Effectiveness of medical clowning in reducing postoperative pain and improving sleep quality in school-aged children.

INTRODUCTION: Postoperative pain and sleep disturbances can hinder recovery in children. Medical clowning is a non-pharmacological intervention using humor and distraction to improve well-being. This study evaluated the effectiveness of medical clowning on postoperative pain and sleep quality in school-aged children following surgery. METHODS: This quasi-experimental study employed a pretest-posttest design with a control group. Using convenience sampling, 130 children (6-12 years) in a Tehran children's hospital were allocated to intervention (n = 65) or control (n = 65) groups. The intervention group received one medical clowning session alongside routine postoperative care. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and pain intensity via the Visual Analog Scale (VAS) at baseline and 15, 30, and 60 min post-intervention. Data were analyzed using repeated-measures ANOVA and Bonferroni post hoc tests. RESULTS: Postoperative pain scores were significantly lower in the intervention group compared to the control group at 30- and 60-min post-intervention (p < 0.001). Regarding sleep, the intervention group showed significantly better sleep quality (lower PSQI scores) compared to the control group (p < 0.001). CONCLUSION: Medical clowning effectively reduces postoperative pain and improves sleep quality in hospitalized children. Integrating medical clowning into postoperative nursing care offers a safe, practical, and cost-effective adjunct to enhance pediatric surgical recovery. IMPLICATIONS TO PRACTICE: Medical clowning may provide pediatric nurses with a non-pharmacological, child-centered approach that can be incorporated alongside routine postoperative care. When delivered by trained personnel and adapted to children's developmental and emotional needs, this intervention may support more holistic postoperative care. CLINICAL TRIAL NUMBER: Not applicable.