Discussion
depression, ’ parental stress, anxiety, self-induced
DER, MUSCLE RELAXATION
We developed and applied DLT using a virtual meeting technology for mothers caring for their young children during the pandemic. We evaluated its impact on reducing levels of depression, anxiety, and parental stress and assessed its application feasibility. We found that parental stress levels during the pandemic were notably more severe compared to those in previous years. The mean score for mothers’ parental stress in this study was 3.30 and were higher than the scores reported by Korean mothers with young children in 2002 and 2007, which were 2.51 and 2.73 respectively, using the same scale [In this study, participants in the experimental group demonstrated a significant decrease in their depression and anxiety levels after completing the DLT. These findings align with Van der Wal and Kok [However, the degree of decrease in depression and anxiety levels did not differ significantly from that observed in the control group, who were exposed to an entertainment TV show. Therefore, hypotheses H1-2 and H2-2 were not supported. This might be attributed to the positive effects that the general TV entertainment show had on the participants’ depression and anxiety levels.Parental stress was significantly reduced in the experimental group post-intervention, contrasting with the control group where it remained relatively unchanged. As such, Hypothesis H3-1 is supported. This suggests that, unlike solitary TV viewing, simulated laughter and group interaction may help alleviate parenting-induced stress. However, since the degree of between-group difference did not reach statistical significance, our interpretation requires caution, and thus Hypothesis H3-2 is not supported.Considering our quantitative results, we cannot definitively claim that DLT is the superior choice for mothers, particularly given the effort and resources required for participation compared to simply watching TV. Indeed, a substantial number of participants (n = 5) withdrew from the experimental group because they were “busy,” while none withdrew from the control group. Nevertheless, owing to our small sample size, the quantitative findings should be interpreted with caution and require confirmation through future studies. Additionally, as we did not measure or compare the amount of laughter between the experimental and control groups, we could not ascertain the frequency of laughter in the control group or how effective the amount of laughter was in reducing depression, anxiety, and parental stress.Despite the limited effects of DLT, as indicated by the quantitative data, the study participants reported positive experiences and changes from multiple perspectives, including physical transformations. Specifically, they mentioned muscle relaxation and feeling energized, which aligns with Yim’s findings [A noteworthy observation was the effectiveness of simulated laughter as a self-care strategy, given its ease of self-implementation and repetition. In contrast, spontaneous laughter, which is not as easily self-induced or repetitively invoked, may not be an effective self-care strategy. This contrast might explain why simulated laughter has consistently shown more positive outcomes compared to spontaneous laughter in previous meta-analyses [This study’s participants reported an increase in feelings of happiness and joy, which they attributed to observing their own and others’ laughter-filled faces. Furthermore, participants noted positive changes in their children and spouses who observed their bouts of laughter and merriment. This phenomenon may reflect the “contagion effect of laughter” noted in previous studies, which assert that witnessing or hearing another person’s laughter can trigger one’s laughter [The ongoing pandemic has significantly curtailed social interaction, leaving health professionals struggling to adapt existing interventions for isolated individuals. Even though the DLT program in this study did not outperform entertainment TV shows in terms of impact, we still advocate for its use as an intervention for isolated mothers. Using virtual meeting technology, the DLT has showed a significant effect in alleviating levels of depression, anxiety, and parental stress among mothers, and it has garnered positive feedback. Participants voiced high satisfaction levels, appreciating the opportunity to participate comfortably in an enjoyable environment. They also expressed appreciation for the chance to meet and interact with like-minded people through the DLT during the pandemic. Moreover, according to the Balance between Risks and Resources theory, parental burnout can occur when the demands of parenting surpass available resources [However, it is important to note that the findings of this study may not be readily applicable to diverse populations with varying ethnic backgrounds in different geographic locations because of the limited sample of women from a single ethnicity. Moreover, the small sample size utilized in this study necessitates cautious interpretation of the results obtained from quantitative data analysis. It is also worth mentioning that the effectiveness of the program on unmarried or divorced women remains unexplored, as our study did not include this demographic. Additionally, as we did not conduct a quantitative follow-up to assess the duration of the program’s effects beyond completion, we cannot determine how long these effects persist. Another factor to consider is that the humorous content of the TV show exposed to the control group may have had an impact, as it is known to have its own benefits, including solitary laughter [Therefore, it is imperative that further research is conducted to address these limitations. Specifically, future studies should aim to test the efficacy of DLT using a larger sample size to ensure sufficient statistical power. Additionally, it is crucial to explore the effects of DLT while considering participant characteristics such as parents’ gender, age, relationship with their children, and existing social support systems. Finally, it is necessary to investigate the impact of DLT on diverse populations residing in various geographical regions, as well as its long-term effects.