Clowns may help children cope with the pain and anxiety of hospital treatment

December 16, 2020

Hospital clowns might help improve physical symptoms and psychological wellbeing in children and adolescents having treatment for acute or chronic conditions, finds a study in the Christmas issue of The BMJ.

The findings suggest that incorporating appropriate laughter and play into clinical practice can be beneficial for young patients who need to stay in hospital.

Previous studies have suggested that hospital clowns can help to reduce stress and anxiety in children before and after surgery, but results have been inconsistent.

To address this knowledge gap, researchers based in Brazil and Canada examined evidence on the effectiveness of hospital clowns for a range of symptoms in children and adolescents admitted to hospital with acute (short-term) and chronic (long-term) conditions.

They trawled research databases looking for suitable clinical trials, published up to February 2020, and found 24 relevant trials (13 randomised controlled trials and 11 non-randomised controlled trials) involving 1612 children and adolescents.

The trials were designed differently, and were of varying quality, but the researchers were able to allow for that in their analysis.

Anxiety was the most frequently analysed symptom, followed by pain, psychological and emotional responses and perceived wellbeing, stress, cancer related fatigue, and crying.

Results suggested that children and adolescents who were in the presence of hospital clowns, either with or without a parent present, reported significantly less anxiety during a range of medical procedures, as well as improved psychological wellbeing, compared with standard care.

Three trials that evaluated chronic conditions (such as cancer) showed significant reductions in stress, fatigue, pain, and distress in children who interacted with hospital clowns, compared with standard care.

Only one trial found no difference in level of distress among children who interacted with hospital clowns compared with a control group.

This was a large study that analysed a vast amount of trial data, but the researchers highlight some limitations, such as risk of bias, differences in data collection, follow-up time points, and severity and onset of the conditions, all of which may have affected the reliability of the results.

However they say, overall, their findings suggest that hospital clowns "might have a positive effect in improving psychological wellbeing and emotional responses in children and adolescents in hospital with acute as well as chronic disorders."

"Our findings also support the continued investigation of complementary treatments for better psychological adjustment during the hospital admission process in paediatrics," they conclude.
Peer reviewed? Yes
Evidence type: Systematic review of randomised and non-randomised controlled trials
Subjects: Children and adolescents


Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to