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Ağrı Yönetiminde Alternatif Bir Yaklaşım: Kahkaha Terapisi

Year 2021, Volume: 11 Issue: 1, 108 - 114, 21.01.2021
https://doi.org/10.33631/duzcesbed.773239

Abstract

Ağrı, Uluslararası Ağrı Araştırmaları Birliği tarafından “vücudun belli bir bölgesinden kaynaklanan, doku harabiyetine bağlı olan veya olmayan bireyin geçmişteki deneyimleriyle ilgili istenmedik bir duysal, emosyonel ve hoş olmayan bir duyum ya da davranış şekli” olarak tanımlanmıştır. Ağrı için farmakolojik ve nonfarmakolojik tedavi yöntemleri bulunmaktadır. Nonfarmakolojik ağrı tedavi yöntemleri; ağrı eğitim programları, egzersiz tedavileri, transkutanöz elektrik stimülasyonu, kognitif-davranışsal terapiler, akupunktur, masaj teknikleri, sıcak-soğuk uygulamalar ve relaksasyon egzersizlerini içermektedir. Ağrı yönetiminde kullanılan bilişsel-davranışsal stratejiler; hipnozu, relaksasyon tekniklerini ve distraksiyonu içermektedir. Kahkaha yaklaşımı ise ağrı yönetiminde kullanılan distraksiyon tekniklerinden biridir. Çalışmalarda kahkahanın, romatizmal hastalıklar, diabetes mellitus, alerjik yanıtlar, bağışıklık sistemi, kardiyopulmoner rahatsızlıklar, kanserler, yaşlılıkla gelişen problemler ve ağrı üzerine iyileştirici etkileri incelenmiştir. Ağrı yönetiminde kullanılan non-farmakolojik tedavi yöntemlerinden biri de kahkaha terapisidir. Ancak ülkemizde literatüre göre kahkaha terapisinin ağrı yönetimindeki yeri ve önemini açıklayan yeterli çalışmaya rastlanmamıştır. Bu nedenle derlemenin amacı; ağrı ve kahkaha terapisi kavramları ile kahkaha terapisinin ağrı yönetiminde kullanımını ve ağrı üzerindeki etkilerini incelemektir.

Supporting Institution

yoktur.

