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Medical clowning in hospitalized children: a meta-analysis
Rim Kasem Ali Sliman1,2, Noam Meiri3,4, Giora Pillar3,4
1Department of Pediatrics, Carmel Medical Center, Carmel Hospital, 7 Michal St., 3436212, Haifa, Israel. reem.kasimali.275@gmail.com.
Insights
Medical clowning significantly reduces anxiety in hospitalized children and their parents. This meta-analysis confirms the beneficial effects of medical clowns in pediatric care settings.
Area of Science:
- Pediatric healthcare
- Psychological interventions
- Evidence-based medicine
Background:
- Medical clowning is recognized for its positive impact on pain, anxiety, and stress.
- Previous studies are often small-scale, necessitating a comprehensive review.
Purpose of the Study:
- To evaluate the efficacy of medical clowning in reducing pain and anxiety.
- To assess the impact on hospitalized pediatric patients and their parents across various medical fields.
Main Methods:
- A systematic literature search was performed across multiple databases.
- Included only randomized controlled trials (RCTs) involving pediatric patients aged 0-18 years.
- Statistical analysis was conducted on data from 18 selected studies.
Main Results:
- Medical clowning significantly reduced anxiety in 912 children (14 studies) and preoperative anxiety in 512 children (9 studies).
- A trend towards reduced pain during procedures was observed in 338 participants (6 studies).
- Parental anxiety was significantly reduced in 489 participants (10 studies), including preoperative anxiety in 380 participants (6 studies).
Conclusions:
- Medical clowns provide significant benefits in alleviating stress and anxiety for pediatric patients.
- The positive effects extend to parents, improving the overall family experience in healthcare settings.
Background:
Medical clowning has been proven effective in reducing pain, anxiety, and stress in many sporadic, usually small-scale studies. Our meta-analysis aims to evaluate the efficiency of medical clowns in reducing pain and anxiety in hospitalized pediatric patients and their parents in different medical fields.
Methods:
A thorough literature search was conducted from different databases, and only randomized controlled trials (RCTs) were included with children aged 0 to 18 years old. A total of 18 studies were included, and statistical analysis was performed on the combined data.
Results:
A total of 912 children (14 studies) showed significantly reduced anxiety when procedures were performed with a medical clown compared with the controls (- 0.76 on anxiety score, P < 0.001). Preoperative anxiety was lower in 512 children (nine studies) with clown interventions than in the controls (- 0.78, P < 0.001). The pain scale was completed by 338 participants (six studies), indicating a trend toward reduced pain during procedures performed while the clown was acting compared to controls (- 0.49, P = 0.06). In addition, medical clown significantly (- 0.52, P = 0.001) reduced parental anxiety in 489 participants in ten studies; in six of the ten studies, with a total of 380 participants, medical clown significantly reduced parental preoperative anxiety (P = 0.02).
Conclusion:
Medical clowns have substantial positive and beneficial effects on reducing stress and anxiety in children and their families in various circumstances in pediatrics.
