Medical clowns reduce hospitalization length in pediatric community-acquired pneumonia
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Key takeaways:
- In addition to hospital stay, IV antibiotic treatment length was shorter in the medical clown group vs. standard care alone group.
- Respiratory and heart rate significantly improved from hospital day 1 to day 2.
Pediatric patients with community-acquired pneumonia spent less time in the hospital and receiving IV antibiotics when visited by a medical clown, according to a presentation at the European Respiratory Society International Congress.
“The findings of our study strengthen the importance of integrating medical clowns into the care team of pediatric community-acquired pneumonia and implementing humor and laughter in everyday hospital work,” Karin Yaacoby-Bianu, pediatrician at Carmel Medical Center and in the Ruth and Bruce Rappaport Faculty of Medicine at Technion-Israel Institute of Technology, told Healio. “This can improve the quality of care, as well as the burden to children and their families endured by hospitalization.”
In a single-center, prospective, randomized controlled trial, Yaacoby-Bianu and colleagues assessed 51 children/adolescents (mean age, 4.4 years; 58.8% male) aged 2 to 18 years hospitalized for community-acquired pneumonia to find out how a medical clown intervention plus standard care impacts hospitalization duration, IV antibiotic length, well-being scores, complications and alterations in vital signs and inflammatory markers vs. standard care alone.
Within the total cohort, 25 children/adolescents had been assigned standard care alone, which involved “as needed IV antibiotics, adequate respiratory support, hydration, pain and antipyretic treatment,” according to researchers. The remaining 26 children/adolescents had been assigned the medical clown plus standard care intervention. In this group, a medical clown visited two times a day for 15 minutes in the patient’s first 48 hours of hospitalization. The clown helped children/adolescents relax through music, singing and guided imagination and “engaged the children in starting drinking and eating by themselves,” according to the poster.
On the first two days of admissions, both the doctor and parent of the child/adolescent filled out a case report form.
Among those receiving standard care plus the medical clown intervention, the average length of hospitalization was 43.5 hours, whereas those receiving just standard care had a longer average length at 70 hours (P = .03).
IV antibiotic treatment length was also shorter in the standard care plus medical clown intervention group vs. the standard care alone group (48 hours vs. 72 hours; P = .01), according to researchers.
“We knew from past research that hospital clown intervention has been shown to have a positive effect on pediatric patient outcomes for acute conditions and during medical procedures, by managing anxiety, stress, pain, fatigue and improving psychological adjustment, yet we were surprised by the magnitude that medical clowns had on objective parameters of hospitalization due to pneumonia, such as shortening length of stay and IV antibiotic treatment,” Yaacoby-Bianu told Healio.
Additionally, several measures significantly improved from day 1 to day 2 among those receiving standard care plus the medical clown intervention:
- respiratory rate (36.6 to 31.3 breaths per minute; P = .01);
- heart rate (122.7 to 112.3 beats per minute; P = .03);
- mood according to the doctor (6.3 to 7.5; P = .01);
- vitality according to the doctor (8 to 9; P = .01);
- white blood cell count (22.7 k/μL to 14.7 k/μL; P = .04); and
- absolute neutrophil count (19.7 k/μL to 10.6 k/μL; P = .02).
“We proved that laughter is good for health (and health systems) in strengthening the mind-body connection,” Yaacoby-Bianu told Healio.
“Further large-scale studies should aim to better elucidate the populations and clinical scenarios where medical clown interventions are most impactful,” Yaacoby-Bianu said. “Also, exploration and understanding of the mechanisms underlying these changes, could offer valuable insights into the integration of holistic approaches to patient care in health care settings.”
Reference:
- Medical clowns shorten hospital stays for children with pneumonia. https://www.ersnet.org/news-and-features/news/medical-clowns-shorten-hospital-stays-for-children-with-pneumonia/. Published Sept. 8, 2024. Accessed Sept. 8, 2024.