Clowning compared to parental presence or no intervention in children undergoing potentially anxiety-provoking procedures | ||||||
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Patient or population: children undergoing potentially anxiety-provoking procedures Setting: any setting Intervention: clowning Comparison: parental presence or no intervention | ||||||
Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
Risk with parental presence or no intervention | Risk with clowning | |||||
Children’s anxiety during preoperative time Assessed with m-YPAS Scale: from 0 to 100 | – | The mean children’s anxiety during preoperative time in the intervention group was 7.16 lower (10.58 lower to 3.75 lower) | – | 183 (4 RCTs) | ⨁◯◯◯ Very lowa,b,c,d,e,f | – |
Children’s anxiety in operation/induction/patient room Assessed with mYPAS Scale: from 0 to 100 | – | The mean children’s anxiety in operation/induction/patient room in the intervention group was 20.45 lower (35.54 lower to 5.37 lower) | – | 255 (5 RCTs) | ⨁◯◯◯ Very lowa,b,c,d,e,f,g | – |
Children’s anxiety during mask application/physician examination Assessed with m-YPAS Scale: from 0 to 100 | – | The mean children’s anxiety during mask application/physician examination in the intervention group was 2.33 higher (4.82 lower to 9.48 higher) | – | 115 (2 RCTs) | ⨁◯◯◯ Very lowa,f,h,i,j | – |
Children’s anxiety throughout process Assessed with m-YPAS Scale: from 0 to 100 | – | The mean children’s anxiety throughout process in the intervention group was 13.8 lower (21.28 lower to 6.32 lower) | – | 91 (1 RCT) | ⨁◯◯◯ Very lowa,c,d,f,i | – |
Parental anxiety-state anxiety Assessed with STAI Y-1 Scale: from 20 to 80 | – | The mean parental anxiety-state anxiety in the intervention group was 4 lower (6.35 lower to 1.65 lower) | – | 278 (5 RCTs) | ⨁◯◯◯ Very lowa,b,c,d,e,f | – |
Parental anxiety-trait anxiety Assessed with STAI Y-2 Scale: from 20 to 80 | – | The mean parental anxiety-trait anxiety in the intervention group was 3.67 lower (6.65 lower to 0.69 lower) | – | 231 (4 RCTs) | ⨁◯◯◯ Very lowa,b,c,d,e,f | – |
Parental anxiety Assessed with VRS scale Scale: from 0 to 45 | – | The mean parental anxiety in the intervention group was 1.4 lower (2.4 lower to 0.4 lower) | – | 50 (1 RCT) | ⨁◯◯◯ Very lowa,c,d,e,f | – |
Children’s pain Assessed with combined score of FPS-R and VAS | – | The mean children’s pain in the intervention group was 5.3 lower (6.77 lower to 3.83 lower) | – | 53 (1 RCT) | ⨁◯◯◯ Very lowa,b,e,f,j | – |
Children’s cooperation Assessed with questionnaire and child observation form Scale: from 0 to 16 | – | The mean children’s cooperation in the intervention group was 6.2 lower (8.64 lower to 3.76 lower) | – | 50 (1 RCT) | ⨁◯◯◯ Very lowa,c,d,e,f,i | – |