WHO Collaborating Centre for Nursing Research Development. Ribeirão Preto, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirao Preto, Brazil.
Faculty of Nursing, University of Alberta, Edmonton, Canada.
BMJ Open. 2019 Jan 21;9(1):e026524. doi: 10.1136/bmjopen-2018-026524.
Clown intervention may playing an important complementary role in paediatric care and recovery. However, data on its utility for symptom cluster management of hospitalised children and adolescents in acute and chronic disorders are yet to be critically evaluated. As clinicians strive to minimise the psychological burden during hospitalisation, it is important that they are aware of the scientific evidences available regarding clown intervention for symptom management. We aim to provide quality evidence for the effectiveness of clown intervention on symptom cluster management in paediatric inpatients, both in acute and chronic conditions.
A systematic review of randomised controlled trials (RCTs) and non-randomised controlled trials (NRCTs) will be conducted. MEDLINE, Web of Science, Cochrane Library, Science Direct, PsycINFO, CINAHL, LILACS and SciELO databases will be searched from January 2000 to December 2018. Primary outcomes will include measures related with the effect of clown intervention on symptom cluster of paediatric inpatients (anxiety, depression, pain, fatigue, stress and psychological, emotional responses and perceived well-being). Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the methodological appraisal of the studies will be assessed by the Jadad Scale as well as Cochrane Risk-of-Bias Tool for RCTs, and Risk-of-Bias In Non-Randomized Studies Tool for NRCTs. A narrative synthesis will be conducted for all included studies. Also, if sufficient data are available, a meta-analysis will be conducted. The effect sizes will be generated using Hedges' g score for both fixed and random effect models. I statistics will be used to assess heterogeneity and identify their potential sources.
As it will be a systematic review, without human beings involvement, there will be no requirement for ethical approval. Findings will be disseminated widely through peer-reviewed publication and in various media, for example, conferences, congresses or symposia.
CRD42018107099.
小丑干预在儿科护理和康复中可能发挥着重要的补充作用。然而，关于其在急性和慢性疾病住院儿童症状群管理中的效用的数据尚未经过严格评估。由于临床医生努力在住院期间减轻心理负担，因此了解有关小丑干预用于症状管理的科学证据非常重要。我们旨在为小丑干预在儿科住院患者的症状群管理中的有效性提供高质量的证据，无论是在急性还是慢性疾病中。
将进行系统的随机对照试验（RCT）和非随机对照试验（NRCT）的综述。将从 2000 年 1 月至 2018 年 12 月，在 MEDLINE、Web of Science、Cochrane 图书馆、Science Direct、PsycINFO、CINAHL、LILACS 和 SciELO 数据库中搜索。主要结果将包括与小丑干预对儿科住院患者症状群（焦虑、抑郁、疼痛、疲劳、压力和心理、情绪反应和感知幸福感）的影响相关的措施。研究选择将遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南，研究的方法学评估将通过 Jadad 量表以及 Cochrane RCT 偏倚风险工具和 NRCT 偏倚风险工具进行评估。将对所有纳入的研究进行叙述性综合分析。此外，如果有足够的数据，将进行荟萃分析。将使用固定和随机效应模型的 Hedges'g 评分生成效应大小。I 统计量将用于评估异质性并确定其潜在来源。
由于这将是一个系统评价，不涉及人类，因此不需要伦理批准。研究结果将通过同行评审出版物和各种媒体广泛传播，例如会议、大会或研讨会。
CRD42018107099。
