JOY THERAPY IN PEDIATRICS: SCIENTIFIC EVIDENCE AND IMPACTS ON HOSPITAL CARE FROM A MULTIPROFESSIONAL PERSPECTIVE

Abstract

Hospitalization exposes children to fear, pain, and disruption of their family routine, and the past five years have consolidated a body of empirical evidence on interventions based on structured humor, known as joy therapy, clown therapy, or medical clowning, as complementary resources to conventional pediatric care. This narrative and integrative review synthesizes evidence retrieved from PubMed, Scopus, Web of Science, and ScienceDirect (2021-2026) on the physiological mechanisms, clinical outcomes, and multiprofessional implications of joy therapy in hospitalized children. The search combined the descriptors “clown therapy,” “medical clowning,” “laughter therapy,” “pediatric hospitalization,” and “patient care team.” Meta-analytic data show consistent, moderate-to-large reductions in preoperative and procedural anxiety, some reduction in self-reported pain, shorter crying time, and lower parental anxiety, accompanied by biologically plausible mechanisms involving modulation of the hypothalamic-pituitary-adrenal axis, endorphin release, and parasympathetic activation. Evidence on outcomes related to the health care team (professional satisfaction, perceived efficiency, and reduced tension during procedures) remains scarcer, but points to a favorable multiprofessional impact, particularly among nursing teams. Heterogeneity of intervention protocols, high risk of bias in several primary studies, and the near absence of cost-effectiveness data remain the main gaps. It is concluded that joy therapy is a biologically grounded, low-risk component that is increasingly supported by evidence in humanized pediatric care, being best implemented through structured interprofessional protocols rather than isolated voluntary initiatives.