{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:15:22Z","timestamp":1790151322355,"version":"4.0.1"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,6,11]],"date-time":"2016-06-11T00:00:00Z","timestamp":1465603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007457","name":"Magi foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007457","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this paper is to investigate prospectively the potential benefits of the participation of the medical clowns in the outpatient paediatric penile surgery programme.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty children undergoing meatotomy, age 2 to 16\u2009years, were randomised into two groups (40 each). In the first group, the medical clown was an integral part of the medical team, and in the second group, the treatment was given without participation of the medical clown. The following parameters were measured: the level of pre\u2010operative anxiety, the level of the post\u2010operative pain, the amount of pain medication use in the first 24\u2009h after surgery and the time needed to return to normal activities. The operating room time and hospital costs were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patients from the first group demonstrated a lower pre\u2010operative anxiety index upon (<jats:italic>P<\/jats:italic>\u2009=\u20090.0319) and after surgery (<jats:italic>P<\/jats:italic>\u2009=\u20090.0042), required less induction time for anaesthesia (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), spent overall less time in the operating room (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) and required less time to recover from the surgery and to be discharged (<jats:italic>P<\/jats:italic>\u2009=\u20090.0172). The overall OR time and post\u2010operative unit care savings of 20 and 155\u2009min, respectively, led to the cost savings of $467.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data demonstrated that the use of the medical clown functioning as an integral part of the operating team reduces children pre\u2010operative anxiety and leads to a shortening of the overall time in the hospital thereby reducing the overall medical cost justifying the participation of medical clown as an integral part of the health team in a paediatric urology outpatient surgical unit.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.13242","type":"journal-article","created":{"date-parts":[[2016,6,11]],"date-time":"2016-06-11T19:46:46Z","timestamp":1465674406000},"page":"877-881","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Medical clowns reduce pre\u2010operative anxiety, post\u2010operative pain and medical costs in children undergoing outpatient penile surgery: A randomised controlled trial"],"prefix":"10.1111","volume":"52","author":[{"given":"Stanislav","family":"Kocherov","sequence":"first","affiliation":[{"name":"Department of Pediatric Urology, Faculty of Medicine Shaare Zedek Medical Center, Hebrew University  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaniv","family":"Hen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Postoperative Pain Care, Faculty of Medicine Shaare Zedek Medical Center, Hebrew University  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sol","family":"Jaworowski","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine Shaare Zedek Medical Center, Hebrew University  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israel","family":"Ostrovsky","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Postoperative Pain Care, Faculty of Medicine Shaare Zedek Medical Center, Hebrew University  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur I","family":"Eidelman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine Shaare Zedek Medical Center, Hebrew University  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yakov","family":"Gozal","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Postoperative Pain Care, Faculty of Medicine Shaare Zedek Medical Center, Hebrew University  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Chertin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Faculty of Medicine Shaare Zedek Medical Center, Hebrew University  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006447.pub2"},{"key":"e_1_2_9_3_1","first-page":"461","article-title":"Preoperative parental information and parents' presence at induction of anaesthesia","volume":"72","author":"Astuto M","year":"2006","journal-title":"Minerva Anestesiol."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-0466"},{"key":"e_1_2_9_5_1","first-page":"30","article-title":"Medical clowns at hospitals and their effect on hospitalized children","volume":"147","author":"Bornstein Y","year":"2008","journal-title":"Harefuah"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecam\/neq064"},{"key":"e_1_2_9_7_1","first-page":"12","article-title":"The clown doctors","volume":"30","author":"Spitzer P","year":"2001","journal-title":"Aust. Fam. Physician"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359104513492746"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.1994.20010183.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199710000-00012"},{"key":"e_1_2_9_11_1","first-page":"293","article-title":"Malviya S. The FLACC: A behavioral scale for scoring postoperative pain in young children","volume":"23","author":"Merkel SI","year":"1997","journal-title":"Pediatr. Nurs."},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(01)00314-1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecam\/nem033"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2008.02903.x"},{"key":"e_1_2_9_15_1","first-page":"305","article-title":"Ballatrophobia: When clowns aren't funny","volume":"2","author":"Austin RK","year":"1996","journal-title":"Anxiety"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7489(97)00026-6"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-13-166"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2010.0534"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/10538711003622752"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922813502257"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(96)70238-X"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2001.118863"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1197\/aemj.9.3.199"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjpc.13242","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjpc.13242","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.13242","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T12:41:11Z","timestamp":1695559271000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.13242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6,11]]},"references-count":22,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2016,9]]}},"alternative-id":["10.1111\/jpc.13242"],"URL":"https:\/\/doi.org\/10.1111\/jpc.13242","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6,11]]},"assertion":[{"value":"2016-03-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-06-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}