variables Pretest Posttest t p
    M±SD M±SD
    Xerostomia 29.17±12.41 21.09±12.07 4.41 <.001
    Salivary pH 6.24±0.83 7.24±0.48 -7.94 <.001
    Table 1 Contents of Laughter Therapy Program

    Table 2 The General Characteristics and Oral related Health (N=41)

    Table 3 Subjective Xerostomia according to Oral related Health Characteristics by Laughter Therapy (N=41)

    Table 4 Salivary pH according to Oral related Health Characteristics by Laughter Therapy (N=41)

    Table 5 Xerostomia, Salivary pH by Laughter Therapy (N=41)

    Table 1

    Table 2

    Table 3

    Table 4

    Table 5

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