Medical Clowns Research Articles

Send in the Clowns: A Special Tribute to Medical Clowning and Clown Eponyms in Dermatology

Clowns have long delighted circus crowds and are celebrated not only in popular culture but also in the dermatology literature as medical eponyms. This contribution discusses four such eponyms: 1) clown nose-like lesion, 2) clown eczema (perioral dermatitis) 3) clown alopecia pattern in frontal fibrosing alopecia and 4) clown's face of Brachman de Lange syndrome (Cornelia de Lange syndrome). This contribution also highlights the role of medical clowning in patient care by paying tribute to Cobo the Clown, also known as Barbara Joyce Cohen, who has served as a dedicated caring clown for over thirty years.

Stories of stories: Dialogues between psychology and art on pediatric hospital clowns’ visits narratives.

Stories of stories: Dialogues between psychology and art on pediatric hospital clowns’ visits narratives.

Consolation Effect of Medical Clown Care Model in Children with Inguinal Hernia During Perioperative Period: A Single-Center Study in China

Background: Due to differences in medical backgrounds, there have been few studies on medical clown care in Chinese hospitals. Objectives: This study aimed to explore the consolatory effect of the medical clown care model on children in a Chinese hospital. Methods: This study included 236 children aged 4 - 6 years and divided them into an intervention group (n = 116) and a control group (n = 120). The control group received routine nursing measures, while the intervention group experienced the medical clown care model. To assess the children’s pain levels and the anxiety levels of their parents, the Face Legs Activity Cry and Consolability (FLACC) Scale, Wong-Baker FACES Pain Rating Scale (W-B FPS-R), and Self-Rating Anxiety Scale (SAS) were used. Results: The baseline data for both groups were comparable at admission (P > 0.05). The FLACC score, W-B FPS-R score, and crying rate in the intervention group were significantly lower than those in the control group (4.81 vs 6.71, 4.69 vs 7.02, 44.83 % vs 79.16 %, P < 0.05). Parents in the intervention group also had lower preoperative anxiety scores compared to those in the control group (42.85 vs 52.69, P < 0.05). Furthermore, the postoperative pain incidence and drug use rates were significantly lower in the intervention group (18.97 % vs 30.83 %, 27.27 % vs 56.76 %, P < 0.05). Compliance and satisfaction were significantly higher in the intervention group than in the control group (P < 0.05). Conclusions: The application of the clown care model can effectively reduce children's pain, provide consolation, and relieve parental anxiety.

Jesters of Well-Being: Examining the Relationship between Clown Doctors and Patients.

Clown doctors play a crucial role in enhancing the well-being of patients through the use of humor. However, little is known about how the use of humor by clown doctors changes in relation to the developmental age of patients. This research explores the interplay between the type of humor used by clown doctors, their experience (in terms of years of clowning and type of clowning), and the developmental age of the patients (children, adolescents, adults, elderly). Data for this cross-sectional study were collected through an online survey distributed to 210 Italian clown doctors (143 females, 67 males), aged between 18 and 75 years (M = 47.34, SD = 12.31), affiliated with different Clown Care Units. The survey included the Comic Styles Markers, questions on the patients' developmental age, type of clowning (Auguste vs. Whiteface), and years of experience. The findings enhance our understanding on how clown doctors interact with patients of different developmental ages. The discussion draws connections to previous studies conducted on groups of clown doctors, providing a broader context for understanding the implications of humorous interactions in this unique healthcare domain.

Assessment of Medical Clowning in Influencing the Anxiety and Behavior Scores of Children Undergoing Various Dental Treatments and the Stress Levels of the Operator.

To investigate the potential effectiveness of "medical clowns" on preoperative, intraoperative, and postoperative anxiety of children undergoing various dental treatments and also its effect on the operator's stress levels in a dental setup. A total of 170 pediatric patients, aged 4-8 years, indicated for preventive therapy, extractions, restorative, and endodontics were included and divided into two groups [group I-audiovisual (A-V) aids; group II-medical clowns], group of 85 patients each after recording Modified yale preoperative scale. Both pre- and postoperatively, Frankl's behavior score was recorded for each patient. During treatment, the face, legs, activity, cry, consolability (FLACC) pain scale, and dental operator's stress level were recorded. Intervention of medical clowns positively influenced children during dental treatment by increasing their pain threshold. The majority of children showed positive Frankl rating scales after dental treatment. Also, the operator's stress was significantly reduced, which led to enhanced treatment outcomes. Humor yields the power of healing, distracts pediatric patients, reduces their anxiety, and alleviates their pain, conferring the patients with a sense of laughter, creativity, and care.Therefore, medical clowns in pediatric dentistry can prove to be serviceable and valuable as a nonpharmacological approach to behavior management. Aggarwal P, Mathur S, Chopra R. Assessment of Medical Clowning in Influencing the Anxiety and Behavior Scores of Children Undergoing Various Dental Treatments and the Stress Levels of the Operator. Int J Clin Pediatr Dent 2024;17(1):59-66.

