When it comes to child health care, it could help to send in the clowns. According to a recent review of clinical trials conducted in many countries, interacting with clowns can help paediatric patients better manage symptoms and improve their psychological and emotional well-being.

The researchers from Brazil and Canada, who published their review in The BMJ, noted the positive effects of clowns on both children and adolescents confined in hospitals, when compared with those receiving standard care. In some of the studies reviewed by researchers, clowns were found to have "helped clinicians conduct examinations and enhanced patients’ cooperation with medical procedures". With clowns around, crying spells were also shorter when drawing blood or in an injection.

"Twelve studies showed that children and adolescents who received hospital clowns either with or without a parent present at the moment of the intervention reported significantly less anxiety and better psychological adjustment or showed a reduced increase in anxiety scores in the preoperative room before painful procedures and during the induction of anaesthesia, compared with those in control groups with standard care," the researchers said in their review.

One of the studies reviewed also found that a three-hour playing session with clowns was linked to an earlier end to symptoms of children with respiratory diseases. The children who played with clowns also showed a significant reduction in diastolic blood pressure, respiratory frequency and temperature compared with the control group.

The benefits of clown intervention in hospitals are already known to medical practitioners for more than a century. The researchers showed a September 1908 edition of the Parisian newspaper Le Petit Journal that presented on its front page an illustration of clowns and children in a London hospital ward. However, it was American physician Patch Adams, considered a pioneer in therapeutic clowning, who introduced the practice to a wider audience when he started clowning for patients in the mid-1970s.

In the UAE, there are medical clowning groups that have been working with medical and rehabilitation centres for children, including those with special needs.

What the recent review does offer are new insights on the benefits of hospital clowns during stressful medical procedures such as the induction of anaesthesia, and when the child is in the preoperative room. The researchers also offered new findings on how clowns can help improve the psychological well-being and emotional responses of children and adolescents with acute or chronic conditions.

The systematic review evaluated 24 studies from randomised and non-randomised controlled trials, involving some 1,612 children and adolescents. The researchers did note that further research is required to understand the impact of hospital clowns in symptom clusters in long-term hospital stay. While the review found favourable results of hospital clown intervention from a cross-section of paediatric patients with multiple conditions, it also noted that more research is needed to understand the effects of clowns on certain disorders such as cancer.

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