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 12

•This study examined the effects of a clown–nurse educational intervention on children undergoing day surgery for strabismus.•The use of clowns as part of preoperative education may alleviate postoperative problems including anxiety levels among children and parents, and children's pain to surgery.•Pediatric nurses should consider developing and providing anxiety and pain reduction intervention prior to surgical procedures in children.

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.