Clowns, Clown Doctors, and Coulrophobia: A Scoping Review

INTRODUCTION Clown therapy in pediatric care settings is becoming increasingly popular. However, clown doctors encounter some children in their visits who are uncomfortable or express feelings of fear. This emotional state is also found among parents and health care personnel. The phenomenon, called coulrophobia, is little studied in the biomedical field, although it has been known for some time. It is deemed necessary to learn more about it to prevent anxiety and fear that is as harmful as it is unnecessary. OBJECTIVE To identify, analyze and synthesize the available literature focused on coulrophobia. METHODS Scoping review adhering to the framework of Arksey and O'Mally. Retrieval of studies by querying and consulting electronic databases and web resources. Screening of records, analysis of included studies, synthesis of data and information in narrative form and through tables. RESULTS Twenty-six studies met the eligibility criteria. The prevalence of coulrophobia among children ranges from 1.1 percent to 6.1 percent. Mostly female and preschoolers are exposed, due to cognitive immaturity that limits the ability to distinguish between fantasy and reality. In adults, the prevalence of coulrophobia is between 18.6 percent and 53.5 percent and mainly prerogative of the female gender. The condition may be the result of childhood trauma associated with an encounter with a clown or mass media promotion of the figure of the evil clown. With some measures, clown doctors can try to prevent children's discomfort or fear. CONCLUSIONS Coulrophobia is a specific phobia falling under anxiety disorders that can have a significant and lasting impact in childhood and adulthood and therefore deserves further research.

Medical clowns improve sleep and shorten hospitalization duration in hospitalized children

Intervention by medical clowns was proven to have a positive effect in reducing stress and anxiety, increasing cooperation and improving the child's experience prior to a medical procedure and during the various stages of hospitalization. Sleep has long been known to be essential for recovery from injury and sickness, improving immune functions, and there is an emerging understanding of the restorative role quality sleep has on health and diseases. Hospitalized children are more exposed to sleep disorders and sleep deprivation due to the hospitalized environment, anxiety, and illness. Different behavioral interventions to promote sleep were previously studied in hospitalized children, some showing potential benefits. In this study, we sought to examine the ability of medical clowns to positively impact the child's sleep during hospitalization. The study is an observational matching (case–control) interventional study which took place at the department of pediatrics in Carmel Medical Center. Forty-two hospitalized children ages 2–17 were included in two equal groups of intervention or control. Children in the control group were recruited based on a method of matching the chief complaint plus the medical diagnosis and age of the children in the intervention group in a 1:1 matching. The children's sleep parameters were objectively evaluated for two consecutive nights using an Actigraph device and subjectively by parent's questionnaire. Additional factors such as hospital length of stay and demographics were also monitored. The study group had an encounter with a medical clown (15–30 min) before bedtime on either the first or the second night, and the control group was not exposed to a medical clown at all. We then compared the data from both groups using unpaired t-tests. Hospitalized children exposed to a medical clown prior to bedtime (n = 21) and children not exposed to a medical clown (n = 21) were comparable in age and clinical characteristics. The study group had a significantly delayed wake-up time compared to the control group (06:59 ± 46 min vs. 07:26 ± 42 min, p < 0.05) (mean difference of 27 min). Night's duration (from bedtime to wake-up) was significantly longer in the study versus the control group (570 ± 76 vs. 500 ± 66.1 min, p < 0.05), a total mean increase of 70 min, and sleep efficiency were significantly increased (92.3 ± 4.6% vs. 87.9 ± 8.7%, p < 0.05). Within the clown group, when comparing nights with and without exposure to a medical clown, total sleep time was prolonged by a mean of 54 min on the night of the intervention (518 ± 74 min vs. 464 ± 59 min, p < 0.01), and the total wake time during the night were reduced (52 ± 27 min vs. 77 ± 61 min, P < 0.05), mean difference of 25 min), mainly by reduction of wake period after sleep onset (WASO) (42 ± 25 min vs. 66 ± 58 min, p < 0.05), mean difference of 24 min). Regarding general medical outcomes, hospital stay was significantly shorter in the clown group vs. control (104 ± 42 h vs. 128 ± 42 h, p < 0.05), a mean reduction of 23 h—nearly an entire day. An encounter with a medical clown before bedtime in hospitalized children positively affects sleep parameters, which may be of great importance for healing in general. The clown intervention was also shown to shorten the hospital stay. Larger scale studies are warranted to establish these findings.

