Improving the quality and productivity of home based healthcare provided by 134 women HIV health care workers in South Africa with aerobic laughter therapy psychosocial support programs over three and six month periods

Background: Healthcare workers providing home based care for people living with HIV and orphans and vulnerable children (OVC) from AIDS experience high levels of stress. Many experience depression and burnout that can reduce the quality and quantity of care provided. Psychosocial support programs using aerobic laughter therapy (ALT) provide cognitive behavioral therapy within the framework of positive psychology. The efficacy of this program in improving the quality and productivity of care provided was investigated in two groups of home based healthcare workers. Methods: 37 workers in Northwest province providing care to HIV affected adults and children (group 1), and 97 workers in Eastern Cape Province providing care to OVC (group 2), received ALT training and engaged in daily peer-to-peer ALT therapy group sessions of 10-15 minutes for six months and three months respectively. Qualitative, quantitative and performance assessments were conducted with participants before training, then after 2 weeks, 2, 4, and 6 months (group 1), and after 2 weeks and 2 months (group 2). Results: Results for group 1 showed dramatic increases in problem solving ability, emotional intelligence, productivity (56%), and mindfulness. Reductions were seen in absenteeism (52%), presenteeism, burnout, stress, depression, workplace conflict, and other factors known to reduce workplace efficacy. Participants reported significant improvements in patient relations and patient outcomes including adherence to medications and treatment. Results for group 2 confirmed these findings. Conclusions: Aerobic laughter based PSS programs can result in significant improvements in the quality and quantity of home based care provided.