Yildirim Meltem, Koroglu Ecem, Yucel Cagla, Kirlak Senay, Sen Sevim
Serra Hunter Fellow, University of Vic, Faculty of Health Sciences and Welfare, Department of Nursing, Sagrada Família, 7, 08500 Vic, Barcelona, Spain.
Anadolu Medical Center, John Hopkins International, Cumhuriyet Mahallesi, 2255, Cumhuriyet Cd. No: 3, 41400 Gebze/Kocaeli, Turkey.
Burns. 2019 Feb;45(1):190-198. doi: 10.1016/j.burns.2018.08.033. Epub 2018 Sep 21.
Pediatric burn injury is a traumatic experience which affects the child both physically and psychologically. Following the burn injury, repetitive dressing changes are one of the main problems, and to manage the level of distress caused this procedure, various distraction strategies are being used. However, the effect of hospital clown during burn dressing change among children has not been studied before. Therefore, the present study aimed to investigate the effect of hospital clown-nurse on children's compliance to burn dressing change.
This randomized controlled experimental study was conducted with 50 children between 3-7years. There were 25 children in the experimental group and 25 children in the control group. In the intervention group, clown-nurse accompanied the child during burn dressing change while the children in the control group received standard care without hospital clown. Children's behavioral reactions were observed during dressing change.
Children in the intervention group had better compliance to burn dressing change, in other words, they cried and/or yelled less, they were more active, had better mood, better communication and interaction with the accompanying parent and the nurse. In addition, older children in the experimental group had better compliance to the burn dressing change.
小儿烧伤是一种创伤性经历，会对儿童的身体和心理造成影响。烧伤后，反复换药是主要问题之一，为了应对换药过程中产生的痛苦程度，人们采用了各种分散注意力的策略。然而，此前尚未研究过医院小丑在儿童烧伤换药过程中的作用。因此，本研究旨在调查医院小丑护士对儿童烧伤换药依从性的影响。
本随机对照实验研究对50名3至7岁的儿童进行。实验组有25名儿童，对照组有25名儿童。干预组中，小丑护士在儿童烧伤换药时陪伴在旁，而对照组的儿童接受无医院小丑的标准护理。换药过程中观察儿童的行为反应。
干预组儿童对烧伤换药的依从性更好，也就是说，他们哭闹和/或叫嚷得更少，更活跃，情绪更好，与陪伴的家长和护士的沟通及互动更佳。此外，实验组中年龄较大的儿童对烧伤换药的依从性更好。
