Universität zu Köln

Koensgen, Nadja, Polus, Stephanie, Rombey, Tanja ORCID: 0000-0001-5777-9738 and Pieper, Dawid (2019). Clowning in children undergoing potentially anxiety-provoking procedures: a systematic review and meta-analysis. Syst. Rev., 8. LONDON: BMC. ISSN 2046-4053

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Abstract

Background: The operation areas of clowns in the medical context are multifaceted. Clowning in children undergoing surgery has been shown to be able to lessen children's anxiety. Hence, our aim was to assess the effectiveness of clowning on anxiety in children undergoing potentially anxiety-provoking procedures. Methods: We searched MEDLINE, CENTRAL, and EMBASE for randomized controlled trials (RCTs) in December 2018. The primary outcome was children's anxiety. We used the Cochrane risk of bias tool to assess risk of bias of the included studies. Results: We found eleven RCTs including 733 children. Their risk of bias was relatively high. Children undergoing clowning were significantly less anxious in preoperative time compared to parental presence or no intervention (mean difference (MD) - 7.16; 95% CI - 10.58, - 3.75) and in operation, induction, or patient room (MD - 20.45; 95% CI - 35.54, - 5.37), but not during mask application or physician examination (MD 2.33; 95% CI -4.82, 9.48). Compared with midazolam, children's anxiety was significantly lower in preoperative time (MD - 7.60; 95% CI - 11.73, - 3.47), but not in the induction room (MD - 9.63; 95% CI - 21.04, 1.77). Conclusions: Clowning seems to lower children's anxiety, but because of the increased risk of bias of included studies and the very low quality of evidence, these results should be considered with caution.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koensgen, Nadja UNSPECIFIED UNSPECIFIED UNSPECIFIED Polus, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Rombey, Tanja UNSPECIFIED orcid.org/0000-0001-5777-9738 UNSPECIFIED Pieper, Dawid UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-134974
DOI:	10.1186/s13643-019-1095-4
Journal or Publication Title:	Syst. Rev.
Volume:	8
Date:	2019
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	2046-4053
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PEDIATRIC EMERGENCY-DEPARTMENT; PREOPERATIVE ANXIETY; MEDICAL CLOWNS; EMOTIONAL RESPONSES; PARENTAL ANXIETY; PAIN; ANESTHESIA; DISTRESS; SURGERY; SCALE Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13497