Abstract:

Objective To establish an application plan for clown care in the elderly in elderly institutions and explore its effects. Methods A clown care team was established,and the localized and personalized individual intervention and group intervention programs were determined through theoretical research,pre-experiment and qualitative research methods. 34 older adults in the nursing home received the clown care program for 1.5-2 hours twice a week by flexibly using of humor,improvisation,songs and games,etc. The Geriatric Depression Scale（GDS）,UCLA Loneliness Scale（ULS-6）,Positive and Negative Emotion Scale（PANAS） and semi-structured interviews with the elderly were used to evaluate the effect of the programe. Results After the intervention,the negative emotion,loneliness and depression scores of the elderly in the nursing home decreased,and the positive emotion scores increased significantly. The difference was significant（P<0.05）. Older people think that clown care can meet their social,respect and self-realization needs to a certain extent,but it needs more team members and further enrich- ment of the content. Conclusion Clown care can improve the depression status of elderly people in nursing homes,maintain positive emotions,suppress negative emotions and alleviate their loneliness.

Key words: Clown Care, Nursing Home, Aged, Depression, Loneliness, Mood, Geriatric Nursing

摘要：

目的 建立小丑照护在养老院老年人中的应用方案,并探讨其应用效果。方法 组建小丑照护团队,通过理论研究、预试验和质性研究的方法确定本土化、个性化的个体干预和团体干预方案,灵活运用幽默、即兴表演、歌曲、游戏等技巧和方法,2019年4月—12月对34名养老院老年人实施每周2次,每次1.5~2 h的小丑照护方案。采用老年抑郁量表、UCLA孤独量表中文简化版、正性负性情绪量表和对老年人的半结构式访谈评价干预效果。结果 干预后养老院老年人的负性情绪、孤独感、抑郁评分降低,正性情绪评分提高,差异有统计学意义（P<0.05）。老年人认为小丑照护可一定程度上满足其社交、被尊重和自我实现的需求。结论 小丑照护可改善养老院老年人的抑郁情绪,有利于其维持正性情绪、抑制负性情绪,缓解其孤独感。

关键词: 小丑照护, 养老院, 老年人, 抑郁, 孤独, 情绪, 老年护理学