The Effects of Comedy Movies on Preoperative Anxiety and Postoperative Pain in Patients Who Have Undergone Abdominal Surgery: A Pilot Randomized Controlled Trial
Corresponding Author
Gürkan Kapıkıran
Division of Emergency Aid and Disaster Management, Faculty of Health Sciences, Malatya Turgut Ozal University, Malatya, Türkiye
Correspondence:
Gürkan Kapıkıran ([email protected])
Search for more papers by this authorSemra Bülbüloğlu
Division of Surgical Nursing, Nursing Department, Faculty of Health Sciences, Istanbul Aydin University, Istanbul, Türkiye
Search for more papers by this authorRemziye Cici
Division of Surgical Nursing, Nursing Department, Faculty of Health Sciences, Corum Hitit University, Corum, Türkiye
Search for more papers by this authorCorresponding Author
Gürkan Kapıkıran
Division of Emergency Aid and Disaster Management, Faculty of Health Sciences, Malatya Turgut Ozal University, Malatya, Türkiye
Correspondence:
Gürkan Kapıkıran ([email protected])
Search for more papers by this authorSemra Bülbüloğlu
Division of Surgical Nursing, Nursing Department, Faculty of Health Sciences, Istanbul Aydin University, Istanbul, Türkiye
Search for more papers by this authorRemziye Cici
Division of Surgical Nursing, Nursing Department, Faculty of Health Sciences, Corum Hitit University, Corum, Türkiye
Search for more papers by this authorFunding: The authors received no specific funding for this work.
ABSTRACT
This randomized controlled pilot study, which involved 176 patients, aimed to evaluate the impact of comedy films on preoperative anxiety levels and postoperative pain in patients undergoing abdominal surgery, as well as the feasibility of this intervention. While the patients in the control group did not undergo any intervention other than routine clinical interventions, the patients in the experimental group watched a comedy movie for 25 min. The pretest anxiety score of the experimental group was found to be 57.48 ± 6.09, while the posttest anxiety score of the same group decreased to 37.35 ± 8.10 after watching a comedy movie. The difference between their pretest and posttest anxiety mean scores was statistically significant (Cohen's d: 4.20, 95% CI: 27.8124 to 32.4603, p: 0.000). The mean pretest and posttest pain scores of those in the experimental group were 4.99 ± 1.24 and 4.76 ± 1.33, respectively (Cohen's d: 2.72, 95% CI: −24.6459 to −19.7858, p: 0.003). It was concluded that watching a comedy movie, which is an inexpensive and effective method, reduces preoperative anxiety and postoperative pain in patients undergoing abdominal surgery and provides important information necessary for the design of more precise studies in the future.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
References
- Akelma, H., E. T. Kılıç, M. Özkılıç, Z. A. Karahan, and S. Kaya. 2018. “Determination of Preoperative Fear and Anxıety Levels Caused by Multiple Pediatric Burn Surgeries in Patıents and Their Parents.” Middle East Journal of Family Medicine 7, no. 10: 4–12.
- Arslan, A. K., İ. Balıkçı Çiçek, and C. Çolak. 2019. “Open Source Web Based Software on Random Assignment Methods and Usage: Random Assignment Software.” Turkiye Klinikleri Journal of Biostatistics 11: 267–274.
10.5336/biostatic.2019-70571 Google Scholar
- Aslan, F. E., S. K. Şahin, S. Secginli, and S. Bülbüloğlu. 2018. “Patient Satisfaction With Nursing Practices About Postoperative Pain Management: A Systematic Review.” Pain 30: 105–115. https://doi.org/10.5505/agri.2018.96720.
10.5505/agri.2018.96720 Google Scholar
- Bagheri, H., T. Salmani, J. Nourian, et al. 2020. “The Effects of Inhalation Aromatherapy Using Lavender Essential Oil on Postoperative Pain of Inguinal Hernia: A Randomized Controlled Trial.” Journal of Perianesthesia Nursing 35, no. 6: 642–648. https://doi.org/10.1016/j.jopan.2020.03.003.
- Bagheri, M., M. Maleki, A. Mardani, M. H. Momen-Beromi, S. Daliri, and S. Rezaie. 2022. “The Effect of Video Training and Intraoperative Progress Report on the Anxiety of Family Caregivers Waiting for Relatives Undergoing Surgery.” Heliyon 8, no. 8: e10065. https://doi.org/10.1016/j.heliyon.2022.e10065.
