Objective  To investigate the effectiveness of child life services in alleviating medical fear among pediatric patients in emergency care settings.

Methods  A convenience sampling method was employed to select 85 pediatric patients admitted to the Emergency Department of West China Second University Hospital, Sichuan University, between January 2022 and December 2024. A self-controlled before-and-after study design was adopted, wherein child life interventions were administered to all participants. The Children's Fear Scale was utilized to assess fear levels pre- and post-intervention, and then to compare the differences.

Results After the child life intervention, 69 patients exhibited a score reduction > 0, yielding an intervention efficacy rate of 81.18%. The median (interquartile range) fear score decreased significantly from 3 (2-4) pre-intervention to 1 (1-2) post-intervention (Z = －7.329, P < 0.001). The proportion of participants with severe or extreme fear (≥ 3 points) declined markedly post-intervention, showing statistical significance (11.76% vs. 80.00%, χ² = 33.029, P < 0.001). Intervention efficacy varied significantly among subgroups with different levels of fear (P < 0.01), with better effectiveness observed in cohorts with higher levels of fear.

Conclusion Child life services significantly reduce the levels of medical fear among pediatric patients in emergency care settings and provide comprehensive psychosocial support. It can also serve as an effective measure for establishing a humanistic emergency care environment.