Exploring the usefulness of medical clowns in elevating satisfaction and reducing aggressive tendencies in pediatric and adult hospital wards

Dorit Efrat-Triester,Daniel Altman,Dalit Lev-Arai Margalit,Enav Friedmann,Kinneret Teodorescu

doi:10.1186/s12913-020-05987-9

Abstract

BackgroundMost existing research on medical clowns in health care services has investigated their usefulness mainly among child health consumers. In this research we examined multiple viewpoints of medical staff, clowns, and health consumers aiming to identify the optimal audience (adult or child health consumers) for which medical clowns are most useful. We focused on exploring their usefulness in enhancing health consumers’ satisfaction and, in turn, reducing their aggressive tendencies.MethodsWe conducted three studies that examined the placement fit of medical clowns from different points of view: medical staff (Study 1, n = 88), medical clowns (Study 2, n = 20), and health consumers (Study 3, n = 397). The main analyses in Studies 1 and 2 included frequencies and t-tests comparing perceived adult and child satisfaction with clowns’ performance. Study 3 used moderated-mediation PROCESS bootstrapping regression analysis to test the indirect effect of negative affectivity on aggressive tendencies via satisfaction. Exposure to the medical clown moderated this relationship differently for different ages.ResultsStudies 1 and 2 show that the majority of medical clowns and medical staff report that the current placement of the medical clowns is in pediatric wards; about half (44% of medical staff, 54% of medical clowns) thought that this placement policy should change.In Study 3, data from health consumers in seven different hospital wards showed that clowns are useful in mitigating the effect of negative affectivity on satisfaction, thereby reducing aggressive tendencies among health consumers under the age of 21.6 years.Surprisingly, medical clowns had the opposite effect on most adults: for health consumers who were exposed to the medical clown and were above the age of 21.6 negative affectivity was related to decreased satisfaction, and an increase in aggressive tendencies was observed.DiscussionMedical clowns are most useful in elevating satisfaction and reducing aggressive tendencies of children. Older adults, on the other hand, exhibit lower satisfaction and higher aggressive tendencies following exposure to the performance of medical clowns.ConclusionMedical clowns should be placed primarily in children’s wards.

Highlights

Most existing research on medical clowns in health care services has investigated their usefulness mainly among child health consumers
While Patch Adams referred to clowning for a variety of audiences, most medical clowns operate in pediatric wards, and most studies focus on child health consumers [6]
As the overall goal of the study was to identify the optimal health care audience that will benefit most from medical clowns, we examined whether medical clowns can buffer the harmful effect of negative affectivity on health consumer satisfaction, and whether this buffering effect depends on the age of the health consumer audience

Summary

Introduction

Most existing research on medical clowns in health care services has investigated their usefulness mainly among child health consumers. The current study draws from literature in the fields of service management and organizational behavior to better understand the influence of medical clowns on the perceived satisfaction of health consumers in different hospital wards. This exploration is important as health consumers’ satisfaction measures can help identify the optimal health care audience (adults or children) that will most benefit from medical clowns

Objectives

Methods

Results

Conclusion