Base de dados : MEDLINE
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[PMID]:28466619
[Au] Autor:Rimon A; Shalom S; Wolyniez I; Gruber A; Schachter-Davidov A; Glatstein M
[Ad] Endereço:Pediatric Emergency Medicine, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
[Ti] Título:Medical Clowns and Cortisol levels in Children Undergoing Venipuncture in the Emergency Department: A Pilot Study.
[So] Source:Isr Med Assoc J;18(11):680-683, 2016 Nov.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Medical clowns are increasingly used for diminishing pain and anxiety during painful procedures being performed on children in the hospital setting. Cortisol levels rise as a response to emotional distress. OBJECTIVES: To investigate whether medical clown-assisted interventions to reduce child's distress during venipuncture have an effect on cortisol levels. METHODS: During a 1 year period, children requiring blood work or intravenous access in the pediatric emergency department were prospectively randomized to either the presence or absence of a medical clown during the procedure. The child's distress was evaluated using the Faces Pain Scale - revised (FPS-R) for the 4-7 year age group and the visual analog scales (VAS) for those aged 8-15 years. Serum cortisol levels were measured in blood samples obtained by venipuncture. RESULTS: Fifty-three children aged 2-15 years were randomly assigned to the study group (with medical clown, n=29) or to the control group (without medical clown, n=24). Combined pain scores of the study group and control group were 2.2 and 7.5 respectively (P < 0.001). No difference in mean cortisol levels was found between the study group and the control group at all ages (16.4 µg/dl vs. 18.3 µg/dl, P = 0.65). CONCLUSIONS: In this pilot study, medical clowns reduced the distress from venipuncture in children. No effect on cortisol levels was observed.
[Mh] Termos MeSH primário: Hidrocortisona/sangue
Terapia do Riso/métodos
Manejo da Dor/métodos
Flebotomia/métodos
Estresse Psicológico/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Ansiedade/prevenção & controle
Criança
Pré-Escolar
Serviço Hospitalar de Emergência
Feminino
Seres Humanos
Israel
Masculino
Dor/psicologia
Medição da Dor
Projetos Piloto
Estudos Prospectivos
Estresse Psicológico/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:28414728
[Au] Autor:Ben-Pazi H; Cohen A; Kroyzer N; Lotem-Ophir R; Shvili Y; Winter G; Deutsch L; Pollak Y
[Ad] Endereço:Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel.
[Ti] Título:Clown-care reduces pain in children with cerebral palsy undergoing recurrent botulinum toxin injections- A quasi-randomized controlled crossover study.
[So] Source:PLoS One;12(4):e0175028, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: We investigated the impact of clown-care on pain in 45 children with cerebral palsy who underwent recurrent Botulinum-toxin injections (age 7.04± 4.68 years). Participants were randomized to receive either clown (n = 20) or standard (n = 25) -care. METHODS: Pain Visual-Analogue-Scale (range 1-5) was reported before and after procedures. Pain assessment was lower for children undergoing Botulinum-toxin injections with clown-care (2.89± 1.36) compared to standard-care (3.85± 1.39; p = 0.036) even though pain anticipated prior to procedures was similar (~3). FINDINGS: Children who underwent the first procedure with clown-care reported lower pain even after they crossed-over to the following procedure which was standard (p = 0.048). Carryover effect was more prominent in injection-naïve children (p = 0.019) and during multiple procedures (p = 0.009). Prior pain experience correlated with pain in subsequent procedures only when first experience was standard-care (p = 0.001). CONCLUSIONS: Clown-care alleviated pain sensation during Botulinum-toxin injections and initial clown-care experience reduced pain during subsequent injections even though clowns were not present. TRIAL REGISTRATION: clinicaltrials.gov ID # NCT01377883.
[Mh] Termos MeSH primário: Toxinas Botulínicas/administração & dosagem
Paralisia Cerebral/terapia
Terapia do Riso/métodos
Manejo da Dor/métodos
Dor/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Paralisia Cerebral/tratamento farmacológico
Paralisia Cerebral/fisiopatologia
Criança
Pré-Escolar
Estudos Cross-Over
Feminino
Seres Humanos
Lactente
Injeções Intramusculares
Israel
Masculino
Hipertonia Muscular/tratamento farmacológico
Hipertonia Muscular/fisiopatologia
Fármacos Neuromusculares/administração & dosagem
Dor/fisiopatologia
Medição da Dor
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Neuromuscular Agents); EC 3.4.24.69 (Botulinum Toxins)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170509
[Lr] Data última revisão:
170509
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170418
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0175028


