title: Effect of interaction with clowns on vital signs and non-verbal communication of hospitalized children.
abstract: Compare the non-verbal communication of children before and during interaction with clowns and compare their vital signs before and after this interaction.
  
  
  
  Uncontrolled, intervention, cross-sectional, quantitative study with children admitted to a public university hospital. The intervention was performed by medical students dressed as clowns and included magic tricks, juggling, singing with the children, making soap bubbles and comedic performances. The intervention time was 20minutes. Vital signs were assessed in two measurements with an interval of one minute immediately before and after the interaction. Non-verbal communication was observed before and during the interaction using the Non-Verbal Communication Template Chart, a tool in which nonverbal behaviors are assessed as effective or ineffective in the interactions.
  
  
  
  The sample consisted of 41 children with a mean age of 7.6±2.7 years; most were aged 7 to 11 years (n=23; 56%) and were males (n=26; 63.4%). There was a statistically significant difference in systolic and diastolic blood pressure, pain and non-verbal behavior of children with the intervention. Systolic and diastolic blood pressure increased and pain scales showed decreased scores.
  
  
  
  The playful interaction with clowns can be a therapeutic resource to minimize the effects of the stressing environment during the intervention, improve the children's emotional state and reduce the perception of pain.
authors.affiliation: Faculdade de Medicina de Jundiaí (FMJ), Jundiaí, SP, Brasil.
authors.forename: Pauline Lima
authors.initials: PL
authors.lastname: Alcântara
authors.affiliation: Faculdade de Medicina de Jundiaí (FMJ), Jundiaí, SP, Brasil.
authors.forename: Ariane Zonho
authors.initials: AZ
authors.lastname: Wogel
authors.affiliation: Faculdade de Medicina de Jundiaí (FMJ), Jundiaí, SP, Brasil.
authors.forename: Maria Isabela Lobo
authors.initials: MI
authors.lastname: Rossi
authors.affiliation: Faculdade de Medicina de Jundiaí (FMJ), Jundiaí, SP, Brasil.
authors.forename: Isabela Rodrigues
authors.initials: IR
authors.lastname: Neves
authors.affiliation: Universidade Guarulhos (UnG), Guarulhos, SP, Brasil.
authors.forename: Ana Llonch
authors.initials: AL
authors.lastname: Sabates
authors.affiliation: Faculdade de Medicina de Jundiaí (FMJ), Jundiaí, SP, Brasil; Universidade Guarulhos (UnG), Guarulhos, SP, Brasil. Electronic address: apuggina@prof.ung.br.
authors.forename: Ana Cláudia
authors.initials: AC
authors.lastname: Puggina
mesh_terms: D002648:Child; D002673:Child, Hospitalized / Q000523:psychology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009633:Nonverbal Communication; D010988:Play and Playthings; D055986:Vital Signs
keywords: Comunicação não verbal; Laughter therapy; Non‐verbal communication; Sinais vitais; Terapia do riso; Vital signs