Pediatrik Cerrahide Terapötik Mizahın Kullanımı

Özet

Pediatrik cerrahi süreçlerinde çocuklar kaygı ve korku gibi olumsuz duygular yaşayabilmekte ve bu durum hem çocuk hem de aile için psikososyal açıdan zorlayıcı olabilmektedir. Bu duyguların azaltılması, cerrahi sürecin daha etkili yönetilmesi açısından önemlidir. Pediatri hemşireliği uygulamalarında kaleydoskop, müzik ve sanal gerçeklik gibi çeşitli nonfarmakolojik girişimler çocukların kaygısını azaltmak için kullanılmaktadır. Son yıllarda terapötik mizah ve hastane palyaçosu uygulamaları da çocukların stresle başa çıkmasına yardımcı olan etkili yöntemler arasında yer almıştır. Mizah ve oyun temelli etkileşimler çocuklarda kaygı, korku ve ağrının hafifletilmesine, tedaviye uyumun artırılmasına ve hastane deneyiminin daha olumlu hale gelmesine katkı sağlamaktadır. Bu bölümde pediatrik cerrahide terapötik mizahın kapsamı, hastane palyaçosu uygulamalarının etkileri ve pediatri hemşireliği bakımına olan katkıları ele alınmıştır.

Children undergoing pediatric surgical procedures may experience negative emotions such as anxiety and fear, which can create psychosocial challenges for both the child and the family. Reducing these emotions is essential for the effective management of the surgical process. In pediatric nursing practice, various nonpharmacological interventions such as kaleidoscopes, music, and virtual reality are commonly used to decrease anxiety. In recent years, therapeutic humor and hospital clown interventions have also emerged as effective methods that support children in coping with stress. Humor and play based interactions help reduce anxiety, fear, and pain, promote adaptation to treatment, and contribute to a more positive hospital experience. This section examines the scope of therapeutic humor in pediatric surgery, the effects of hospital clown interventions, and their contributions to pediatric nursing care.

Referanslar

Ahmadipour, M., Sattari, H., & Nejad, M. A. (2022). Incidence and risk factors related to anxiety of children and adolescents before elective surgery. European Journal of Translational Myology, 32(2), 10449.

Akkoyun, S. (2025). Pediatrik cerrahi hastalarında preoperatif dönemde uygulanan nonfarmakolojik yöntemlerin kaygı düzeyine etkisi: Lisansüstü tezlerin sistematik derlemesi. Güncel Hemşirelik Araştırmaları Dergisi, 5(2), 141–158.

Aldamanhori, R. (2019). Rare yet devastating complications of circumcision. In A. Zaghal & N. Rahman (Eds.), Circumcision (pp. 1–10). London: IntechOpen. https://doi.org/10.5772/intechopen.89129

Arslan, D. (2014). Acile servise başvuran ebeveynlerde kaygı ve memnuniyetin değerlendirilmesi, etkileyen faktörlerin belirlenmesi (Yüksek lisans tezi). Atatürk Üniversitesi, Sağlık Bilimleri Enstitüsü, Erzurum.

Atay, G., Eras, Z., & Ertem, İ. (2011). Çocuk hastaların hastane yatışları sırasında gelişimlerinin desteklenmesi. Çocuk Dergisi, 11(1), 1–4. https://doi.org/10.5222/j.child.2011.001

Auerbach, S., Ruch, W., & Fehling, A. (2016). Positive emotions elicited by clowns and nurses: An experimental study in a hospital setting. Translational Issues in Psychological Science, 2(1), 14. https://doi.org/10.1037/tps0000055

Barkmann, C., Siem, A. K., Wessolowski, N., & Schulte-Markwort, M. (2013). Clowning as a supportive measure in paediatrics: A survey of clowns, parents and nursing staff. BMC Pediatrics, 13, 1–10.

Bodelet, C. (2024). “We don't do a job like the others”: The professionalization of hospital clowns and their work on identities. L'Année Sociologique, 74(1), 147–175.

