Infectious Disease

Clowns enhance kids’s wellbeing in hospitals, research present

December 29, 2020

2 min read

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According to a systematic review published in the BMJ, doctors disguised as clowns have been shown to improve the symptoms and psychological well-being of children in hospital.

“As clinicians strive to minimize the psychological distress during hospitalization, especially in pediatrics, they need to be aware of the available science to help them incorporate appropriate laughter and games into clinical practice.” Luís Carlos Lopes-Júnior, BScN, RN, OCN, PhD, An associate professor and researcher at the Health Science Center of the Federal University of Espírito Santo in Brazil told Healio Primary Care.

According to the authors of a systematic review, clown doctors have significantly improved anxiety, pain, cancer-related fatigue, emotional well-being, and stress in pediatric patients. Photo source: Adobe Stock

“Children and adolescents in need of hospitalization are a particular challenge for the health system and health professionals because of the disease itself and the treatment process,” he said. “Hospital children and adolescents with acute or chronic disorders are also stressed by the separation from their parents, the hospital environment, the fear of painful treatments and the uncertainty of the treatment outcome.”

Lopes-Júnior and colleagues noted that the first documented use of hospital clowns dates back to 1908 in the Paris newspaper, which featured clowns and children in a London infirmary.

To determine the effect of “clown doctors” on patients, Lopes-Júnior and colleagues reviewed 13 randomized and 11 non-randomized controlled studies with 1,612 children and adolescents. Seventeen trials were carried out in Europe, four in South America, two in Asia and one in Canada. The clown doctors typically used improvisation, juggling, magic, music, puppetry, and / or storytelling to complement a patient’s existing care. Some studies used validated methods (e.g., Yale Preoperative Anxiety Scale and Posttraumatic Stress Disorder Symptoms Scale) to assess responses, while others used one or more biomarkers to measure effect on children.

The researchers reported that pediatric patients who had been visited by a hospital clown reported significant improvements in anxiety (13 studies), pain (nine studies), and cancer-related fatigue (three studies). Pediatric patients who were visited by a hospital clown also reported significant improvements in emotional well-being (four studies) and stress (four studies).

In addition, clown doctors resulted in significant improvements in intraoperative serum cortisol levels (one study) and a reduction in pain from strabismus surgery (one study). Additionally, both pain and anxiety improved significantly in patients who were visited by a clown compared to patients who were not (one study).

“The results support the continued investigation of complementary treatments for better psychological adjustment during the hospital admission process in pediatrics,” said Lopes-Júnior.

He encouraged continued use of clown doctors amid the pandemic when visits can be done safely or via telemedicine.

“Contact is important to enable a better interpersonal relationship between the child or young person and the clown, especially due to the social and emotional rupture of family members and friends,” said Lopes-Júnior.

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