Background and Aims Many studies show that cancer-related fatigue is one of the most common symptoms experienced by children as a side effect of cancer therapy. This problem has recently grown considerably. Nurses envolve in assisting children and parents to face illness and treatment procedures. The aim of this study was to investigate whether clown intervention could reduce fatigue in children with cancer undergoing chemotherapy.

Methods Ninety-nine children (aged 7–18 years) with cancer and with at least one cycle of chemotherapy, and one of their parents, participated in the study:during their hospitalization 54 of them interacted with clowns in the ward, while 45 children did not get them. Fatigue as measured by PedsQL Multidimensional Fatigue Scale and structured cognitive interviews on clown therapy.

Results The results emphasized the relevance of clown intervention on the reduction of fatigue in children. The study shows that in the sample that received clown intervention, the fatigue score was better than appears in the sample without the support of this activity (77.4DS±13.9vs49.3DS±9.9p=.000),and that cognitive fatigue domain had the least affected (90vs62), compared with general fatigue (73.4DS±16.9vs49.2DS±12.4) and sleep fatigue (69DS±16.4vs37.3DS±11.5) domains. Age was a factor associated with a significant increase in the fatigue scores.

Conclusions Children that receive the clown’s care has shown a lower fatigue. It is essential for healthcare professionals to consider the effect of chemotherapy on the children and to recognize the specific needs of this patient. Nurses should routinely screen pediatric patients for fatigue and intervene to minimize their impact using pharmacologic and nonpharmacologic strategies.