Measuring patient experiences in a Children’s hospital with a medical clowning intervention: a case-control study

Abstract Background Because the healthcare sector is shifting to a customer-oriented approach, it is important to understand experiences of children as users of healthcare services. So far, studies that measure the influence of medical clowning on patient experiences are scarce. This study aims to m...

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Main Authors: Nina Karisalmi, Katja Mäenpää, Johanna Kaipio, Pekka Lahdenne
Format: Article
Language:English
Published: BMC 2020-04-01
Series:BMC Health Services Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12913-020-05128-2
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spelling doaj-7f77c34f0b7145b29d14f9cfeebf17e52020-11-25T03:23:31ZengBMCBMC Health Services Research1472-69632020-04-0120111210.1186/s12913-020-05128-2Measuring patient experiences in a Children’s hospital with a medical clowning intervention: a case-control studyNina Karisalmi0Katja Mäenpää1Johanna Kaipio2Pekka Lahdenne3Department of Computer Science, Aalto UniversityDepartment of Computer Science, Aalto UniversityDepartment of Computer Science, Aalto UniversityHospital for Children and Adolescents, Helsinki University HospitalAbstract Background Because the healthcare sector is shifting to a customer-oriented approach, it is important to understand experiences of children as users of healthcare services. So far, studies that measure the influence of medical clowning on patient experiences are scarce. This study aims to measure experiences of children and their parents during day-surgery in hospital setting. Methods A case-control study was conducted in a large Finnish children’s hospital. Seventy children aged 4–17 years coming for a minor operative procedure including pre-operative cannula insertion prior to surgery were included. Thirty-eight children were exposed to the medical clowning intervention and 32 children (the reference group) did not receive exposure to medical clowning. A novel digital survey tool was used to measure patient experiences before and after the insertion of a venous cannula needed for anaesthesia. The children were asked about their emotions, anxiety levels, the pain from the cannula insertion and the best and worst things about the hospital. The parents were asked about their emotions, expectations and the fluency of the procedure and the hospital day. Results Before the procedure, 32% or 36% of the children in the intervention group and 44% or 28% of those in the reference group expressed positive or neutral emotions, respectively. After the procedure, 76% or 63% of children in the intervention group or reference group, respectively, expressed positive emotions. The intervention group rated the medical clowns as the best aspect of the hospital day. Both groups reported that the best aspects of the hospital day were related to the nurses and food and the worst were related to waiting and pain. Most commonly the parents felt uncertainty, anxiety or calmness before the procedure and relief afterwards. Their expectations towards the procedure related to its success and the certainty of the diagnosis. Conclusions The results show a trend towards more positive emotions in children with exposure to medical clowning. The digital survey tool was suitable for gathering information about the experiences of children and their parents. Information on emotions and expectations of children and parents during a procedure is useful when improving the quality of healthcare services. Trial registration Current Controlled Trials NCT04312217 , date of registration 17.03.2020. Retrospectively registered.http://link.springer.com/article/10.1186/s12913-020-05128-2Patient experiencechildren’s hospitalChildrenParentsDigital survey toolCase-control study
collection DOAJ
language English
format Article
sources DOAJ
author Nina Karisalmi
Katja Mäenpää
Johanna Kaipio
Pekka Lahdenne
spellingShingle Nina Karisalmi
Katja Mäenpää
Johanna Kaipio
Pekka Lahdenne
Measuring patient experiences in a Children’s hospital with a medical clowning intervention: a case-control study
BMC Health Services Research
Patient experience
children’s hospital
Children
Parents
Digital survey tool
Case-control study
author_facet Nina Karisalmi
Katja Mäenpää
Johanna Kaipio
Pekka Lahdenne
author_sort Nina Karisalmi
title Measuring patient experiences in a Children’s hospital with a medical clowning intervention: a case-control study
title_short Measuring patient experiences in a Children’s hospital with a medical clowning intervention: a case-control study
title_full Measuring patient experiences in a Children’s hospital with a medical clowning intervention: a case-control study
title_fullStr Measuring patient experiences in a Children’s hospital with a medical clowning intervention: a case-control study
title_full_unstemmed Measuring patient experiences in a Children’s hospital with a medical clowning intervention: a case-control study
title_sort measuring patient experiences in a children’s hospital with a medical clowning intervention: a case-control study
publisher BMC
series BMC Health Services Research
issn 1472-6963
publishDate 2020-04-01
description Abstract Background Because the healthcare sector is shifting to a customer-oriented approach, it is important to understand experiences of children as users of healthcare services. So far, studies that measure the influence of medical clowning on patient experiences are scarce. This study aims to measure experiences of children and their parents during day-surgery in hospital setting. Methods A case-control study was conducted in a large Finnish children’s hospital. Seventy children aged 4–17 years coming for a minor operative procedure including pre-operative cannula insertion prior to surgery were included. Thirty-eight children were exposed to the medical clowning intervention and 32 children (the reference group) did not receive exposure to medical clowning. A novel digital survey tool was used to measure patient experiences before and after the insertion of a venous cannula needed for anaesthesia. The children were asked about their emotions, anxiety levels, the pain from the cannula insertion and the best and worst things about the hospital. The parents were asked about their emotions, expectations and the fluency of the procedure and the hospital day. Results Before the procedure, 32% or 36% of the children in the intervention group and 44% or 28% of those in the reference group expressed positive or neutral emotions, respectively. After the procedure, 76% or 63% of children in the intervention group or reference group, respectively, expressed positive emotions. The intervention group rated the medical clowns as the best aspect of the hospital day. Both groups reported that the best aspects of the hospital day were related to the nurses and food and the worst were related to waiting and pain. Most commonly the parents felt uncertainty, anxiety or calmness before the procedure and relief afterwards. Their expectations towards the procedure related to its success and the certainty of the diagnosis. Conclusions The results show a trend towards more positive emotions in children with exposure to medical clowning. The digital survey tool was suitable for gathering information about the experiences of children and their parents. Information on emotions and expectations of children and parents during a procedure is useful when improving the quality of healthcare services. Trial registration Current Controlled Trials NCT04312217 , date of registration 17.03.2020. Retrospectively registered.
topic Patient experience
children’s hospital
Children
Parents
Digital survey tool
Case-control study
url http://link.springer.com/article/10.1186/s12913-020-05128-2
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