Salivary Cortisol Levels: The Importance of Clown Doctors to Reduce Stress

Abstract

This study was designed to correlate entertainment of clown-doctors (CD) activities on hospitalized children and aphysiological bio-marker. For this purpose we collected saliva samples and verified children satisfaction with these activities by using a visual analog scale (VAS). Children from 6 to 7 years-old, with diagnosis of any acute pathology, interned in the Pediatric Ward of the Botucatu Medical School Hospital (São Paulo, Brazil) were interviewed. Two groups were taken into consideration: lunchCD and dinnerCD. The following protocol was applied in each group (lunch and dinner): collection of the first saliva sample and presentation of VAS prior to CD activities, followed by collection of a second saliva sample and another VAS assessment after CD activities. The salivary cortisol was reduced in both groups comparing the first saliva sample. The satisfaction of the intervention was evident for lunchCD. The CD intervention is effective in decreasing an important physiological biomarker of stress factor, cortisol, in hospitalized children, been effective for the healing process.

Palhaçoterapia em ambiente hospitalar: uma revisão de literatura

“…Saliba et al 25 desenhou um estudo para correlacionar as atividades de palhaços com crianças hospitalizadas e o nível de cortisol, um importante biomarcador fisiológico do estresse. O cortisol salivar foi reduzido em todos os participantes que receberam a visita dos palhaços, demonstrando satisfação, indicando relativa atenuação dos efeitos da hospitalização e seu possível efeito colaborador no processo de recuperação da saúde 25 .…”

The effect of medical clowns on performance of spirometry among preschool aged children

“…The presence of MCs reduced the length of respiratory hospitalizations and shortened the duration of respiratory symptoms . Levels of salivary cortisol were reduced after MCs intervention which is an indication that stress was reduced (salivary cortisol was not measured in the current study). It is also possible that if the use of traditional incentive was suspected to under estimate pulmonary function test, as suspected by certain investigators, the use of MCs as additional incentive may induce a more accurate measure of lung function in preschool children.…”

Cortisol salivar e atenção auditiva sustentada

“…(Sarsted). Este dispositivo comercial é uma maneira comum e muito utilizada para obtenção de saliva para análise em adultos (Aardal e Holm 1995, Kirschbaum et al 1996, Wust et al 2000b , Vedhara et al 2000, Lindauer et al 2005, Gallagher et al 2006, Keller 2006, Kanegane 2007, Roelofs et al 2007, Ferreira 2011, Gassling et al 2012, Henckens et al 2012, Abu-Samak et al 2014, Campos e David 2014, Lima 2014, Qi et al 2016) e crianças (Tornhage 2002, Groschl et al 2003, Rosmalen et al, 2005, Curcio et al 2013, Gomes et al 2015, Nederhof et al 2015, Gomes et al 2016, Saliba et al 2016). permanece sem alterações por três meses, quando armazenado a 5 °C, ou até um ano, quando congelado de -20°C a -80°C (Groschl et al 2001, Garde e Hansen 2005.…”

“…O cortisol presente nas amostras de saliva foi mensurado por um kit imunoensaio enzimático (Salimetrics, Stage College, PA, USA) 14,71 9,76 17,50 16,40 8 4,36 4,3 2,80 22,71 8,54 21,83 16,17 1,42 1,27 3 2,28 10,66 6,96 8 8,37 7,22 6,04 3 2,16 17,89 11,30 11 8,41 1,6 1,58 2,5 Kirschbaum et al 1996, Vedhara et al 2000, Wust et al 2000b , Ellenbogen et al 2002, Tornhage 2002, Groschl et al 2003, Lindauer et al 2005, Rosmalen et al 2005, Gallagher et al 2006 Gomes et al 2015, Nederhof et al 2015, Qi et al 2016, Saliba et al 2016.…”

“…A forma de armazenamento, seguida de acordo com as instruções do fabricante, também foi a mesma utilizada por vários autores (Riad-Fahmy et al 1982, Aardal e Holm 1995, Kiess et al 1995, Kirschbaum et al 1996, Ellenbogen et al 2002, Lindauer et al 2005, Amenábar 2006, Gallagher et al 2006, Kanegane 2007, Roelofs et al 2007, McCarthy et al 2009, Abu-Samak et al 2014 (Kiess et al 1995, Kirschbaum et al 1996, Vedhara et al 2000, Morelius et al 2004, Rosmalen et al 2005, Lindauer et al 2006, Tornhage e Alfven 2006, Gassling et al 2012, ng/mL (Qi et al 2016, Nohara et al 2016 e g/mL (Saliba et al 2016…”