<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Pediatrician (St. Petersburg)</journal-id><journal-title-group><journal-title xml:lang="en">Pediatrician (St. Petersburg)</journal-title><trans-title-group xml:lang="ru"><trans-title>Педиатр</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2079-7850</issn><issn publication-format="electronic">2587-6252</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">34637</article-id><article-id pub-id-type="doi">10.17816/PED112109-116</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Clinical psychology</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Клиническая психология</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Hospital clownery – entertainment or treatment? History of development and experience</article-title><trans-title-group xml:lang="ru"><trans-title>Больничная клоунада — развлечение или лечение? История развития и опыт применения</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Uvarov</surname><given-names>Nikolay A.</given-names></name><name xml:lang="ru"><surname>Уваров</surname><given-names>Николай Алексеевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Intern Department of Outpatient Pediatrics name after A.F. Tour</p></bio><bio xml:lang="ru"><p>клинический ординатор, кафедра поликлинической педиатрии им. акад. А.Ф. Тура</p></bio><email>uvarov.9595@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Uvarova</surname><given-names>Daria B.</given-names></name><name xml:lang="ru"><surname>Уварова</surname><given-names>Дарья Борисовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Intern</p></bio><bio xml:lang="ru"><p>клинический ординатор</p></bio><email>darya.uvarova@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Sakhno</surname><given-names>Larisa V.</given-names></name><name xml:lang="ru"><surname>Сахно</surname><given-names>Лариса Викторовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Associate Professor, Department of Outpatient Pediatrics name after A.F. Tour</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доцент кафедры поликлинической педиатрии им. акад. А.Ф. Тура</p></bio><email>lvs_doc@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Zemlianykh</surname><given-names>Marina V.</given-names></name><name xml:lang="ru"><surname>Земляных</surname><given-names>Марина Веанировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Associate Professor Department of Psychosomatic and Psychotherapy</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доцент кафедры психосоматики и психотерапии</p></bio><email>mvz6@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation</institution></aff><aff><institution xml:lang="ru">Федеральное государственное бюджетное образовательное учреждение высшего образования «Санкт-Петербургский государственный педиатрический медицинский университет» Министерства здравоохранения Российской Федерации</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">St. Petersburg Research Institute of Ear, Throat, Nose and Speech Ministry of Healthcare in Russian Federation</institution></aff><aff><institution xml:lang="ru">Федеральное государственное бюджетное учреждение «Санкт-Петербургский научно-исследовательский институт уха, горла, носа и речи» Министерства здравоохранения Российской Федерации</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2020-06-08" publication-format="electronic"><day>08</day><month>06</month><year>2020</year></pub-date><volume>11</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>109</fpage><lpage>116</lpage><history><date date-type="received" iso-8601-date="2020-06-08"><day>08</day><month>06</month><year>2020</year></date><date date-type="accepted" iso-8601-date="2020-06-08"><day>08</day><month>06</month><year>2020</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2020, Uvarov N.A., Uvarova D.B., Sakhno L.V., Zemlianykh M.V.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2020, Уваров Н.А., Уварова Д.Б., Сахно Л.В., Земляных М.В.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="en">Uvarov N.A., Uvarova D.B., Sakhno L.V., Zemlianykh M.V.</copyright-holder><copyright-holder xml:lang="ru">Уваров Н.А., Уварова Д.Б., Сахно Л.В., Земляных М.В.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">http://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://journals.eco-vector.com/pediatr/article/view/34637">https://journals.eco-vector.com/pediatr/article/view/34637</self-uri><abstract xml:lang="en"><p>The article discusses one of the areas of psychological rehabilitation of children in a hospital – hospital clowns. The theoretical and practical prerequisites of the history of the development of hospital clownery both abroad and in the Russian Federation are shown. The results of studies of the effectiveness of the impact of hospital clownery and laughter therapy on the emotional state of children and their parents, in particular on the experience of anxiety and fears in the postoperative period, as well as on the severity of pain during medical manipulations such as venipuncture, allergy