Project Number

yoktur

References

  • 1. Henschke N, Kamper SJ, Maher CG. The epidemiology and economic consequences of pain. Mayo Clinic Proceedings. 2015; 90(1): 139-47. doi: 10.1016/j.mayocp.2014.09.010.
  • 2. Loeser JD, Treede RD. The Kyoto protocol of IASP basic pain terminology. Pain. 2008; 137(3): 473-7. doi: 10.1016/j.pain.2008.04.025.
  • 3. WHO. WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. Geneva: World Health Organization; 2018.
  • 4. Saastamoinen P, Leino-Arjas P, Laaksonen M, Lahelma E. Socio-economic differences in the prevalence of acute, chronic and disabling chronic pain among ageing employees. Pain. 2005; 114(3): 364-71. doi: 10.1016/j.pain.2004.12.033.
  • 5. Erdine S, Hamzaoğlu O, Özkan Ö, Balta E, Domaç M. Türkiye’de erişkinlerin ağrı prevalansı. Ağrı. 2001; 13(2): 22-30.
  • 6. Altınel L, Köse KC, Ergan V, Işık C, Aksoy Y, Özdemir A, et al. The prevalence of low back pain and risk factors among adult population in Afyon region, Turkey. Acta Orthop Traumatol Turc. 2008; 42(5): 328-33. doi: 10.3944/aott.2008.328.
  • 7. King S, Chambers CT, Huguet A, MacNevin RC, McGrath PJ, Parker L, et al. The epidemiology of chronic pain in children and adolescents revisited: A systematic review. Pain. 2011; 152(12): 2729-38. doi: 10.1016/j.pain.2011.07.016.
  • 8. Swain MS, Henschke N, Kamper SJ, Gobina I, Ottová-Jordan V, Maher CG. An international survey of pain in adolescents. BMC Public Health. 2014; 14(1): 447. doi: 10.1186/1471-2458-14-447.
  • 9. Thomas MJ, Roddy E, Zhang W, Menz HB, Hannan MT, Peat GM. The population prevalence of foot and ankle pain in middle and old age: A systematic review. Pain. 2011; 152(12): 2870-80. doi: 10.1016/j.pain.2011.09.019.
  • 10. Abdulla A, Bone M, Adams N, Elliott AM, Jones D, Knaggs R, et al. Evidence-based clinical practice guidelines on management of pain in older people. Age and Ageing. 2013; 42(2): 151‐3. doi: 10.1093/ageing/afs199.
  • 11. McBeth J, Jones K. Epidemiology of chronic musculoskeletal pain. Best Practice & Research Clinical Rheumatology. 2007; 21(3): 403-25. doi: 10.1016/j.berh.2007.03.003.
  • 12. Elzahaf RA, Tashani OA, Unsworth BA, Johnson MI. The prevalence of chronic pain with an analysis of countries with a Human Development Index less than 0.9: A systematic review without meta-analysis. Current Medical Research and Opinion. 2012; 28(7): 1221-9. doi: 10.1185/03007995.2012.703132.
  • 13. Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Practice & Research Clinical Rheumatology. 2010; 24(6): 769-81. doi: 10.1016/j.berh.2010.10.002.
  • 14. Côté P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, et al. The burden and determinants of neck pain in workers: Results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Spine. 2008; 33(4): 60-74. doi: 10.1097/BRS.0b013e3181643ee4.
  • 15. Kuru T, Yeldan İ, Zengin A, Kostanoğlu A, Tekeoğlu A, Akbaba YA, ve ark. Erişkinlerde ağrı ve farklı ağrı tedavilerinin prevalansı. Ağrı. 2011; 23(1): 22-7. doi: 10.5505/agri.2011.40412.
  • 16. Parsons S, Breen A, Foster N, Letley L, Pincus T, Vogel S, et al. Prevalence and comparative troublesomeness by age of musculoskeletal pain in different body locations. Family Practice. 2007; 24(4): 308-16. doi: 10.1093/fampra/cmm027.
  • 17. Davis GC, White TL. Nursing's role in chronic pain management with older adults. Topics in Geriatric Rehabilitation. 2001; 16(3): 45-55.
  • 18. Tse MM, Lo AP, Cheng TL, Chan EK, Chan AH, Chung HS. (2010). Humor therapy: Relieving chronic pain and enhancing happiness for older adults. Journal of Aging Research. 2010: 1-9. doi: 10.4061/2010/343574.
  • 19. Moodi H, Hassanzadeh Taheri MM, Fateme S, Fatemi S, Hosseini M, Akbari A, et al. Evaluating the impact of laughter therapy on hope, self-efficacy, and pain control in patients with chronic low back pain. Pharmacophore. 2017; 8(6): 7. doi: 10.15171/mejdd.2019.151.
  • 20. Melzack R, Wall PD. Pain mechanisms: A new theory. Science. 1965; 150(3699): 971-9.
  • 21. Ryu KH, Shin HS, Yang EY. Effects of laughter therapy on immune responses in postpartum women. The Journal of Alternative and Complementary Medicine. 2015; 21(12): 781-8. doi: 10.1089/acm.2015.0053.
  • 22. Brutsche MH, Grossman P, Müller RE, Wiegand J. Impact of laughter on air trapping in severe chronic obstructive lung disease. International Journal of Chronic Obstructive Pulmonary Disease. 2008; 3(1): 185. doi: 10.2147/copd.s2204.
  • 23. Kim S, Kim Y, Kim H. Laughter and stress relief in cancer patients: A pilot study. Evidence-Based Complementary and Alternative Medicine. 2015; 1-6. doi: 10.1155/2015/864739.
  • 24. Hirosaki M, Ohira T, Kajiura M, Kiyama M, Kitamura A, Sato S, et al. Effects of a laughter and exercise program on physiological and psychological health among community‐dwelling elderly in Japan: Randomized controlled trial. Geriatrics & Gerontology International. 2013; 13(1): 152-60. doi:10.1111/j.1447-0594.2012.00877.x.
  • 25. Yazdani M, Esmaeilzadeh M, Pahlavanzadeh S, Khaledi F. The effect of laughter yoga on general health among nursing students. Iran J Nurs Midwifery Res. 2014; 19: 36-40.
  • 26. laughteryoga.org [Internet]. Bangalore: Laughter Yoga University [Updated: 2019; Cited: 2019 May 19]. Available from: https://laughteryoga.org/laughter -yoga/about-laughter-yoga/
  • 27. Kataria M. Laughter yoga: Daily laughter practices for health and happiness. India: Penguin Random House India Private Limited; 2018.
  • 28. Ripoll RM, Casado IQ. Laughter and positive therapies: Modern approach and practical use in medicine. Rev Psiquiatr Salud Ment. 2010; 3(1): 27-34. doi: 10.1016/S1888-9891(10)70006-9.
  • 29. Weisenberg M, Tepper I, Schwarzwald J. Humor as a cognitive technique for increasing pain tolerance. Pain. 1995; 63(2): 207-12. doi: 10.1016/0304-3959(95)00046-u.
  • 30. Ko YJ, Hyun MY. Effects of laughter therapy on pain, depression, and quality of life of elderly people with osteoarthritis. J Korean Acad Psychiatr Ment Health Nurs. 2013; 22(4): 359-67. doi: 10.12934/jkpmhn.2013.22.4.359.
  • 31. Hallberg LRM, Carlsson SG. Psychosocial vulnerability and maintaining forces related to fibromyalgia. Scandinavian Journal of Caring Sciences. 1998; 12(2): 95-103. doi: 10.1111/j.1471-6712.1998.tb00482.x.
  • 32. Auerbach S, Hofmann J, Platt T, Ruch WF. An investigation of the emotions elicited by hospital clowns in comparison to circus clowns and nursing staff. The European Journal of Humour Research. 2014; 1(3): 26-53. doi: 10.7592/EJHR2013.1.3.auerbach.
  • 33. Bodnar RJ, Klein GE. Endogenous opiates and behavior: 2005. Peptides. 2006; 27(12): 3391-478. doi: 10.1016/j.peptides.2006.07.011.
  • 34. Johnson MH. How does distraction work in the management of pain? Current Pain and Headache Reports. 2005; 9(2): 90-5. doi: 10.1007/s11916-005-0044-1.
  • 35. Kuiper NA. Humor and resiliency: Towards a process model of coping and growth. Europe's Journal of Psychology. 2012; 8(3): 475-91. doi: 10.5964/ejop.v8i3.464.
  • 36. Cann A, Collette C. Sense of humor, stable affect, and psychological well‐being. Europe's Journal of Psychology. 2014; 10(3): 464-79. doi: 10.5964/ejop.v10i3.746.
  • 37. Sturgeon JA, Zautra AJ. Social pain and physical pain: Shared paths to resilience. Pain Management. 2016; 6(1): 63-74. doi: 10.2217/pmt.15.56.
  • 38. Brown A, Jeffrey C, Moyle D. Laughter yoga therapy in haemodialysis: One unit’s experience. Renal Society of Australasia Journal. 2019; 15: 38-46.
  • 39. Lee KI, Eun Y. Effect of laugher therapy on pain, depression and sleep with elderly patients in long term care facility. Journal of Muscle and Joint Health. 2011; 18(1): 28-38. doi: 10.15171/mejdd.2019.151.
  • 40. Yu JA, Kim KS. Effects of laughter therapy on stress response and pain of military personnel with low back pain in hospital. Journal of Muscle and Joint Health. 2009; 16(1): 36-45. doi: 10.1155/2015/864739.

