Medical clowning influences the emotions of parents of children undergoing cancer treatment: A quasi-experimental study

Wei-Wen Wu; Cheng-Shi Shiu; Frank L Lu; Chia-Chun Tang; Shiann-Tang Jou; Jiann-Shiuh Chen; Yen-Lin Liu; Shao-Yu Tsai

doi:10.1016/j.pedn.2023.04.009

Medical clowning influences the emotions of parents of children undergoing cancer treatment: A quasi-experimental study

J Pediatr Nurs. 2023 Jul-Aug:71:e11-e17. doi: 10.1016/j.pedn.2023.04.009. Epub 2023 Apr 27.

Authors

Wei-Wen Wu¹, Cheng-Shi Shiu², Frank L Lu³, Chia-Chun Tang⁴, Shiann-Tang Jou³, Jiann-Shiuh Chen⁵, Yen-Lin Liu⁶, Shao-Yu Tsai⁴

Affiliations

¹ School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Adjunct Supervisor, Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: weiwen@ntu.edu.tw.
² Department of Social Work, National Taiwan University, Taipei, Taiwan.
³ Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁴ School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Adjunct Supervisor, Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
⁵ Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
⁶ Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan.

PMID: 37120387
DOI: 10.1016/j.pedn.2023.04.009

Abstract

Background: Medical clowning for children has been found to be effective at enhancing parents' psychological well-being during preoperative preparation, but has not been found during cancer treatment. This study aimed to examine whether and how medical clowning influenced the emotions of parents of children undergoing cancer treatment.

Methods: In this quasi-experimental study, 96 parents of children receiving inpatient cancer treatment were recruited, from June 2018 through April 2020. A demographic questionnaire measuring characteristics of parent and dyadic child, Brief Symptom Rating Scale measuring psychological distress of the parent, and Mood Assessment Scale measuring emotional status of parent and child were administered 1 day before a clowning service. The day after the clowning service, the Mood Assessment Scale again collected emotional status for parent and child. Descriptive analysis, bivariate analysis, and structural equation modeling to fit the actor-partner, cross-lagged model were used.

Findings: Parents experienced a low degree of psychological distress that called for emotional management. The indirect effect of medical clowning on parents' emotions through children's emotions was significant, as were the direct effect and total effect of medical clowning on parents' emotions.

Discussion: Parents experienced psychological distress during their child's inpatient cancer treatment. Medical clowning can directly improve children's emotions and through this pathway indirectly improve their parents' emotions.

Application to practice: There is need to monitor psychological distress and provide interventions for parents of children undergoing cancer treatment. Medical clowns should continue to serve parent-child dyads in pediatric oncology practice and become members of multidisciplinary health care teams.

Keywords: Emotions; Neoplasms; Parents; Pediatric nursing; Psychosocial intervention.

MeSH terms

Emotions
Hospitalization
Humans
Neoplasms* / psychology
Neoplasms* / therapy
Parent-Child Relations
Parents* / psychology
Surveys and Questionnaires