Parental anxiety and stress before pediatric anesthesia: A pilot study on the effectiveness of preoperative clown intervention

Abstract

As induction of pediatric anesthesia can elicit anxiety in children and parents alike, this study was aimed at evaluating the effectiveness of clown intervention in decreasing maternal anxiety and stress in the preoperative phase. Before anesthesia induction, 25 children were randomly assigned to clown intervention and 25 to a control group with a routine procedure. In the waiting room and after separation from the child, maternal anxiety and stress were measured. The results showed that after separation, only in the clown group, maternal state anxiety significantly decreased and the tendency to somatization did not increase. Moreover, after clown intervention, older children's mothers significantly reduced the level of perceived stress. As clown intervention can positively influence maternal anxiety and stress in the preoperative period, its promotion in clinical-hospital environments is recommended.

Palhaços: uma revisão acerca do uso dessa máscara no ambiente hospitalarPayasos: una revisiónsobre el uso de esa máscara en el ambiente hospitalario

“…In this perspective, the clowns, in general, have as objective the ressignification of the hospital environment with resulting improvment in the emotional wellbeing as much of the patients as of companions and staff [3][4][5][6][7][8] .…”

“…It is considered that as much the illness as the internment configure stress generating situations, fear and anxiety, context on which the clowns interventions are based 4,6,[9][10][11][12][13] .Therefore, we propose a short discussion on the physiology of stress for understanding the effect of obtaining better responses to the patients' and companions treatments, the ones who were in contact with the clowns 4,6,14,15 .…”

“…On the other hand, they can unchain anxiety, appetite loss, increase of allergic reaction and aggravation of conditions as hypertension and diabetes 9 . Common signs of these reactions to stress are alterations of the pulse, breathing frequency and skin temperature, that in some studies are used as parameters for evaluation of emotional well-being 4,6,14 . Like this, interventions that aim to reduce the stress levels provoked by the illness and by the internment, for clinical treatment, surgical procedure, anaesthetic 13 or sedative 16 , can contribute to avoid the onset of complications and associated pathologies, promoting even the patients response to the treatment 10,12 .…”

“…The clowns in the hospital resignify structures, functions, people and objects so that they transform the whole hospital environment, benefitting not only the patients, but all those involved in this condition momentarily or definitively subverted: patient, companion and even the own team of the healthcare 3,6,[23][24][25] . This breakdown of the traditional environment of the hospital and its ressignification are the base of most of the projects that act with the clown's language in the hospital, and they bring with themselves the humor besides the laughter through the creation of a "world between the real and the imaginary" that allows showing imagination and creativity 23 .…”

Feeling happy and carefree: a qualitative study on the experiences of parents, medical clowns and healthcare professionals with medical clowns

“…Also, a few studies showed that a clown intervention is able to reduce anxiety in parents (Agostini et al, 2014; Fernandes & Arriaga, 2010; Wolyniez et al, 2013). Other studies show more mixed results.…”