“The Effects of Clown Intervention on Worries and Emotional Responses in Children Undergoing Surgery” by Fernandes and Arriaga Critical Writing

Summary of the Article

“The Effects of Clown Intervention on Worries and Emotional Responses in Children Undergoing Surgery” is the article written by Fernandes and Arriaga in 2010 for the Journal of Health Psychology. The main purpose of this work is the evaluation of clown activities’ effects on children who have to undergo surgery.

The authors of this article introduce one question and certain conditions under which the research should be conducted and aim at answering this question and examining the situations from different perspectives. The peculiar feature of this article is the idea to unite theory and practice and prove that anxiety and preoperational worries may be influenced by the presence of such distracting options like clowns and their tricks.

What is more important about the work is parents’ involvement into research: children undergoing surgery are usually supported by parents, however, it is also necessary to admit that parents are to be supported by some other factors at the same time because their anxiety may influence the development of the events considerably.

Article Critique

By means of a number of independent variables like parents, children, and clowns and dependent variables such as the level of anxiety and worries, the experiment is conducted.

On the one hand, taking into consideration the ideas presented and the outcomes which are achieved at the end of the work, it is possible to believe that it is a true experiment that was conducted under real conditions in the hospital. However, on the other hand, it is hard to believe that children undergoing surgery and their parents are eager to participate in such experiment and use clowns’ activities to improve the situation.

From the very beginning of the article, it becomes clear that the researchers find it possible that clowns may influence the emotional state of a child who is going to undergo surgery. This is why the idea of biased attitude to the research is evident. It is already clear that some changes should take place, and clown intervention has a number of effects on children.

To introduce the topic and explain its urgency and correctness, different sources are used. As a rule, the authors rely on up-to-date works and discoveries which explain children conditions and attitudes to operations. It is not always possible to know for sure what kind of reaction on surgery may be expected from a child, this is why it is better to use children of different age (the authors of the article under discussion invited children between 5 and 12 years and their families).

As it has been mentioned above, the research question is stated clearly that deprives the reader of the necessity to dig for some additional facts in order to comprehend the matter. The hypothesis that clown intervention has some effects on children undergoing surgery is perfectly stated and explained in the paper.

This study is characterized by both types of validity: external and internal. External validity is explained by the possibility to use achieved results in the same sphere with other children. The research shows that the group of children who accompanied by clowns before the operation itself have the lower level of preoperational worries in comparison to the group where children are supported by parents only.

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This is why internal validity of the study plays an important role as well as has a number of factors which have to be considered. For example, child maturation may influence the results of the study. A child under 12 and a child under 6 have different perception of the situation: it may be connected to physical growth, temperament of a child, and even the level of education. This is why the threat that some dependent variable influences independent variable exists and has its own outcomes.

The participants of the study are children under 5-12, their parents, and clowns who have to introduce activities and influence the emotional conditions of children. The sampling frame is obtained independently from the records of the hospital: children under surgery and their parents who worry about overcoming operations and their outcomes. This is why this study is characterized by random selection of 70 children only (from all those patients in the hospital) without any random assignment.

A number of works and theories are used to create this work and introduce such kind of hypothesis. First, it is necessary to admit that the ideas of such sophisticated people like Bennet and Lengacher, Martin, Stuber and his team, or Peterson and his team prove that child hospitalization may be influenced by many outside factors.

The idea that some entertaining books, video, and programs have some benefits and need to be developed to improve child condition and attitude to the treatment required. The idea that humor is a good treatment is not a new one. So the idea to use clowns should be regarded as a powerful and theoretically-based idea to treat children or at least improve their emotional condition is not new.

As for the instruments used in the research, all of them are connected to measurements represented as a separate part of the work. Reliability of the instruments is evaluated by means of the Self-Assessment Mannequin (SAM) and the Child Surgery Worries Questionnaire (CSWQ). It is reported that the group that is supported by clowns has lower level of anxiety among children than the group that received support from parents only.

Construct validity that deals with operationalization of the study is properly organized as well. First, a number of theoretical material helps to comprehend that certain studies have been already made on the idea of different types of intervention into child treatment. Second, the fact that humor is helpful during treatment is also evident, this is why the idea that clowns may influence child emotional condition seems to be rather understandable and believable.

Of course, it is wrong to believe that child physical condition and health may be improved due to clown intervention but still the possibility to achieve certain emotional improvements should be considered. The only measurement that has to be admitted is children’s physical state and parents’ agreement to such kind of interference. In the study, there are no control/covariant variables which have to be controlled all the time. All variables used are already mentioned in the paper.

In general, the design and methods chosen are appropriate for the work. Its title, abstract, and main idea have the connection and represent one clear source of information. The major strength of the article is its theoretical background and the possibility to check how the offered idea may be used on practice and influence the treatment of children.

However, there are also some weaknesses which have to be mentioned: first, there are no legal arguments which prove that this research was conducted in real; second, there are no concrete formula according to which evaluation is done; and finally, there are no opinions which are given by the participants, this is why it is hard to define whether they are satisfied with the results.

However, the article itself seems to be reasonable and believable because it is never wrong to identify one more idea that may help children and improve their conditions even if these conditions are emotional only.