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

doi:10.12799/jkachn.2016.27.1.72

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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

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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Abstract

Abstract

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)
Household type	Married children living	23 (56.1)
Smoking	Yes	1 (2.4)
Smoking	No	40 (97.6)
Drinking	Yes	6 (14.6)
Drinking	No	35 (85.4)
Chronic illness	Yes	34 (82.9)
Chronic illness	No	7 (17.1)
Current drug medication	Yes	34 (82.9)
Current drug medication	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)
Stress	Less	22 (53.6)
Exercise	Yes	15 (36.6)
Exercise	No	26 (63.4)
Digestion status	Not changed	37 (90.2)
Digestion status	Hard to digest	4 (9.8)
Self-rated oral health (tooth and gum)	Good	16 (39.0)
Self-rated oral health (tooth and gum)	Bad	25 (61.0)
Denture	Present	25 (61.0)
Denture	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
Self-rated oral health (tooth and gum)	Bad	32.84±11.74	22.60±14.34	-10.24±10.62	1.50	.140
Denture	Present	30.64±12.68	26.87±12.01	-8.60±12.80	-0.35	.724
Denture	Absence	26.87±12.01	19.62±11.16	-7.25±10.08	-0.35	.724
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
Self-rated oral health (tooth and gum)	Bad	6.12±0.83	7.32±0.47	1.20±0.81	-2.06	<.05
Denture	Present	6.12±0.83	7.20±0.50	1.08±0.86	0.79	.434
Denture	Absence	6.44±0.81	7.31±0.47	0.87±0.71	0.79	.434
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
Variables	M±SD	M±SD	t	p
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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