In the present study we examined the positive effects of a healthcare clown intervention on children undergoing surgeries, and the role parent-child relationships may play in their effectiveness. Children between 5 and 12 years, who were scheduled to undergo elective surgical procedures in a large university hospital, were randomly assigned to an intervention group (IG; n = 35) that was visited by a healthcare clown, and a control group (CG; n = 27) that received treatment as usual (i.e., company of parents before the surgery). Children in both groups were videotaped and the videos were later used to rate their activity, arousal, emotional expressivity, and vocalizations. Additionally, children and parents rated their mood and perceived quality of life at several points during the procedure, and parents reported their perceptions of the relationship with their children. Results showed that children in the IG showed more positive emotions and vocalizations than children in the CG. Parents of children in the IG also reported more positive mood than parents of children in the CG. In contrast, children in the CG reported higher quality of life than children in the IG. Importantly, analyses showed considerable effects of the parent-child relationship on all outcome measures. Results of the present study demonstrate that a healthcare clown intervention had some positive effects on behaviors and mood of hospitalized children and their parents. Importantly, our findings also suggest that we need to consider the pre-existing “relationship microcosmos” that the clowns enter when assessing their effectiveness in the hospital.

3 Klinika dětské hematologie a onkologie, 2. LF UK a Fakultní nemocnice Motol, Praha Psychologická a psychoterapeutická péče je nedílnou součástí multidisciplinární péče paliativního týmu. U dětí se závažnou diagnózou a nepříznivou prognózou, jako je HR neuroblastom, představuje klíčovou formu podporu nemocnému dítěti a jeho rodině. Její snahou je podpora adaptace rodiny na novou těžkou situaci a v rámci celého procesu protinádorové léčby. Forma psychologické péče a frekvence psychologických intervencí jsou dány potřebami rodiny a dále jsou ovlivněny fází a průběhem léčby, stejně jako individuálními charakteristikami dítěte i celé rodiny. V článku popisujeme poradenskou a psychoterapeutickou péči poskytovanou psychologem v rámci dětského paliativního týmu FN Motol nemocnému dítěti a jeho rodičům, případně také sourozencům nemocných dětí, v jednotlivých fázích léčby.Klíčová slova: psychologická podpora, paliativní péče, dětský pacient, rodina. Role of a palliative care team psychologist in children with HR neuroblastomaPsychological and psychotherapeutic care represents an integral part of multidisciplinary approach provided by palliative care team. In children with severe diagnosis and unfavourable prognosis such as HR neuroblastoma, psychological care plays a crucial role in providing support to the sick child and his family with the intention to help them in adaptation in the new challenging situation and in the process of anticancer treatment. The type of psychological care and frequency of psychological interventions are determined by family needs, treatment phase and individual characteristics of the patient. The article presents the role of psychologist in pediatric palliative care team in University Hospital Motol in Prague provided towards the patient, his parents and siblings in specific phases of the anticancer treatment.