Medical clowns reduce stress & shorten hospital stays for children, new study finds

Two doctors dressed as clowns sit with a young boy patient in a children's hospital, where they draw pictures together.

Clowns can solve a lot more than just a broken funny bone, according to a new study.

As it turns out, spending time with a medical clown can shorten the length of hospital stays for children — especially those with pneumonia — per a recent study presented at the European Respiratory Society Congress in Vienna, Austria. 

Two doctors dressed as clowns sit with a young boy patient in a children's hospital, where they draw pictures together.
Photo courtesy of The Dream Doctors Project

“Medical clowns undergo specific training to work in hospitals. They have been shown to reduce pain and alleviate stress and anxiety in children and their families during medical treatment, and have been gradually integrated into many aspects of hospital care,” said Dr. Karin Yaacoby-Bianu of the Carmel Medical Center, the lead author of the study.

“But their impact on children being treated for pneumonia has not yet been investigated.”

Pneumonia is one of the leading causes of hospitalization in children around the globe, and considering factors that improve their well-being, vital signs, need for antibiotics, and more, could be monumental in improving their care.

The research team followed 51 children between the ages of 2 and 18 years old who were hospitalized due to pneumonia. A control group received standard care, and the second group received standard care — plus a 15-minute visit from a medical clown.

A sick child lays in a hospital bed, smiling at a doctor wearing a red nose.
Photo courtesy of The Dream Doctors Project

Three clowns from The Dream Doctors Project came twice daily during the first 48 hours of hospitalization and employed a myriad of techniques to help the patients de-stress.

This included music, singing, and what they call guided imagination. The clowns also playfully encouraged the patients to eat and drink by themselves.

After this, the researchers found that the group of patients who interacted with a medical clown had a shorter hospital stay — 43.5 hours on average, compared to 70 hours. They also only needed two days of intravenous antibiotics, compared to three days for patients in the control group.

As far as stress relief goes, the researchers noted a significant decrease in respiratory rate, heart rate, and inflammatory markers in the children who met with the clowns.

Dr. Karin Yaacoby-Bianu, a white woman with shoulder-length straight blond hair. She smiles, wearing a royal blue blouse and white lab coat.
Dr. Karin Yaacoby-Bianu. Photo courtesy of European Respiratory Society (CC BY-SA)

“While the practice of medical clowning is not a standardized interaction, we believe it helps to alleviate stress and anxiety, improves psychological adjustment to the hospital environment, and allows patients to better participate in treatment plans, like adherence to oral antibiotics and fluids,” Dr. Yaacoby-Bianu said.

“This, in turn, helps the children to recuperate faster.”

The research also indicated that laughter and humor could have direct physiological benefits for children recovering from pneumonia, like lowering respiratory and heart rates, reducing air trapping, modulating hormones, and enhancing immune function.

These findings are aligned with other studies on the positive impacts of medical clowning, which have found that the practice improves sleep in sick children, reduces feelings of fear and helplessness in pediatric care, and can even lower costs for hospitals

Three medical clowns in head-to-toe PPE, with red noses under their clear face coverings
Photo courtesy of The Dream Doctors Project

Some studies have also found that medical clowns can relieve stress for healthcare providers, and may even go as far as reducing physical pain in patients

“This study indicates the positive effect that humor can have in healthcare settings,” Dr. Stefan Unger, a consultant respiratory pediatrician at the Royal Hospital for Children and Young People in Edinburgh, UK, said in a statement, in reference to Dr. Yaacoby-Bianu’s work.

Dr. Unger was not involved in the research but said that it “emphasizes the potential for non-pharmacological interventions to influence clinical outcomes.”

The researchers say that they believe a future investigation could reveal more “specific mechanisms by which humor influences clinical outcomes,” and hope to engage in further trials in larger patient cohorts.

A Ukrainian child touches noses with a medical clown from the Dream Doctors Project
The Dream Doctors Project has sent teams to support refugees in Ukraine. Photo courtesy of The Dream Doctors Project

In the meantime, however, medical teams all over the world — in hospitals, refugee communities, and crisis response — are confident sending in the clowns.

“The clowns have [shown] us that there’s a lot more to medicine than simply giving medications,” Professor Anthony Luder, the head of pediatrics at Ziv Medical Center Zefat, said in a video about The Dream Doctors Project.

“As they say, clowning is a serious business.”

Header image courtesy of The Dream Doctors Project

Article Details

September 10, 2024 10:59 AM
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