An Alternative Approach in Pain Management: Laughter Therapy

Year 2021, Volume: 11 Issue: 1, 108 - 114, 21.01.2021
https://doi.org/10.33631/duzcesbed.773239

Abstract

Pain is defined by The International Association for the Study of Pain as an “unpleasant sensory, emotional and sensation or behavior pattern related to the past experiences of the individual associated with actual or potential tissue damage, originating from a certain part of the body”. There are pharmacological and nonpharmacological treatment methods for pain. Nonpharmacological treatment methods include pain training programs, exercise therapies, transcutaneous electrical stimulation, cognitive-behavioral therapies, acupuncture, massage techniques, hot-cold treatments, and relaxation exercises. Cognitive-behavioral strategies used in pain management are hypnosis, relaxation techniques, distraction. The laughter approach is one of the distraction techniques used in pain management. In the studies, the effects of laughter on rheumatic diseases, diabetes mellitus, allergic responses, immune system, cardiopulmonary disorders, cancers, aging problems, and pain were investigated. One of the non-pharmacological treatment methods used in pain management is laughter therapy. However, according to literature in our country, there are not enough studies that explain the place and importance of laughter therapy in pain management. Therefore, the purpose of the article; to review the concepts of pain and laughter therapy, laughter therapy in pain management, and its effects on pain.

