Does clowning benefit children in hospital? Views of Theodora Children’s Trust clown doctors

Abstract

This paper reports on one part of a service evaluation designed to assess the impact of clown doctors in English children’s hospitals and children’s units. With the objective to gain the opinions of Theodora Trust special clowns, senior fully trained and experienced clown doctors (n=5), and trainee clown doctors (n=7), were asked what works best and least during a clown encounter with a sick child in hospital. Focus group meetings using the nominal group technique were held in two centres in London. The main outcome measures were the description and analysis of those factors that inhibit or enhance clown doctor encounters with sick children and their families. The results provide five voted items of importance of what works best when a clown doctor (junior or senior) visits a sick child in hospital, including gaining the child’s consent. Five voted items of what works least best during a clown encounter, including disrespect of hospital procedure and staff were also recorded. The clown doctors were very supportive of the use of humour for sick children and their families in hospital, believing it to be beneficial, but were critical of some elements of the visit arrangements, including prejudice by some staff.

Hospital clowning: a paediatrician’s view

“…This suggests that physicians consider their own perceptions of hospital clowning to be less important than their patients’ opinion, which is consistent with other studies on the position of hospital clowns from the perspective of hospital staff [2, 3, 11]. According to physicians, neither interaction with visiting hospital clowns nor facilitating the visits of the clowns on the ward is part of their job responsibilities.…”

“…Physicians who participated in our study reported no existing collaboration with hospital clowns. However, one of the conditions physicians listed which would assure an efficient collaboration, clear communication, is mentioned in previous research as an element which can negatively impact the child’s overall experience in the hospital [11]. …”

“…Firstly, we included a higher number of participants compared to similar studies [11]. Secondly, this study used a study methodology which explored paediatricians and paediatric residents’ perceptions in more detail than previously conducted studies, which were mainly surveys [2, 3].…”

“…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]. …”

Therapeutic clowning in paediatric practice

“…They also believe they have an important role in enhancing the care of sick children, and they feel that they should be given sufficient information by an experienced health professional to avoid giving an inappropriate performance to a sick child. They feel that all members of staff should be encouraged to engage in dialogue with clown doctors to appreciate their role in the healthcare team (Glasper et al, 2007b). The second part of the evaluation looked at the perception of doctors, nurses, parents and patients on whether clowning benefited children in hospital.…”