Friedrich Amos-Silvio Erik, Holzmeier Lorena, Ehlers Johanna, Seebacher Simone, Rössler Maggie, Skoluda Nadine, Nater Urs Markus, Zemp Martina
Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria.
Department of Research and Learning, RED NOSES Austria, Vienna, Austria.
Front Psychiatry. 2025 May 13;16:1556932. doi: 10.3389/fpsyt.2025.1556932. eCollection 2025.
Clown visits are an effective intervention to alleviate patients' stress and anxiety in pediatric hospital settings. However, while children and adolescents in inpatient psychiatric treatment might uniquely benefit from healthcare clowning, little research has addressed the effectiveness of clown visits in this setting.
This pilot study examined the short-term effects of clown visits on psychological (self-reported stress and mood) and physiological (salivary cortisol) outcomes in 29 children and adolescents aged between 7 and 17 years (M = 12.69, SD = 2.90) in a noncontrolled repeated pre-post design over 4 weeks. In addition, 21 care staff members reported separately on their perceived impact of clown visits.
Self-reported stress levels of children and adolescents were decreased significantly from before to after clown visits, whereas salivary cortisol indicated a similar, but nonsignificant decrease. According to the Multidimensional Mood Questionnaire (MDMQ), patients showed significant improvements in energetic arousal, but there were no effects on mood valence and calmness. The effectiveness of the clown visits did not change over repeated visits. Care staff reported that clown visits had a positive impact on patients' and their own well-being, but their evaluations regarding their stress levels and work processes on the ward were mixed.
The present results provide preliminary evidence that the stress-reducing and energizing effects of clown visits, which previous studies have demonstrated in various pediatric settings, can also be transferred to the field of inpatient child and adolescent psychiatry. Mixed self- and work-related evaluations from care staff suggest that improvements in the implementation of clown visits could help eliminate disruptive elements of this intervention.
小丑探访是缓解儿科医院环境中患者压力和焦虑的有效干预措施。然而，虽然住院精神科治疗中的儿童和青少年可能特别受益于医疗小丑服务，但很少有研究探讨小丑探访在这种环境下的有效性。
本试点研究采用非对照重复前后设计，在4周内对29名7至17岁（M = 12.69，SD = 2.90）的儿童和青少年进行了小丑探访对心理（自我报告的压力和情绪）和生理（唾液皮质醇）结果的短期影响研究。此外，21名护理人员分别报告了他们对小丑探访感知到的影响。
儿童和青少年自我报告的压力水平在小丑探访前后显著降低，而唾液皮质醇也有类似但不显著的下降。根据多维情绪问卷（MDMQ），患者在精力激发方面有显著改善，但对情绪效价和平静度没有影响。小丑探访的有效性在多次探访中没有变化。护理人员报告说，小丑探访对患者及其自身的幸福感有积极影响，但他们对自己压力水平和病房工作流程的评价不一。
目前的结果提供了初步证据，表明小丑探访的减压和激发活力的效果，此前在各种儿科环境中已得到证明，也可以应用到住院儿童和青少年精神病学领域。护理人员对自我和工作相关的评价不一，这表明改善小丑探访的实施方式可能有助于消除这种干预措施中的干扰因素。
