Bloorview Research Institute, Bloorview Kids Rehab, University of Toronto, Toronto, Ontario, Canada.
Evid Based Complement Alternat Med. 2011;2011:732394. doi: 10.1093/ecam/neq008. Epub 2011 Mar 13.
This pilot study examined the effects of Therapeutic Clowning on inpatients in a pediatric rehabilitation hospital. Ten disabled children with varied physical and verbal expressive abilities participated in all or portions of the data collection protocol. Employing a mixed-method, single-subject ABAB study design, measures of physiological arousal, emotion and behavior were obtained from eight children under two conditions-television exposure and therapeutic clown interventions. Four peripheral autonomic nervous system (ANS) signals were recorded as measures of physiological arousal; these signals were analyzed with respect to measures of emotion (verbal self reports of mood) and behavior (facial expressions and vocalizations). Semistructured interviews were completed with verbally expressive children (n = 7) and nurses of participating children (n = 13). Significant differences among children were found in response to the clown intervention relative to television exposure. Physiologically, changes in ANS signals occurred either more frequently or in different patterns. Emotionally, children's (self) and nurses' (observed) reports of mood were elevated positively. Behaviorally, children exhibited more positive and fewer negative facial expressions and vocalizations of emotion during the clown intervention. Content and themes extracted from the interviews corroborated these findings. The results suggest that this popular psychosocial intervention has a direct and positive impact on hospitalized children. This pilot study contributes to the current understanding of the importance of alternative approaches in promoting well-being within healthcare settings.
本初步研究考察了治疗小丑对儿科康复医院住院患者的影响。十名身体和言语表达能力各异的残疾儿童参与了数据收集协议的全部或部分内容。采用混合方法、单个主体 ABAB 研究设计，从八名儿童在两种条件下（电视暴露和治疗小丑干预）获得了生理唤醒、情绪和行为的测量结果。四个外周自主神经系统 (ANS) 信号被记录为生理唤醒的测量指标；这些信号与情绪（情绪的口头自我报告）和行为（面部表情和发声）的测量指标进行了分析。对具有言语表达能力的儿童（n = 7）和参与儿童的护士（n = 13）进行了半结构化访谈。相对于电视暴露，发现儿童对小丑干预的反应存在显著差异。在生理上，ANS 信号的变化发生得更频繁或模式不同。在情绪上，儿童（自我）和护士（观察到的）的情绪报告都有所提高。在行为上，儿童在小丑干预期间表现出更多的积极情绪和更少的消极情绪的面部表情和发声。访谈中提取的内容和主题证实了这些发现。结果表明，这种流行的心理社会干预对住院儿童有直接的积极影响。本初步研究有助于当前对在医疗保健环境中促进幸福感的替代方法的重要性的理解。
