4.6 Article

The beneficial effect of medical clowns on performance of EEG in young children: a randomized controlled study

Journal

EUROPEAN JOURNAL OF PEDIATRICS
Volume 181, Issue 9, Pages 3449-3457

Publisher

SPRINGER
DOI: 10.1007/s00431-022-04555-z

Keywords

EEG (electroencephalography) children; Medical clown

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The study aimed to investigate the effects of a close collaboration with medical clowns on the performance of EEG in young children. The results showed that the study group, which had medical clowns present during the EEG, had significantly higher technical scores, higher cooperation rates, and higher parent satisfaction compared to the control group without medical clowns. Additionally, sedation was not necessary in the study group. This suggests that collaborating with medical clowns during EEG testing in young children can improve the quality of the test and increase satisfaction for both parents and technicians.
Electroencephalography (EEG) is an important test in the diagnosis of epilepsy. To perform the test, many electrodes are placed on the child's scalp, a stressful situation that may contribute to uncooperative behavior. The aim of our study was to investigate the effects provided by a close collaboration with medical clowns on the performance of EEG in young children. A prospective randomized control study was conducted between July 2020 and September 2021. The study included children aged 1-5 years who were scheduled to undergo EEG testing at the Bnai Zion Medical Center. The children were randomly allocated to each group (study group with medical clowns and control group without medical clowns) according to the day of the test. The medical clowns, the EEG technician, and the children's caregivers all independently rated the entire process in designated questionnaires composed of items rated on a 5-point Likert scale. In addition, the technical quality of all EEG tests was evaluated and rated by one neurologist (G.J.) in a blinded manner. One hundred children participated in the study. Fifty children underwent the EEG accompanied by one of two medical clowns (study group), and fifty children underwent routine EEG, without medical clowns (control group). The physician-rated technical score of the EEG recording was significantly higher in the study group (p < 0.001). Among parents of the study group, 96% were highly satisfied from the presence of the medical clowns during the EEG (median 5). Both the EEG technician and the parents denoted a significantly higher cooperation rate in the study group children, of 72% and 82%, respectively, compared to the control group. The rating of child/parent's cooperation was not correlated with age, sex, or ethnicity of the child. There was no need for sedation in the study group. Conclusion: Performing EEG in young children in collaboration with medical clowns can increase the quality of the EEG recording possibly due to higher cooperation rates, which in turn lead to mutual satisfaction of both parents and technicians with the procedure.

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