- Bennett, M. P., and C. Lengacher. 2006. “Humor and Laughter May Influence Health: II. Complementary Therapies and Humor in a Clinical Population.” Evidence-Based Complementary and Alternative Medicine 3, no. 2: 187–190. https://doi.org/10.1093/ecam/nel014.
- Bülbüloğlu, S., F. Eti Aslan, G. Kapıkıran, S. Sarıtaş, E. Kaplan Serin, and H. A. Güneş. 2021. “Systematic Compilation of the Satisfaction Levels of Patients With Nursing Interventions Regarding Post-Operative Pain Management.” Gevher Nesibe Journal 6, no. 4: 28–37. https://doi.org/10.46648/gnj.184.
10.46648/gnj.184 Google Scholar
- Cha, M. Y., and H. S. Hong. 2015. “Effect and Path Analysis of Laughter Therapy on Serotonin, Depression and Quality of Life in Middle-Aged Women.” Journal of Korean Academy of Nursing 45, no. 2: 221–230. https://doi.org/10.4040/jkan.2015.45.2.221.
- Cohen, J. 1988. Statistical Power Analysis for the Behavioral Sciences. 2nd ed, 20–26. Lawrence Erlbaum Associates.
- Crichton, N. 2001. “Visual Analogue Scale (VAS).” Journal of Clinical Nursing 10, no. 5: 697–706.
- Doan, L. V., and J. Blitz. 2020. “Preoperative Assessment and Management of Patients With Pain and Anxiety Disorders.” Current Anesthesiology Reports 10: 28–34. https://doi.org/10.1007/s40140-020-00367-9.
- Eldridge, S. M., C. L. Chan, M. J. Campbell, et al. 2016. “CONSORT 2010 Statement: Extension to Randomised Pilot and Feasibility Trials.” Pilot and Feasibility Studies 2: 64. https://doi.org/10.1186/s40814-016-0105-8.
- Elmali, H., and R. B. Akpinar. 2017. “The Effect of Watching Funny and Unfunny Videos on Postsurgical Pain Levels.” Complementary Therapies in Clinical Practice 26: 36–41. https://doi.org/10.1016/j.ctcp.2016.11.003.
- Hamidi, N., M. Duvarci, T. Uzel, O. Ceylan, S. H. Unal, and E. Ozturk. 2025. “Is the Effectiveness of Self-Visualization During Flexible Cystoscopy Gender-Dependent in Patients With no Previous Cystoscopy History? A Prospective Randomized Study.” International Brazilian Journal of Urology 51, no. 2: e20240498. https://doi.org/10.1590/S1677-5538.IBJU.2024.0498.
- Ip, H. Y. V., A. Abrishami, P. W. Peng, J. Wong, and F. Chung. 2009. “Predictors of Postoperative Pain and Analgesic Consumption: A Qualitative Systematic Review.” Anesthesiology 111, no. 3: 657–677.
- Iwasaki, M., M. Edmondson, A. Sakamoto, and D. Ma. 2015. “Anesthesia, Surgical Stress, and “Long-Term” Outcomes.” Acta Anaesthesiologica Taiwanica 53, no. 3: 99–104. https://doi.org/10.1016/j.aat.2015.07.002.
- Kang, H. 2021. “Sample Size Determination and Power Analysis Using the G* Power Software.” Journal of Educational Evaluation for Health Professions 18: 1–12. https://doi.org/10.3352/jeehp.2021.18.17.
- Kavak Akelma, F., S. Altınsoy, M. T. Arslan, and J. Ergil. 2020. “Wirkung von Lieblingsmusik auf postoperative Angst und Schmerz.” Der Anaesthesist 69: 198–204. https://doi.org/10.1007/s00101-020-00731-8.
- Kong, M., S. H. Shin, E. Lee, and E. K. Yun. 2014. “The Effect of Laughter Therapy on Radiation Dermatitis in Patients With Breast Cancer: A Single-Blind Prospective Pilot Study.” Oncotargets and Therapy 7: 2053–2059. https://doi.org/10.2147/OTT.S72973.
