跨文化背景下“医疗小丑”护理志愿服务模式的实践探讨

Discussion on practice of nursing volunteer service model of "clown doctor" under cross-cultural background

[目的]探讨跨文化背景下"小丑医生"志愿服务对住院患儿静脉穿刺疼痛、焦虑程度及对"小丑医生"志愿者成员(护理研究生)职业价值观的影响。[方法]将某三级甲等医院儿科东区的43例患儿设为干预组,儿科西区的38例患儿设为对照组,对照组给予常规护理,干预组在此基础上融入"小丑医生"志愿服务,采用修改版面部表情疼痛量表和学前儿童焦虑量表评估静脉穿刺时患儿疼痛程度和焦虑状况;利用护士职业价值观量表对"小丑医生"志愿者成员职业价值观进行评估,并随机选取15名进行深入访谈,将获得资料分析整理,提炼主题。[结果]干预组住院患儿静脉穿刺时疼痛评分(2.69分±0.57分)、焦虑评分(67.70分±12.37分)均优于对照组(3.45分±0.92分,80.70分±10.81分),差异有统计学意义(P<0.05);"小丑医生"志愿者成员的心理体验包括加深护理职业认知、体验护理职业艰辛和护理职业的价值、感受护理传递的正向情感等方面。[结论]"小丑医生"志愿服务可降低住院患儿静脉穿刺时疼痛程度和焦虑状况,同时提升"小丑医生"志愿者成员的职业价值观。

Objective： To probe into the effect of volunteer service of ＂clown doctor＂ under cross cultural context on the pain and anxiety during vein puncture of hospitalized children and the professional values of ＂clown doctor＂ volunteer members（nursing graduate students）. Methods： A total of 43 cases in the eastern paediatrics section of third grade A hospital were assigned to intervention group,38 cases in the western paediatrics section were assigned to control group.Routine care was given to the control group.On this basis,the intervention group was integrated into the volunteer service of ＂clown doctor＂.The Facepain Scale Revised and Preschool Anxiety Scale were used to evaluate the pain degree and anxiety of the children during venipuncture.The Nurses Professional Values Scale was used to evaluate the professional values of the volunteer members of ＂clown doctor＂.15 members were randomly selected for in depth interviews,and the data were analyzed and sorted out to refine the subject. Results： The pain score （2.69±0.57） and anxiety score （67.70±12.37） in intervention group were better than those in control group（3.45±0.92,80.70±10.81）,and the difference was statistically significant（ P 〈0.05）.The psychological experience of the volunteer members of ＂clown doctor＂ included deepening the nursing profession cognition,experiencing the nursing profession hard and value,feeling the positive emotion of nursing delivery and so on. Conclusions： The volunteer service of ＂clown doctor＂ could reduce the degree of pain and anxiety during vein puncture in hospitalized children, and improve the professional values of volunteer members of ＂clown doctor＂.