What is the effect of medical clowns on distress levels associated with venipuncture in children?

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In this pilot study, medical clowns reduced the distress from venipuncture in children. No effect on cortisol levels was observed” Rimon et al (2016).

Abstract:

BACKGROUND: Medical clowns are increasingly used for diminishing pain and anxiety during painful procedures being performed on children in the hospital setting. Cortisol levels rise as a response to emotional distress.

OBJECTIVES: To investigate whether medical clown-assisted interventions to reduce child’s distress during venipuncture have an effect on cortisol levels.

METHODS: During a 1 year period, children requiring blood work or intravenous access in the pediatric emergency department were prospectively randomized to either the presence or absence of a medical clown during the procedure. The child’s distress was evaluated using the Faces Pain Scale – revised (FPS-R) for the 4-7 year age group and the visual analog scales (VAS) for those aged 8-15 years. Serum cortisol levels were measured in blood samples obtained by venipuncture.

RESULTS: Fifty-three children aged 2-15 years were randomly assigned to the study group (with medical clown, n=29) or to the control group (without medical clown, n=24). Combined pain scores of the study group and control group were 2.2 and 7.5 respectively (P < 0.001). No difference in mean cortisol levels was found between the study group and the control group at all ages (16.4 µg/dl vs. 18.3 µg/dl, P = 0.65).

CONCLUSIONS: In this pilot study, medical clowns reduced the distress from venipuncture in children. No effect on cortisol levels was observed.

Reference:

Rimon, A., Shalom, S., Wolyniez, I., Gruber, A., Schachter-Davidov, A. and Glatstein, M. (2016) Medical Clowns and Cortisol levels in Children Undergoing Venipuncture in the Emergency Department: A Pilot Study. The Israel Medical Association Journal. 18(11), p.680-683.

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