- Kurudirek, F., and D. Arıkan. 2020. “Effects of Therapeutic Clowning on Pain and Anxiety During Intrathecal Chemotherapy in Turkey.” Journal of Pediatric Nursing 53: 6–13. https://doi.org/10.1016/j.pedn.2020.01.015.
- Lapierre, S. S., B. D. Baker, and H. Tanaka. 2019. “Effects of Mirthful Laughter on Pain Tolerance: A Randomized Controlled Investigation.” Journal of Bodywork and Movement Therapies 23: 733–738. https://doi.org/10.1016/j.jbmt.2019.04.005.
- Liptak, A., J. Tate, J. Flatt, M. A. Oakley, and J. Lingler. 2014. “Humor and Laughter in Persons With Cognitive Impairment and Their Caregivers.” Journal of Holistic Nursing 32, no. 1: 25–34. https://doi.org/10.1177/0898010113500075.
- Maduka, I. C., E. E. Neboh, and S. A. Ufelle. 2015. “The Relationship Between Serum Cortisol, Adrenaline, Blood Glucose and Lipid Profile of Undergraduate Students Under Examination Stress.” African Health Sciences 15, no. 1: 131–136. https://doi.org/10.4314/ahs.v15i1.18.
- Mallı, C. 2013. “Ertem Eğilmez Sinemasının Üretiminde Bir Gösterge Olarak: “Grotesk Halk Kültürü” [Grotesque Folk Culture As An Indication In Ertem Eğilmez Film Production]” (Master's thesis, Marmara University, Istanbul, Turkey).
- Martin, R. A. 2004. “Sense of Humor and Physical Health: Theoretical Issues, Recent Findings, and Future Directions.” Humor 17: 1–19.
- Marziali, E., L. McDonald, and P. Donahue. 2008. “The Role of Coping Humor in the Physical and Mental Health of Older Adults.” Aging and Mental Health 12, no. 6: 713–718. https://doi.org/10.1080/13607860802154374.
- Mavros, M. N., G. C. Velmahos, J. Lee, A. Larentzakis, and H. M. Kaafarani. 2014. “Morbidity Related to Concomitant Adhesions in Abdominal Surgery.” Journal of Surgical Research 192, no. 2: 286–292. https://doi.org/10.1016/j.jss.2014.07.044.
- Mei, W., M. Seeling, M. Franck, et al. 2010. “Independent Risk Factors for Postoperative Pain in Need of Intervention Early After Awakening From General Anaesthesia.” European Journal of Pain 14, no. 2: 149-e1–149-e7. https://doi.org/10.1016/j.ejpain.2009.03.009.
- Mitchell, L. A., R. A. MacDonald, and E. E. Brodie. 2006. “A Comparison of the Effects of Preferred Music, Arithmetic and Humour on Cold Pressor Pain.” European Journal of Pain 10, no. 4: 343–351. https://doi.org/10.1016/j.ejpain.2005.03.005.
- Nanashima, A., M. Hiyoshi, N. Imamura, et al. 2018. “A Cohort Study on the Risk of Hepatectomy and Pancreatectomy After History of Abdominal Surgery on Other Organs.” Annals of Hepato-Biliary-Pancreatic Surgery 22, no. 4: 344–349. https://doi.org/10.14701/ahbps.2018.22.4.344.
- O'Hanlon, S. 2018. “ Management of Delirium on the Surgical Ward.” In Cognitive Changes After Surgery in Clinical Practice, 1st ed, 61–79. Springer International Publishing.
10.1007/978-3-319-75723-0_5 Google Scholar
- Öner, N., and A. Le Compte. 1985. Durumluluk ve Sürekli Kaygı Envanteri El Kitabı. 2nd ed. Bogaziçi University Publishment.
- Öztürk, R., Ü. Sevil, A. Sargin, and M. S. Yücebilgin. 2018. “The Effects of Reflexology on Anxiety and Pain in Patients After Abdominal Hysterectomy: A Randomised Controlled Trial.” Complementary Therapies in Medicine 36: 107–112. https://doi.org/10.1016/j.ctim.2017.12.005.
- Pan, X., J. Wang, Z. Lin, W. Dai, and Z. Shi. 2019. “Depression and Anxiety Are Risk Factors for Postoperative Pain-Related Symptoms and Complications in Patients Undergoing Primary Total Knee Arthroplasty in the United States.” Journal of Arthroplasty 34, no. 10: 2337–2346. https://doi.org/10.1016/j.arth.2019.05.035.
