Hospital clown intervention to reduce the perception of pain and anxiety in pediatric oncology patients before lumbar puncture
Intervención del clown hospitalario para la disminución de la percepción del dolor y ansiedad en pacientes de oncología pediátrica antes de la punción lumbar.
Article Sidebar
PDF (Español (España))
FLIP
XML (Español (España))
Los autores que publican en la Revista Iberoamericana de Psicología están de acuerdo con los siguientes términos:
- El Autor o los autores, desde que presenta(n) a consideración de esta revista su manuscrito, esta(n) informado(s) acerca de la política de Acceso Abierto, como condición indisociable de publicación, lo que significa que ni él(los), ni la revista han de percibir ingreso alguno por concepto de la lectura de resúmenes o del artículo completo, tampoco por su uso o explotación para generar nuevo conocimiento o para desarrollar aprendizajes alrededor de la obra.
- Los autores conservan los derechos de autor y garantizan a la revista el derecho de ser la primera publicación del trabajo, al igual que licenciado bajo una Creative Commons Atribución-NoComercial-CompartirIgual 4.0 Internacionalque permite que permite a terceros utilizar lo publicado, siempre que se haga mención a la autoría del trabajo y la primera publicación en esta revista, no se utilice con fines comerciales y que las obras que se deriven del artículo se compartan en iguales condiciones.
- Los conceptos y opiniones expresados en los artículos son responsabilidad exclusiva de los autores y no comprometen a la Revista Iberoamericana de Psicología ni a la Corporación Universitaria Iberoamericana. Los contenidos de esta revista se distribuyen bajo licencia de tipo Creative Commons Atribución 4.0 Internacional, la cual exige el debido reconocimiento de las obras y cuyos términos se encuentran en: https://creativecommons.org/licenses/by/4.0/deed.es
- La Revista Iberoamericana de Psicología es una revista de acceso abierto, por lo que tanto el proceso editorial como los contenidos publicados están disponibles para todos los usuarios sin cargo alguno: la Revista no realiza cobro alguno por acceso, lectura o descarga de contenidos ni por procesos o actividades de la editorial con fines de publicación.
Main Article Content
Patients with chronic diseases often face potentially stressful and invasive procedures that are part of their treatment. Hospital clowns have proven to be a good resource for the improvement of psychological and emotional aspects in chronic patients. The aim of the study was to evaluate the effect of hospital clowning on anxiety and pain perception in pediatric patients with acute lymphoblastic leukemia (ALL) before lumbar puncture. For this purpose, a quasi-experimental protocol was designed with the intervention of the hospital clowns. The sample consisted of 17 pediatric patients with ALL between 4 and 16 years of age (M=8.93 and SD=4.11). The participants were evaluated with the Wong-Baker FACES pain scale and the Self-assessment manikin instrument, before and after lumbar puncture without intervention and after approximately 6-8 weeks they were evaluated with the clowns intervention. A repeated measures ANOVA with 2 within-subject factors was performed. The results showed a significant decrease in the levels of pain perception and anxiety in the patients after the intervention. It can be concluded that the hospital clowns intervention can be an effective tool to decrease the levels of pain perception and anxiety in this type of patients. These findings highlight the importance of creating suitable environments in hospital settings, which will be a benefit in the mental health of children with chronic diseases. It highlights the need for further studies adding physiological measures to support these findings in other contexts and with other populations.
Downloads
Article Details
Anes, L., & Obi, M. (2014). Hospital Clowning as Play Stimulus in Healthcare. Children (Basel, Switzerland), 1(3), 374–389. https://doi.org/10.3390/children1030374 DOI: https://doi.org/10.3390/children1030374
Bennett, M., Zeller, J., Rosenberg, L., & McCann, J. (2003). The effect of mirthful laughter on stress and natural killer cell activity. Altern Ther Health Med, 9(2), 38–45. http://digitalcommons.wku.edu/nurs_fac_pub/9
Ben-Pazi, H., Cohen, A., Kroyzer, N., Lotem-Ophir, R., Shvili, Y., Winter, G., Deutsch, L., & Pollak, Y. (2017). Clown-care reduces pain in children with cerebral palsy undergoing recurrent botulinum toxin injections- A quasi-randomized controlled crossover study. PLoS ONE, 12(4). https://doi.org/10.1371/journal.pone.0175028 DOI: https://doi.org/10.1371/journal.pone.0175028