tests and radionuclide scanning are presented. The results of a qualitative analysis of the author’s empirical research of 133 children and 65 parents are presented. The aim of the research was to study the effect of hospital clownery on the emotional state of children resulting from hospitalization and treatment received (painful manipulations, surgical intervention). Subjective assessments by children and parents of their psycho-emotional state were recorded using questionnaires. The projective method was also used – the Luscher Test. The results of a qualitative analysis demonstrated a subjective sensation of an improvement in the psychoemotional state in 97% of children and in 92% of parents (improving mood, decreasing of anxiety and fears). 67% of children noted a weakening of the pain syndrome. Thus, the authors have confirmed by their own research the positive effect of hospital clownery on children’s health. The presented review clearly demonstrates the feasibility of expanding the use of this method in children’s hospitals of various profiles.</p></abstract><trans-abstract xml:lang="ru"><p>В статье рассматривается одно из направлений психологической реабилитации детей в условиях стационара — больничная клоунада. Показаны теоретические и практические предпосылки истории ее развития как за рубежом, так и в Российской Федерации. Изложены результаты исследований эффективности воздействия больничной клоунады и смехотерапии на эмоциональное состояние детей и их родителей, в частности на переживание тревоги и страха в послеоперационный период, а также на степень выраженности болевого синдрома при таких медицинских манипуляциях, как венепункция, проведение аллергических проб и радионуклидное сканирование. Представлены результаты качественного анализа собственного эмпирического исследования 133 детей и 65 родителей. Изучалось влияние больничной клоунады на эмоциональное состояние детей, возникающее вследствие госпитализации и получаемого лечения (болезненные манипуляции, оперативное вмешательство). Фиксировались субъективные оценки детьми и родителями своего психоэмоционального состояния с помощью анкетирования. Использовался также проективный метод — тест Люшера. Качественный анализ продемонстрировал субъективное ощущение улучшения психоэмоционального состояния у 97 % детей и 92 % родителей в виде повышения настроения, ослабления тревоги и страхов. Ослабление болевого синдрома отмечали 67 % детей. Таким образом, положительное влияние больничной клоунады на здоровье детей авторы статьи подтвердили собственным исследованием, а представленный обзор наглядно демонстрирует целесообразность расширения использования данного метода в детских стационарах различного профиля.</p></trans-abstract><kwd-group xml:lang="en"><kwd>hospital clownery</kwd><kwd>laugh therapy</kwd><kwd>psycho-emotional state of children and parents</kwd><kwd>anxiety</kwd><kwd>fear of medical manipulation</kwd><kwd>pain syndrome</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>больничная клоунада</kwd><kwd>смехотерапия</kwd><kwd>психоэмоциональное состояние детей и родителей</kwd><kwd>тревога</kwd><kwd>страх медицинских манипуляций</kwd><kwd>болевой синдром</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Долженкова М.И. Больничная клоунада в структуре технологий социокультурной реабилитации // Вестник Тамбовского университета. Серия: Гуманитарные науки. – 2016. – Т. 21. – № 8. – С. 84–94. [Dolzhenkova MI. Hospital clown in the structure of technologies of socio-cultural rehabilitation. Vestnik Tambovskogo universiteta. Seriya: Gumanitarnye nauki. 2016;21(8): 84-94. (In Russ.)] https://doi.org/10.20310/1810-0201-2016-21-7/8(159/160)-84-94.</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Казинс Н. Анатомия болезни. – М.: Физкультура и спорт, 1991. [Kazins N. Anatomiya bolezni. Moscow: Fizkul’tura i sport; 1991. (In Russ.)]</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>Лэндрет Г.Л. Игровая терапия: искусство отношений. – М.: Международная педагогическая академия, 1994. [Lendret GL. Igrovaya terapiya: iskusstvo otnosheniy. Moscow: Mezhdunarodnaya pedagogicheskaya akademiya; 1994. (In Russ.)]</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>Мазайлова Т.А., Сиротина Т.В. Основы паллиативной помощи. – Барнаул: АлтГУ, 2015. [Mazaylova TA, Sirotina TV. Osnovy palliativnoy pomoshchi. Barnaul: AltGU; 2015. (In Russ.)]</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Ольшанский В.М. Путь клоуна. История смехотерапии. – М.: Зебра Е, 2013. [Ol’shanskiy VM. Put’ klouna. Istoriya smekhoterapii. Mоscow: Zebra E; 2013. (In Russ.)]</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>Сахно Л.В., Поздняк В.В., Уваров Н.А., и др. Смехотерапия — механизм партисипативности (родитель – врач – пациент) в социально-психологической реабилитации детей, находящихся в стационаре // Медицина: теория и практика. – 2019. – Т. 4. – № S. – С. 500–501. [Sakhno LV, Pozdnyak VV, Uvarov NA, et al. Smekhoterapiya – mekhanizm partisipativnosti (roditel’-vrach-patsient) v sotsial’no-psikhologicheskoy reabilitatsii detey, nakhodyashchikhsya v statsionare. Meditsina: teoriya i praktika. 