护理学报 ›› 2023, Vol. 30 ›› Issue (18): 31-35.doi: 10.16460/j.issn1008-9969.2023.18.031
小丑照护在儿童围术期的应用进展
石晶1,2a, 钟娟平1,2b, 谢琪1, 王兴蕾2c, 杨萌1, 史晓凤2a, 豆欣蔓1,2d
- 1.兰州大学 护理学院,甘肃 兰州 730011;
2.兰州大学第二医院 a.泌尿外科; b.PICC门诊;c.肝病科;d.护理部,甘肃 兰州 730030
摘要： 目的 对小丑照护在儿童围术期的应用进展进行文献综述,为今后的临床实践应用提供参考。方法 检索回顾相关国内外文献,对小丑照护的起源发展、作用机制和小丑照护在儿童围术期的应用方法及效果进行综述。结果 小丑照护可以减轻儿童围术期的焦虑、疼痛、提高家属及医务人员的满意度,从而节约医疗成本。结论 小丑照护作为一种非药物干预方法,在儿童围术期照护中取得了显著成效,但部分研究结果仍有争议,建议后续研究者基于儿童年龄进行分层设计、扩大样本量,加强相关机制的研究,为小丑照护在儿童围术期的实践与应用提供依据。
中图分类号:
- R473.72
| [1] Kühlmann AYR, Van Rosmalen J, Staals LM, et al.Music interventions in pediatric surgery (the music under surgery in children study): a randomized clinical trial[J]. Anesth Analg,2020, 130(4):991-1001.DOI:10.1213/ANE.0000000000003983. [2] Yang CQ, Yu KH, Huang RR, et al.Comparison of different sedatives in children before general anaesthesia for selective surgery: a network Meta-analysis[J]. J Clin Pharm Ther, 2022, 47(10):1495-1505. DOI:10.1111/jcpt.13763. [3] Vagnoli L, Bettini A, Amore E, et al.Relaxation-guided imagery reduces perioperative anxiety and pain in children: a randomized study[J]. Eur J Pediatr, 2019, 178(6):913-921. DOI:10.1007/s00431-019-03376-x. [4] Kasem Ali Sliman R, Meiri N, Pillar G. Medical clowning in hospitalized children: a Meta-analysis[J]. World J Pediatr,2023,19(11):1055-1061.DOI:10.1007/s12519-023-00720-y. [5] 丁永霞, 李军莉, 郭文俊, 等. 小丑照护在我国本土化的可行路径思考[J].护理学杂志,2019, 34(21):99-103. DOI:10.3870/j.issn.1001—4152.2019.21.099. [6] Neumark Y, Bar-lev A, Barashi D, et al. A feasibility study of the use of medical clowns as hand-hygiene promoters in hospitals[J]. PLoS One,2022,17(12):e0279361.DOI:10.1371/journal.pone.0279361. [7] Babis D, Korin O, Ben-shalom U, et al. Medical clowns in coronavirus wards: a milestone in further integration into israeli hospitals[J]. Complement Ther Clin Pract, 2023, 51: 101742. DOI: 10.1016/j.ctcp.2023.101742. [8] Rousseau J, Cuervo-lombardx CV. Clowning as a therapeutic intervention with the elderly: a literature review[J]. Geriatr Psychol Neuropsychiatr Vieil, 2022, 20(2):248-255. DOI: 10.1684/pnv.2022.1040. [9] 郭潇雅. “小丑医生”植根中国[J].中国医院院长,2016(17): 28-29. [10] Ding Y, Yin H, Wang S, et al.Effectiveness of clown intervention for pain relief in children: a systematic review and Meta-analysis[J]. J Clin Nurs, 2022, 31(21/22):3000-3010. DOI: 10.1111/jocn.16195. [11] van der Wal CN, Kok RN. Laughter-inducing therapies: Systematic review and Meta-analysis[J].Soc Sci Med (1982), 2019, 232: 473-488.DOI:10.1016/j.socscimed.2019.02.018. [12] 刘璇, 肖泽梅. 小丑照护在老年痴呆患者中的应用研究进展[J].护理学杂志,2020, 35(17):28-31. DOI:10.3870/j.issn.1001-4152.2020.17.028. [13] Dionigi A, Fermani A, Canestrari C.Do clowns really taste funny? An investigation of the relationship between humor and playfulness in clown doctors[J]. Behav Sci(Basel), 2023, 13(4):328. DOI:10.3390/bs13040328. [14] Wu WW, Lu FL, Shiu CS, et al.The effectiveness of a medical clowning program on improving emotional status among hospitalized children undergoing cancer treatment: a quasi-experimental study[J]. J Nurs Scholarsh, 2022, 54(2):161-168.DOI:10.1111/jnu.12720. [15] Lopes-junior LC, Silveira DSC, Olson K, et al. Clown intervention on psychological stress and fatigue in pediatric patients with cancer undergoing chemotherapy[J]. Cancer Nurs, 2020, 43(4):290-299.DOI:10.1097/NCC.0000000000000690. [16] 卫平莲, 刘安诺. 虚拟现实技术联合小丑照护在门诊伤口换药患儿中的应用[J].军事护理,2023, 40(4):28-31. DOI:10.3969/j.issn.2097-1826.2023.04.007. [17] Cosi A, Tieri M, Lombardi L, et al.Clowntherapy in paediatric dentistry: the psychological approach to the paediatric patient[J]. Eur J Paediatr Dent, 2022, 23(3):242-248. DOI: 10.23804/ejpd.2022.23.03.12. [18] Yun OB, Kim SJ, Jung D.Effects of a clown-nurse educational intervention on the reduction of postoperative anxiety and pain among preschool children and their accompanying parents in South Korea[J]. J Pediatr Nurs, 2015, 30(6): e89-99. DOI:10.1016/j.pedn.2015.03.003. [19] Ofer S, Keisari S.Butterflies, dwarves, and plastic lollypops: a case report on medical clowning in a children's rehabilitation hospital[J]. Children (Basel), 2022, 9(12):1805. DOI: 10.3390/children9121805. [20] Raisin G, Cohen R, Galant O, et al.Medical clowns versus sedation for paediatric urinary catheter insertion-A randomised pilot study[J]. Acta Paediatr, 2023, 112(6): 1319-1323. DOI: 10.1111/apa.16733. [21] 李荣, 陈伟博, 王冉冉, 等. 