Do Clown Visits Improve Psychological and Sense of Physical Well-being of Hospitalized Pediatric Patients? A Randomized-controlled Trial

 

 Buy Article Permissions and Reprints

Abstract

The study tested whether clown visits would be associated with an increase in psychological and perceived physical well-being of pediatric patients. Patients (6–14 years old) were randomized to a clown visit (n=50) or no-visit control (n=50). Patients and parents were administered a modified version of the KINDL-R questionnaire at pretest, immediately after the clown visit (posttest), and at a 4-h follow-up. The experimental group showed an increase in self-reported and parent-reported psychological well-being at posttest. However, these effects were not maintained at follow-up. There was no effect of the clown visit on perceived physical well-being. It is concluded that clown visits appear to improve psychological well-being of pediatric patients, but the effects may only be short lived.

Zusammenfassung

Die vorliegende Studie testete, ob Clownbesuche mit Verbesserungen des psychischen und wahrgenommenen körperlichen Befindens von pädiatrischen Patienten einhergehen. Patienten (6–14 Jahre) wurden per Zufall einem Clownbesuch (n=50) und einer Kontrollbedingung (n=50) zugeordnet. Die Patienten und Eltern füllten eine modifizierte Version des Kindl-R-Fragebogens zum Prätest, unmittelbar nach dem Clownbesuch (Posttest) und 4 Stunden später (Follow-up) aus. Die Experimentalgruppe zeigte sowohl in den Selbst- und Elternberichten eine Verbesserung des psychischen Befindens im Posttest, die allerdings nicht im Follow-up Bestand hatte. Veränderungen im wahrgenommenen körperlichen Befinden traten nicht auf. Geschlussfolgert wird, dass Clownbesuche das Befinden verbessern können, der Effekt aber nur kurze Zeit Bestand hat.

References

• 1 Battrick C, Glasper EA, Prudhoe G. et al . Clown humour: the perceptions of doctors, nurses, parents and children.  J Children's Young People's Nurs. 2007;  1 174-179
  PubMedGoogle Scholar
• 2 Bertini M, Isola GP, Curcio G. Clowns benefit children hospitalized for respiratory pathologies.  eCAM. 2010;  7
  PubMedGoogle Scholar
• 3 Birch J, Curtis P, James A. Sense and sensibilities: In search of the child-friendly hospital.  Built Environm. 2007;  33 405-416
  PubMedGoogle Scholar
• 4 Bullinger M, Brütt AL, Erhart M. et al . Psychometric properties of the KINDL-R questionnaire.  Eur Child Adolesc Psychiatry. 2008;  17 (Suppl. 1) 125-132
  CrossrefPubMedGoogle Scholar
• 5 Cantó MA, Quiles JM, Vallejo OG. et al . Evaluation of the effect of hospital clown's performance about anxiety in children subjected to surgical intervention [in Spanish].  Cirugia Pediatrica. 2008;  21 195-198
  PubMedGoogle Scholar
• 6 Cohen J. A power primer.  Psychol Bull. 1992;  112 155-159
  CrossrefPubMedGoogle Scholar
• 7 Dayton L. Healing with humor: Clowns on call bring hugs and happiness.  Mich Health Hosp. 1997;  33 16
  PubMedGoogle Scholar
• 8 Golan G, Tighe P, Dobija N. et al . Clowns for the prevention of preoperative anxiety in children: a randomized controlled trial.  Pediatr Anesth. 2009;  19 262-266
  CrossrefPubMedGoogle Scholar
• 9 Goldbeck L, Hölling I, Schlack R. et al . The impact of an inpatient family-oriented rehabilitation program on parent-reported psychological symptoms of chronically ill children.  Klin Padiatr. 2011;  223 79-84
  Article in Thieme ConnectPubMedGoogle Scholar
• 10 Gorfinkle KS, Slater JA, Bagiella E. et al . Child behavioral distress during invasive oncologic procedures and cardiac catheterization with the Big Apple Circus Clown Care Unit.  Pediatr Res. 1998;  43 12
  PubMedGoogle Scholar
• 11 Kingsnorth S, Blain S, McKeever P. Physiological and emotional responses of disabled children to therapeutic clowns: A pilot study.  eCAM. 2010;  7
  PubMedGoogle Scholar
• 12 Koller D, Gryski C. The life threatened child and the life enhancing clown: Towards a model of therapeutic clowning.  eCAM. 2008;  5 17-25
  PubMedGoogle Scholar
• 13 Meisel V, Chellew K, Ponsell E. et al . The effect of «hospital clowns» on distress and maladaptive behaviours of children who are undergoing minor surgery [in Spanish].  Psicothema. 2009;  21 604-609
  PubMedGoogle Scholar
• 14 Remmick JE, Rashotte J. Psychological outcomes in children following pediatric intensive care unit hospitalization: a systematic review of the research.  J Child Health Care. 2009;  13 28-149
  PubMedGoogle Scholar
• 15 Smerling AJ, Skolnick E, Bagiella E. et al . Perioperative clown therapy for pediatric patients.  Anesth Anal. 1999;  88 S3065
  PubMedGoogle Scholar
• 16 Spitzer P. Hospital clowns – modern-day court jesters at work.  Lancet. 2006;  368 34-35
  CrossrefPubMedGoogle Scholar
• 17 Vagnoli L, Bastiani C, Turchi F. et al . Preoperative anxiety in pediatrics: is clown's intervention effective to alleviate children discomfort?.  Algia Hospitales. 2007;  2 114-119
  PubMedGoogle Scholar
• 18 Vagnoli L, Caprilli S, Robiglio A. et al . Clown doctors as a treatment for preoperative anxiety in children: a randomized, prospective study.  Pediatrics. 2005;  116 563-567
  CrossrefPubMedGoogle Scholar
• 19 Weaver K, Prudhoe G, Battrick C. et al . Sick children's perceptions of clown doctor humour.  J Child Young People's Nurs. 2007;  1 359-365
  PubMedGoogle Scholar
• 20 Wilson ME, Megel ME, Enenbach L. et al . The voices of children: Stories about hospitalization.  J Pediatr Health Care. 2010;  24 95-102
  CrossrefPubMedGoogle Scholar
• 21 Peeters J, Meitert J, Paulides M. et al . Health-related quality of life in ALL-patients treated with chemotherapy only – A report from the late effects surveillance system in Germany.  Klin Padiatr. 2009;  221 156-161
  Article in Thieme ConnectPubMedGoogle Scholar
• 22 Wood C, Magnello ME. Diurnal changes in perceptions of energy and mood.  J R Soc Med. 1992;  85 191-194
  PubMedGoogle Scholar

Correspondence

Prof. Dr. habil. Martin Pinquart

Philipps-Universität

Psychologie

Gutenbergstraße 18

35032 Marburg

Germany

Phone: +49/6421/282 3626

Fax: +49/6421/282 3685

Email: pinquart@staff.uni-marburg.de