Khoury Lana, Shwartz Naddam Irit, Paz Tzruia Meital, Shehadeh Shereen, Konopnicki Muriel, Hamad Saied Mohamad, Meiri Noam, Livnat Galit, Yaacoby-Bianu Karin
Department of Pediatrics, Carmel Medical Center, Haifa, Israel.
Pediatric Infectious Unit, Carmel Medical Center, Haifa, Israel.
Sci Rep. 2025 Jun 4;15(1):19498. doi: 10.1038/s41598-025-04706-w.
Community-acquired pneumonia (CAP) is a leading cause of hospitalization in children. The hospitalization duration depends on factors as child's well-being, vital signs, need for parenteral treatments, and development of complications. Medical clowns (MCs) are known to assist in reducing pain and alleviating anxiety and have been integrated into many aspects of hospital treatment routines. Our aim was to evaluate the effect of MC intervention on length of hospitalization in children admitted with CAP. A prospective quasi-randomized controlled trial allocated 51 children (2-18 years) hospitalized for CAP to receive standard care (control group, n = 25) or standard care plus 15-minute MC visits twice daily during the first 48 h of hospitalization (intervention group, n = 26). The primary outcome was hospitalization duration. Both groups were comparable in all demographic and clinical characteristics at admission with a mean age of 4.4 ± 3.6 years. The intervention group had significantly shorter duration of hospitalization (43.5 vs. 70 h, p = 0.03) and IV antibiotic treatment duration (48 vs. 72 h, p < 0.01) compared to controls. When comparing day 1 to day 2 in each group, significant decreases in respiratory rate, heart rate, white blood cell count, and absolute neutrophil count were noted in the study group. No significant differences were observed between the two groups in changes in patient well-being. The integration of MC into the pediatric CAP care-team reduced length of hospitalization and need for IV antibiotics. This can improve the quality of care as well as the burden and cost endured by hospitalization with CAP. Future larger studies are warranted to support these positive effects of MC.Trial registration ClinicalTrials.gov Identifier NCT06750029, 27/12/2024.
社区获得性肺炎(CAP)是儿童住院的主要原因。住院时间取决于儿童的健康状况、生命体征、肠外治疗需求以及并发症的发生情况。已知医疗小丑(MCs)有助于减轻疼痛和缓解焦虑,并已融入医院治疗常规的许多方面。我们的目的是评估MC干预对因CAP入院儿童住院时间的影响。一项前瞻性半随机对照试验将51名因CAP住院的儿童(2至18岁)分配为接受标准护理(对照组,n = 25)或在住院的前48小时内每天接受两次15分钟的MC探访的标准护理(干预组,n = 26)。主要结局是住院时间。两组入院时的所有人口统计学和临床特征均具有可比性,平均年龄为4.4±3.6岁。与对照组相比,干预组的住院时间(43.5对70小时,p = 0.03)和静脉抗生素治疗时间(48对72小时,p < 0.01)明显更短。在比较每组第1天和第2天时,研究组的呼吸频率、心率、白细胞计数和绝对中性粒细胞计数均显著下降。两组在患者健康状况变化方面未观察到显著差异。将MC纳入儿科CAP护理团队可缩短住院时间和减少静脉抗生素的需求。这可以提高护理质量以及CAP住院所带来的负担和成本。未来有必要进行更大规模的研究来支持MC的这些积极作用。试验注册ClinicalTrials.gov标识符NCT06750029,2024年12月27日。