Table 2. General characteristics of the included studies (n = 18).
| Reference | publication year | Country | Study Design | population | clowns practitioner | Timing of intervention | Forms of intervention | conclusion mark |
|---|---|---|---|---|---|---|---|---|
| Ben-Pazi H, et al. [16] | 2017 | Italy | Randomized controlled trial | A | Medical clowns | puncture therapy | Cognitive responses; Empowerment; Emotional reflection; |
① |
| Felluga M, et al.[17] | 2016 | Italy | quasi-randomized controlled trial | A | Medical clowns | puncture therapy | Cognitive responses; Divert attention; |
①② |
| Goldberg A, et al [18] | 2014 | Israel | Randomized controlled tria | A | Medical clowns | puncture therapy | Divert attention | ①② |
| Kristensen HN, et al. [19] | 2018 | Denmark | Controlled clinical trial | A | Medical clowns | puncture therapy | Cognitive responses; Divert attention; |
① |
| Meiri N, et al.[20] | 2015 | United States | Randomized controlled tria | A | Medical clowns | puncture therapy | Divert attention; | ①②④ |
| NingXuemei,et al. [21] | 2023 | China | Randomized controlled tria | A | Medical clowns | puncture therapy | Divert attention | ①②④ |
| Yang Fan, et al.[22] | 2022 | China | Randomized controlled tria | A | Medical clowns | puncture therapy | Cognitive responses; Divert attention; Guided imagery; |
①④ |
| Dionigi A, et al. [23] | 2014 | Italy | Randomized controlled tria | B | Medical clowns | perioperative period | Divert attention; | ① |
| Markova G,et al. [24] | 2021 | Germany | Randomized controlled tria | B | Medical clowns | perioperative period | Guided imagery; Divert attention; |
② |
| Vagnoli L, et al. [25] | 2005 | Italy | Randomized controlled tria | B | Medical clowns | perioperative period | Guided imagery; Divert attention |
② |
| Cheng Zongyan, et al. [26] | 2019 | China | Randomized controlled tria | B | Medical clowns | perioperative period | Cognitive responses; Divert attention; Guided imagery; |
①④ |
| Yildirim M, et al. [12] | 2018 | Turkish | Randomized controlled tria | C | Medical clowns | dressing changes | Guided imagery; Emotional reflection; |
③ |
| Yan Guifan, et al. [27] | 2023 | China | Randomized controlled tria | C | Medical clowns | dressing changes | Divert attention; | ①④ |
| Wan Lin, et al. [28] | 2023 | China | Randomized controlled tria | D | Medical clowns | Postoperative fracture and rehabilitation | Divert attention; Cognitive responses |
①④ |
| Lopes-Junior LC, et al [29] | 2020 | Brazil | quasi-randomized controlled trial | E | volunteers | Before and after chemotherapy | Divert attention; | ②④ |
| Shefer S, et al. [30] | 2019 | Israel | Controlled clinical trial | F | Medical clowns | When treating autism | Emotional reflection; Cognitive responses |
③ |
| Bertini, et al. [31] | 2011 | Italy | Randomized controlled tria | G | Medical clowns | When the child was in the hospital room | Divert attention | ④ |
| Shauna, et al.[32] | 2011 | Canada | non-randomised controlled trials | H | Medical clowns | When the child was in the hospital room | Divert attention Empowerment; |
② |
A children with puncture therapy, B children in perioperative period, C children with burns, D children after fracture surgery, E children with chemotherapy, F children with autism;G Children hospitalized for respiratory pathologies, H disabled children. ①physiological indicators, ②psychological indicators, ③ cognitive-behavioral indicators, ④other indicators.