Abstract
Evaluate the effects of clown activities on quality of life, depression, stress, anxiety, aid, and social support in patients eligible for palliative care (PC) attended in Primary Health Care (PHC). A quasi-experimental study, with pre-intervention and post-intervention evaluation, carried out with 16 patients eligible for early PC in PHC in a Midwestern city. Patients received 24 visits with home-based clown activities. The interventions evidenced improved quality of life and social support, with significant results for the Social Activities dimension (p = 0.023). Increased scores for Anxiety (p = 0.007) and Depression (p = 0.023) were also observed. Clown activities can bring positive results for the quality of life and social support of patients eligible for PC at home. They should be encouraged to interact with family knowledge and enhance humanized care, integral and centered on human relationships in PHC.
Highlights
Clown therapy is a flexible approach that adapts to changing conditions and circumstances imposed by disease, pain, alienation, and anguish since the clown can see things from another perspective[1]
Its practice has been identified since the time of Hippocrates since physicians of that era believed that humor produced positive effects on health; and introduced into the medical environment by the renowned Hunter Adams (Patch), who stressed that love and humor are fundamental characteristics of this scenario[2,3]
Education: eight (50.0%) participants had elementary possible to observe significant results for anxiety (p = 0.007) and school education, four (25.0%) were illiterate, three had (18.8%) depression (p = 0.023), which increased after the intervention
Summary
Clown therapy is a flexible approach that adapts to changing conditions and circumstances imposed by disease, pain, alienation, and anguish since the clown can see things from another perspective[1]. Considering the decline in health status, pain, and loss of hope when faced with the diagnosis of a life-limiting disease and the need for palliative care (PC), this type of therapy becomes relevant. PC configure as a therapeutic possibility by addressing the human being’s biopsychosocial and spiritual dimensions, aiming to improve the quality of life of patients and their families in a multi-professional and interdisciplinary way[4,5]. In this context, clown therapy enables patients to make imaginative and intelligent reflections and associations about their living conditions, helping them cope with everyday problems[1]. Several nomenclatures for therapies use clowns trained to act in health environments, especially hospitals: therapeutic clown, clown therapy, clown care, or juxtaposing words from different languages like English and Portuguese, such as“clownterapia”and “arte clown.” The present study adopted the terminology “clown activities”, to differentiate the activities of circus clowns from those who perform in other scenic spaces for specific audiences, as in the case of health care and community service environments[6]
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