The effectiveness of a medical clowning program on improving emotional status among hospitalized children undergoing cancer treatment: A quasi‐experimental study
Purpose To examine the effectiveness of one‐time medical clowning on improving short‐term positive emotions among hospitalized children undergoing cancer treatment, and to analyze whether age moderates this effect. Design In this quasi‐experimental research study, we recruited a pooled sample of 96...
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| Veröffentlicht in: | Journal of nursing scholarship 2022-03, Vol.54 (2), p.161-168 |
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| creator | Wu, Wei‐Wen Lu, Frank L. Shiu, Cheng‐Shi Tang, Chia‐Chun Jou, Shiann‐Tang Chen, Jiann‐Shiuh Liu, Yen‐Lin |
| description | Purpose
To examine the effectiveness of one‐time medical clowning on improving short‐term positive emotions among hospitalized children undergoing cancer treatment, and to analyze whether age moderates this effect.
Design
In this quasi‐experimental research study, we recruited a pooled sample of 96 children who were undergoing cancer treatment in pediatric oncology/hematology wards at three university‐affiliated medical centers in Taiwan from June 2018 through April 2020.
Methods
Children’s demographic characteristics, symptom distress, quality of life, and pretest emotional status were collected at T1. At T2, we collected only posttest emotional status. We adapted generalized estimating equation models to evaluate the effectiveness of medical clowning on enhancing positive emotions.
Findings
Changes in the probabilities of positive emotion were significantly different across groups (51.84% for the experimental group, 15.76% for the control group; Δ = 36.08, p = 0.001), and the change was more than two times larger for the experimental group (effect ratio = 3.28, p < 0.05) than for the control group. When evaluating the moderating effect of age on the intervention, none of the coefficients reached the significant (p < 0.05) levels, suggesting that age may not moderate the intervention effect.
Conclusion
This study demonstrates the core value of medical clowning in child‐friendly health care. Our findings clearly support the benefit of the one‐time medical clowning program on enhancing short‐term emotional well‐being across age groups of children. Medical clowning programs should be strongly encouraged and supported in pediatric oncology wards.
Clinical relevance
Medical clowning programs should be widely and continuously implemented in pediatric oncology wards as a routine clinical practice for enhancing emotional well‐being among children receiving cancer treatment. Nurses need to be aware of medical clowning’s equal effectiveness across age groups, not only or better for younger children. |
| doi_str_mv | 10.1111/jnu.12720 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2595564889</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2649764621</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3530-2fb968e1e390fe4d0582cae56e1f42b05c13b48c50ed17a8a3c2013b913209613</originalsourceid><addsrcrecordid>eNp1kc1u1DAUhS0Eoj-w4AWQJTZ0kdb_SdhVFVBQVTbtOvI4NzMeJfbUPy3DikfgHXgznqROp7CohDf2Pfp8pHMPQm8oOablnKxdPqasZuQZ2qdS1JUkqn0-v1ldKSnUHjqIcU0IUbTmL9EeF7UkrWr20e-rFWAYBjDJ3oKDGLEfsMYT9NboEZvR3znrlngT_DLoCXuH7VSG21mEySfrXeFi0ilHrCdf5JWPG5v0aH9Aj83Kjn0Ah7PrISz9_M9oZyDgFECnCVz6gE_xTdbR_vn5C75vINhZfbDN_fYVejHoMcLrx_sQXX_6eHV2Xl18-_zl7PSiMlxyUrFhUSIBBd6SAURPZMOMBqmADoItiDSUL0RjJIGe1rrR3DBSpJZyVpZB-SF6v_Mt8W4yxNRNNhoYR-3A59gx2UqpRNO0BX33BF37HMoiCqVEWyuh2Gx4tKNM8DEGGLpNSabDtqOkm5vrSnPdQ3OFffvomBdl-f_Iv1UV4GQH3NkRtv936r5eXu8s7wGLT6bX</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2649764621</pqid></control><display><type>article</type><title>The effectiveness of a medical clowning program on improving emotional status among hospitalized children undergoing cancer treatment: A quasi‐experimental study</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Wu, Wei‐Wen ; Lu, Frank L. ; Shiu, Cheng‐Shi ; Tang, Chia‐Chun ; Jou, Shiann‐Tang ; Chen, Jiann‐Shiuh ; Liu, Yen‐Lin</creator><creatorcontrib>Wu, Wei‐Wen ; Lu, Frank L. ; Shiu, Cheng‐Shi ; Tang, Chia‐Chun ; Jou, Shiann‐Tang ; Chen, Jiann‐Shiuh ; Liu, Yen‐Lin</creatorcontrib><description>Purpose
To examine the effectiveness of one‐time medical clowning on improving short‐term positive emotions among hospitalized children undergoing cancer treatment, and to analyze whether age moderates this effect.