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[PMID]:28179270
[Au] Autor:Mortamet G; Roumeliotis N; Vinit F; Simonds C; Dupic L; Hubert P
[Ad] Endereço:Pediatric Intensive Care Unit, Hôpital Necker, Paris, France.
[Ti] Título:Is there a role for clowns in paediatric intensive care units?
[So] Source:Arch Dis Child;102(7):617-620, 2017 Jul.
[Is] ISSN:1468-2044
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Hospital clowning is a programme in healthcare facilities involving visits from specially trained actors. In the paediatric intensive care unit (PICU), clowning may appear inappropriate and less intuitive. The patient could appear too ill and/or sedated, the environment too crowded or chaotic and the parents too stressed. Relying on our experience with professionally trained clowns both in France and Canada, the purpose of this article is to offer a model for hospital clowning and to suggest standards of practice for the implementation of clowning in PICUs. In this work, we provide a framework for the implementation of clown care in the PICU, to overcome the challenges related to the complex technical environment, the patient's critical illness and the high parental stress levels. Regardless of the specifics of the PICU, our experience suggests that professional clown activity is feasible, safe and can offer multiple benefits to the child, his/her parents and to hospital personnel. Due to the specific challenges in the PICU, clowns must be educated and prepared to work in this highly specialised environment. We stress that prior to clowning in a PICU, professional performers must be highly trained, experienced, abide by a code of ethics and be fully accepted by the treating healthcare team.
[Mh] Termos MeSH primário: Cuidados Críticos/métodos
Terapia do Riso/métodos
Senso de Humor e Humor como Assunto/psicologia
[Mh] Termos MeSH secundário: Criança
Criança Hospitalizada/psicologia
Doença Crônica
Cuidados Críticos/psicologia
Estado Terminal
Pessoal de Saúde/psicologia
Seres Humanos
Unidades de Terapia Intensiva Pediátrica
Dor/prevenção & controle
Apoio Social
Estresse Psicológico/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170210
[St] Status:MEDLINE
[do] DOI:10.1136/archdischild-2016-311583


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[PMID]:28107850
[Au] Autor:Lam MT; Lam HR; Chawla L
[Ad] Endereço:Department of Family Medicine, Schulich School of Medicine & Denistry, Western University, Canada.
[Ti] Título:Application of magic in healthcare: A scoping review.
[So] Source:Complement Ther Clin Pract;26:5-11, 2017 Feb.
[Is] ISSN:1873-6947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:STUDY DESIGN: Scoping review. INTRODUCTION: The art and science of magic traces back to ancient days. Physicians are often compared to magicians metaphorically. Nonetheless, there exist various genuine applications of magic in the healthcare setting. PURPOSE: To explore and summarize the literature reporting the applications of magic tricks or any derived techniques in healthcare or clinical environments. METHODS: A literature search was performed on ten databases: Medline, Embase, CINAHL, Cochrane Central, Cochrane Database of Systematic Reviews, PEDro, Scopus, the International Index to Performing Arts, General OneFile and Newstand, to identify references related to the application of magic in healthcare. Relevant studies were charted, categorized, and summarized. RESULTS: 29 relevant references were found, consisting of 20 peer-reviewed publications and nine popular literature articles. Five distinct applications of magic in the clinical setting were identified. The literature showed an overall lack of academic evidence.
[Mh] Termos MeSH primário: Terapias Complementares
Magia
[Mh] Termos MeSH secundário: Seres Humanos
Terapia do Riso
Terapia Ocupacional
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170122
[St] Status:MEDLINE


