Trial reportEuropean journal of pediatrics2016
A quasi randomized-controlled trial to evaluate the effectiveness of clowntherapy on children's anxiety and pain levels in emergency department.
Trial report in European journal of pediatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03888690 (Randomized Controlled Trial Evaluating the Effectiveness of the Virtual Reality Distraction Compared to Current Practice, on Reducing Procedural Pain in Children and Adolescents Supported in Pediatric Onco-Hematology Unit.), which is not on this map. Cited by 25 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized Controlled Trial Evaluating the Effectiveness of the Virtual Reality Distraction Compared to Current Practice, on Reducing Procedural Pain in Children and Adolescents Supported in Pediatric Onco-Hematology Unit.
Who cites it
25 citing papers in PubMed, 8 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Efficacy of psychosensory interventions for the management of pediatric pain, fear, and distress during emergency care: a systematic review and meta-analysis of randomized clinical trials.Frontiers in pediatrics · 2025Pooled it
- Medical clowning in hospitalized children: a meta-analysis.World journal of pediatrics : WJP · 2023Pooled it
- The impact of humor therapy on people suffering from depression or anxiety: An integrative literature review.Brain and behavior · 2023Pooled it
- Clown therapy for procedural pain in children: a systematic review and meta-analysis.European journal of pediatrics · 2022Pooled it
- Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials.BMJ (Clinical research ed.) · 2020Pooled it
- Clowning in children undergoing potentially anxiety-provoking procedures: a systematic review and meta-analysis.Systematic reviews · 2019Pooled it
- Psychological interventions for needle-related procedural pain and distress in children and adolescents.The Cochrane database of systematic reviews · 2018Pooled it
- Therapeutic clowns in pediatrics: a systematic review and meta-analysis of randomized controlled trials.European journal of pediatrics · 2016Pooled it
- Trial
- Combined use of EMLA cream and Buzzy for peripheral intravenous cannulation in children: a randomized controlled trial.Frontiers in pediatrics · 2026Article
- A Narrative Review of Nonpharmacological Approaches to Control Anxiety in Pediatric Dentistry.International journal of pediatrics · 2025Review
- Article
- The Effects of Hospital-Based School Lessons on Children's Emotions, Distress and Pain.Continuity in education · 2024Article
- Effect of soap bubbles technique, coughing and distraction cards on reducing pain and anxiety during phlebotomy in children.Paediatric & neonatal pain · 2023Article
- Motivations and Personal Traits Can Predict Self-Efficacy of the Clown Therapist: A Descriptive Study.International journal of environmental research and public health · 2022Article
- Managing acute pain in children presenting to the emergency department without opioids.Journal of the American College of Emergency Physicians open · 2022Review
- Use of Audiobooks as an Environmental Distractor to Decrease State Anxiety in Children Waiting in the Pediatric Emergency Department: A Pilot and Feasibility Study.Frontiers in pediatrics · 2020Article
- An ongoing WE: A focused ethnographic study of the relationship between child and hospital clown during recurrent pain-related procedures and conditions.Paediatric & neonatal pain · 2019Article
- Needle-related pain and distress management during needle-related procedures in children with and without intellectual disability.European journal of pediatrics · 2018Article
- Feeling happy and carefree: a qualitative study on the experiences of parents, medical clowns and healthcare professionals with medical clowns.International journal of qualitative studies on health and well-being · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledThe aim of the study is to investigate if the presence of medical clowns during painful procedures in the emergency department (ED) affects children's anxiety and pain. Forty children (4-11 years) admitted to the ED with the need of painful procedures were prospectively enrolled. They were randomly assigned to the clown group, where children interacted with clowns or to the control group in which they were entertained by parents and ED nurses. The children's anxiety was assessed by the Children's Anxiety and Pain Scales; pain was evaluated with the Numerical Rating Scale and Wong-Backer Scale, according to the children's age. Staff and clown's opinions were evaluated by means of dedicated questionnaires. Children's anxiety levels in the clown group were significantly lower than those compared with the control group, while children's pain levels did not change between the two groups.
conclusionThe presence of clowns in the ED before and during painful procedures was effective in reducing children's anxiety. WHAT IS KNOWN: • Anxiety and fear caused by medical procedures exacerbate children's pain and may interfere with the procedure. • To reduce anxiety, fear, and pain and to facilitate patient's evaluation, different non-pharmacological approaches have been proposed and positive effects of laughter and humor have been reported. What is New: • The presence of clowns in the waiting room and in the ED during medical evaluation and painful procedures helps to reduce children's anxiety.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.