Design
In this quasi‐experimental research study, we recruited a pooled sample of 96 children who were undergoing cancer treatment in pediatric oncology/hematology wards at three university‐affiliated medical centers in Taiwan from June 2018 through April 2020.
Methods
Children’s demographic characteristics, symptom distress, quality of life, and pretest emotional status were collected at T1. At T2, we collected only posttest emotional status. We adapted generalized estimating equation models to evaluate the effectiveness of medical clowning on enhancing positive emotions.
Findings
Changes in the probabilities of positive emotion were significantly different across groups (51.84% for the experimental group, 15.76% for the control group; Δ = 36.08, p = 0.001), and the change was more than two times larger for the experimental group (effect ratio = 3.28, p < 0.05) than for the control group. When evaluating the moderating effect of age on the intervention, none of the coefficients reached the significant (p < 0.05) levels, suggesting that age may not moderate the intervention effect.
Conclusion
This study demonstrates the core value of medical clowning in child‐friendly health care. Our findings clearly support the benefit of the one‐time medical clowning program on enhancing short‐term emotional well‐being across age groups of children. Medical clowning programs should be strongly encouraged and supported in pediatric oncology wards.
Clinical relevance
Medical clowning programs should be widely and continuously implemented in pediatric oncology wards as a routine clinical practice for enhancing emotional well‐being among children receiving cancer treatment. Nurses need to be aware of medical clowning’s equal effectiveness across age groups, not only or better for younger children.</description><identifier>ISSN: 1527-6546</identifier><identifier>EISSN: 1547-5069</identifier><identifier>DOI: 10.1111/jnu.12720</identifier><identifier>PMID: 34750968</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Age differences ; Age groups ; Cancer ; Cancer therapies ; Caregivers ; Child ; Child psychology ; Child, Hospitalized - psychology ; Children ; Children & youth ; Clinical medicine ; Clowning ; Clowns ; Demography ; emotion ; Emotional well being ; Emotions ; Health care ; Hematology ; Hospitalization ; Hospitalized ; Hospitals ; Humans ; Intervention ; medical clowning ; Neoplasms - therapy ; Nurses ; Oncology ; Pediatrics ; Positive emotions ; Psychological distress ; Quality of Life ; Quasi-experimental methods ; Short term ; Taiwan ; Therapy ; Treatment needs ; Well being</subject><ispartof>Journal of nursing scholarship, 2022-03, Vol.54 (2), p.161-168</ispartof><rights>2021 Sigma Theta Tau International</rights><rights>2021 Sigma Theta Tau International.</rights><rights>Copyright Blackwell Publishing Ltd. Mar 2022</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3530-2fb968e1e390fe4d0582cae56e1f42b05c13b48c50ed17a8a3c2013b913209613</citedby><cites>FETCH-LOGICAL-c3530-2fb968e1e390fe4d0582cae56e1f42b05c13b48c50ed17a8a3c2013b913209613</cites><orcidid>0000-0002-6439-5369</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjnu.12720$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjnu.12720$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,12825,27901,27902,30976,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34750968$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Wei‐Wen</creatorcontrib><creatorcontrib>Lu, Frank L.</creatorcontrib><creatorcontrib>Shiu, Cheng‐Shi</creatorcontrib><creatorcontrib>Tang, Chia‐Chun</creatorcontrib><creatorcontrib>Jou, Shiann‐Tang</creatorcontrib><creatorcontrib>Chen, Jiann‐Shiuh</creatorcontrib><creatorcontrib>Liu, Yen‐Lin</creatorcontrib><title>The effectiveness of a medical clowning program on improving emotional status among hospitalized children undergoing cancer treatment: A quasi‐experimental study</title><title>Journal of nursing scholarship</title><addtitle>J Nurs Scholarsh</addtitle><description>Purpose
To examine the effectiveness of one‐time medical clowning on improving short‐term positive emotions among hospitalized children undergoing cancer treatment, and to analyze whether age moderates this effect.
Design
In this quasi‐experimental research study, we recruited a pooled sample of 96 children who were undergoing cancer treatment in pediatric oncology/hematology wards at three university‐affiliated medical centers in Taiwan from June 2018 through April 2020.
Methods
Children’s demographic characteristics, symptom distress, quality of life, and pretest emotional status were collected at T1. At T2, we collected only posttest emotional status. We adapted generalized estimating equation models to evaluate the effectiveness of medical clowning on enhancing positive emotions.
