Exploring the impact of clown intervention on hospitalized children: A scoping review

Introduction

Various studies have demonstrated the effectiveness of clown therapy in improving the emotional state of hospitalized children. However, the specifics of clown therapy and the indicators of assessment are unclear. So it is necessary to explore clown interventions.

Aim

Identify and map evidence regarding clown therapy for hospitalized children.

Methods

The Joanna Briggs Institute scoping review method and the PRISMA extension for Scoping Reviews guided the work. Seven databases were used: PubMed, Embase, Web of Science, EBSCO, CINAHL, the Cochrane Library, and OVID. This study searched databases for English peer-reviewed articles on clown interventions for hospitalized children from January 2000 to April 2025. Data were extracted by one author and checked by another and analyzed descriptively.

Results

Thirty-three articles met the established criteria. Most of the research has been focused on the European and Asian regions and has been carried out on a one-to-one basis. Many studies did not report on the qualifications of the individuals performing as clowns. The outcome indicators chosen for evaluating the effectiveness of the intervention were relatively homogeneous.

Conclusion

Clown interventions reduce negative emotions, but specifics and potential adverse effects need further research.

Implication

This study details how researchers conducted clown care and developed pathways for interventions in practice. In the future, the use of clowning interventions in the hospital setting will be critical in facilitating the acclimatization of the child and his/her family to the inpatient setting, positive treatment, and recovery from illness.