Project Number

yoktur

References

  • 1. Henschke N, Kamper SJ, Maher CG. The epidemiology and economic consequences of pain. Mayo Clinic Proceedings. 2015; 90(1): 139-47. doi: 10.1016/j.mayocp.2014.09.010.
  • 2. Loeser JD, Treede RD. The Kyoto protocol of IASP basic pain terminology. Pain. 2008; 137(3): 473-7. doi: 10.1016/j.pain.2008.04.025.
  • 3. WHO. WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. Geneva: World Health Organization; 2018.
  • 4. Saastamoinen P, Leino-Arjas P, Laaksonen M, Lahelma E. Socio-economic differences in the prevalence of acute, chronic and disabling chronic pain among ageing employees. Pain. 2005; 114(3): 364-71. doi: 10.1016/j.pain.2004.12.033.
  • 5. Erdine S, Hamzaoğlu O, Özkan Ö, Balta E, Domaç M. Türkiye’de erişkinlerin ağrı prevalansı. Ağrı. 2001; 13(2): 22-30.
  • 6. Altınel L, Köse KC, Ergan V, Işık C, Aksoy Y, Özdemir A, et al. The prevalence of low back pain and risk factors among adult population in Afyon region, Turkey. Acta Orthop Traumatol Turc. 2008; 42(5): 328-33. doi: 10.3944/aott.2008.328.
  • 7. King S, Chambers CT, Huguet A, MacNevin RC, McGrath PJ, Parker L, et al. The epidemiology of chronic pain in children and adolescents revisited: A systematic review. Pain. 2011; 152(12): 2729-38. doi: 10.1016/j.pain.2011.07.016.
  • 8. Swain MS, Henschke N, Kamper SJ, Gobina I, Ottová-Jordan V, Maher CG. An international survey of pain in adolescents. BMC Public Health. 2014; 14(1): 447. doi: 10.1186/1471-2458-14-447.
  • 9. Thomas MJ, Roddy E, Zhang W, Menz HB, Hannan MT, Peat GM. The population prevalence of foot and ankle pain in middle and old age: A systematic review. Pain. 2011; 152(12): 2870-80. doi: 10.1016/j.pain.2011.09.019.
  • 10. Abdulla A, Bone M, Adams N, Elliott AM, Jones D, Knaggs R, et al. Evidence-based clinical practice guidelines on management of pain in older people. Age and Ageing. 2013; 42(2): 151‐3. doi: 10.1093/ageing/afs199.
  • 11. McBeth J, Jones K. Epidemiology of chronic musculoskeletal pain. Best Practice & Research Clinical Rheumatology. 2007; 21(3): 403-25. doi: 10.1016/j.berh.2007.03.003.
  • 12. Elzahaf RA, Tashani OA, Unsworth BA, Johnson MI. The prevalence of chronic pain with an analysis of countries with a Human Development Index less than 0.9: A systematic review without meta-analysis. Current Medical Research and Opinion. 2012; 28(7): 1221-9. doi: 10.1185/03007995.2012.703132.
  • 13. Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Practice & Research Clinical Rheumatology. 2010; 24(6): 769-81. doi: 10.1016/j.berh.2010.10.002.
  • 14. Côté P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, et al. The burden and determinants of neck pain in workers: Results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Spine. 2008; 33(4): 60-74. doi: 10.1097/BRS.0b013e3181643ee4.
  • 15. Kuru T, Yeldan İ, Zengin A, Kostanoğlu A, Tekeoğlu A, Akbaba YA, ve ark. Erişkinlerde ağrı ve farklı ağrı tedavilerinin prevalansı. Ağrı. 2011; 23(1): 22-7. doi: 10.5505/agri.2011.40412.
  • 16. Parsons S, Breen A, Foster N, Letley L, Pincus T, Vogel S, et al. Prevalence and comparative troublesomeness by age of musculoskeletal pain in different body locations. Family Practice. 2007; 24(4): 308-16. doi: 10.1093/fampra/cmm027.
  • 17. Davis GC, White TL. Nursing's role in chronic pain management with older adults. Topics in Geriatric Rehabilitation. 2001; 16(3): 45-55.
  • 18. Tse MM, Lo AP, Cheng TL, Chan EK, Chan AH, Chung HS. (2010). Humor therapy: Relieving chronic pain and enhancing happiness for older adults. Journal of Aging Research. 2010: 1-9. doi: 10.4061/2010/343574.
  • 19. Moodi H, Hassanzadeh Taheri MM, Fateme S, Fatemi S, Hosseini M, Akbari A, et al. Evaluating the impact of laughter therapy on hope, self-efficacy, and pain control in patients with chronic low back pain. Pharmacophore. 2017; 8(6): 7. doi: 10.15171/mejdd.2019.151.
  • 20. Melzack R, Wall PD. Pain mechanisms: A new theory. Science. 1965; 150(3699): 971-9.