Findings
Changes in the probabilities of positive emotion were significantly different across groups (51.84% for the experimental group, 15.76% for the control group; Δ = 36.08, p = 0.001), and the change was more than two times larger for the experimental group (effect ratio = 3.28, p < 0.05) than for the control group. When evaluating the moderating effect of age on the intervention, none of the coefficients reached the significant (p < 0.05) levels, suggesting that age may not moderate the intervention effect.
Conclusion
This study demonstrates the core value of medical clowning in child‐friendly health care. Our findings clearly support the benefit of the one‐time medical clowning program on enhancing short‐term emotional well‐being across age groups of children. Medical clowning programs should be strongly encouraged and supported in pediatric oncology wards.
Clinical relevance
Medical clowning programs should be widely and continuously implemented in pediatric oncology wards as a routine clinical practice for enhancing emotional well‐being among children receiving cancer treatment. Nurses need to be aware of medical clowning’s equal effectiveness across age groups, not only or better for younger children.</description><subject>Age differences</subject><subject>Age groups</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Caregivers</subject><subject>Child</subject><subject>Child psychology</subject><subject>Child, Hospitalized - psychology</subject><subject>Children</subject><subject>Children & youth</subject><subject>Clinical medicine</subject><subject>Clowning</subject><subject>Clowns</subject><subject>Demography</subject><subject>emotion</subject><subject>Emotional well being</subject><subject>Emotions</subject><subject>Health care</subject><subject>Hematology</subject><subject>Hospitalization</subject><subject>Hospitalized</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intervention</subject><subject>medical clowning</subject><subject>Neoplasms - therapy</subject><subject>Nurses</subject><subject>Oncology</subject><subject>Pediatrics</subject><subject>Positive emotions</subject><subject>Psychological distress</subject><subject>Quality of Life</subject><subject>Quasi-experimental methods</subject><subject>Short term</subject><subject>Taiwan</subject><subject>Therapy</subject><subject>Treatment needs</subject><subject>Well being</subject><issn>1527-6546</issn><issn>1547-5069</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kc1u1DAUhS0Eoj-w4AWQJTZ0kdb_SdhVFVBQVTbtOvI4NzMeJfbUPy3DikfgHXgznqROp7CohDf2Pfp8pHMPQm8oOablnKxdPqasZuQZ2qdS1JUkqn0-v1ldKSnUHjqIcU0IUbTmL9EeF7UkrWr20e-rFWAYBjDJ3oKDGLEfsMYT9NboEZvR3znrlngT_DLoCXuH7VSG21mEySfrXeFi0ilHrCdf5JWPG5v0aH9Aj83Kjn0Ah7PrISz9_M9oZyDgFECnCVz6gE_xTdbR_vn5C75vINhZfbDN_fYVejHoMcLrx_sQXX_6eHV2Xl18-_zl7PSiMlxyUrFhUSIBBd6SAURPZMOMBqmADoItiDSUL0RjJIGe1rrR3DBSpJZyVpZB-SF6v_Mt8W4yxNRNNhoYR-3A59gx2UqpRNO0BX33BF37HMoiCqVEWyuh2Gx4tKNM8DEGGLpNSabDtqOkm5vrSnPdQ3OFffvomBdl-f_Iv1UV4GQH3NkRtv936r5eXu8s7wGLT6bX</recordid><startdate>202203</startdate><enddate>202203</enddate><creator>Wu, Wei‐Wen</creator><creator>Lu, Frank L.</creator><creator>Shiu, Cheng‐Shi</creator><creator>Tang, Chia‐Chun</creator><creator>Jou, Shiann‐Tang</creator><creator>Chen, Jiann‐Shiuh</creator><creator>Liu, Yen‐Lin</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>4U-</scope><scope>7QJ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6439-5369</orcidid></search><sort><creationdate>202203</creationdate><title>The effectiveness of a medical clowning program on improving emotional status among hospitalized children undergoing cancer treatment: A quasi‐experimental study</title><author>Wu, Wei‐Wen ; Lu, Frank L. ; Shiu, Cheng‐Shi ; Tang, Chia‐Chun ; Jou, Shiann‐Tang ; Chen, Jiann‐Shiuh ; Liu, Yen‐Lin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3530-2fb968e1e390fe4d0582cae56e1f42b05c13b48c50ed17a8a3c2013b913209613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age differences</topic><topic>Age groups</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Caregivers</topic><topic>Child</topic><topic>Child psychology</topic><topic>Child, Hospitalized - psychology</topic><topic>Children</topic><topic>Children & youth</topic><topic>Clinical medicine</topic><topic>Clowning</topic><topic>Clowns</topic><topic>Demography</topic><topic>emotion</topic><topic>Emotional well being</topic><topic>Emotions</topic><topic>Health care</topic><topic>Hematology</topic><topic>Hospitalization</topic><topic>Hospitalized</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intervention</topic><topic>medical clowning</topic><topic>Neoplasms - therapy</topic><topic>Nurses</topic><topic>Oncology</topic><topic>Pediatrics</topic><topic>Positive emotions</topic><topic>Psychological distress</topic><topic>Quality of Life</topic><topic>Quasi-experimental methods</topic><topic>Short term</topic><topic>Taiwan</topic><topic>Therapy</topic><topic>Treatment needs</topic><topic>Well being</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Wei‐Wen</creatorcontrib><creatorcontrib>Lu, Frank L.