The effect of medical clowns on performance of spirometry among preschool aged children
Co-therapy is increasingly common in pediatric hospitals, here is an example of usefulness.
It has been proven that the presence of medical clowns (MC) during medical procedures reduced pain perception and anxiety levels. Currently there is no standard method for evaluating pulmonary function in preschool children younger than 6 years of age. Spirometry is the most accessible method for evaluating pulmonary function. Whereas 95% of children aged 8-9 years were able to yield adequate spirometry results, success rates among preschoolers ranged from 50% to 85%. The aim of the current study is to evaluate the ability of MCs to assist preschool children aged 3 to 6 years in the performance of spirometry. This is a prospective, randomized controlled trial. Children aged 3 to 6 years were recruited between April 2016 and May 2017 among the children attending the pediatric pulmonary clinic in Hillel Yaffe medical center in Hadera, Israel. After a first spirometry, children were divided into two groups: the first performed a second spirometry with an MC. The second repeated spirometry with the technician. Primary outcome was second spirometry values compared between the groups. Secondary outcome were change in spirometry values within groups, and difference between the groups. A total of 140 children aged 3-6 years were randomly assigned into two groups of 70 children each. The MC group had significantly better FVC and FEV1 compared to the control group (P = 0.046 and 0.042, respectively). There was no significant difference in expiratory time (P = 0.188).
Conclusions: MCs improved performance of spirometry among preschoolers. It is possible that laughter and relief of stress had a physiological effect. Further studies are required to better establish the ability of MCs to improve active participation and to better understand whether the mechanism of the improvement is better cooperation or true physiological change.
Nir V, Schichter-Konfino V, Kassem E, Klein A. The effect of medical clowns on performance of spirometry among preschool aged children. Pediatr Pulmonol. 2018 Apr 2.