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[PMID]:28107847
[Au] Autor:Elmali H; Balci Akpinar R
[Ad] Endereço:Department of Nursing, Marmara University Institute of Health Sciences, Istanbul, Turkey. Electronic address: hyl_06_@hotmail.com.
[Ti] Título:The effect of watching funny and unfunny videos on post-surgical pain levels.
[So] Source:Complement Ther Clin Pract;26:36-41, 2017 Feb.
[Is] ISSN:1873-6947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to describe pain intensity before and after watching funny and unfunny videos on post-surgical pain levels. METHODS: Ninety patients were divided into three groups. Group A watched funny videos, Group B watched unfunny videos, Group C did not watch any videos. Pain assessment of the patients was carried out before (first), immediately after (second), and 30 min after (third) watching videos. RESULTS: The first pain scoremean in Group A was 40.83 ± 22.62, in Group B was 37.46 ± 24.31, in Group C was 48.86 ± 24.06. The second pain scoremean in Group A was 32.93 ± 20.28, in Group B was 29.76 ± 20.26, in Group C was 48.96 ± 24.11. The third pain scoremean in Group A was 37.43 ± 23.07, in Group B was 36.80 ± 22.67, in Group C was 52.30 ± 23.97. CONCLUSION: Watching funny or unfunny videos reduces the post-surgical pain level.
[Mh] Termos MeSH primário: Terapia do Riso
Manejo da Dor/métodos
Dor Pós-Operatória/terapia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Medição da Dor
Gravação em Vídeo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170122
[St] Status:MEDLINE


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[PMID]:28013377
[Au] Autor:van Venrooij LT; Barnhoorn PC
[Ad] Endereço:Department of Public Health and Primary Care, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
[Ti] Título:Hospital clowning: a paediatrician's view.
[So] Source:Eur J Pediatr;176(2):191-197, 2017 Feb.
[Is] ISSN:1432-1076
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:This study investigates the current position of hospital clowns from the perspective of paediatricians and paediatric residents. A total of 14 attending paediatricians and paediatric residents participated in two focus group sessions. Data were analysed using Atlas.ti 5.0. In general, physicians reported positive experiences regarding the interaction between hospital clowns and paediatric patients on the ward. Physicians were more interested in research on children's perception of hospital clowns than in research on the clinical efficacy of hospital clowning. No direct collaboration between physicians and hospital clowns was reported. However, physicians proposed conditions which may streamline their encounters with hospital clowns such as clear communication prior to hospital clown visits, and the condition that visits do not impede medical interventions. CONCLUSION: Overall, paediatricians and paediatric residents view the positive impact on paediatric patients as the most important aspect of hospital clown visits, rather than the clinical efficacy of hospital clowning. In light of the growing number of hospital clowns worldwide, this article provides recommendations for arranging their encounters with paediatricians and paediatric residents to maintain optimal health care. What is known: • Previous studies show a clinically significant pain- and anxiety-reducing effect of hospital clowning in paediatric patients admitted to hospitals or undergoing (invasive) medical procedures. • In general, paediatricians have positive ideas about hospital clowns, aside from personal prejudices. What is new: • This novel study gives deeper insight into day-to-day interaction between paediatricians and hospital clowns on the ward. • This study provides recommendations for clinical practice to arrange encounters between physicians and hospital clowns during hospital clown visits.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Criança Hospitalizada/psicologia
Assistência à Saúde/organização & administração
Relações Interprofissionais
Terapia do Riso/psicologia
Pediatras/psicologia
[Mh] Termos MeSH secundário: Adulto
Criança
Comunicação
Feminino
Grupos Focais
Seres Humanos
Internato e Residência
Masculino
Países Baixos
Pediatria
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161226
[St] Status:MEDLINE
[do] DOI:10.1007/s00431-016-2821-8