Clowns, Clown Doctors, and Coulrophobia: A Scoping Review

INTRODUCTION Clown therapy in pediatric care settings is becoming increasingly popular. However, clown doctors encounter some children in their visits who are uncomfortable or express feelings of fear. This emotional state is also found among parents and health care personnel. The phenomenon, called coulrophobia, is little studied in the biomedical field, although it has been known for some time. It is deemed necessary to learn more about it to prevent anxiety and fear that is as harmful as it is unnecessary. OBJECTIVE To identify, analyze and synthesize the available literature focused on coulrophobia. METHODS Scoping review adhering to the framework of Arksey and O'Mally. Retrieval of studies by querying and consulting electronic databases and web resources. Screening of records, analysis of included studies, synthesis of data and information in narrative form and through tables. RESULTS Twenty-six studies met the eligibility criteria. The prevalence of coulrophobia among children ranges from 1.1 percent to 6.1 percent. Mostly female and preschoolers are exposed, due to cognitive immaturity that limits the ability to distinguish between fantasy and reality. In adults, the prevalence of coulrophobia is between 18.6 percent and 53.5 percent and mainly prerogative of the female gender. The condition may be the result of childhood trauma associated with an encounter with a clown or mass media promotion of the figure of the evil clown. With some measures, clown doctors can try to prevent children's discomfort or fear. CONCLUSIONS Coulrophobia is a specific phobia falling under anxiety disorders that can have a significant and lasting impact in childhood and adulthood and therefore deserves further research.

Medical clowning in hospitals: practices, training and perception

Previous studies on medical clowning focused on patients, while research remains inadequate concerning clowning itself: training programmes and prerequisite requirements, clowning methods, deontology and accepted practices. Diverse approaches and paradigms...

Clown doctors virtualized: hospital professionals’ perception regarding online visits during confinement in Portuguese public hospitals

Abstract Clown doctors’ artistic interventions directed to hospitalized children in the Portuguese public hospitals have been performed over the last 20 years, uninterruptedly. During the Covid-19 pandemic, the doctor clowns’ visits were interrupted, but soon after resumed in some hospitals, by means of visits online. The present study evaluates hospital professionals’ perception (n = 152) regarding clowns’ online visits. Participants were mostly nurses (n = 76), and child educators/teachers (n = 39) working in pediatrics (n = 139). Six months after the beginning of the visits, an online questionnaire was used to collect the data. A mixed-methods approach was used to analyse the data. Results indicate that most hospital professionals have a positive perception of online visits, considering that the quality of performance was preserved, and that children were engaged and benefited from the interactions. Moreover, participants acknowledge the organizations’ ability and promptness in developing an alternative way of visiting the children, even though some stressed that in-person visits are the most desirable format.

The impact of humor therapy on people suffering from depression or anxiety: An integrative literature review.

To identify and synthesize existing research on the effectiveness and feasibility of multiform humor therapy on people suffering from depression or anxiety, with the hope of benefiting future research. An integrative literature review of quantitative, qualitative, and mixed studies was performed. The PubMed, Cochrane Library, Web of Science, Embase, and CINAHL databases were searched up to March 2022. Two independent reviewers conducted each stage of the review process, by assessing eligibility using preferred reporting items for systematic review and meta-analyses (PRISMA) and quality appraisal using the Mixed Methods Appraisal Tool, and data extraction. In this integrative review, 29 papers were included, containing 2964 participants across a diverse range of studies, including quantitative, qualitative, and mixed methods. The articles were from the United States, Australia, Italy, Turkey, South Korea, Iran, Israel, China, and Germany. The findings indicated that most of the subjects thought humor therapy was effective in improving depression and anxiety while a few participants considered the effect insignificant. However, more high-quality studies will be needed to confirm these conclusions. This review collated and summarized findings from studies examining the impact of humor therapy (medical clowns, laughter therapy/yoga) on people with depression or anxiety, including children undergoing surgery or anesthesia, older people in nursing homes, patients with Parkinson's disease, cancer, mental illness, and undergoing dialysis, retired women, and college students. The results from this review may help inform future research, policy, and practice in humor therapy to improve people's symptoms of depression and anxiety. This systematic review objectively evaluated the effect of humor therapy on depression and anxiety. As a simple and feasible complementary alternative therapy, humor therapy may provide a favorable alternative for clinicians, nurses, and patients in the future.

