Hospital clowning: a paediatrician\u2019s view

Lennard T Van Venrooij,Pieter C Barnhoorn

doi:10.1007/s00431-016-2821-8

Lennard T Van Venrooij, Pieter C Barnhoorn

Open Access

https://doi.org/10.1007/s00431-016-2821-8

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Abstract

This study investigates the current position of hospital clowns from the perspective of paediatricians and paediatric residents. A total of 14 attending paediatricians and paediatric residents participated in two focus group sessions. Data were analysed using Atlas.ti 5.0. In general, physicians reported positive experiences regarding the interaction between hospital clowns and paediatric patients on the ward. Physicians were more interested in research on children’s perception of hospital clowns than in research on the clinical efficacy of hospital clowning. No direct collaboration between physicians and hospital clowns was reported. However, physicians proposed conditions which may streamline their encounters with hospital clowns such as clear communication prior to hospital clown visits, and the condition that visits do not impede medical interventions.Conclusion: Overall, paediatricians and paediatric residents view the positive impact on paediatric patients as the most important aspect of hospital clown visits, rather than the clinical efficacy of hospital clowning. In light of the growing number of hospital clowns worldwide, this article provides recommendations for arranging their encounters with paediatricians and paediatric residents to maintain optimal health care.What is known:• Previous studies show a clinically significant pain- and anxiety-reducing effect of hospital clowning in paediatric patients admitted to hospitals or undergoing (invasive) medical procedures.• In general, paediatricians have positive ideas about hospital clowns, aside from personal prejudices.What is new:• This novel study gives deeper insight into day-to-day interaction between paediatricians and hospital clowns on the ward.• This study provides recommendations for clinical practice to arrange encounters between physicians and hospital clowns during hospital clown visits.

Highlights

The hospital clown has existed in many different cultures since the end of the twentieth century [9]
Overall, paediatricians and paediatric residents view the positive impact on paediatric patients as the most important aspect of hospital clown visits, rather than the clinical efficacy of hospital clowning
Two focus group discussions were held with one paediatrician and eight paediatric residents in focus group 1 and two paediatricians and three paediatric residents in focus group 2 (n = 14)

Summary

Introduction

The hospital clown has existed in many different cultures since the end of the twentieth century [9]. Modern hospital clowns use humour to achieve a personal and trusting atmosphere between hospital workers and patients in the clinic [9]. Hospital clowns aim to reduce stress, fear, helplessness and sadness in the hospitalised paediatric patient [2]. Randomised controlled trials among children who underwent various invasive procedures showed pain relief and anxiety reduction in children and parents before or during the intervention by means of the presence of a hospital clown [8, 12, 13, 21, 24]. Previous studies show that hospital clowns are appreciated by patients, parents and hospital staff [2]. Most physicians believe that hospital clowns can have a positive impact on the paediatric patient and its health, despite the fact that some physicians personally do not like hospital clowns [2, 3, 11]

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