ArticleBMC geriatrics2026
Clowning in care: long-term effectiveness of clown visits on residents' affect, resilience, sleep quality and functionality.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundClown visits are increasingly used as psychosocial interventions in long-term care settings. However, existing evidence is predominantly qualitative and/or short-term, with a lack of controlled longitudinal studies examining effects across affective, resilience-related, sleep-related, and functional outcomes. Moreover, the role of individual-based visit frequency remains largely unexplored.
methodsThis longitudinal controlled field study examined the effects of clown visits over two years in four long-term care facilities in Eastern Germany. The intervention group comprised n
resultsAfter one year, residents receiving clown visits showed more favourable developments in sleep-related outcomes and depressive mood than the control group. After two years, the declines in positive mood and resilience were significantly less pronounced in the intervention group. No consistent effects emerged for other functional domains, and visit frequency did not moderate longitudinal change. Exploratory analyses indicated that, within individuals, higher visit frequency was associated with greater self-care difficulties, disorientation, withdrawal, lower resilience, and higher daytime sleepiness; between individuals, it was linked to higher disorientation, positive affect, and lower negative affect.
conclusionClown visits showed time-specific benefits for residents' mood, sleep quality, and resilience - without adverse effects. Their contribution appears to lie particularly in supporting residents' emotional well-being and sustaining resilience over time, rather than broadly altering functional trajectories. The pattern of visit frequency underscores an adaptive delivery aligned with residents' psychosocial and functional needs, highlighting clown visits as a flexible, context-sensitive intervention embedded in everyday care. As such, clown visits may contribute to preventive care and supportive emotional climate in long-term care, with potential benefits for nursing practice.
trial registrationNot applicable.
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