The present research aims at identifying emotional states induced in observers of hospital\ud clown interventions utilizing a list of clown-specific ratings, the 29 Clown Emotion List\ud (CLEM-29, Auerbach et al. 2012a). Study 1 investigated whether hospital clowns elicit\ud emotional states other than those already covered by scales representing existing models of\ud emotional states. One hundred and nineteen adults watched videos of hospital clowns and\ud circus clowns. After each video, they completed a general mood scale, a humour-related\ud mood scale, the CLEM-29, and indicated the global intensity of positive and negative feelings\ud towards each video. Results showed that emotional states elicited by hospital clowns go\ud beyond states represented in general mood scales. Some elements of the CLEM-29 relating to\ud humour and amusement overlapped with existing models of mood, but many other emotional\ud qualities like “feeling connected to the clown” or feeling “appreciated” were not well\ud represented. Some of the clown-specific ratings best predicted the positive experiences\ud towards the videos. In Study 2, 183 adults watched 15 videos of hospital clown interventions,\ud circus clown performances and nurse-patient interactions, and filled in the CLEM-29. Four\ud factors emerged from a factor analysis of the ratings: amusement, transcendence, arousal,\ud and uneasiness. Both circus and hospital clowns elicited amusement, but only the hospital\ud clowns additionally elicited feelings of transcendence (i.e., feeling privileged and\ud appreciated). Nurses also elicited transcendent experiences without being amusing. This\ud research shows that prior studies underestimated emotional states elicited by hospital clowns,\ud which go beyond a typical humour response

The present research is first to investigate the unique effect of a humorous clown intervention on patients' emotional state in comparison with a different kind of intervention in a hospital setting using a controlled experimental method. Forty-four adult patients of a physical rehabilitation center were randomly assigned to either participate or observe 2 interventions: a hospital clown and a nurse intervention. Compared with baseline and the nurse intervention, the clown intervention elicited a higher level of amusement in patients. Both interventions elicited arousal, and neither intervention led to a change in negative emotions. No difference was found between the emotional states of participants and observers of the interventions at any level. A combination of general funniness of clown performances and felt transcendence during the hospital clown intervention best predicted the total amount of positive affect experienced during the intervention, which supports and extends results from previous studies. The results clearly support the benefit of hospital clown interventions for the elicitation of a positive emotional state in patients. Clowns working in hospitals should be encouraged to continue their work with patients in need of care. Positive Emotions Elicited by Clowns and Nurses: An Experimental Study in a Hospital Setting AbstractThe present research is first to investigate the unique effect of a humorous clown intervention

Trait cheerfulness predicts individual differences in experiences and behavioral responses in various humor experiments and settings. The present study is the first to investigate whether trait cheerfulness also influences the impact of a hospital clown intervention on the emotional state of patients. Forty-two adults received a clown visit in a rehabilitation center and rated their emotional state and trait cheerfulness afterward. Facial expressions of patients during the clown visit were coded with the Facial Action Coding System. Looking at the total sample, the hospital clown intervention elicited more frequent facial expressions of genuine enjoyment (Duchenne smiles) than other smiles (Non-Duchenne smiles), and more Duchenne smiles went along with more perceived funniness, a higher level of global positive feelings and transcendence. This supports the notion that overall, hospital clown interventions are beneficial for patients. However, when considering individual differences in the receptiveness to humor, results confirmed that high trait cheerful patients showed more Duchenne smiles than low trait cheerful patients (with no difference in Non-Duchenne smiles), and reported a higher level of positive emotions than low trait cheerful individuals. In summary, although hospital clown interventions on average successfully raise the patients’ level of positive emotions, not all patients in hospitals are equally susceptible to respond to humor with amusement, and thus do not equally benefit from a hospital clown intervention. Implications for research and practitioners are discussed.

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