title: Parental perceptions of clown care in paediatric intensive care units.
abstract: OBJECTIVE
  The objective of this study was to report family satisfaction with regards to the presence of clowns in the paediatric intensive care unit (PICU).
  
  
  METHODS
  This is a single-centre survey-based study, conducted over 4 months in a 12-bed third level PICU in a university hospital. All parents present at the bedside of their child during clowning were considered as potential participants. Eligible parents were approached by one of the two intensivists as investigators and asked to complete a survey within the 48 h following the clowns' intervention.
  
  
  RESULTS
  Thirty-three parents consented to complete the survey. Median age of children was 14 months (15 days to 16 years) and median Pediatric Logistic Organ Dysfunction (PELOD) score was 1 (0-22). Twenty-four (72.7%) were considered as clinically stable while the clowns intervened. Twenty-eight parents (84.8%) and 27 (81.8%) considered that clowns had a positive effect on themselves and on their child, respectively. Clown care was considered as necessary in 19 cases (57.6%), optional in 13 (39.4%) and unnecessary in 1 (3.0%). The degree of parental satisfaction was not significantly associated with the child's clinical stability.
  
  
  CONCLUSIONS
  We suggested that medical clowning in the PICU is well accepted by parents, regardless of severity of their child's condition. This study supports the adoption of medical clowning in PICUs as a patient- and family-centred care practice.
authors.affiliation: Paediatric Intensive Care Unit, Necker Hospital, Paris, France.|University of Montreal, Montreal, Quebec, Canada.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Mortamet
authors.affiliation: Paediatric Intensive Care Unit, Necker Hospital, Paris, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Merckx
authors.affiliation: University of Montreal, Montreal, Quebec, Canada.|Paediatric Intensive Care Unit, Sainte-Justine University Hospital, Montreal, Quebec, Canada.
authors.forename: Nadia
authors.initials: N
authors.lastname: Roumeliotis
authors.affiliation: Le Rire Medecin Organisation, Necker Hospital, Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Simonds
authors.affiliation: Paediatric Intensive Care Unit, Necker Hospital, Paris, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Renolleau
authors.affiliation: Paediatric Intensive Care Unit, Necker Hospital, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Hubert
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods* / Q000523:psychology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D027641:Laughter Therapy / Q000379:methods* / Q000523:psychology; D008297:Male; D010290:Parents / Q000523:psychology*; D010465:Perception
keywords: clown; clowning; intensive care; paediatric; parents