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Isr Med Assoc J. 2016 Nov;18(11):680-683.

Medical Clowns and Cortisol levels in Children Undergoing Venipuncture in the Emergency Department: A Pilot Study.

Author information

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.

PMID:
28466619
[Indexed for MEDLINE]
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