家庭参与式小丑照护在肿瘤患儿PICC置管及维护中的应用[J]. 中华护理教育,2022, 19(1): 75-80. DOI:10.3761/j.issn.1672-9234.2022.01.013. [22] 张桂丽, 郭红丽, 陶晓坤, 等. “医疗小丑”辅助麻醉干预在小儿外科手术中的应用效果[J]. 中华现代护理杂志,2021,27(29):4024-4028.DOI:10.3760/cma.j.cn115682-20201127-06421. [23] 王玲, 易羽, 黄玉婷, 等. 小丑照护在儿童肱骨髁上骨折术后康复中的应用[J].护理管理杂志,2023, 23(1):71-75. DOI:10.3969/j.issn.1671-315x.2023.01.015. [24] Newman N, Kogan S, Stavsky M, et al.The impact of medical clowns exposure over postoperative pain and anxiety in children and caregivers: an Israeli experience[J]. Pediatr Rep, 2019, 11(3): 8165. DOI: 10.4081/pr.2019.8165. [25] Liguori S, Stacchini M, Ciofi D, et al.Effectiveness of an App for reducing preoperative anxiety in children: a randomized clinical trial[J]. JAMA Pediatr, 2016, 170(8): e160533. DOI: 10.1001/jamapediatrics.2016.0533. [26] De Faveri S, Roessler M.Clowning during COVID-19 - A survey of European Healthcare Clowning Organisations highlights the role of humour and art in the healthcare system[J]. Public Health, 2021, 196: 82-84. DOI: 10.1016/j.puhe.2021.05.016. [27] Bromfalk Å, Myrberg T, Walldén J, et al.Preoperative anxiety in preschool children: a randomized clinical trial comparing midazolam, clonidine, and dexmedetomidine[J]. Paediatr Anaesth, 2021, 31(11): 1225-1233. DOI: 10.1111/pan.14279. [28] 余小燕, 刘于, 黄毅. 小丑照护对患儿焦虑疼痛干预效果的Meta分析[J].护理学报,2022, 29(4): 21-26. DOI:10.16460/j.issn1008-9969.2022.04.021. [29] O'gara BP, Gao L, Marcantonio ER, et al.Sleep, pain, and cognition: modifiable targets for optimal perioperative brain health[J]. Anesthesiology,2021,135(6):1132-1152.DOI:10.1097/ALN.0000000000004046. [30] Fuller C, Huang H, Thienprayoon R.Managing pain and discomfort in children with cancer[J].Curr Oncol Rep, 2022, 24(8): 961-973. DOI: 10.1007/s11912-022-01277-1. [31] Caci L, Zander-Schellenberg T, Gerger H.Effectiveness of hospital clowning on pediatric anxiety and pain: network Meta-analysis[J]. Health Psychol, 2023, 42(4):257-269. DOI: 10.1037/hea0001285. [32] Meiri N, Ankri A, Hamad-saied M, et al. The effect of medical clowning on reducing pain, crying, and anxiety in children aged 2-10 years old undergoing venous blood drawing--a randomized controlled study[J]. Eur J Pediatr, 2016, 175(3): 373-379. DOI:10.1007/s00431-015-2652-z. [33] 钟娟平, 程斐然, 王兴蕾, 等. 小丑照护在儿童操作性疼痛中的应用进展[J].军事护理,2023, 40(7): 86-88. DOI:10.3969/j.issn.2097-1826.2023.07.020. [34] Koller D, Gryski C.The life threatened child and the life enhancing clown: towards a model of therapeutic clowning[J]. Evid Based Complement Alternat Med, 2008, 5(1): 17-25. DOI: 10.1093/ecam/nem033. [35] Finlay F, Baverstock A, Lenton S.Therapeutic clowning in paediatric practice[J].Clin Child Psychol Psychiatry, 2014, 19(4): 596-605. DOI: 10.1177/1359104513492746. [36] Gomberg J, Raviv A, Fenig E, et al.Saving costs for hospitals through medical clowning: a study of hospital staff perspectives on the impact of the medical clown[J]. Clin Med Insights Pediatr, 2020, 14: 1179556520909376. DOI: 10.1177/1179556520909376. eCollection 2020. [37] Tyson PJ, Davies SK, Scorey S, et al.Fear of clowns: an investigation into the aetiology of coulrophobia[J]. Front Psychol,2023,14:1109466.DOI:10.3389/fpsyg.2023.1109466. [38] Kocherov S, Hen Y, Jaworowski S, et al.Medical clowns reduce pre-operative anxiety, post-operative pain and medical costs in children undergoing outpatient penile surgery: a randomised controlled trial[J]. J Paediatr Child Health,2016,52(9):877-881.DOI: 10.1111/jpc.13242. |
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