</creatorcontrib><creatorcontrib>Shiu, Cheng‐Shi</creatorcontrib><creatorcontrib>Tang, Chia‐Chun</creatorcontrib><creatorcontrib>Jou, Shiann‐Tang</creatorcontrib><creatorcontrib>Chen, Jiann‐Shiuh</creatorcontrib><creatorcontrib>Liu, Yen‐Lin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>University Readers</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Sociology Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of nursing scholarship</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Wei‐Wen</au><au>Lu, Frank L.</au><au>Shiu, Cheng‐Shi</au><au>Tang, Chia‐Chun</au><au>Jou, Shiann‐Tang</au><au>Chen, Jiann‐Shiuh</au><au>Liu, Yen‐Lin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effectiveness of a medical clowning program on improving emotional status among hospitalized children undergoing cancer treatment: A quasi‐experimental study</atitle><jtitle>Journal of nursing scholarship</jtitle><addtitle>J Nurs Scholarsh</addtitle><date>2022-03</date><risdate>2022</risdate><volume>54</volume><issue>2</issue><spage>161</spage><epage>168</epage><pages>161-168</pages><issn>1527-6546</issn><eissn>1547-5069</eissn><abstract>Purpose
To examine the effectiveness of one‐time medical clowning on improving short‐term positive emotions among hospitalized children undergoing cancer treatment, and to analyze whether age moderates this effect.
Design
In this quasi‐experimental research study, we recruited a pooled sample of 96 children who were undergoing cancer treatment in pediatric oncology/hematology wards at three university‐affiliated medical centers in Taiwan from June 2018 through April 2020.
Methods
Children’s demographic characteristics, symptom distress, quality of life, and pretest emotional status were collected at T1. At T2, we collected only posttest emotional status. We adapted generalized estimating equation models to evaluate the effectiveness of medical clowning on enhancing positive emotions.
Findings
Changes in the probabilities of positive emotion were significantly different across groups (51.84% for the experimental group, 15.76% for the control group; Δ = 36.08, p = 0.001), and the change was more than two times larger for the experimental group (effect ratio = 3.28, p < 0.05) than for the control group. When evaluating the moderating effect of age on the intervention, none of the coefficients reached the significant (p < 0.05) levels, suggesting that age may not moderate the intervention effect.
Conclusion
This study demonstrates the core value of medical clowning in child‐friendly health care. Our findings clearly support the benefit of the one‐time medical clowning program on enhancing short‐term emotional well‐being across age groups of children. Medical clowning programs should be strongly encouraged and supported in pediatric oncology wards.
Clinical relevance
Medical clowning programs should be widely and continuously implemented in pediatric oncology wards as a routine clinical practice for enhancing emotional well‐being among children receiving cancer treatment. Nurses need to be aware of medical clowning’s equal effectiveness across age groups, not only or better for younger children.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>34750968</pmid><doi>10.1111/jnu.12720</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6439-5369</orcidid></addata></record> |
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| ispartof | Journal of nursing scholarship, 2022-03, Vol.54 (2), p.161-168 |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Age differences Age groups Cancer Cancer therapies Caregivers Child Child psychology Child, Hospitalized - psychology Children Children & youth Clinical medicine Clowning Clowns Demography emotion Emotional well being Emotions Health care Hematology Hospitalization Hospitalized Hospitals Humans Intervention medical clowning Neoplasms - therapy Nurses Oncology Pediatrics Positive emotions Psychological distress Quality of Life Quasi-experimental methods Short term Taiwan Therapy Treatment needs Well being |
| title | The effectiveness of a medical clowning program on improving emotional status among hospitalized children undergoing cancer treatment: A quasi‐experimental study |
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