小丑在儿童肉毒杆菌毒素注射时的作用：一项随机、前瞻性研究。
Effect of a clown's presence at botulinum toxin injections in children: a randomized, prospective study.
机构信息
Department of Paediatrics, Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense.
出版信息
J Pain Res. 2011;4:297-300. doi: 10.2147/JPR.S23199. Epub 2011 Sep 21.
BACKGROUND
The effect of the presence of a hospital clown during pediatric procedures has rarely been evaluated. In a pediatric ward, botulinum toxin injection is a painful procedure and a stressful experience for the child. We undertook a study of the effect of the presence of a hospital clown on children treated with botulinum toxin in an outpatient setting.
METHODS
In total, 60 children, the majority of whom had spastic cerebral palsy, were subjected to a total of 121 botulinum toxin treatment sessions. Thirty-two children were being treated for the first time. During a 2-year period, we enrolled 121 treatment sessions prospectively, and the children were randomized to either the presence of a female clown during treatment or to no presence of a clown. The duration of the child's crying during the procedure was used as an indicator of the effect of the presence of a clown.
RESULTS
The effect of the clown was significantly related to patient gender. Girls were found to have a significantly shorter period of crying when the clown was present. For children younger than 8 years, the effect on boys was negative. Children treated for the first time did not appear to benefit from the presence of the clown, and showed no difference in effect between genders.
CONCLUSION
No effect of the clown was documented for children being treated for the first time. At repeat treatments, we saw a positive effect of the female clown in relation to girls, and a negative effect on boys younger than 8 years of age.
背景
医院小丑在儿科手术中的作用很少被评估。在儿科病房中，肉毒杆菌毒素注射对儿童来说是一种痛苦的程序，也是一种压力体验。我们进行了一项研究，评估了在门诊环境中使用医院小丑对接受肉毒杆菌毒素治疗的儿童的影响。
方法
共有 60 名儿童参与了研究，他们大多患有痉挛性脑瘫，总共接受了 121 次肉毒杆菌毒素治疗。其中 32 名儿童是首次接受治疗。在 2 年的时间里，我们前瞻性地纳入了 121 次治疗，将儿童随机分配到治疗期间有女性小丑或没有小丑的情况下。儿童在治疗过程中哭泣的持续时间被用作评估小丑存在效果的指标。
结果
小丑的效果与患者性别显著相关。当小丑在场时，女孩哭泣的时间明显缩短。对于 8 岁以下的男孩，小丑的效果是负面的。首次接受治疗的儿童似乎没有受益于小丑的存在，并且在性别方面没有表现出效果差异。
结论
对于首次接受治疗的儿童，没有记录到小丑的效果。在重复治疗中，我们观察到女性小丑对女孩有积极的影响，而对 8 岁以下的男孩则有负面的影响。
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