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[Clowns in the pediatric intensive care unit in France]
G Mortamet1, C Simonds2, A Hattab2
1Service de réanimation et de surveillance continue médicochirurgicale pédiatrique, hôpital Necker, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France.
Insights
Professional clowns are increasingly present in French pediatric intensive care units (PICUs). This study found that clown interventions are a common and valued practice in these critical care settings.
Area of Science:
- Pediatric Intensive Care
- Medical Clowning
- Child Health Services
Background:
- Professional clowns are increasingly involved in pediatric intensive care units (PICUs) in children's hospitals.
- This study is the first to investigate the role and impact of professional clowns within the PICU environment.
- The practice aims to support severely ill children at the bedside.
Purpose of the Study:
- To describe the practice of professional clowns in French pediatric intensive care units.
- To understand the integration and reception of clown interventions in PICUs.
Main Methods:
- A descriptive and prospective study was conducted in December 2013.
- A survey was emailed to heads of all pediatric PICUs across France.
- The study analyzed responses from 26 PICUs regarding clown interventions.
Main Results:
- Clowns intervened in 50% of the responding PICUs (13 out of 26).
- Medical clowns were professional artists, often working in duos, and coordinated with healthcare staff.
- Head physicians reported high satisfaction rates (92.3%) with the clown interventions.
Conclusions:
- Clowning in PICUs is a common and valuable practice in French pediatric hospitals, despite the critical nature of the environment.
- Successful implementation requires understanding, acceptance, and support from the PICU team.
- Clown interventions should be validated within the overall care plan for each child.
Introduction:
In recent years, in children's hospitals, clowns are involved in pediatric intensive care units (PICUs), at the bedside of the most severely ill children. This study is the first that addresses the work of professional clowns in the PICU. Its aim is to describe this practice in French hospitals.
Methods:
This study is a descriptive and prospective study conducted in December 2013 involving all the pediatric PICUs in French hospitals. A survey was emailed to all the PICU department heads in France.
Results:
Questionnaires were sent to 32 PICUs (21 pediatric and neonatal intensive care units and 11 pediatric intensive care units). The response rate was 81.2% (26 questionnaires completed). Among the 26 units that responded to the survey, clowns intervened in 13 of them (50%). Eight had an exclusive pediatric activity and five had both pediatric and neonatal activities. The clown visit was twice a week in six units and once in seven (missing data: one unit). The head doctor was satisfied or very satisfied in 92.3% of the cases (n=12/13). Medical clowns were trained and professional artists in all of the units. They worked in duo in most units (n=12/13) and solo in one unit. The clown rounds were preceded by a meeting with a healthcare worker in 12 of the 13 PICUs in which the clowns worked. They dialogued with a doctor in four and a nurse (or head nurse) in eight.
Discussion:
Prior to implementation, the clowns' work should be understood, accepted, and supported by each PICU team, to be validated in the overall care plan for each child.
Conclusion:
Despite the severity of the situations met in the PICU, the instability of patients and the technical environment, clowning in PICUs appears to be a common and worthwhile practice in most French pediatric hospitals.
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