Bradley, M., & Lang, P. (1994). Measuring emotion: The self-assessment manikin and the semantic differential. Journal of Behavior Therapy and Experimental Psychiatry, 25, 49–59. DOI: 10.1016/0005-7916(94)90063-9 DOI: https://doi.org/10.1016/0005-7916(94)90063-9
Caci, L., Zander-Schellenberg, T., & Gerger, H. (2023). Effectiveness of hospital clowning on pediatric anxiety and pain: Network meta-analysis. Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 42(4), 257–269. https://doi.org/10.1037/hea0001285 DOI: https://doi.org/10.1037/hea0001285
Campbell, D., & Stanley, J. (1963). Experimental and quasi-experimental designs for research on teaching. (In N. L. Gage). Handbook of research on teaching. https://www.sfu.ca/~palys/Campbell&Stanley-1959-Exptl&QuasiExptlDesignsForResearch.pdf
Dowling, J. S., Hockenberry, M., & Gregory, R. L. (2003). Sense of humor, childhood cancer stressors, and outcomes of psychosocial adjustment, immune function, and infection. Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses, 20(6), 271–292. https://doi.org/10.1177/1043454203254046 DOI: https://doi.org/10.1177/1043454203254046
Fernández Hawrylak, M., Heras Sevilla, D., Cepa Serrano, A., & Bastida Susinos, J. (2017). Uso del humor como método de intervención terapéutica. En menores afectados por procesos oncológicos. Revista De Pedagogía De La Universidad De Salamanca, 23, 91–105. https://doi.org/10.14201/aula20172391105 DOI: https://doi.org/10.14201/aula20172391105
García, L. Y., Meléndez, J. V., & Valenzuela, D. K. (2016). Intervención de la risoterapia en el dolor del paciente en edad escolar diagnósticado con Leucemia Linfoblástica Aguda. Universidad Peruana Cayyetano Heredia. https://hdl.handle.net/20.500.12866/681
Ibarra, J. (2020). Día Mundial Contra el Cáncer Infantil. https://santafe.lat/cancer-infantil/
Jones, B., Currin-Mcculloch, J., Pelletier, W., Sardi-Brown, V., Brown, P., & Wiener, L. (2018). Psychosocial standards of care for children with cancer and their families: A national survey of pediatric oncology social workers. Social work in health care, 57(4), 221–249. https://doi.org/10.1080/00981389.2018.1441212 DOI: https://doi.org/10.1080/00981389.2018.1441212
INEGI. (2021, February 4). Estadísticas a propósito del día mundial contra el cáncer(4 de Febrero). https://www.inegi.org.mx/contenidos/saladeprensa/aproposito/2021/cancer2021_Nal.pdf
Karisalm, N., Mäenpää, K., Kaipio, J., & Lahdenne, P. (2020). Measuring patient experiences in a Children’s hospital with a medical clowning intervention: a case-control study. BMC Health Services Research, 360(20). https://doi.org/10.1186/s12913-020-05128-2 DOI: https://doi.org/10.1186/s12913-020-05128-2
Koller, D., & Gryski, C. (2008). The life threatened child and the life enhancing clown: Towards a model of therapeutic clowning. Evidence-Based Complementary and Alternative Medicine, 6(1), 17–25. https://doi.org/10.1093/ecam/nem033 DOI: https://doi.org/10.1093/ecam/nem033
Kristensen, H. N., Sørensen, E. E., Stinson, J., & Haslund‐Thomsen, H. (2019). An ongoing WE: A focused ethnographic study of the relationship between child and hospital clown during recurrent pain‐related procedures and conditions. Paediatric and Neonatal Pain, 2(1), 5–14. https://doi.org/10.1002/pne2.12005 DOI: https://doi.org/10.1002/pne2.12005
Lancheros, E., Tovar, J., & Rojas, C. (2011). Laughter and health: therapeutic approaches. Med UNAB, 14(1), 69–75. https://biblat.unam.mx/hevila/Medunab/2011/vol14/no1/8.pdf
Lopes-Júnior, L. C., Bomfim, E., Olson, K., Neves, E. T., Silveira, D. S. C., Nunes, M. D. R., Nascimento, L. C., Pereira-Da-Silva, G., & Lima, R. A. G. (2020). Effectiveness of hospital clowns for symptom management in paediatrics: Systematic review of randomised and non-randomised controlled trials. BMJ (Clinical research ed.), 371, m4290. https://doi.org/10.1136/bmj.m4290 DOI: https://doi.org/10.1136/bmj.m4290
Lopes-Junior, L. C., Silveira, D. S. C., Olson, K., Bomfim, E. O., Veronez, L. C., Santos, J. C., Alonso, J. B., Nascimento, L. C., Pereira-Da-Silva, G., & Lima, R. A. G. (2020). Clown Intervention on Psychological Stress and Fatigue in Pediatric Patients with Cancer Undergoing Chemotherapy. Cancer Nursing, 43(4), 290–299. https://doi.org/10.1097/NCC.0000000000000690 DOI: https://doi.org/10.1097/NCC.0000000000000690
