Highly sensitive persons, caregiving strategies and humour: the case of Italian and Israeli medical clowns

Dionigi, Alberto; Goldberg, Alon

doi:10.7592/ejhr2019.7.4.dionigi

Cited by 6 publications

(6 citation statements)

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“…The common knowledge is that MCs focus on humor with the ultimate goal of making the patient smile ( Battrick et al, 2007 ; Dionigi & Goldberg, 2019 ; Finlay et al, 2014 ; Friedler et al, 2017 ; Mora-Ripoll, 2010 ). However, this study showed that expressions of joy and relief were considered positive but were not the only or even the principal goal.…”

Section: Discussionmentioning

confidence: 99%

“…Medical clowns (MCs), also called hospital clowns or clown doctors, are trained professionals who aim to change the perception of the hospital environment by creating humoristic situations to elicit laughter and joy in children’s wards as well as with adults and older adults ( Dionigi et al, 2014 ; Dionigi & Goldberg, 2019 ; Friedler et al., 2017 ; Koller & Gryski, 2008 ; Lalantika & Yuvaraj, 2020 ; Linge, 2008 ; Ofir et al, 2016 ; Weaver et al, 2007 ). In many cases, patients, families, and staff value MCs ( Dionigi & Canestrari, 2016 ; Higueras et al, 2006 ; Schwebke & Gryski, 2003 ; Warren & Spitzer, 2013 ), especially for improving patients’ physical and mental well-being through creating an alternative atmosphere ( Dionigi et al, 2014 ; Friedler et al, 2017 ; Lopes-Júnior et al, 2020 ; Nuttman-Shwartz et al, 2010 ; Weaver et al, 2007 ).…”

Section: Introductionmentioning

confidence: 99%

“…The need to learn about MCs’ skills and competencies has led to an increase in research papers, in recent years, including quantitative satisfaction surveys, case studies, storytelling, observational perspectives, and ethnographic fieldwork ( Dionigi et al, 2014 ; Dionigi & Goldberg, 2019 ; Finlay et al, 2014 ; Friedler et al., 2017 ; Holland et al, 2022 ; Kristensen et al, 2018 ; Mora-Ripoll, 2010 ) 1 . These papers were very important in identifying performance arts skills among MCs (such as music, comedy, mime, magic, or puppetry) that entail cognitive distraction, humor, improvisation, imagery, and relational aspects to shift attention from pain or distress ( Barkmann et al, 2013 ; Dionigi & Canestrari, 2016 ; Finlay et al, 2014 ; Koller & Gryski, 2008 ; Kristensen et al, 2018 ; Linge, 2008 , 2013 ; Ofir et al, 2016 ; Tener et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

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More Than Just an Entertainment Show: Identification of Medical Clowns’ Communication Skills and Therapeutic Goals

et al. 2022

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Medical clowns (MCs) are trained professionals who aim to change the hospital environment through humor. Previous studies focused on their positive impact and began identifying their various skills in specific situations. When placed in pediatrics, MCs face various challenges, including approaching frustrated adolescents who are unwilling to cooperate with their care, dealing with their anxious parents, and communicating in a team in the presence of other health professionals. Research that systematically describes MCs’ skills and therapeutic goals in meeting these challenges is limited. This article describes a qualitative, immersion/crystallization study, triangulating between 26 video-recorded simulations and 12 in-depth-semi-structured interviews with MCs. Through an iterative consensus-building process we identified 40 different skills, not limited to humor and entertainment. Four main therapeutic goals emerged: building a relationship, dealing with emotions, enhancing a sense of control, caring, and encouragement, and motivating treatment adherence. Mapping MCs’ skills and goals enhances the understanding of MCs’ role and actions to illustrate their unique caring practices. This clarification may help other healthcare professionals to recognize their practices and the benefits in involving them in care. Furthermore, other health professionals may apply some of the identified skills when faced with these challenges themselves.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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More Than Just an Entertainment Show: Identification of Medical Clowns’ Communication Skills and Therapeutic Goals

et al. 2022

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“…Since the emergence of hospital clowns in North America in the 1980s, it has become a popular practice in paediatric settings, mainly in acute and rehabilitation hospitals worldwide 14. Hospital clowns have a positive effect on paediatric patient outcomes, mainly in patients with acute conditions and during medical procedures 14151617181920. Hospital clowns are also increasingly thought to have a complementary role in healthcare by easing the recovery of these patients 1415…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials

