The goal of this clinical trial is to learn if laughter yoga can improve both individual and organizational outcomes in nurse managers. The main questions it aims to answer are:

• Does laughter yoga lower burnout and stress levels in nurse managers?
• Does laughter yoga improve work-life quality and job performance?
• Does laughter yoga help nurse managers make better decisions and solve problems more effectively?
• Does laughter yoga lower compassion fatigue and support positive approaches to workplace conflict? Researchers will compare a laughter yoga group with a control group to see if there are meaningful differences.

Participants will:

• Join structured laughter yoga sessions for a defined period (weekly sessions).
• Complete surveys before and after the program about stress, burnout, work-life quality, decision-making, problem solving, job performance, compassion fatigue, and conflict approaches.
• Continue their usual work while attending sessions.

Nurse managers play a vital role in healthcare systems by ensuring the quality of nursing services, supporting staff, coordinating care, and solving organizational problems. However, the combination of administrative responsibilities, staff shortages, and high expectations often leads to stress, burnout, compassion fatigue, and difficulties in maintaining work-life balance. These conditions not only affect the individual health and well-being of nurse managers but also reduce team motivation, patient care quality, and overall organizational performance.

Laughter yoga is a mind-body practice that combines intentional laughter with breathing exercises. It does not rely on humor or jokes; instead, participants engage in guided group exercises that promote spontaneous and prolonged laughter. Scientific evidence suggests that laughter yoga can lower stress hormones, increase endorphins, improve mood, and strengthen social bonds. Although laughter yoga has been studied in various populations, there is a lack of randomized controlled trials (RCTs) specifically focusing on nurse managers and their professional challenges.

This randomized controlled trial aims to fill this gap by evaluating the individual and organizational outcomes of laughter yoga among nurse managers working in university and state hospitals.

The expected contribution of this study is to provide new evidence on a cost-effective, non-pharmacological intervention that can be easily integrated into hospital settings. If laughter yoga proves effective, it can be adopted as a sustainable strategy to support nurse managers' mental health, enhance their leadership capacity, and indirectly improve patient care and organizational outcomes.

Inclusion Criteria:

• Currently working as a nurse manager
• Having at least six months of managerial experience
• Continuing to serve as a nurse manager throughout the study period

Exclusion Criteria:

• Having previously received laughter yoga training
• Use of medications affecting general health components during the study (e.g., for depression, anxiety)
• Being pregnant
• Experiencing an acute stressful life event, such as the death of a close relative
• Having undergone abdominal surgery within the past 6 months