Ben-Gurion University of the Negev, 8499000, Beer-Sheva, Israel.
Technion - Israel Institute of Technology, Haifa, Israel.
BMC Health Serv Res. 2021 Jan 6;21(1):15. doi: 10.1186/s12913-020-05987-9.
Most existing research on medical clowns in health care services has investigated their usefulness mainly among child health consumers. In this research we examined multiple viewpoints of medical staff, clowns, and health consumers aiming to identify the optimal audience (adult or child health consumers) for which medical clowns are most useful. We focused on exploring their usefulness in enhancing health consumers' satisfaction and, in turn, reducing their aggressive tendencies.
We conducted three studies that examined the placement fit of medical clowns from different points of view: medical staff (Study 1, n = 88), medical clowns (Study 2, n = 20), and health consumers (Study 3, n = 397). The main analyses in Studies 1 and 2 included frequencies and t-tests comparing perceived adult and child satisfaction with clowns' performance. Study 3 used moderated-mediation PROCESS bootstrapping regression analysis to test the indirect effect of negative affectivity on aggressive tendencies via satisfaction. Exposure to the medical clown moderated this relationship differently for different ages.
Studies 1 and 2 show that the majority of medical clowns and medical staff report that the current placement of the medical clowns is in pediatric wards; about half (44% of medical staff, 54% of medical clowns) thought that this placement policy should change. In Study 3, data from health consumers in seven different hospital wards showed that clowns are useful in mitigating the effect of negative affectivity on satisfaction, thereby reducing aggressive tendencies among health consumers under the age of 21.6 years. Surprisingly, medical clowns had the opposite effect on most adults: for health consumers who were exposed to the medical clown and were above the age of 21.6 negative affectivity was related to decreased satisfaction, and an increase in aggressive tendencies was observed.
Medical clowns are most useful in elevating satisfaction and reducing aggressive tendencies of children. Older adults, on the other hand, exhibit lower satisfaction and higher aggressive tendencies following exposure to the performance of medical clowns.
Medical clowns should be placed primarily in children's wards.
大多数现有的医疗小丑在医疗保健服务中的研究主要调查了他们在儿童健康消费者中的有用性。在这项研究中，我们从医务人员、小丑和健康消费者的多个角度考察，旨在确定医疗小丑最有用的最佳受众（成年或儿童健康消费者）。我们专注于探索他们在提高健康消费者满意度方面的有用性，进而降低他们的攻击倾向。
我们进行了三项研究，从不同角度考察了医疗小丑的定位适配性：医务人员（研究 1，n=88）、医疗小丑（研究 2，n=20）和健康消费者（研究 3，n=397）。研究 1 和 2 的主要分析包括频率和 t 检验，比较了对小丑表演的成人和儿童满意度。研究 3 使用调节中介 PROCESS 引导回归分析，通过满意度检验负性情感对攻击倾向的间接效应。对医疗小丑的接触对不同年龄段的这种关系有不同的调节作用。
研究 1 和 2 表明，大多数医疗小丑和医务人员报告说，医疗小丑的当前安置位置在儿科病房；约一半（医务人员的 44%，医疗小丑的 54%）认为这一安置政策应该改变。在研究 3 中，来自七个不同医院病房的健康消费者的数据表明，小丑在减轻负性情感对满意度的影响方面是有用的，从而降低了 21.6 岁以下健康消费者的攻击倾向。令人惊讶的是，医疗小丑对大多数成年人有相反的影响：对于接触过医疗小丑且年龄超过 21.6 岁的健康消费者，负性情感与满意度降低有关，并且观察到攻击倾向增加。
医疗小丑在提高儿童的满意度和降低攻击性方面最有用。另一方面，老年人在接触医疗小丑后表现出较低的满意度和较高的攻击性倾向。
医疗小丑应主要安置在儿童病房。