Lopes-Júnior

Bomfim

Olson

et al. 2020

BMJ

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Objective To evaluate evidence from randomised controlled trials and non-randomised controlled trials on the effectiveness of hospital clowns for a range of symptom clusters in children and adolescents admitted to hospital with acute and chronic conditions. Design Systematic review of randomised and non-randomised controlled trials. Data sources Medline, ISI of Knowledge, Cochrane Central Register of Controlled Trials, Science Direct, Scopus, American Psychological Association PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences Literature. Study selection Randomised and non-randomised controlled trials were peer reviewed using the following eligibility criteria: children and adolescents who were admitted to hospital for acute conditions or chronic disorders, studies comparing use of hospital clowns with standard care, and studies evaluating the effect of hospital clowns on symptom management of inpatient children and adolescents as a primary outcome. Data extraction and synthesis Two investigators independently screened studies, extracted data, and appraised the risk of bias. Methodological appraisal was assessed by two investigators independently using the Jadad scale, the revised Cochrane risk-of-bias tool for randomised controlled trials (RoB 2), and the risk of bias in non-randomised studies (ROBINS-I) tool for non-randomised controlled trials. Results 24 studies (n=1612) met the inclusion criteria for data extraction and analysis. Most studies were randomised controlled trials (n=13). Anxiety was the most frequently analysed symptom (n=13), followed by pain (n=9), psychological and emotional responses and perceived wellbeing (n=4), stress (n=4), cancer related fatigue (n=3), and crying (n=2). Five studies used biomarkers, mainly cortisol, to assess stress or fatigue outcome following hospital clowns. Most of the randomised controlled trials (n=11; 85%) were rated as showing some concerns, and two trials were rated with a high risk of bias. Most non-randomised controlled trials (n=6; 55%) were rated with a moderate risk of bias according to ROBINS-I tool. Studies showed that children and adolescents who were in the presence of hospital clowns, either with or without a parent present, reported significantly less anxiety during a range of medical procedures, as well as improved psychological adjustment (P<0.05). Three studies that evaluated chronic conditions showed favourable results for the intervention of hospital clowns with significant reduction in stress, fatigue, pain, and distress (P<0.05). Conclusions These findings suggest that the presence of hospital clowns during medical procedures, induction of anaesthesia in the preoperative room, and as part of routine care for chronic conditions might be a beneficial strategy to manage some symptom clusters. Furthermore, hospital clowns might help improve psychological wellbeing in admitted children and adolescents with acute and chronic disorders, compared with those who received only standard care. Systematic review registration PROSPERO CRD42018107099.

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“…Some scholars have stressed the risk of emotional exhaustion for clown therapists and the need to have appropriate coping strategies to compensate for their vulnerabilities [ 57 ]. Dionigi had shown that the best predictor to keep in mind for emotional exhaustion in clown therapists was the neuroticism trait [ 58 ]. Some have suggested it can limit the risk of emotional exhaustion, by learning to keep the role being played separate from one’s own person [ 59 , 60 , 61 ], while others recommend a number of expedients that can be applied to mitigate the risk of burnout: spacing out vacations, frequently consulting with a supervisor, and relying on consultation with a mental health professional in the event of perceived discomfort [ 62 , 63 , 64 ].…”

Section: Discussionmentioning

confidence: 99%

Motivations and Personal Traits Can Predict Self-Efficacy of the Clown Therapist: A Descriptive Study

Diotaiuti

Mancone

Corrado

2022

IJERPH

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The individual and collective perception of self-efficacy in clown therapists is fundamental in order to be able to be active, restrained, energetic and defocused, if necessary, without being overwhelmed by any problems patients might have. The present study evaluated both the incidence of motivational and dispositional functions on the level of perceived self-efficacy with a sample of 259 Italian clown therapists who were administered The Volunteer Self-Efficacy Scale, the Volunteer Process Model and the Italy Personality Inventory. The significance of a hierarchical linear regression model of perceived self-efficacy was tested. The results showed that the value orientation of the operators mainly influenced the level of perceived self-efficacy, that is, the search for actions with a high social meaning, rather than the orientation towards situations and experiences that allow one to expand one’s knowledge and promote one’s own person. Profiles with higher perceived self-efficacy were associated with the trait of dynamism and conscientiousness, while a person’s vulnerability was found to be a significant negative predictor of self-efficacy. An additional significant predictor was the experience of the clown therapist. The results of the study also showed a positive and functional role of the synergy conferred by teamwork. The group mitigates the emotional difficulties of the individual and supports him/her by orienting him/her technically and compensating for any inexperience in the field of animation in sensitive contexts, such as hospital wards with serious and vulnerable patients, such as children.

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Highly sensitive persons, caregiving strategies and humour: the case of Italian and Israeli medical clowns

Cited by 6 publications

References 50 publications

More Than Just an Entertainment Show: Identification of Medical Clowns’ Communication Skills and Therapeutic Goals

More Than Just an Entertainment Show: Identification of Medical Clowns’ Communication Skills and Therapeutic Goals

Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials

Motivations and Personal Traits Can Predict Self-Efficacy of the Clown Therapist: A Descriptive Study

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