  • 21. Ryu KH, Shin HS, Yang EY. Effects of laughter therapy on immune responses in postpartum women. The Journal of Alternative and Complementary Medicine. 2015; 21(12): 781-8. doi: 10.1089/acm.2015.0053.
  • 22. Brutsche MH, Grossman P, Müller RE, Wiegand J. Impact of laughter on air trapping in severe chronic obstructive lung disease. International Journal of Chronic Obstructive Pulmonary Disease. 2008; 3(1): 185. doi: 10.2147/copd.s2204.
  • 23. Kim S, Kim Y, Kim H. Laughter and stress relief in cancer patients: A pilot study. Evidence-Based Complementary and Alternative Medicine. 2015; 1-6. doi: 10.1155/2015/864739.
  • 24. Hirosaki M, Ohira T, Kajiura M, Kiyama M, Kitamura A, Sato S, et al. Effects of a laughter and exercise program on physiological and psychological health among community‐dwelling elderly in Japan: Randomized controlled trial. Geriatrics & Gerontology International. 2013; 13(1): 152-60. doi:10.1111/j.1447-0594.2012.00877.x.
  • 25. Yazdani M, Esmaeilzadeh M, Pahlavanzadeh S, Khaledi F. The effect of laughter yoga on general health among nursing students. Iran J Nurs Midwifery Res. 2014; 19: 36-40.
  • 26. laughteryoga.org [Internet]. Bangalore: Laughter Yoga University [Updated: 2019; Cited: 2019 May 19]. Available from: https://laughteryoga.org/laughter -yoga/about-laughter-yoga/
  • 27. Kataria M. Laughter yoga: Daily laughter practices for health and happiness. India: Penguin Random House India Private Limited; 2018.
  • 28. Ripoll RM, Casado IQ. Laughter and positive therapies: Modern approach and practical use in medicine. Rev Psiquiatr Salud Ment. 2010; 3(1): 27-34. doi: 10.1016/S1888-9891(10)70006-9.
  • 29. Weisenberg M, Tepper I, Schwarzwald J. Humor as a cognitive technique for increasing pain tolerance. Pain. 1995; 63(2): 207-12. doi: 10.1016/0304-3959(95)00046-u.
  • 30. Ko YJ, Hyun MY. Effects of laughter therapy on pain, depression, and quality of life of elderly people with osteoarthritis. J Korean Acad Psychiatr Ment Health Nurs. 2013; 22(4): 359-67. doi: 10.12934/jkpmhn.2013.22.4.359.
  • 31. Hallberg LRM, Carlsson SG. Psychosocial vulnerability and maintaining forces related to fibromyalgia. Scandinavian Journal of Caring Sciences. 1998; 12(2): 95-103. doi: 10.1111/j.1471-6712.1998.tb00482.x.
  • 32. Auerbach S, Hofmann J, Platt T, Ruch WF. An investigation of the emotions elicited by hospital clowns in comparison to circus clowns and nursing staff. The European Journal of Humour Research. 2014; 1(3): 26-53. doi: 10.7592/EJHR2013.1.3.auerbach.
  • 33. Bodnar RJ, Klein GE. Endogenous opiates and behavior: 2005. Peptides. 2006; 27(12): 3391-478. doi: 10.1016/j.peptides.2006.07.011.
  • 34. Johnson MH. How does distraction work in the management of pain? Current Pain and Headache Reports. 2005; 9(2): 90-5. doi: 10.1007/s11916-005-0044-1.
  • 35. Kuiper NA. Humor and resiliency: Towards a process model of coping and growth. Europe's Journal of Psychology. 2012; 8(3): 475-91. doi: 10.5964/ejop.v8i3.464.
  • 36. Cann A, Collette C. Sense of humor, stable affect, and psychological well‐being. Europe's Journal of Psychology. 2014; 10(3): 464-79. doi: 10.5964/ejop.v10i3.746.
  • 37. Sturgeon JA, Zautra AJ. Social pain and physical pain: Shared paths to resilience. Pain Management. 2016; 6(1): 63-74. doi: 10.2217/pmt.15.56.
  • 38. Brown A, Jeffrey C, Moyle D. Laughter yoga therapy in haemodialysis: One unit’s experience. Renal Society of Australasia Journal. 2019; 15: 38-46.
  • 39. Lee KI, Eun Y. Effect of laugher therapy on pain, depression and sleep with elderly patients in long term care facility. Journal of Muscle and Joint Health. 2011; 18(1): 28-38. doi: 10.15171/mejdd.2019.151.
  • 40. Yu JA, Kim KS. Effects of laughter therapy on stress response and pain of military personnel with low back pain in hospital. Journal of Muscle and Joint Health. 2009; 16(1): 36-45. doi: 10.1155/2015/864739.
There are 40 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Reviews
Authors