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[PMID]:28004189
[Au] Autor:Sridharan K; Sivaramakrishnan G
[Ad] Endereço:Department of Health Sciences, Fiji National University, Suva, Fiji. skannandr@gmail.com.
[Ti] Título:Therapeutic clowns in pediatrics: a systematic review and meta-analysis of randomized controlled trials-corrigendum.
[So] Source:Eur J Pediatr;176(2):289, 2017 02.
[Is] ISSN:1432-1076
[Cp] País de publicação:Germany
[La] Idioma:eng
[Mh] Termos MeSH primário: Criança Hospitalizada
Terapia do Riso
Ensaios Clínicos Controlados Aleatórios como Assunto
[Mh] Termos MeSH secundário: Criança
Seres Humanos
Pais
Pediatria
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161223
[St] Status:MEDLINE
[do] DOI:10.1007/s00431-016-2832-5


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[PMID]:27966019
[Au] Autor:Meiri N; Schnapp Z; Ankri A; Nahmias I; Raviv A; Sagi O; Hamad Saied M; Konopnicki M; Pillar G
[Ad] Endereço:Department of Pediatrics and Pediatric Emergency Medicine, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel. noam44@gmail.com.
[Ti] Título:Fear of clowns in hospitalized children: prospective experience.
[So] Source:Eur J Pediatr;176(2):269-272, 2017 Feb.
[Is] ISSN:1432-1076
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Medical clowns (MC) have become an integral part of the pediatric staff of hospital wards. While several studies have demonstrated the huge benefits of MC, there are almost no data regarding fear of clowns, a known phenomenon that means an irrational fear of clowns. In the current study, we sought to examine the prevalence of fear of clowns in pediatrics wards, and to characterize the affected children. The clinical work of three certified MCs was prospectively assessed. Every child with fear of clowns was noted, data were retrieved from the medical records, and the parents/child completed a specific questionnaire with a research assistant. Fear of clowns was defined as crying, anxiety response or effort to avoid contact with the MCs in small children, while in older children, it was determined if the child either reported fear of MCs or made actions to avoid clowns' intervention. A total of 1160 children participated in the study. All were hospitalized in the department of pediatrics or the pediatric emergency medicine department at Carmel Medical Center, and were exposed to a MC intervention session. Of the 1160 children, 14 children experienced fear of clowns (1.2%). The average age of children who experienced fear of clowns was 3.5 years (range 1-15). Interestingly, most of the children demonstrating fear of clowns were girls (12 out of 14, 85.7%). We found no association between fear of clowns and specific diagnosis, fever, clinical appearance, religion, or ethnicity. CONCLUSION: The prevalence of fear of clowns in the general pediatric hospitalized population was 1.2%, with a significant predominance of girls (85.7%). Children who experienced significant fear of clowns also experienced significant fear of encountering or thinking about a MC visit. Fear of clowns can affect children at any age (range 1-15), any ethnicity, religion, or degree of illness. Further large scale studies are required to better understand this unique phenomenon of fear of clowns. What is Known: • Fear of clowns is a phenomenon known for more than several decades and related to the increased use of clowns as negative characters in horror movies and TV shows. • The increased use of medical clowns in hospital wards and corridors increases the significance of defining and characterizing this phenomenon in hospital wards. What is New: • The study is novel by giving new data related to the extent of fear of clowns in pediatrics wards and giving demographic characteristic of children experiencing fear of clowns.
[Mh] Termos MeSH primário: Criança Hospitalizada/psicologia
Medo/psicologia
Transtornos Fóbicos/psicologia
[Mh] Termos MeSH secundário: Adolescente
Ansiedade
Criança
Criança Hospitalizada/estatística & dados numéricos
Pré-Escolar
Estudos Transversais
Medo/classificação
Feminino
Seres Humanos
Lactente
Terapia do Riso
Masculino
Pais
Transtornos Fóbicos/epidemiologia
Prevalência
Estudos Prospectivos
Fatores Sexuais
Estresse Psicológico
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161215
[St] Status:MEDLINE
[do] DOI:10.1007/s00431-016-2826-3