The Impacts of a Clown Doctor Program on an Adolescent Psychiatric Unit: A Mixed Methods Investigation.

Inpatient psychiatric care may be required to manage adolescents with severe mental health problems. As the ward can be a challenging environment, this study explored the influence of clown doctors on adolescents. Seventy-seven adolescents (13-18 years) and 22 staff from the Monash Health Stepping Stones Adolescent Unit, and 11 clown doctors from The Humour Foundation participated in the study. Bespoke surveys were developed by the research team to collect quantitative self-report data and qualitative responses. Descriptive statistics and thematic analysis suggested that adolescents experienced high levels of fun as well as positive mood during a clown doctor session. Clown doctor programs show promise within an inpatient unit with opportunities for further development being identified. With considerations of the findings, future clown doctor training could include tailoring sessions to the developmental needs of adolescents and developing strategies on how to interact with adolescents who have a mental health disorder.

An Interactive Augmented and Virtual Reality System for Managing Dental Anxiety among Young Patients: A Pilot Study

Dental anxiety is a common health problem among children. It creates major issues for patients, parents, and dental professionals. Children who cancel or otherwise miss their dental appointments generally do so due to fear of the unknown and lack of understanding of what they can expect from the environment and treatment when they arrive there. Some distraction interventions are already used by dental professionals, such as using clown doctors, watching cartoons, and utilizing the tell–show–do (TSD) technique. Still, the problem is common, and the fail to attend (FTA) rates at clinics are high. Familiarizing children with the dental setting and procedures in advance may help to manage their anxiety. This paper aims to help in managing children’s dental anxiety in a simple, attractive, and age-appropriate way through the use of augmented reality (AR) and virtual reality (VR) technologies. The developed system is named “Dr. Barea”. It targets Arabic-speaking children aged from 7 to 10 years old. It uses model–view–control (MVC) as its architectural design pattern. The proposed solution consists of three main sections: a 360° VR video that simulates a dental clinic environment, an educational description on dental tools using AR technology, and interactive educational stories that educate children about dental hygiene. The system performance was evaluated using unit, integration, performance, and user acceptance testing. The results demonstrate that the proposed solution, which performed reasonably, achieved the usability requirements and was engaging for learning information about dental hygiene. A feasibility study with 16 children was conducted to evaluate the effectiveness of the proposed system. The Child Fear Survey Schedule—Dental Subscale (CFSS-DS) was used to measure children’s dental anxiety level. The T test was used to evaluate the differences between groups, and Fisher’s exact test was used to compare the distributions of gender and age between the groups. The CFSS-DS index in the VR group decreased after dental consultation (35.04 ± 9.14 before consultation and 32.32 ± 8.32 after consultation, p = 0.041). The implications of this study shall be beneficial to patients, parents, and dental professionals.

Medical clowning influences the emotions of parents of children undergoing cancer treatment: A quasi-experimental study

BackgroundMedical clowning for children has been found to be effective at enhancing parents' psychological well-being during preoperative preparation, but has not been found during cancer treatment. This study aimed to examine whether and how medical clowning influenced the emotions of parents of children undergoing cancer treatment. MethodsIn this quasi-experimental study, 96 parents of children receiving inpatient cancer treatment were recruited, from June 2018 through April 2020. A demographic questionnaire measuring characteristics of parent and dyadic child, Brief Symptom Rating Scale measuring psychological distress of the parent, and Mood Assessment Scale measuring emotional status of parent and child were administered 1 day before a clowning service. The day after the clowning service, the Mood Assessment Scale again collected emotional status for parent and child. Descriptive analysis, bivariate analysis, and structural equation modeling to fit the actor-partner, cross-lagged model were used. FindingsParents experienced a low degree of psychological distress that called for emotional management. The indirect effect of medical clowning on parents' emotions through children's emotions was significant, as were the direct effect and total effect of medical clowning on parents' emotions. DiscussionParents experienced psychological distress during their child's inpatient cancer treatment. Medical clowning can directly improve children's emotions and through this pathway indirectly improve their parents' emotions. Application to practiceThere is need to monitor psychological distress and provide interventions for parents of children undergoing cancer treatment. Medical clowns should continue to serve parent-child dyads in pediatric oncology practice and become members of multidisciplinary health care teams.

