Exploring the usefulness of medical clowns in elevating satisfaction and reducing aggressive tendencies in pediatric and adult hospital wards

Abstract

Background Most existing research on medical clowns in health care services has investigated their usefulness mainly among child health consumers. In this research we examined multiple viewpoints of medical staff, clowns, and health consumers aiming to identify the optimal audience (adult or child health consumers) for which medical clowns are most useful. We focused on exploring their usefulness in enhancing health consumers’ satisfaction and, in turn, reducing their aggressive tendencies. Methods We conducted three studies that examined the placement fit of medical clowns from different points of view: medical staff (Study 1, n = 88), medical clowns (Study 2, n = 20), and health consumers (Study 3, n = 397). The main analyses in Studies 1 and 2 included frequencies and t-tests comparing perceived adult and child satisfaction with clowns’ performance. Study 3 used moderated-mediation PROCESS bootstrapping regression analysis to test the indirect effect of negative affectivity on aggressive tendencies via satisfaction. Exposure to the medical clown moderated this relationship differently for different ages. Results Studies 1 and 2 show that the majority of medical clowns and medical staff report that the current placement of the medical clowns is in pediatric wards; about half (44% of medical staff, 54% of medical clowns) thought that this placement policy should change. In Study 3, data from health consumers in seven different hospital wards showed that clowns are useful in mitigating the effect of negative affectivity on satisfaction, thereby reducing aggressive tendencies among health consumers under the age of 21.6 years. Surprisingly, medical clowns had the opposite effect on most adults: for health consumers who were exposed to the medical clown and were above the age of 21.6 negative affectivity was related to decreased satisfaction, and an increase in aggressive tendencies was observed. Discussion Medical clowns are most useful in elevating satisfaction and reducing aggressive tendencies of children. Older adults, on the other hand, exhibit lower satisfaction and higher aggressive tendencies following exposure to the performance of medical clowns. Conclusion Medical clowns should be placed primarily in children’s wards.

The influence of culture on care receivers’ satisfaction and aggressive tendencies in the emergency department

“…From a practical perspective, our study support previous findings showing that low satisfaction levels among care receivers are an antecedent of aggressive tendencies in hospitals [ 93 ]. Our results suggest that ED managers can reduce such aggressive tendencies by investing resources in programs and procedures aimed at improving an atmosphere of cultural sensitivity (e.g., through language accessibility) in the ED.…”

When the medium massages perceptions: Personal (vs. public) displays of information reduce crowding perceptions and outsider mistreatment of frontline staff.

“…Third, we add to the understanding of mistreatment in health care, which typically shows descriptive correlations between various factors and the occurrence of severe mistreatment (Efrat-Triester et al, 2021; Hahn et al, 2008; Landau & Bendalak, 2008). We highlight psychological mechanisms underlying such mistreatment and bring into focus mild (rather than extreme) forms of mistreatment.…”

A Modifying Effect of Trait Empathy on Frustration-Related Attentional Processing of Aggression-Related Words

“…The current study has several limitations. First, since attentional bias is a reliable measurement of aggressive tendencies (Putman et al, 2004; Smith & Waterman, 2003) and aggressive tendencies are strongly positively correlated with aggressive behavior (Efrat-Triester et al, 2021; Reijntjes et al, 2013), our study focused on aggressive tendencies using the dot-probe task and the emotional Stroop task to investigate attentional bias to aggressive stimuli, rather than aggressive behaviors. The differences between aggressive tendencies and aggressive behaviors might need further study.…”

“…According to the General Aggression Model (Anderson & Bushman, 2002), environmental factors may influence aggressive behavior by increasing aggressive tendencies, which represent the desire to act with aggression (Efrat-Treister et al, 2020), which is an important predictor of aggressive behavior (Efrat-Triester et al, 2021; Reijntjes et al, 2013). A frustrating condition, as a negative situation, may cause high trait empathy individuals to pay more attention to their own circumstances of frustration and become insensitive to the feelings of others (Vukosavljevic-Gvozden et al, 2015).…”