Clowns in Paediatric Surgery: Less Anxiety and More Oxytocin? A Pilot Study

Abstract

Background Hospital stays and medical interventions are accompanied by worries and anxiety in children and parents. Recent studies show that hospital clowns may reduce anxiety and enhance well-being. However, so far studies are based solely on subjective measures and clowns are usually not integrated in medical routine. With this pilot study, we aim to provide both psychological and physiological evidence of positive effects of clowns’ interventions in hospitalized children.

Patients/Method In a consecutive randomized intervention-control group design with 31 children aged 4 to 13 years, 17 patients were accompanied by a clown prior to surgery or during ward round (intervention group) and 14 were not (control group). Saliva samples for oxytocin measurement were taken from all patients before hospitalization (T1) and prior to surgery or after ward round (T2). Self- and parents-reports were obtained at T1, T2 as well as at time of discharge from hospital (T3) regarding children’s anxiety (STAI), worries and well-being. Clowns evaluated their success in cheering up the child. Health professionals were asked for their acceptance of clowns in hospitals.

Results Children in the intervention group had lower anxiety ratings and a higher oxytocin concentration at T2 as compared with T1; the control group showed no changes. Parents rated the well-being of their children higher if their child had clown’s contact and were more willing to recommend the hospital. The staff judged the clowns as helpful for patients.

Discussion Consistent psychological and physiological results suggest the positive impact of a clown’s intervention in hospitalized children.

Zusammenfassung

Hintergrund Krankenhausaufenthalte und medizinische Behandlungen sind bei Kindern und Eltern mit Sorgen und Ängsten verbunden. Aktuelle Studien zeigen, dass Krankenhausclowns Angst reduzieren und Wohlbefinden steigern können. Allerdings basieren Studien bisher nur auf subjektiven Maßen und Clowns sind üblicherweise nicht in die medizinische Routine integriert. Daher soll unsere Pilotstudie psychologische und physiologische Belege für die positiven Effekte von Clownsinterventionen bei Kindern im Krankenhaus liefern.

Patienten/Methode In einem konsekutiven randomisierten Interventions-Kontrollgruppen-Design mit 31 Kindern (4–13 Jahre) wurden 17 Patienten vor der Operation bzw. während der Visite (Interventionsgruppe) von Clowns begleitet, während 14 nicht begleitet wurden (Kontrollgruppe). Speichelproben für die Oxytocin-Messung wurden von den Kindern vor der Einweisung (T1) und vor der Operation/Visite (T2) genommen. Selbst- und Elterneinschätzung zu T1, T2 sowie bei Entlassung (T3) wurden bezüglich Angst der Kinder (STAI), Sorgen und Wohlbefinden erhoben. Clowns schätzten ihren Erfolg bei der Aufheiterung der Kinder ein. Das medizinische Personal wurde nach ihrer Akzeptanz von Clowns im Krankenhaus gefragt.

Ergebnisse Kinder in der Interventionsgruppe hatten zu T2 geringere Angstwerte sowie eine höhere Oxytocinkonzentration als zu T1; die Kontrollgruppe zeigte keine Änderung. Die Eltern der Kinder in der Interventionsgruppe schätzten das Wohlbefinden ihrer Kinder höher ein und waren gewillter, das Krankenhaus zu empfehlen. Das Personal bewertete die Clownsinterventionen als hilfreich für Patienten.

Diskussion Konsistente psychologische und physiologische Befunde weisen auf die positive Wirkung von Clowns für Kinder im Krankenhaus hin.

Key words

hospital clowns - medical routine - oxytocine - psychological well-being - anxiety - childcare

Schlüsselwörter

Krankenhausclowns - Routineversorgung - Oxytocin - psychisches Wohlbefinden - Angst - Kinderpflege

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