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J Pediatr Nurs. 2015 Nov-Dec;30(6):e89-99. doi: 10.1016/j.pedn.2015.03.003. Epub 2015 Apr 13.

Effects of a Clown-Nurse Educational Intervention on the Reduction of Postoperative Anxiety and Pain Among Preschool Children and Their Accompanying Parents in South Korea.

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Division of Nursing Science, College of Health Sciences, Ewha Womans University, Seoul, South Korea.
Department of Nursing, Hallym University, Chuncheon, South Korea. Electronic address:


This study examined the effects of a clown-nurse educational intervention on children undergoing day surgery for strabismus. This was a quasi-experimental study, using a nonequivalent control group, non-synchronized design. Fifty preschool children and their parents were invited to participate. The children in the intervention group (n=23) received clown therapy and subsequently reported significantly lower states of physiological anxiety, which was evidenced by systolic blood pressure, standardized behavioral anxiety tests, and post-surgery pain, than the control group (n=27). In addition, the parents in the experimental group showed a low state of physiological anxiety, evidenced by systolic blood pressure, pulse rates, standardized behavioral anxiety tests, and state-trait anxiety. The use of preoperative clown intervention may alleviate postoperative problems, not only for children, but also for their parents.


Children; Day surgery; Nursing; Preschool; Strabismus

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