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[PMID]:27908974
[Au] Autor:Sánchez JC; Echeverri LF; Londoño MJ; Ochoa SA; Quiroz AF; Romero CR; Ruiz JO
[Ad] Endereço:Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia jcsanchez@utp.edu.co.
[Ti] Título:Effects of a Humor Therapy Program on Stress Levels in Pediatric Inpatients.
[So] Source:Hosp Pediatr;7(1):46-53, 2017 01.
[Is] ISSN:2154-1663
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Disease and hospitalization generate stress, which can affect the response to treatment. Humor has been used in many hospitals to decrease stress. The aim of this study was to evaluate the impact of a humor therapy program on stress levels in pediatric inpatients. METHODS: In the first phase, an intervention and a control group were studied over 2 consecutive 3-month periods; the interventions were performed by a team of artists trained in humor therapy. Salivary cortisol levels were measured by enzyme-linked immunosorbent assay, and the Weisz test, a pictorial chart that determines subjective stress perception, and the Parker test, which assesses objective stress, were applied. In the second phase, salivary cortisol levels were measured and the Weisz test was administered before and after the interventions. RESULTS: A total of 306 patients were recruited into this study: 198 in the first phase (94 in the intervention group and 104 in the nonintervention group) and 108 in the second phase. There were no differences between groups regarding age, sex, or medical diagnosis. The children in the intervention group presented lower cortisol levels, lower scores on the Parker test, and higher scores on the Weisz test than children in the nonintervention group. In the second phase, the children showed lower salivary cortisol levels and higher scores on the Weisz test after the intervention. CONCLUSIONS: Humor therapy has beneficial effects on stress and cortisol levels in pediatric inpatients. This supports the implementation and reinforcement of these therapies in pediatric hospitals.
[Mh] Termos MeSH primário: Criança Hospitalizada/psicologia
Hidrocortisona/análise
Terapia do Riso/métodos
Saliva/metabolismo
Estresse Psicológico
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Técnicas Psicológicas
Estresse Psicológico/diagnóstico
Estresse Psicológico/metabolismo
Estresse Psicológico/terapia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170706
[Lr] Data última revisão:
170706
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161203
[St] Status:MEDLINE
[do] DOI:10.1542/hpeds.2016-0128


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[PMID]:27734555
[Au] Autor:Zhang Y; Yang Y; Lau WY; Garg S; Lao J
[Ad] Endereço:Department of Anaesthesiology, Guangzhou Women and Children's Medical Centre, Guangzhou, China.
[Ti] Título:Effectiveness of pre-operative clown intervention on psychological distress: A systematic review and meta-analysis.
[So] Source:J Paediatr Child Health;53(3):237-245, 2017 Mar.
[Is] ISSN:1440-1754
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:AIM: This study aims to provide an overview of the current knowledge available on the effectiveness of pre-operative clown intervention on psychological distress in children and parents. METHODS: PubMed, MEDLINE, Embase and PsycINFO databases were searched to identify relevant studies. Systematic review procedures were followed including a quality assessment. Meta-analysis of suitable studies was conducted. RESULTS: Eight studies were included; six reported that clown intervention reduced children's pre-operative anxiety, while one found that children's pre-operative distress levels were unchanged. Two studies suggested that clown therapy decreased parents' state anxiety, while three others found inconsistent results. No differences were found on parents' trait anxiety score. Meta-analysis of the available data confirmed that clown intervention has a great effect to reduce children's pre-operative distress (six articles, 341 children, Hedges' g = 0.867, 95% confidence intervals: 0.374-1.360, P = 0.001), and also had a small-to-medium effect on reducing parents' state anxiety (five articles, 329 parents, Hedges' g = 0.338, 95% confidence intervals: 0.112-0.564, P = 0.003). CONCLUSIONS: While significant variability existed between studies, the meta-analysis confirmed the effectiveness of pre-operative clown therapy on reducing psychological distress in children and parents. Larger randomised controlled trails and cross-cultural studies should be conducted to investigate the effectiveness of clown therapy in greater detail.
[Mh] Termos MeSH primário: Terapia do Riso/normas
Período Pré-Operatório
Estresse Psicológico/prevenção & controle
Senso de Humor e Humor como Assunto/psicologia
[Mh] Termos MeSH secundário: Criança
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161014
[St] Status:MEDLINE
[do] DOI:10.1111/jpc.13369



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