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Assessing clown therapy to reduce preoperative anxiety in hospitalized children: A quasi-experimental design
L Ruiz-Azcona1, C Lechosa-Muñiz2, M R Ardila-Valle3
1Departamento de Enfermería, Universidad de Cantabria, Avda. Valdecilla s/n, 39008 Santander, Spain; Global Health Research Group, Universidad de Cantabria, Avda. Valdecilla s/n, 39008 Santander, Spain.
Insights
Clown therapy significantly reduced preoperative anxiety in pediatric patients undergoing surgery. This intervention also led to fewer maladaptive behaviors at home 30 days post-discharge.
Area of Science:
- Pediatric surgery
- Child psychology
- Healthcare interventions
Background:
- Preoperative anxiety in children negatively impacts well-being.
- Effective non-pharmacological interventions are needed.
- Clown therapy is a potential intervention.
Purpose of the Study:
- To analyze the impact of clown therapy on preoperative anxiety and postoperative pain in pediatric patients.
- To assess the effect on families.
- To evaluate long-term behavioral outcomes.
Main Methods:
- Quasi-experimental study with 204 children aged 3-12.
- Inclusion of pediatric inpatient and resuscitation unit patients.
- Intervention group received clown therapy before surgery.
Main Results:
- Children in the clown therapy group had significantly lower preoperative anxiety (p=0.012).
- Parental anxiety was also lower in the intervention group (p=0.142).
- Positive correlation found between child anxiety and postoperative pain (r=0.40, p<0.001).
- Fewer maladaptive behaviors observed at home post-discharge in the intervention group.
Conclusions:
- Clown therapy effectively reduces preoperative anxiety in pediatric patients.
- It contributes to a more humanized and emotionally supportive hospital environment.
- Incorporating clown therapy enhances the perioperative experience and emotional well-being.
Introduction:
Preoperative anxiety in pediatric patients negatively impacts their well-being, highlighting the need for effective non-pharmacological interventions.
Objective:
To analyze the impact of a clown therapy intervention before a surgical procedure to decrease preoperative anxiety and postoperative pain in hospitalized pediatric patients and their families.
Methods:
This quasi-experimental study took place from October 2023 to November 2024 and included children aged 3 to 12 who were hospitalized in the pediatric inpatient and resuscitation unit of a tertiary care hospital in northern Spain. A total of 204 children participated, divided into two groups.
Results:
The mean age of children was 6.96 ± 2.72 years, and that of parents was 40.90 ± 5.77 years. Children in the intervention group showed significantly lower preoperative anxiety (mYPAS: 5.57 ± 1.49) compared to controls (6.18 ± 1.92; p = 0.012). Parental anxiety (STAI) was also lower in the intervention group (13.84 ± 7.02) versus the control group (15.63 ± 10.10; p = 0.142). Positive correlations were observed between children's preoperative anxiety and postoperative pain (r = 0.40, p < 0.001), and between parental and child anxiety (r = 0.19, p = 0.007). Thirty days post-discharge, children in the intervention group exhibited fewer maladaptive behaviors at home.
Conclusion:
Clown therapy reduces preoperative anxiety in pediatric patients and may contribute to a more humanized, emotionally supportive hospital environment.
Implications For Practice:
Incorporating clown therapy into perioperative care may enhance emotional support, reduce anxiety, and improve the overall surgical experience, highlighting the importance of addressing emotional well-being.
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