Bruins Slot, J., Hendriks, M., & Batenburg, R. (2018). Feeling happy and carefree: A qualitative study on the experiences of parents, medical clowns and healthcare professionals with medical clowns. International Journal of Qualitative Studies on Health and Well-being, 13(1), 1503909. https://doi.org/10.1080/17482631.2018.1503909

Chen, T., Chen, Q., Lin, Z., & Ye, J. (2024). Family participatory clown therapy in venipuncture in hospitalized children: A non-randomized controlled trial. PLoS ONE, 19(7), e0305101. https://doi.org/10.1371/journal.pone.0305101

Conk, Z., Başbakkal, Z., Balyılmaz, H., & Bolışık, B. (2022). Pediatri hemşireliği (3. baskı). Ankara: Akademisyen Kitabevi.

Çelebi, A., Aytekin, A., Küçükoğlu, S., & Çelebioğlu, A. (2015). Hastanede yatan çocuk ve oyun. İzmir Dr. Behçet Uz Çocuk Hast Dergisi, 5(3), 156–160. https://doi.org/10.5222/buchd.2015.156

Çevik Özdemir, H. N., Tuncer, A. A., & Kılıç, İ. (2025). The effect of immersive virtual reality and music on anxiety, fear, and pain during circumcision surgery in children: A randomized controlled study. Journal of Health Science and Medicine, 5(8), 852–858. https://doi.org/10.32322/jhsm.1744007

Demir, K., & Törüner, E. K. (2020). Çocuklara yönelik günübirlik cerrahide hazırlık programlarının kullanımı ve hemşirelik süreci. Türkiye Sağlık Bilimleri ve Araştırmaları Dergisi, 3(1), 11–18.

Dionigi, A. (2018). Healthcare clowning: Use of specific complementary and alternative medicine for hospitalized children. OBM Integrative and Complementary Medicine, 3(2), 1–22. https://doi.org/10.21926/obm.icm.1802009

Efrat-Triester, D., Altman, D., Friedmann, E., Margalit, D. L. A., & Teodorescu, K. (2021). Exploring the usefulness of medical clowns in increasing satisfaction and reducing aggressive tendencies in pediatric and adult hospital wards. BMC Health Services Research, 21, 1–14. https://doi.org/10.1186/s12913-020-05987-9

Erola, E., Viitanen, J., Karisalmi, N., & Savolainen, K. (2023). Improving children’s patient experience with a mobile hospital clowning application: Initial user experiences from the clowns perspective. Finnish Journal of eHealth and eWelfare, 15(2), 157–173. https://doi.org/10.23996/fjhw.126855

Finlay, F., Baverstock, A., & Lenton, S. (2014). Therapeutic clowning in paediatric practice. Clinical Child Psychology and Psychiatry, 19(4), 596–605. https://doi.org/10.1177/1359104513492746

Fronk, E., & Billick, S. B. (2020). Pre-operative anxiety in pediatric surgery patients: Multiple case study analysis with literature review. Psychiatric Quarterly, 91(4), 1439–1451. https://doi.org/10.1007/s11126-020-09780-z

Javed, T., Khan, A. S., Jarral, N. A., Taqi, Z., Raza, M., & Shahid, Z. (2021). Medical clowning: A cost-effective way to reduce stress among children undergoing invasive procedures. Cureus, 13(10), e19003. https://doi.org/10.7759/cureus.18886

Kasem Ali Sliman, R., Meiri, N., & Pillar, G. (2023). Medical clowning in hospitalized children: A meta-analysis. World Journal of Pediatrics, 19(11), 1055–1061. https://doi.org/10.1007/s12519-023-00720-y

Kingsnorth, S., Blain, S., & McKeever, P. (2011). Physiological and emotional responses of disabled children to therapeutic clowns: A pilot study. Evidence-Based Complementary and Alternative Medicine, 2011, 732394. https://doi.org/10.1093/ecam/neq008

Koç Aslan, S., Wooten, P., & Yazgaç, R. (2018). Hastane palyaçoları ile ilgili genel bilgiler. İyileşme ve İyileştirmede Gülümsemenin Gücü (2. baskı, ss. 23–43). Ankara: Nobel Yayınları.