- Ralph, N., and P. Norris. 2018. “Current Opinion About Surgery-Related Fear and Anxiety.” Journal of Perioperative Nursing 31, no. 4: 3–5.
10.26550/2209-1092.1046 Google Scholar
- Ripoll, R. M., and I. Q. Casado. 2010. “Risa y Terapias Positivas: Moderno Enfoque y Aplicaciones Prácticas en Medicina.” Revista de Psiquiatria y Salud Mental 3, no. 1: 27–34. https://doi.org/10.1016/S1888-9891(10)70006-9.
- Rotton, J., and M. Shats. 1996. “Effects of State Humor, Expectancies, and Choice on Postsurgical Mood and Self-Medication: A Field Experiment.” Journal of Applied Social Psychology 26, no. 20: 1775–1794. https://doi.org/10.1111/j.1559-1816.1996.tb00097.x.
- Sarıtaş, S., H. Genc, Ş. Okutan, R. Inci, A. Özdemir, and G. Kizilkaya. 2019. “The Effect of Comedy Films on Postoperative Pain and Anxiety in Surgical Oncology Patients.” Complementary Medicine Research 26, no. 4: 231–239. https://doi.org/10.1159/000497234.
- Smeltzer, S. C., B. G. Bare, J. L. Hinkle, and K. H. Cheever. 2010. “ Cheever, Perioperative Concepts and Nursing Management.” In Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 12th ed., 422–482. Lippincott Williams and Wilkins.
- Spielberger, C. D., R. L. Gorsuch, R. Lushene, P. R. Vagg, and G. A. Jacobs. 1983. Manual for the State-Trait Anxiety Inventory. CA. Consulting Psychologists Press.
- Sridharan, K., and G. Sivaramakrishnan. 2016. “Therapeutic Clowns in Pediatrics: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” European Journal of Pediatrics 175: 1353–1360. https://doi.org/10.1007/s00431-016-2764-0.
- Takeda, M., R. Hashimoto, T. Kudo, et al. 2010. “Laughter and Humor as Complementary and Alternative Medicines for Dementia Patients.” BMC Complementary and Alternative Medicine 10, no. 28: 1–7. http://www.biomedcentral.com/1472-6882/10/28.
- Villa, G., I. Lanini, T. Amass, et al. 2020. “Effects of Psychological Interventions on Anxiety and Pain in Patients Undergoing Major Elective Abdominal Surgery: A Systematic Review.” Perioperative Medicine 9, no. 38: 1–8. https://doi.org/10.1186/s13741-020-00169-x.
10.1186/s13741?020?00169?x Google Scholar
- Wolyniez, I., A. Rimon, D. Scolnik, et al. 2013. “The Effect of a Medical Clown on Pain During Intravenous Access in the Pediatric Emergency Department: A Randomized Prospective Pilot Study.” Clinical Pediatrics 52, no. 12: 1168–1172. https://doi.org/10.1177/0009922813502257.
- Yesilyurt, D. S., and Ü. Y. Findik. 2019. “Effect of Preoperative Video Information on Anxiety and Satisfaction in Patients Undergoing Abdominal Surgery.” CIN: Computers, Informatics, Nursing 37, no. 8: 430–436. https://doi.org/10.1097/CIN.0000000000000505.
- Yuceer, S. 2011. “Nursing Approaches in the Postoperatif Pain Management.” Journal of Clinical and Experimental Investigations 2, no. 4: 474–478. https://doi.org/10.5799/ahinjs.01.2011.04.0100.
10.5799/ahinjs.01.2011.04.0100 Google Scholar
- Yun, O. B., S. Kim, and D. Jung. 2015. “Effects of a Clown–Nurse Educational Intervention on the Reduction of Postoperative Anxiety and Pain Among Preschool Children and Their Accompanying Parents in South Korea.” Journal of Pediatric Nursing 30, no. 6: e89–e99. https://doi.org/10.1016/j.pedn.2015.03.003.
- Zhao, J., H. Yin, G. Zhang, et al. 2019. “A Meta-Analysis of Randomized Controlled Trials of Laughter and Humour Interventions on Depression, Anxiety and Sleep Quality in Adults.” Journal of Advanced Nursing 75, no. 11: 2435–2448. https://doi.org/10.1111/jan.14000.