A Lifetime of Play: Group Medical Clowning with Older Adults

Play is fundamental to a person’s well-being. However, cultural norms and ageism have negatively impacted this practice among older adults. This study explored to what extent medical clowning promotes play among older adults. Qualitative data were collected in weekly group sessions of medical clowning in an Israeli retirement home. Group medical clowning offered participants a new sort of playground, which combined body play, cognitive play, and role-play. The clown created an ambience that legitimized older adults’ loosening-up, expanding their space, feeling happy, and developing new creative interactions. He enabled participants to get involved in free play, thus freeing them of social constructions regarding older adults. The medical clown created a community of play and legitimized play among older adults, thereby breaking rules based on social stereotypes, the convention that older adults should not behave nonsensically and challenging the accepted social norms of the retirement home.

Disaster Medicine Education for Israeli Medical Response Teams to the Ukrainian Refugee Crisis.

Disaster Medicine (DM) requires skills, knowledge, and prior experience that are rarely put to test by health care providers. Pediatric DM presents unique challenges in terms of both knowledge and practice. An anonymous survey consisting of demographic and five-point Likert scale questions was administered to physicians, nurses, and other medical personnel from Israel's major medical emergency teams who were deployed to respond to the refugee crisis in Ukraine. This included teams from the Hadassah and Tel Aviv Sourasky Medical Centers and the Israel Ministry of Health. Of the 171 members of the medical teams deployed on the Ukraine border, a total of 105 responses were obtained (61.4%) from 61 physicians, 50 nurses, and 12 other health care providers. The teams were composed of pediatricians (31.6%), internal medicine physicians (21.6%), Emergency Medicine and intensive care physicians (18.0%), and 31.0% other specialties.For 60% of the participants, this was their first deployment, and 78% had received no training in DM. Members rated the need for DM training at 4/5 (IQR 3-5). Forty-nine (49) members (46.6%) were not briefed on situational awareness and 97 members (89.5%) were not trained in the recognition of acute stress reactions. The responders also rated their concerns about providing medical aid to children at 2/5 (IQR 1-3). A medical clown was part of the teams 42.8% of the time; the presence of clowns was rated at a median of 4/5 (IQR 4-5). The team members underscored the need for more targeted training in DM at 5/5 (IQR 3-5). The findings highlight the need for the formulation of a disaster education model that includes pediatric DM.

Improving children’s patient experience with a mobile hospital clowning application – Initial user experiences from the clowns’ perspective

eHealth solutions are increasingly being developed to support patient care and improve patients’ experiences (PXs). Recently, the coronavirus disease 2019 (COVID-19) pandemic and the shortage of nurses in several countries, including Finland, have further underscored the need for new digital services. In the context of children’s hospitals, care-supporting services include hospital clowns who work to provide emotional support for children and improve their PXs. Hospital clowns are known to have a positive impact on children’s PX. The Finnish hospital clown organization Sairaalaklovnit ry has published its first mobile application Sairaalaklovnit to provide a digital contact platform to reach patients remotely via messages. The application is mainly targeted at child patients and includes both entertainment and messaging facets for communication between child patients and hospital clowns. The two main user groups for this application can be considered to be child patients and hospital clowns. This article presents the data and results found during a study related to the user experience (UX) of the Sairaalaklovnit application. With the research questions, “Which aspects influence the UX of the hospital clown application?” and more specifically, out of the two user groups, “How do Finnish hospital clowns experience the new hospital clown mobile application?”, this study aims to gain an understanding of how Finnish hospital clowns experience the newly developed application for expanding physical contact with patients into a digital form. The qualitative data used in this article were collected in the summer of 2022 through an online questionnaire (n = 5) and semi-structured interviews (n = 3) with hospital clowns. The hospital clowns were mostly satisfied with the published application, but some deficiencies were mentioned. Most of the complaints were related to technical issues. However, the application was seen as a useful tool that can bridge physical and digital contact with children. The developer has been made aware of the technical issues and fixes expected in the future. For future research, it can be beneficial to rerun the UX study for the hospital clowns and possibly with a larger sample to see whether there have been any changes after the technical issues have been solved. Moreover, studying how child patients, which constitute the other user group, experience the new application, can prove to be beneficial for possible future development.

Do Clowns Really Taste Funny? An Investigation of the Relationship between Humor and Playfulness in Clown Doctors.