Merve Çakar 0000-0001-6251-4427

Esra Kınacı 0000-0002-2977-0928

Sarfinaz Ataoğlu 0000-0002-9521-7653

Project Number yoktur
Publication Date January 21, 2021
Submission Date July 24, 2020
Published in Issue Year 2021 Volume: 11 Issue: 1

Cite

APA Çakar, M., Kınacı, E., & Ataoğlu, S. (2021). Ağrı Yönetiminde Alternatif Bir Yaklaşım: Kahkaha Terapisi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 11(1), 108-114. https://doi.org/10.33631/duzcesbed.773239
AMA Çakar M, Kınacı E, Ataoğlu S. Ağrı Yönetiminde Alternatif Bir Yaklaşım: Kahkaha Terapisi. DÜ Sağlık Bil Enst Derg. January 2021;11(1):108-114. doi:10.33631/duzcesbed.773239
Chicago Çakar, Merve, Esra Kınacı, and Sarfinaz Ataoğlu. “Ağrı Yönetiminde Alternatif Bir Yaklaşım: Kahkaha Terapisi”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 11, no. 1 (January 2021): 108-14. https://doi.org/10.33631/duzcesbed.773239.
EndNote Çakar M, Kınacı E, Ataoğlu S (January 1, 2021) Ağrı Yönetiminde Alternatif Bir Yaklaşım: Kahkaha Terapisi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 11 1 108–114.
IEEE M. Çakar, E. Kınacı, and S. Ataoğlu, “Ağrı Yönetiminde Alternatif Bir Yaklaşım: Kahkaha Terapisi”, DÜ Sağlık Bil Enst Derg, vol. 11, no. 1, pp. 108–114, 2021, doi: 10.33631/duzcesbed.773239.
ISNAD Çakar, Merve et al. “Ağrı Yönetiminde Alternatif Bir Yaklaşım: Kahkaha Terapisi”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 11/1 (January 2021), 108-114. https://doi.org/10.33631/duzcesbed.773239.
JAMA Çakar M, Kınacı E, Ataoğlu S. Ağrı Yönetiminde Alternatif Bir Yaklaşım: Kahkaha Terapisi. DÜ Sağlık Bil Enst Derg. 2021;11:108–114.
MLA Çakar, Merve et al. “Ağrı Yönetiminde Alternatif Bir Yaklaşım: Kahkaha Terapisi”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, vol. 11, no. 1, 2021, pp. 108-14, doi:10.33631/duzcesbed.773239.
Vancouver Çakar M, Kınacı E, Ataoğlu S. Ağrı Yönetiminde Alternatif Bir Yaklaşım: Kahkaha Terapisi. DÜ Sağlık Bil Enst Derg. 2021;11(1):108-14.