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Intervention Effect of Child Life Specialists on Paediatric Patients: A Systematic Review of Randomized Controlled
Fangqin Li1, Jianli Jin1, Liwei Feng1
1Department of Pediatric Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
Insights
Child life specialists (CLSs) help reduce pediatric pain, distress, and anxiety during medical procedures. While CLS intervention shows promise, further research is needed to confirm its effectiveness in alleviating children's fear.
Area of Science:
- Pediatric healthcare
- Psychological support in medicine
- Evidence-based practice
Background:
- Child life specialists (CLSs) are increasingly integrated into pediatric care.
- Existing evidence on the efficacy of CLS interventions for children is limited.
- This review systematically evaluates the impact of CLS interventions on pediatric patients.
Purpose of the Study:
- To comprehensively assess the effects of child life specialist interventions on pediatric patients.
- To synthesize evidence from randomized controlled trials on CLS efficacy.
- To evaluate the impact of CLSs on pain and psychological outcomes in children.
Main Methods:
- Systematic literature search across six major databases (PubMed, Web of Science, Embase, Cochrane Library, CINAHL, APA PsycArticles).
- Inclusion of randomized controlled trials (RCTs) focusing on CLS effects on pediatric pain and psychological outcomes.
- Meta-analysis using a random-effects model to calculate standardized mean differences (SMD) and 95% confidence intervals (CI).
Main Results:
- Twelve studies involving 1096 participants were included in the meta-analysis.
- CLS presence was associated with significant reductions in children's pain (SMD = -0.28), distress (SMD = -0.26), and anxiety (SMD = -0.37).
- The effect of CLSs on alleviating children's fear was not statistically significant (SMD = -0.11).
Conclusions:
- Current evidence supports the use of CLSs in alleviating pediatric pain, psychological distress, and anxiety.
- Further research is required to validate the efficacy of CLSs in reducing children's fear.
- The findings underscore the potential value of CLSs in clinical pediatric practice, advocating for broader recognition.
Background:
Child life specialists (CLSs) are increasingly recognized in paediatric practice, yet evidence regarding the efficacy of CLS intervention in children remains insufficient. This review aims to comprehensively evaluate the intervention effects of CLSs on paediatric patients.
Methods:
Six databases (PubMed, Web of Science, Embase, Cochrane Library, CINAHL and APA PsycArticles) were systematically searched using subject terms and free terms. Randomized controlled trials (RCTs) assessing CLS effects on paediatric pain and psychological outcomes were included, with searches from database inception through 30 January 2026. Two reviewers independently screened literature and extracted data. Methodological quality was assessed using the Cochrane Risk of Bias tool. Meta-analysis was conducted using Stata/MP 18.0, calculating standardized mean difference (SMD) with 95% confidence interval (CI) via a random-effects model.
Results:
The initial search yielded 1140 records, and 12 studies (n = 1096 participants) were ultimately included in the analysis. The included studies primarily originated from the United States and Canada. Intervention settings included inpatient units, outpatient clinics and emergency departments. The meta-analysis revealed that, compared to conditions without CLS involvement, the presence of CLSs may alleviate children's pain (SMD = -0.28, 95% CI -0.49 to -0.07, p = 0.009), distress (SMD = -0.26, 95% CI -0.48 to -0.05, p = 0.018) and anxiety (SMD = -0.37, 95% CI -0.65 to -0.01, p = 0.007) during medical procedures and treatments. However, the effect on alleviating children's fear was not statistically significant (SMD = -0.11, 95% CI -0.32 to 0.10, p = 0.290).
Conclusion:
Current evidence supports the potential of CLSs to alleviate paediatric pain, psychological distress and anxiety. However, their efficacy in reducing fear requires further validation. Despite the uncertainties involved, the potential value of CLSs in clinical practice warrants broader recognition.