TY - JOUR
T1 - Medical clowns and cortisol levels in children undergoing venipuncture in the emergency department
T2 - A pilot study
AU - Rimon, Ayelet
AU - Shalom, Shelly
AU - Wolyniez, Ido
AU - Gruber, Alejandro
AU - Schachter-Davidov, Anita
AU - Glatstein, Miguel
N1 - Publisher Copyright:
© 2016, Israel Medical Association. All rights reserved.
PY - 2016/11
Y1 - 2016/11
N2 - 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.
AB - 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.
KW - Cortisol
KW - Emergency department (ED)
KW - Medical clown
KW - Pain
KW - Pediatrics
UR - http://www.scopus.com/inward/record.url?scp=84995546439&partnerID=8YFLogxK
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C2 - 28466619
AN - SCOPUS:84995546439
SN - 1565-1088
VL - 18
SP - 680
EP - 683
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 11
ER -