G442(P) Therapeutic clowning – history, medicine and evidence

Abstract

History of clowning There is documented evidence for the role of a ‘Jester’ figure in most ancient cultures including, Egyptian, Greek, Chinese, Roman and mediaeval Europe. The term ‘clown’, derived from the Scandinavian word ‘cloyne’ to describe a ‘clumsy person’, started to appear in the 1500s to describe foolish characters in Shakespearean plays. Modern clowns are strongly associated with the tradition of the circus clown which developed from earlier comedic theatre roles during the 19th centuries. Joseph Grimaldi (1778–1837) being the first recognisable ancestor of the modern clown. Clowns in hospitals/health environments Dr Hunter Doherty ‘Patch’ Adams was the founder of clown doctors. He put on a red nose as he worked in hospitals believing that humour and laughter creates an atmosphere of trust and love between staff and patients. Clown doctors now work throughout the world including the Big Apple Circus Clown Care Unit, in USA, the Theodora Foundation in Europe, Africa and Asia and the Humour Foundation Clown Doctor Program in Australia. Therapeutic clowns are selected for personal qualities such as communication skills, compassion and empathy so they complement clinicians and play an integral role in the paediatric care team using magic, music and storytelling to engage children and enable them to deal with the emotions they may experience while in hospital such as fear, anxiety, boredom and loneliness. Evidence of effect Clowns may have positive cognitive, physiological, social and emotional effects. A review of the paediatric literature reveals their value in the following areas: Reducing stress and anxiety during the pre-operative period, in both children and parents Reducing pain during invasive medical procedures Reducing anxiety during sexual abuse examination Shorter induction time for anaesthesia and faster discharge Promoting patient- and family-centred care in PICU Positive impact on staff working in disaster area field hospital Improving team function