Medical clowns can shorten hospital stays for children with pneumonia

Spending time with a medical clown can shorten the length of hospital stay for children with pneumonia, according to a study presented at the European Respiratory Society (ERS) Congress in Vienna, Austria. They can also shorten the length of time they need to give intravenous antibiotics.

The study was presented by Dr. Karin Yaacoby-Bianu from Carmel Medical Center and Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel.

She explains: “Medical clowns undergo special 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 gradually been integrated into many areas of hospital care. However, their effects on children being treated for pneumonia have not yet been studied.”

“Community-acquired pneumonia is one of the most common reasons for hospitalization in children worldwide. The length of a child's hospital stay depends on several factors, including their well-being, vital signs, need for intravenous fluids and antibiotics, and whether complications arise.”

The team followed 51 children between the ages of two and 18 who had been hospitalized for pneumonia. One group received standard care; the second received standard care plus a 15-minute visit from a medical clown twice a day during the first 48 hours of hospital stay.

Three medical clowns from the Dream Doctors Project used various techniques to relax the patients, such as music, singing and guided imagery. They also encouraged the children to drink and eat independently again.

The researchers found that the group visited by a medical clown had a shorter hospital stay (an average of 43.5 hours versus 70 hours) and required only two days of intravenous antibiotic treatment compared to three days in the control group. In the clown group, the researchers also found a significant decrease in respiratory rate, heart rate and inflammatory markers.

Dr. Yaacoby-Bianu explains, “Although the practice of medical clowning is not a standardized interaction, we believe it helps reduce stress and anxiety, improves psychological adjustment to the hospital environment, and allows patients to better participate in treatment plans such as adherence to oral antibiotics and fluids. This, in turn, helps children recover faster.”

“Laughter and humor may also have direct physiological benefits by lowering respiratory and heart rates, reducing air trapping, modulating hormones, and improving immune function.”

The team is conducting further studies on the effects of medical clowns on other diseases to find out which ones they might be most effective for.

Dr Stefan Unger is chair of the ERS Paediatric Respiratory Infections and Immunology Group and a consultant paediatrician in respiratory diseases at the Royal Hospital for Children and Young People in Edinburgh, UK. He was not involved in the study. He said: “This study demonstrates the positive impact that humour can have in healthcare and highlights the potential of non-pharmacological interventions to influence clinical outcomes.”

“Shortening children's hospital stays by adding medical clowns to a multidisciplinary pneumonia treatment team can reduce physical and emotional stress for children and their families. It can also reduce costs and reduce the burden on health care systems.”

“The specific mechanisms by which humor influences clinical outcomes remain a matter of future investigation, and further studies in larger patient cohorts are warranted to confirm the findings of this study.”

Provided by the European Respiratory Society