Koller, D., & Gryski, C. (2008). The life threatened child and the life enhancing clown: Towards a model of therapeutic clowning. Evidence-Based Complementary and Alternative Medicine, 5(1), 17–25. https://doi.org/10.1093/ecam/nem033

Kristensen, H. N., Sørensen, E. E., Stinson, J., & Thomsen, H. H. (2019). “We do this together!” The ethnographic study of alliance between child and hospital clown during venipuncture. Journal of Pediatric Nursing, 46, e77–e85.

Kurudirek, F., & Arıkan, D. (2020). Effects of therapeutic clowning on pain and anxiety during intrathecal chemotherapy in Turkey. Journal of Pediatric Nursing, 53, e6–e13. https://doi.org/10.1016/j.pedn.2020.01.015

Kurudirek, F., Arikan, D., & Sarialioğlu, A. (2021). The effect of therapeutic clowning on pain and anxiety during venous blood sampling in Turkey: A randomized controlled trial. Journal of Specialist Pediatric Nursing, 26(4), e12352. https://doi.org/10.1111/jspn.12352

Liang, Y., Huang, W., Hu, X., Jiang, M., Liu, T., Yue, H., & Li, X. (2021). Preoperative anxiety in children aged 2–7 years old: A cross-sectional analysis of the associated risk factors. Translational Pediatrics, 10(8), 2024–2034. https://doi.org/10.21037/tp-21-215

Lopes-Júnior, L. C., Bomfim, E., Olson, K., Neves, E. T., Silveira, D. S. C., Nunes, M. D. R., Lima, R. A. G. (2020). Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomized and non-randomized controlled trials. BMJ, 371, m4290. https://doi.org/10.1136/bmj.m4290

Markova, G., Houdek, L., & Kocabova, Z. (2021). To the operating room! The positive effects of medical clown intervention on children undergoing surgery. Frontiers in Public Health, 9, 653884. https://doi.org/10.3389/fpubh.2021.653884

Mastal, M. F. (2010). Ambulatory care nursing: Growth as a professional specialty. Nursing Economics, 28(4), 267–275.

Mortamet, G., Roumeliotis, N., Vinit, F., Simonds, C., Dupic, L., & Hubert, P. (2017). Is there a role for clowns in paediatric intensive care units? Archives of Disease in Childhood, 102(7), 672–675. https://doi.org/10.1136/archdischild-2016-311583

Soyer, T., & Yalçın, M. (2022). Çocuklarda apandisit yönetimi. Journal of Pediatric Surgery - Türkiye, 8(1), 11–19.

Sridharan, K., & Sivaramakrishnan, G. (2017). Therapeutic clowns in pediatrics: A systematic review and meta-analysis of randomized controlled trials. European Journal of Pediatrics, 176(2), 289. https://doi.org/10.1007/s00431-016-2764-0

Ucun, Y., & Küçük, L. (2020). Terapötik palyaço müdahalesinin çocukların ruh sağlığına etkisi: Sistematik derleme. Jaren, 6(2), 179–186. https://doi.org/10.5222/jaren.2020.93584

Wang, L., Zhu, J., & Chen, T. (2024). Clown care in the clinical nursing of children: A meta-analysis and systematic review. Frontiers in Pediatrics, 12, 1324283. https://doi.org/10.3389/fped.2024.1324283

Wu, W. W., Lu, F. L., Shiu, C. S., Tang, C. C., Jou, S. T., Chen, J. S., & Liu, Y. L. (2022). The effectiveness of a medical clowning program on improving emotional status among hospitalized children undergoing cancer treatment: A quasi‐experimental study. Journal of Nursing Scholarship, 54(2), 161–168. https://doi.org/10.1111/jnu.12720

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13 Şubat 2026

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