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

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. To investigate whether medical clown-assisted interventions to reduce child's distress d...

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Bibliographic Details
Published in:The Israel Medical Association journal 2016-11, Vol.18 (11), p.680-683
Main Authors: Rimon, Ayelet, Shalom, Shelly, Wolyniez, Ido, Gruber, Alejandro, Schachter-Davidov, Anita, Glatstein, Miguel
Format: Article
Language:English
Subjects:
Adolescent
Anxiety - prevention & control
Child
Child, Preschool
Emergency Service, Hospital
Female
Humans
Hydrocortisone - blood
Israel
Laughter Therapy - methods
Male
Pain - psychology
Pain Management - methods
Pain Measurement
Phlebotomy - methods
Pilot Projects
Prospective Studies
Stress, Psychological - blood
Stress, Psychological - prevention & control
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Summary: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. To investigate whether medical clown-assisted interventions to reduce child's distress during venipuncture have an effect on cortisol levels. 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. 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). In this pilot study, medical clowns reduced the distress from venipuncture in children. No effect on cortisol levels was observed.
ISSN:1565-1088