A quasi randomized-controlled trial to evaluate the effectiveness of clowntherapy on children’s anxiety and pain levels in emergency department

Margherita Felluga, Ingrid Rabach, M. Minute, Marcella Montico, Rita Giorgi, Isabella Lonciari, Andrea Taddio, Egidio Barbi

Research output: Contribution to journalArticle


The aim of the study is to investigate if the presence of medical clowns during painful procedures in the emergency department (ED) affects children’s anxiety and pain. Forty children (4–11 years) admitted to the ED with the need of painful procedures were prospectively enrolled. They were randomly assigned to the clown group, where children interacted with clowns or to the control group in which they were entertained by parents and ED nurses. The children’s anxiety was assessed by the Children’s Anxiety and Pain Scales; pain was evaluated with the Numerical Rating Scale and Wong-Backer Scale, according to the children’s age. Staff and clown’s opinions were evaluated by means of dedicated questionnaires. Children’s anxiety levels in the clown group were significantly lower than those compared with the control group, while children’s pain levels did not change between the two groups. Conclusion: The presence of clowns in the ED before and during painful procedures was effective in reducing children’s anxiety.(Table presented.)

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalEuropean Journal of Pediatrics
Publication statusAccepted/In press - Jan 12 2016



  • Anxiety
  • Clown therapy
  • Emergency department
  • Procedural pain

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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