小丑照护对儿童及其照顾者干预效果的Meta分析

Effects of clown care on children and their caregivers:a Meta-analysis

目的:系统评价小丑照护对儿童及其照顾者的干预效果。方法:计算机检索相关数据库,收集关于小丑照护对儿童及其照顾者影响的随机对照试验,检索时间均为建库至2021年10月。由2名研究者对文献质量进行评价并提取资料,采用RevMan5.4进行Meta分析。结果:共纳入14篇文献,总计2160名儿童。Meta分析结果显示,与常规护理相比,小丑照护能减轻儿童疼痛[SMD=-0.70,95%CI(-1.24,-0.17),P=0.01],缓解焦虑情绪[MD=-13.50,95%CI(-20.05,-6.95),P<0.0001],缩短住院时间[MD=-0.86,95%CI(-1.06,-0.66),P<0.0001]和哭泣时间[MD=-1.41,95%CI(-1.79,-1.03),P<0.00001];改善照顾者状态焦虑[MD=-3.60,95%CI(-5.78,-1.43),P=0.001]和特质焦虑[MD=-3.70,95%CI(-6.68,-0.72),P=0.02]。结论:小丑照护能减轻儿童的疼痛、焦虑,缩短住院时间及哭泣时间,改善照顾者焦虑状况。受纳入研究质量和数量的限制,仍需要更多高质量研究进一步验证上述结论。

Objective:To systematically evaluate the effectiveness of clown care on children and their caregivers.Methods:We searched related databases to collect randomized controlled trials on the effects of clown care on children and their caregivers from the establishment of these databases to October 2021.Two researchers conducted quality evaluation and data extraction.Meta-analysis was performed using RevMan 5.4 software.Results:A total of 14 articles involving 2160 children were included.Meta-analysis results showed that compared with routine care,clown care could reduce children's pain[SMD=-0.70,95%CI(-1.24,-0.17),P=0.01],anxiety[MD=-13.50,95%CI(-20.05,-6.95),P<0.0001],hospital stay[MD=-0.86,95%CI(-1.06,-0.66),P<0.0001],crying time[MD=-1.41,95%CI(-1.79,-1.03),P<0.00001],caregivers'state of anxiety[MD=-3.60,95%CI(-5.78,-1.43),P=0.001]and caregivers'trait anxiety[MD=-3.70,95%CI(-6.68,-0.72),P=0.02].Conclusion:Clown care can not only reduce children's pain and anxiety,but also shorten their hospital stay and crying time,and relieve the anxiety of their caregivers.Limited by the quality and quantity of included studies,the above conclusion still needed more high-quality studies to verify in the future.