2019;4(S):500-501. (In Russ.)]</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Трутаева Л.Н., Седов К.С., Александрова К.О. Больничная клоунада как психотерапевтический метод коррекции у детей старшего возраста // Медицинский совет. – 2013. – № 2. – С. 119–120. [Trutaeva LN, Sedov KS, Аlexandrova KO. Hospital clowning as a psychotherapeutic method of correction in preschool children. Meditsinskiy sovet. 2013;(2-3):122-124. (In Russ.)]</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Agostini F, Monti F, Neri E, et al. Parental anxiety and stress before pediatric anesthesia: a pilot study on the effectiveness of preoperative clown intervention. J Health Psychol. 2014;19(5):587-601. https://doi.org/10.1177/1359105313475900.</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Dionigi A, Sangiorgi D, Flangini R. Clown intervention to reduce preoperative anxiety in children and parents: a randomized controlled trial. J Health Psychol. 2014;19(3):369-380. https://doi.org/10.1177/1359105312471567.</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Bains G, Berk L, Lohman E, et al. Decrease in Inflammation (CRP) and Heart Rate Through Mirthful Laughter. FASEB J. 2017;31(1S).</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Bennett MP, Zeller JM, Rosenberg L, McCann J. The effect of mirthful laughter on stress and natural killer cell activity. Altern Ther Health Med. 2003;9(2):38-45.</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Berk L, Prowse M, Bains G, et al. Humor-associated laughter affects appetite hormones. FASEB J. 2010;24(1S).</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>Berk LS, Tan SA. [beta]-Endorphin and HGH increase are associated with both the anticipation and experience of mirthful laughter. FASEB J. 2006;20(4).</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Berk LS, Tan SA, Fry WF, et al. Neuroendocrine and Stress Hormone Changes During Mirthful Laughter. Am J Med Sci. 1989;298(6):390-396. https://doi.org/10.1097/00000441-198912000-00006.</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>Dvory A, Goshen Y, Ruimi S, et al. Dream Doctor Intervention Instead of Sedation: Performing Radionuclide Scanning Without Sedation in Young Children: A Study in 142 Patients. J Altern Complement Med. 2016;22(5):408-412. https://doi.org/10.1089/acm.2015.0090.</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>Ford K, Courtney-Pratt H, Tesch L, Johnson C. More than just clowns — Clown doctor rounds and their impact for children, families and staff. J Child Health Care. 2014;18(3):286-296. https://doi.org/ 10.1177/1367493513490447.</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>Goldberg A, Stauber T, Peleg O, et al. Medical clowns ease anxiety and pain perceived by children undergoing allergy prick skin tests. Allergy. 2014;69(10): 1372-1379. https://doi.org/10.1111/all.12463.</mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation>Dean RA, Gregory DM. Humor and laughter in palliative care: an ethnographic investigation. Palliat Support Care. 2004;2(2):139-148. https://doi.org/10.1017/s1478951504040192.</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>Linge L. Magical attachment: Children in magical relations with hospital clowns. Int J Qual Stud Health Well-being. 2012;7. https://doi.org/10.3402/qhw.v7i0.11862.</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>Meiri N, Ankri A, Hamad-Saied M, et al. The effect of medical clowning on reducing pain, crying, and anxiety in children aged 2–10 years old undergoing venous blood drawing – a randomized controlled study. Eur J Pediatr. 2016;175(3):373-379. https://doi.org/10.1007/s00431-015-2652-z.</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>Meiri N, Ankri A, Ziadan F, et al. Assistance of Medical Clowns Improves the Physical Examinations of Children Aged 2–6 Years. Isr Med Assoc J. 2017;19(12): 786-791.</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation>Polak P. The crisis of admission. Soc Psychiatry. 1967;2:150-157. https://doi.org/10.1007/BF00578050.</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation>Redman J. How many kids can a clown hug at one time? The Hospital Clown Newsletter. 2008;11(4): 16-17.</mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation>Spielberger CD, Gorsuch RL, Lushene R, et al. Manual for the State-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press; 1983.</mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation>Tarsitani L, Biondi M. Development and validation of the VRS, a rating scale for rapid stress assessment. [Italian]. Medicina psicosomatica. 1999;44:163-177.</mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation>Wolyniez I, Rimon A, Scolnik D, et al. The Effect of a Medical Clown on Pain During Intravenous Access in the Pediatric Emergency Department. Clini Pediatr. 2013;52(12):1168-1172. https://doi.org/10.1177/0009922813502257.</mixed-citation></ref></ref-list></back></article>
