Ayelet Rimon1, Shelly Shalom1, Ido Wolyniez1, Alejandro Gruber2, Anita Schachter-Davidov3, Miguel Glatstein1. 1. Pediatric Emergency Medicine, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 2. The Dream Doctors Project, Philnor Foundation, Israel. 3. Pediatric Endocrinology Service, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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.
RCT Entities:
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.
Authors: Leah I Stein Duker; Anita R Schmidt; Phung K Pham; Sofronia M Ringold; Alan L Nager Journal: Front Pediatr Date: 2021-01-05 Impact factor: 3.418
Authors: Corrie E Chumpitazi; Cindy Chang; Zaza Atanelov; Ann M Dietrich; Samuel Hiu-Fung Lam; Emily Rose; Tim Ruttan; Sam Shahid; Michael J Stoner; Carmen Sulton; Mohsen Saidinejad Journal: J Am Coll Emerg Physicians Open Date: 2022-03-12