The impact of medical clowns exposure over postoperative pain and anxiety in children and caregivers: An Israeli experience.

While postoperative pain management was shown to reduce unwanted physiological and emotional outcomes, pediatric postoperative pain management remains suboptimal. Medical-clowns were shown to be beneficial in many medical contexts including reduction of stress, anxiety and pain. This study was set to assess the effectiveness of medical-clowns on pediatric postoperative pain reduction. Children age 4 or above, planned for elective hernia repair surgery were recruited. Children were randomly divided to a control or medicalclown escorted groups. Demographical and clinical data were collected using questionnaires and electronic sheets. Children escorted by clowns reported lower levels of pain upon admittance, discharge and 12- hours post-surgery. Statistically significant reduction of parental distress and significantly higher serum cortisol levels were observed in the clown-therapy group. Although small, our study supports the possibility that preoperative medical-clown therapy might be a cheap, safe and yet beneficial method for postoperative pain reduction.

Setting a research agenda for pediatric complementary and integrative medicine: A consensus approach.

BACKGROUND: Pediatric use of complementary medicine (CM) is common and offers numerous research questions about diverse therapies and conditions. Although research priorities for pediatric CM have been identified, there was a need to update in light of the rapid evolution of the field. METHODS: Building on previous work, we conducted an international, consensus-based 4-step modified Delphi process to develop and refine a pediatric CM research agenda, including on-line questionnaires and an in-person meeting. Participants included health care professionals, researchers, and educators. RESULTS: We received 376 responses; participants included conventional and CM providers, researchers, educators, administrators, and policy-makers from 15 countries (Australia, Bangladesh, Belgium, Canada, China, Germany, India, Israel, Italy, New Zealand, Norway, Sri Lanka, The Netherlands, United Kingdom, and United States). While it was recognized that each region must set their own priorities based on use, access, and expertise, a "minimum set" for a pediatric CM research agenda was identified. After three rounds of surveys, participants identified the highest priorities for pediatric CM research as: (i) safety of CM therapies for infants, children, and adolescents; (ii) conditions for which CM use is highly prevalent and for which conventional medicine lacks safe, cost-effective therapies; iii) therapies/therapists to be examined for quality and reproducibility of interventions, comparative and cost effectiveness, dose, etc.; and iv) identification of relevant outcomes and outcome measurement tools. CONCLUSIONS: The results of our study identify that "first do no harm" is the leading research priority for pediatric CM research, followed by more research on effectiveness of CM therapies for conditions not safely and effectively treated with conventional care. In order to improve pediatric health care, interdisciplinary collaborative approaches are needed between CM and conventional providers and researchers.

The effect of acupuncture therapy on pain perception and coping strategies: a preliminary report.

The objective of the present study was to examine the effect of acupuncture on the perception of pain and coping strategies, thus focusing on the psychological aspects of pain. The study was conducted in two complementary and alternative medicine clinics of public hospitals. Forty-one patients scheduled for routine acupuncture therapy because of chronic musculoskeletal pain were recruited for the study to receive eight acupuncture treatments. Twenty-four patients completed the treatment schedule and filled two self-reported questionnaires before and after therapy: (1) Illness Perception Questionnaire-Revised (IPQ-R); and (2) Coping Strategies questionnaire (Brief COPE). A significant improvement was found in the following measures related to pain perception: timeline (chronic versus acute), treatment control, and personal control. Additionally, significant improvement was displayed in three measures related to coping strategies: positive reframing, religion, and venting. The results indicate that acupuncture therapy might be efficient in changing patient's pain perception from chronic to acute and in enhancing their sense of personal and treatment control over their pain. In addition, acupuncture therapy partially improved coping strategies. The present study provides further validation for acupuncture therapy in pain and highlights its possible role in affecting the psychological aspects of pain.