Healthcare clowning represents a well-established method for relieving patients and their relatives of discomfort during hospitalization. Although studies concerning the effectiveness of this approach are increasing in number, state-of-the-art studies conducted to evaluate the psychological characteristics of clown doctors are scarce. In this cross-sectional study, a convenient sample of 210 clown doctors (143 females, 67 males) aged between 18 and 75 years (M = 47.34, SD = 12.31) completed a demographic questionnaire, the Comic Styles Markers, and the Short Measure for Adult Playfulness. The results demonstrated that clown doctors bring higher levels of fun, benevolent humor, and nonsense and a lower level of cynicism compared to the populace. Moreover, the participants with more experience tend to use less irony, sarcasm, and cynicism than those with less experience. Playfulness was primarily related to the lighter styles of humor, and specific differences between the Whiteface and the Auguste clown doctors were observed. The results are discussed with reference to previous studies conducted on groups of clown doctors.

Effectiveness of hospital clowning on pediatric anxiety and pain: Network meta-analysis.

Anxiety and pain during medical procedures may have adverse short and long-term consequences. We summarize the effectiveness of hospital clown interventions, as compared with medication, the presence of a parent, standard care, and other non-pharmacological distraction interventions on anxiety and pain in minors undergoing medical procedures. Randomized trials were identified in PsycINFO, MEDLINE, Embase, Scopus and CINAHL, and previous reviews. Screening of titles and abstracts and full-texts, data extraction and risk of bias assessment was done by two independent reviewers. We conducted random-effects network and pairwise meta-analyses based on a frequentist framework. Our analyses with 28 studies showed significantly lower anxiety scores in clowning and other distraction interventions as compared with the presence of parents. No differences were observed between clowning, medication, and other distraction interventions. Clowning interventions were superior to standard care in our main analyses, but non-significant in some of the sensitivity analyses. Furthermore, clowning led to significantly lower pain as compared with presence of parents and standard care. No differences were observed between clowning interventions and the other comparators. For both outcomes, large between study heterogeneity was present but no significant inconsistency between designs. Risk of bias was mainly high and accordingly the certainty of evidence is considered moderate to low. We found no significant difference between medication, other non-medical distraction interventions and hospital clown interventions. Hospital clowns and other distraction interventions were more effective in reducing anxiety and pain in children undergoing medical procedures than the presence of parents alone. In order to allow for better insights regarding the comparative effectiveness of clowning interventions future trials should include detailed descriptions about the clowning intervention itself and the comparator. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Effect of Hospital Clown Intervention on Children on Anxiety in the Preoperative Period: A Systematic Review

Amaç: Preoperatif dönemde çocuklar kaygı yaşarlar. Çocukların uygulanan prosedürlere uyumunun artırılabilmesi için preoperatif dönemdeki kaygının azaltılması gerekmektedir. Bu sistematik derleme, çocuklara uygulanan tıbbi palyaço girişiminin preoperatif dönemdeki kaygı düzeyine etkisini belirlemek amacıyla gerçekleştirilmiştir.&#x0D; Yöntem: Bu araştırma sistematik derleme niteliğindedir. Bu amaçla “preoperative, non-pharmacological methods, child, anxiety ve clown” anahtar kelimeleri eşleştirilerek PubMed, MEDLINE, Google Scholar, Science Direct ve Cochrane olmak üzere beş veri tabanı 2005-2021 yıllarını kapsayacak şekilde taranmıştır. &#x0D; Bulgular: Bu araştırmada veri tabanlarının taraması sonucunda toplam 1207 yayına ulaşılmıştır. Araştırmaya dâhil edilme kriterlerine uygun olan toplam 10 (N=1506) yayın araştırma kapsamına alınmış ve sonuçlar açısından değerlendirilmiştir. Araştırma kapsamında 2-16 yaş arasında olan çocuklara pediatri servisi, ameliyathaneye transfer süreci, anestezi indüksiyonu sırasında ve ameliyattan sonraki dönemde tıbbi palyaço, sanat terapi, midazolam, hidroksizin ve ebeveyn varlığı ile müdahaleler yapılmıştır. Çocukların kaygı düzeyleri “Durumluk-Süreklik Kaygı Envanteri” veya “Modifiye Yale Preoperatif Kaygı Skalası” ile değerlendirilmiştir. &#x0D; Sonuç: Çocuklara uygulanan tıbbi palyaço müdahalesinin preoperatif dönemdeki kaygıyı azaltmada etkili olduğu sonucuna ulaşılmıştır.