Clowning Around the Operating Room
Clowns Reduce Pre-operative Anxiety in Children

October 11, 2005

Laughter as Medicine

There is an old saying: "Laughter is good medicine." Now there may be proof that this is true. Research has shown that laughing can alter levels of neurochemicals, boost the immune system, reduce muscle tension, and improve respiration. Some hospitals are experimenting with "Humor Rooms," "Comedy Carts," and clowns to speed a patient's recovery and boost morale. New research from scientists at Anna Meyer Children's Hospital in Florence, Italy, has shown that clowns can reduce the pre-operative anxiety in children.

Clowns Reduce Anxiety, But Bother Nurses and Doctors

Dr. Laura Vagnoli and her team divided 40 children (average age = 7 years old) who were going to have an operation into two groups:

  • Clown Group: two clowns visited children for 30 minutes in a waiting room before the children went into the operating room for surgery. The clowns also stayed with the children for 15 minutes in the operating room. During this time, the clowns used magic tricks, music, games, puppets and bubbles to entertain the children. A parent also stayed with each child.

  • Control Group: only parents stayed with the children in the waiting room and the operating room.

Two psychologists observed the entire experiment and rated the anxiety levels of the children.

The anxiety levels of children in the clown group and control group were the same when the children were in the waiting room. However, once the children were taken into the operating room, those children in the control group showed significantly higher levels of anxiety than children in the clown group.

Nurses and doctors who took care of the children were asked whether the clowns were useful. Of these health professionals, 44% had a favorable or very favorable level of appreciation for the clowns and 78% said that the clowns were useful for the children. However, 84% of the nurses and doctors said that the clowns were at least sometimes a disturbance in the operating room and only 28% of them wanted the clown program to continue.

Clowning Around

The time before surgery can be stressful for anyone, especially children. Thoughts about possible pain, being separated from parents, and strange places and smells can all increase anxiety in a child. Although it is possible to give children drugs to calm them before an operation, it may be preferable to use a method that does not involve medications. Using clowns appears to be one such method.

It remains to be determined if the presence of clowns can improve the outcome of the operation and speed the recovery of the children after surgery. Also, to be successful, the clown program must not interfere with the work of doctors and nurses.

Reference and more information:
  1. Vagnoli, L., Caprilli, S., Robiglio, A and Messeri, A., Clown doctors as a treatment for preoperative anxiety in children: a randomized, prospective study, Pediatrics, 116:e563-e567, 2005.
  2. Laughter and the Brain - Neuroscience for Kids

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