Maratos, A. S., Gold, C., Wang, X., & Crawford, M. J. (2008). Music therapy for depression. The Cochrane database of systematic reviews, (1), CD004517. https://doi.org/10.1002/14651858.CD004517.pub2 DOI: https://doi.org/10.1002/14651858.CD004517.pub2
Ministerio de Salud. (2010). Guía Clínica Leucemia en menores de 15 años. https://www.minsal.cl/portal/url/item/7220fdc433e944a9e04001011f0113b9.pdf
Newman, N., Kogan, S., Stavsky, M., Pintov, S., & Lior, Y. (2019). The impact of medical clowns exposure over postoperative pain and anxiety in children and caregivers: An Israeli experience. Pediatric Reports, 11(3), 44–48. https://doi.org/10.4081/pr.2019.8165 DOI: https://doi.org/10.4081/pr.2019.8165
Organización Panamericana de la Salud [OPS]. (2022, February 15). El 55% de los niños y adolescentes con cáncer se curan en América Latina y el Caribe. Día internacional contra el cáncer infantil. https://www.paho.org/es/temas/cancer-ninez-adolescencia
Osorio-Sandoval, J. A., Torres Reyes, A., Tenahua-Quitl, I., De-Ávila-Arroyo, M. L., Morales-Castillo, Francisco.-A., García-López, M. A., Gracía-Verónica, R., & González-Hernández, A. R. (2019). Efectividad de la risaterapia en manejo el dolor en pacientes pediátricos postoperados de apendicetomía. Journal Health NPEPS, 4(2), 44–57. https://doi.org/10.30681/252610103698 DOI: https://doi.org/10.30681/252610103698
Pai, A. L. H., McGrady, M., & Ventura, A. K. (2016). Psychological Interventions to Improve Adherence to Oral Medications in Adolescents With Chronic Conditions: A Systematic Review. Journal of Pediatric Psychology, 41(8), 859-874. doi: 10.1093/jpepsy/jsw007. DOI: https://doi.org/10.1093/jpepsy/jsw007
Quesada, C., Belén, A., Díaz, J., Dolores, M., López, R., Berbén, G., & Trinidad, M. (2014). La enfermedad crónica infantil. Repercusiones emocionales en el paciente y la familia. International Journal of Developmental and Educational Psychology INFAD Revista de Psicología, No1, 4(0214–9877), 569–576. https://www.redalyc.org/articulo.oa?id=349851787062 DOI: https://doi.org/10.17060/ijodaep.2014.n1.v4.832
Salinas Morales, C. A. (2007). Efectividad de la risoterapia en el estado de ánimo y percepción del dolor en niños hospitalizados. In Lexus (Vol. 4, Issue None). http://dspace.unitru.edu.pe/handle/UNITRU/13340
Sánchez, C. A. V., & Lozano, J. A. F. (1995). El niño ante el hospital. Programas para reducir la ansiedad hospitalaria. Universidad de Oviedo.
Sridharan, K., & Sivaramakrishnan, G. (2016). Therapeutic clowns in pediatrics: a systematic review and meta-analysis of randomized controlled trials. European journal of pediatrics, 175(10), 1353–1360. https://doi.org/10.1007/s00431-016-2764-0 DOI: https://doi.org/10.1007/s00431-016-2764-0
Taddio, A., Soin, H. K., Schuh, S., Koren, G., & Scolnik, D. (2005). Liposomal lidocaine to improve procedural success rates and reduce procedural pain among children: A randomized controlled trial. CMAJ: Canadian Medical Association Journal = Journal de L´Associatioon Medicale Canadienne, 172(13), 1691–1695. https://doi.org/10.1503/cmaj.045316 DOI: https://doi.org/10.1503/cmaj.045316
Tan, S., Tan, L., Lukman, S., & Berk; Lee. (2007). Humor, as an adjunct therapy in cardiac rehabilitation, attenuates catecholamines and myocardial infarction recurrence. Adv Mind Body Med ., 22(3–4), 8–12. https://pubmed.ncbi.nlm.nih.gov/20664127/
Vagnoli, L., Caprilli, S., Robiglio, A., & Messeri, A. (2005). Clown doctors as a treatment for preoperative anxiety in children: a randomized, prospective study. Pediatrics, 116(4), e563-e567. https://doi.org/10.1542/peds.2005-0466 DOI: https://doi.org/10.1542/peds.2005-0466
Vagnoli, L., Caprilli, S., & Messeri, A. (2010). Parental presence, clowns or sedative premedication to treat preoperative anxiety in children: what could be the most promising option?. Pediatric Anesthesia, 20(10), 937-943. https://doi.org/10.1111/j.1460-9592.2010.03403.x DOI: https://doi.org/10.1111/j.1460-9592.2010.03403.x
Vessey, J. A., Carlson, K. L., MacKinnon, M. J., & Tudiver, F. (2002). Pediatric stress and parental perceptions during invasive procedures. Pediatric Nursing, 28(5), 453-459.
https://doi.org/10.1177/089431841984539
Wong, D. L., & Baker, C. M. (1988). Pain in children: comparison of assessment scales. Pediatric nursing, 14(1), 9–17. https://pubmed.ncbi.nlm.nih.gov/3344163/
Wong-Baker FACES Foundation. (1988). Wong-Baker FACES® Pain Rating Scale. https://wongbakerfaces.org DOI: https://doi.org/10.1037/t05330-000
