Effects of a Clown-Nurse Educational Intervention on the Reduction of Postoperative Anxiety and Pain Among Preschool Children and Their Accompanying Parents in South Korea

J Pediatr Nurs. 2015 Nov-Dec;30(6):e89-99. doi: 10.1016/j.pedn.2015.03.003. Epub 2015 Apr 13.


This study examined the effects of a clown-nurse educational intervention on children undergoing day surgery for strabismus. This was a quasi-experimental study, using a nonequivalent control group, non-synchronized design. Fifty preschool children and their parents were invited to participate. The children in the intervention group (n=23) received clown therapy and subsequently reported significantly lower states of physiological anxiety, which was evidenced by systolic blood pressure, standardized behavioral anxiety tests, and post-surgery pain, than the control group (n=27). In addition, the parents in the experimental group showed a low state of physiological anxiety, evidenced by systolic blood pressure, pulse rates, standardized behavioral anxiety tests, and state-trait anxiety. The use of preoperative clown intervention may alleviate postoperative problems, not only for children, but also for their parents.

Keywords: Children; Day surgery; Nursing; Preschool; Strabismus.

Publication types

  • Comparative Study

MeSH terms

  • Ambulatory Surgical Procedures / methods
  • Ambulatory Surgical Procedures / psychology*
  • Anxiety / nursing*
  • Anxiety / prevention & control*
  • Child, Preschool
  • Education, Nursing / methods
  • Female
  • Humans
  • Male
  • Nurses, Pediatric / education*
  • Ophthalmologic Surgical Procedures / methods
  • Pain, Postoperative / prevention & control*
  • Parents / psychology
  • Preoperative Care / methods
  • Republic of Korea
  • Strabismus / diagnosis
  • Strabismus / surgery*
  • Wit and Humor as Topic / psychology