Effects of clown activities on patients eligible for palliative care in primary health care

Santos, Fernando Ribeiro dos; Pinto, Sandra; Pessalácia, Juliana Dias Reis; Luchesi, Bruna Moretti; Silva, Lucimeire Aparecida da; Marinho, Maristela Rodrigues

doi:10.1590/0034-7167-2020-0431

Cited by 4 publications

(4 citation statements)

References 35 publications

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“…According to these results, HC accompanies children and families in PC, mediating and facilitating social relationships, being a bridge of magic and fantasy [ 38 ]. In addition to the evidence on its positive psychological and physiological effects on cancer patients [ 30 31 39 ], these results are in line with evidence showing that it has social effects, for example on the organizational climate of the hospital [ 40 41 ], and on the quality of life and social support of PC patients and families [ 32 ].…”

Section: Discussion Sectionsupporting

confidence: 80%

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Integration of Healthcare Clowns into Pediatric Palliative Care: A Bridge Between Life and Death

Farlane

2022

International Journal of Integrated Care

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Introduction:The objective of this paper was to describe the vision of death from the perspective of families of children who experienced palliative care, and team members working in one unit, and to explore the roles of healthcare clowns in working with life and death. The major research of which this paper is part was a requirement of one healthcare clown organization, that since 2008 works as members of the palliative care unit in a public hospital in Chile.Description: Using a qualitative methodology, and an emergent and descriptive design, 26 people, including mothers and team members of one palliative care unit, participated in in-depth interviews and discussion groups separately. Data analysis was performed using grounded theory and critical discourse analysis techniques. Results:The roles played by healthcare clowns in palliative care were accompanying, mediating between team members and families, facilitating to process death, provision of humane care using socioemotional competences, promotion of social relationships, and being complementary therapy. Conclusion:The six roles of healthcare clowns identified by this research have implications for public policies and actions in palliative care. There is also a need to expand this type of work to other public health services in Chile.

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Section: Discussion Sectionsupporting

confidence: 80%

“…Moreover, previous evidence indicates that HCs have a positive effect in psychological [ 30 31 ] and physical [ 31 ] symptoms faced by PC oncological patients, improving their quality of life and social support [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

Integration of Healthcare Clowns into Pediatric Palliative Care: A Bridge Between Life and Death

Farlane

2022

International Journal of Integrated Care

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“…Attrition has even been identified as a major problem in palliative care research [ 24 , 25 ]. We aimed to reduce attrition with a combination of patient-reported outcome questionnaires with physiological parameters [ 11 , 26 ]. Using the level of oxytocin in saliva as biomarker has been evaluated critically in the past [ 27 ] because of its strong concentration fluctuations and potentially not measurable amount in saliva.…”

Section: Discussionmentioning

confidence: 99%

Humour interventions for patients in palliative care—a randomized controlled trial

Linge-Dahl

Kreuz²,

Stoffelen³

et al. 2023

Support Care Cancer

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Purpose The effect of humour on end-of-life patients could be beneficial and is worth investigating. However, data on humour interventions for patients in palliative care are scarce. This study evaluated the effects of a humour intervention in a palliative care setting. Methods A two-step intervention was developed based on the humour habits programme by McGhee. Patients were assisted to remember funny episodes from their past and recognize humorous aspects of the present and encouraged to produce humour. The intervention and control group completed questionnaires on life satisfaction, cheerfulness, symptom burden, and perceived stress and if possible gave saliva samples to investigate oxytocin levels. The study was a randomized controlled monocentre study on patients treated in a palliative care ward. Participants had to be conscious and alert enough to complete data collection. Overall, 55 patients were included and randomized to the intervention or control group. Results Parameters in the control group did not change significantly. In the intervention group, seriousness, bad mood, and stress were reduced. Cheerfulness increased significantly after the intervention. However, the methodologically complex intervention setting was too exhausting for the majority of patients. Conclusion Patients who were able to participate benefited from the effects of the intervention on multiple levels. For future research simple interventions, biomarkers for well-being and assessments by staff or proxies are needed to include patients with reduced cognitive and physical performance status at the end of their lives. Trial registration DRKS00028978 German Registry of Clinical Studies.

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“…In systematic reviews on the use of humor or laughter in palliative care patients, a number of studies reported that humor was useful for reducing the level of agitation, sadness, and depression; adapting to situations of depression and anxiety; managing fear; counteracting stress; transforming a more positive atmosphere; and expressing joy 3,6 . In contrast, Dos Santos et al 35 reported that clown activities inducing spontaneous laughter were not effective in reducing the anxiety and depression of palliative care patients who participated in their study. They explained the reason was that some patients’ conditions deteriorated while participating in the study.…”

Section: Discussionmentioning

confidence: 99%

Effect of Laughter Therapy on Mood Disturbances, Pain, and Burnout in Terminally Ill Cancer Patients and Family Caregivers

2022

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Background: Humor has been commonly used in palliative care and identified as a coping strategy of palliative care patients and family caregivers. However, the use of humor or laughter in palliative care settings is still limited. Objective: The aim of this study was to examine the effect of laughter therapy involving spontaneous laughter on mood disturbances and pain in terminally ill patients with cancer and mood disturbances and the levels of burnout in family caregivers. Methods: This quasi-experimental study used a nonequivalent control group pretest-posttest design. The laughter therapy developed was provided for 20 to 30 minutes a day for 5 consecutive days. Twenty-six pairs of terminally ill cancer patients and family caregivers in the intervention group and 23 pairs in the comparison group from the hospice ward of a tertiary teaching hospital participated in this study. The data were collected using structured questionnaires and analyzed using descriptive statistics and 2-way repeated-measures analysis of variance.Results: There were significant decreases in mood disturbances in the patients ( P < .001) and family caregivers ( P < .001), pain in the patients ( P < .001), and levels of burnout in the caregivers ( P < .001) in the intervention group. Conclusion: Laughter therapy can be an alternative intervention to support both terminally ill patients with cancer and their family caregivers experiencing multidimensional distress in palliative care settings. Implications for Practice: The appropriate use of laughter or humor

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Effects of clown activities on patients eligible for palliative care in primary health care

Cited by 4 publications

References 35 publications

Integration of Healthcare Clowns into Pediatric Palliative Care: A Bridge Between Life and Death

Integration of Healthcare Clowns into Pediatric Palliative Care: A Bridge Between Life and Death

Humour interventions for patients in palliative care—a randomized controlled trial

Effect of Laughter Therapy on Mood Disturbances, Pain, and Burnout in Terminally Ill Cancer Patients and Family Caregivers

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