How to use participatory design to develop an eHealth intervention to reduce preprocedural stress and anxiety among children visiting the hospital: The Hospital Hero app multi-study and pilot report

Clown care in the clinical nursing of children: a meta-analysis and systematic review

Background

Children treated in hospitals often experience high levels of anxiety and pain. The purpose of this meta-analysis was to analyze the effect of clown care in clinical nursing on children and to provide ideas for improving the clinical nursing care provided to children.

Methods

Two authors searched PubMed, Embase, Clinical trials, Cochrane Library, Web of Science, CINAHL, Scopus, China National Knowledge Infrastructure (CNKI), Weipu, and Wanfang databases to identify randomized controlled trials (RCTs) related to clown care for children until 15 September 2023. The quality assessment of the included RCTs and the data extraction were performed by two researchers, and meta-analysis was carried out using RevMan5.4.

Results

A total of 15 RCTs involving 2,252 children were finally included in this meta-analysis. The findings from this meta-analysis revealed that clown care was beneficial in reducing the pain [SMD = -0.96, 95% CI (-1.76, 0.16)], anxiety [SMD = -0.81, 95% CI (-1.16, -0.46)], and crying time [SMD = -1.09, 95% CI (-1.74, -0.44)] of children and the anxiety level of caregivers [SMD = -0.99, 95% CI (-1.95, -0.03)] (all P's < 0.05). No significant publication biases were detected in the synthesized outcomes (all P's > 0.05).

Conclusions

Clown care is helpful in reducing the pain, anxiety, and crying time of children and the anxiety level of caregivers. However, additional high-quality studies with larger sample sizes are warranted to further analyze the role of clown care in clinical practice.

Patient Co-Creation Initiatives in the Ambulatory Care Setting during COVID-19: A Systematic Review

Background and Objectives: The COVID-19 pandemic has led to significant changes in ambulatory care to meet new healthcare demands. Materials and Methods: A review of 21 articles focusing on patient co-creation initiatives during the pandemic shows that integrating patient feedback was crucial in transforming care delivery. Results: Joint efforts between healthcare professionals and patients led to new patient-focused telemedicine platforms, more efficient appointment systems, and improved safety measures. These adaptations overcame care barriers and maintained continuity of care. Key themes identified include monitoring community health standards, combining technology with patient-provider communication, and enhancing patient participation in health research. Conclusions: These co-creation efforts not only boosted patient satisfaction and outcomes but also demonstrated the potential for long-term healthcare innovations beyond the pandemic. The review further illuminates that co-creation in healthcare, particularly in tracking community health trends, is a practical strategy that involves diverse stakeholders in shaping healthcare delivery. The widespread adoption of co-creation in outpatient care during the pandemic highlights its role in driving patient-centered behavioral changes through innovative methods like crowdsourcing and dialogue conferencing. The review also recognizes that co-creation has been instrumental in responding to demographic changes, enhancing resources, creativity, and problem-solving in municipal-volunteer collaborations. Additionally, the evolution of technology in patient-provider communication, from initial resistance in the 1990s to its current critical role, particularly during the COVID-19 pandemic, underscores its importance in enhancing healthcare service delivery and patient data communication. The review also emphasizes the need for ethically and accessibly designed technology, especially for vulnerable groups, and highlights the significance of patient involvement in healthcare research, advocating for user-centered design and shared decision-making to create truly patient-centric interventions.