Keywords
Pediatric outpatient department
Nursing staff
Cognition
Training
Investigation
Submitted : 2025-09-23
Accepted : 2025-10-08
Published : 2025-10-23
Abstract
Aim: To evaluate the impact of professional training on pediatric outpatient nurses’ cognition and attitudes towards the use of clown therapy, and to assess its clinical applicability. Design: A pre- and post-training evaluation study. Methods: A total of 31 pediatric outpatient nurses participated in the study, completing a self-designed 15-item questionnaire focused on clown therapy. The questionnaires were administered both before and after a structured training program. The assessment aimed to measure changes in nurses’ knowledge and attitudes toward clown therapy. Results: The results indicated a statistically significant improvement in the nurses’ cognition following the training (mean score post-training: 8.55 vs pre-training: 7.71, p = 0.003). Conclusion: Notably, the training also eliminated the age-related differences in cognition observed prior to the intervention. Furthermore, nurses expressed more positive attitudes toward the clinical implementation of clown therapy post-training.
References
YYang. F, Li. J, Dan. B, Yan. Z, Xiaoqin. L, Yi. H, and Lin. H. "providing clown care in pediatric department." Journal of Nursing Science 35, no. 09 (2020): 59-60.
Sun, X., J. Zhang, Y. Wang, X. Zhang, S. Li, Z. Qu, and H. Zhang. "The Impact of Humor Therapy on People Suffering from Depression or Anxiety: An Integrative Literature Review." Brain Behav 13, no. 9 (2023): e3108.
Xiaoyan. Y, Yu. L, and Yi. H. "Effects of Clown Care on Children's Anxiety and Pain: A Meta-analysis." Journal of Nurs-ing(China) 29, no. 04 (2022): 21-26.
Yongxia. D, Wenjun. G, and Binquan. W. "Discussion on Practice of Nursing Volunteer Service Model of 'Clown Doctor' Under Cross-Cultural Background." Chinese Nursing Research 32, no. 19 (2018): 3041-45.
Agüero-Millan, B., R. Abajas-Bustillo, and C. Ortego-Maté. "Efficacy of Nonpharmacologic Interventions in Preoperative Anxiety: A Systematic Review of Systematic Reviews." J Clin Nurs 32, no. 17-18 (2023): 6229-42.
Krieger, Y., M. Pachevsky, Y. Shoham, R. Biederko, L. Novack, and O. Sarid. "Relieving Pain and Distress Symptoms in the Outpatient Burn Clinic: The Contribution of a Medical Clown." Burns 48, no. 3 (2022): 654-61.
Jacob, G., B. Einav, M. Ashy, M. A. Nofar, S. Aviad, and M. Ayed. "The Beneficial Effect of Medical Clowns on Perfor-mance of Eeg in Young Children: A Randomized Controlled Study." Eur J Pediatr 181, no. 9 (2022): 3449-57.
Masetti, M., S. Caires, D. Brandão, and D. A. Vieira. "Confirmatory Factor Analysis of the Questionnaire on the Health Staff's Perceptions Regarding Doutores Da Alegria's Interventions." J Health Psychol 24, no. 2 (2019): 166-74.
Junli. L, Peili. Z, Yongxia. D, Limei. C, Huihui. W, Lipei. Y, Huiqun. S, and Xiaohong. C. "application of clown care in vac-cination of preschool children." Chinese Nursing Research 34, no. 10 (2020): 1811-15.
Pei. W., Lanfang. Z., Yi. C., and Yinling. Z. "Research progress on the application of clown care in pediatric patients." Clin J Nurs 58, no. 08 (2023): 1012-16.
Wu, W. W., C. S. Shiu, F. L. Lu, C. C. Tang, S. T. Jou, J. S. Chen, Y. L. Liu, and S. Y. Tsai. "Medical Clowning Influences the Emotions of Parents of Children Undergoing Cancer Treatment: A Quasi-Experimental Study." J Pediatr Nurs 71 (2023): e11-e17.
Yildirim, M., E. Koroglu, C. Yucel, S. Kirlak, and S. Sen. "The Effect of Hospital Clown Nurse on Children's Compliance to Burn Dressing Change." Burns 45, no. 1 (2019): 190-98.
Mengxing. X., Rong. H., Xia. G., and Baolin. W. "Research progress of the effect of medical clowns on the work of healthcare staff." Journal of Modern Medicine and Health 39, no. 16 (2023): 2795-98.
Sanchez, J. C., G. L. Porras, M. A. Torres, J. C. Olaya, A. M. Garcia, L. V. Munoz, H. Y. Mesa, and A. F. Ramirez. "Effects of Clowning on Anxiety, Stress, Pain, and Hormonal Markers in Paediatric Patients." BMC Pediatr 24, no. 1 (2024): 728.
Qian, J., S. Sun, M. Wu, L. Liu, S. Yaping, and X. Yu. "Preparing Nurses and Midwives to Provide Perinatal Bereavement Care: A Systematic Scoping Review." Nurse Educ Today 103 (2021): 104962.
Korin, O., and D. Babis. "Medical Clowning in Hospitals: Practices, Training and Perception." Med Humanit 50, no. 2 (2024): 383-91.
Lai, J., S. Ma, Y. Wang, Z. Cai, J. Hu, N. Wei, J. Wu, H. Du, T. Chen, R. Li, H. Tan, L. Kang, L. Yao, M. Huang, H. Wang, G. Wang, Z. Liu, and S. Hu. "Factors Associated with Mental Health Outcomes among Health Care Workers Exposed to Coronavirus Disease 2019." JAMA Netw Open 3, no. 3 (2020): e203976.
Sánchez, J. C., G. L. Porras, M. A. Torres, J. C. Olaya, A. M. García, L. V. Muñoz, H. Y. Mesa, and A. F. Ramírez. "Effects of Clowning on Anxiety, Stress, Pain, and Hormonal Markers in Paediatric Patients." BMC Pediatr 24, no. 1 (2024): 728.
Korin, O., and D. Babis. "Medical Clowning in Hospitals: Practices, Training and Perception." Med Humanit 50, no. 2 (2024): 383-91.
Aggarwal, P., S. Mathur, and R. Chopra. "Assessment of Medical Clowning in Influencing the Anxiety and Behavior Scores of Children Undergoing Various Dental Treatments and the Stress Levels of the Operator." Int J Clin Pediatr Dent 17, no. 1 (2024): 59-66.