Abstract
Objective: To analyze the actions of clown therapy and the effects of physiological variation in renal patients on hemodialysis. Methods: This is a controlled and randomized clinical trial, conducted with 27 individuals, of both genders, who were undergoing hemodialysis at a public hospital in Pernambuco and were randomly assigned to intervention and control groups. For inferential analysis, Wilcoxon and Mann-Whitney tests were used, all with a significance level of 5%. Test information was generated using the SPSS statistical package, version 20 (2011). The study was approved by the Research Ethics Committee. Results: From the results obtained, there is a higher prevalence of females 59.3%, 48.1% are single and live with family members. The initial access fistulas 66.7%, 66% do not report pain/discomfort. Clown therapy contributes to hemodialysis sessions, improves the patient's mood (12.5%). No modifications were identified for depressive symptoms. Heart rate showed the expected decrease in values in the intervention group (p < 0.003). Conclusion: It was concluded that clown therapy had positive reactions in patients on hemodialysis, it contributes to the performance of hemodialysis and has effects in reducing heart rate.
References
BRASIL. Ministério da Saúde. Política Nacional de Humanização. 2013. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_humanizacao_pnh_folheto.pdf. Acesso em: 7 de fevereiro de 2023.
CAMARGOS BC, et al. Avaliação da influência de um projeto de palhaçaria sobre a empatia de acadêmicos de medicina. Revista Eletrônica Acervo Médico, 2022; 13: e10546.
CATAPAN SC, et al. Palhaçoterapia em ambiente hospitalar: uma revisão de literatura. Ciênc. Saúde coletiva, 2019; 24(9): 3417-3429.
DA SILVA WLC, et al. O uso da ludicidade durante o tratamento hemodialítico: vivências de acadêmicas de enfermagem. Revista Eletrônica Acervo Saúde, 2021; 13(2): e6349.
DE RESENDE MDC, et al. Doutores Só Risos: percepções dos estudantes de medicina sobre as contribuições da palhaçaria na sua formação médica. Revista Eletrônica Acervo Saúde, 2021; 13(5): e7383.
FUSETTI V, et al. Clown therapy for procedural pain in children: a systematic review and meta-analysis. Eur J Pediatr., 2022; 181(6): 2215-2225.
GARCÍA-MASET R, et al. Documento de información y consenso para la detección y manejo de la enfermedad renal crónica. Nefrología (Madrid), 2022; 42(3): 1-32.
GUZMÁN-CARRILLO KY, et al. Intervención cognitivo conductual para promover la adhesión al tratamiento médico, recursos psicológicos y calidad de vida en pacientes pediátricos con hemodiálisis en México. Rev. psicol. clín. niños adolesc., 2022; 9(2): 26-31.
LIM KA e LEE JH. Factors Affecting Quality of Life in Patients Receiving Hemodialysis. Iran J Public Health, 2022; 51(2): 355-363.
LOPES-JÚNIOR LC, et al. The Effect of Clown Intervention on Self-Report and Biomarker Measures of Stress and Fatigue in Pediatric Osteosarcoma Inpatients: A Pilot Study. Integr Cancer Ther., 2018; 17(3): 928-940.
LOPES-JUNIOR LC, et al. Clown Intervention on Psychological Stress and Fatigue in Pediatric Patients With Cancer Undergoing Chemotherapy. Cancer Nurs. 2020; 43(4): 290-299.
MORTAMET G, et al. Is there a role for clowns in paediatric intensive care units?. Arch Dis Child. 2017a; 102(7): 672-675.
MORTAMET G, et al. Parental perceptions of clown care in paediatric intensive care units. J Paediatr Child Health, 2017b; 53(5): 485-487.
NEWMAN N, et al. The impact of medical clowns exposure over postoperative pain and anxiety in children and caregivers: An Israeli experience. Pediatr Rep., 2019; 11(3): 8165.
NGUYEN TTN, et al. Self-care self-efficacy and depression associated with quality of life among patients undergoing hemodialysis in Vietnam. PLoS One, 2022; 17(6): e0270100.
PAULA TB, et al. Potencialidade do lúdico como promoção de bem-estar psicológico de pacientes em hemodiálise. Psicol Ciênc Prof., 2017; 37: 146-58.
PAULA GK, et al. Estratégias lúdicas no cuidado de enfermagem à criança hospitalizada. Rev enferm UFPE on line, 2019; 13: e238979.
RASYID H, et al. Quality of Life in Patients with Renal Failure Undergoing Hemodialysis. Acta Med Indones, 2022; 54(2): 307-313.
RIBEIRO WF, et al. Contributions of therapeutic play in the care process for hospitalized children: a study of the literature. Research, Society and Development, 2020; 9(7): e1000974706.
RIGBI NE, et al. Medical clown support is associated with better quality of life of children with food allergy starting oral immunotherapy. Pediatr Allergy Immunol., 2021; 32(5): 1029-1037.
SHEFER S, et al. Benefits of medical clowning in the treatment of young children with autism spectrum disorder. Eur J Pediatr., 2019; 178(8): 1283-1289.
SHI Y, et al. Anxiety, depression, and related factors in hemodialysis patients during the lockdown period of COVID-19 in China: a multicenter study. Psychol Health Med., 2022; 1-7.
TEIXEIRA CFS, et al. A saúde dos profissionais de saúde no enfrentamento da pandemia de Covid-19. Ciênc. Saúde coletiva, 2020; 25(9): 3465-3474.
ZEMP M, et al. Effects of clown visits on stress and mood in children and adolescents in psychiatric care-Protocol for a pilot study. PLoS One, 2022; 17(2): e0264012.
