Impact of orally administered tramadol combined with self-selected music on adult outpatients with burns undergoing dressing change: A randomized controlled trial

Influence of burn specific pain anxiety on pain experienced during wound care in adult outpatients with burns

Burn pain is known as the most difficult type of pain to manage. In order to improve patient outcomes, nurses must be aware of burn pain and the conditions that affect it. This study aimed to evaluate the influence of burn-specific pain anxiety on pain experienced by adult outpatients with burns during burn wound care. This was a single-center, prospective, and descriptive study. The study was conducted with 60 adult outpatients with burns between March 2021 and April 2021 in a burn centers' outpatient service in Ankara. Personal information form, burn-specific pain anxiety scale, numerical rating scale, and verbal category scale were used for data collection. The mean age of the patients was 38.50 ± 14.27 years, and 53.33% patients were females. The primary cause of burns was home accidents (80%), and patients generally suffered from scalding-type burns (73.33%). This study demonstrated that the patients reported high pain anxiety associated with burns (59.85 ± 15.71), the mean pain score experienced during wound care was 6.33 ± 2.14 and the pain was primarily classified as disturbing (35%) based on the verbal category scale. In this study, it was found that burn-specific pain anxiety affects the pain experienced during burn wound care in adults receiving outpatient treatment. Hence, nurses should provide effective pain management to patients with burn injuries. In addition, the inclusion of anxiety-reducing practices in the care plans of such patients is recommended, and further studies are needed to identify and meet the care needs of patients with severe burns.

Optimal timing and effect of music therapy in patients with burn injuries: Systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Burn injuries may have both physiological and psychological consequences. Numerous studies have reported the use of music therapy during burn injury treatment, but the optimal timing for music therapy remains unclear. Therefore, we performed a systematic review and meta-analysis of randomized controlled trials on patients with burn injuries to analyze the effects of music intervention on them at different timings: background (T0) and time before (T1), during (T2), and after (T3) change dressing (CD).

METHOD

The PubMed and EMBASE databases were searched for articles published before Novenber 2020 based on predetermined criteria. Our search focused on two keywords: music and burn. Reviewers extracted data from all eligible studies independently. The I² statistic was used to determine statistical heterogeneity. The endpoints included standardized mean differences (SMDs) and 95% confidence intervals (CIs). Relevant Forest plots were also created.

RESULT

This study finally included seven trials recruiting a total of 524 patients. The results indicated that compared with non-music intervention, music intervention significantly reduced anxiety at T0 (SMD = -1.32, 95% CI [-2.61, -0.02], T1 (SMD = -2.15, 95% CI [-4.30, -0.00]) and T2 (SMD = -0.39, 95% CI [-0.74, -0.04]). Moreover, they also significantly reduced the pain levels at T0 (SMD = -1.59, 95% CI [-2.00, -1.17]) and T2 (SMD = -0.47, 95% CI [-0.82, -0.12]), improved the mental condition, and reduced the amount of opioid analgesics used at T0.

CONCLUSION

Music therapy seems to have some effects at T0 and T1 in patients with burn injuries. Music therapy was more effective in improving psychological outcomes than physiological outcomes. However, additional high-quality studies related to music therapy for patients with burn injuries are warranted.

Music therapy and music medicine interventions with adult burn patients: A systematic review and meta-analysis

BACKGROUND

Pain is one of the most common and most difficult symptoms to manage in adult burn patients in the Intensive Care Unit (ICU). Insufficient or unsuccessful pain management can negatively affect physiological, psychological, and social health in burn patients, both during and after hospitalization. Music therapy and music medicine interventions have been shown to positively affect pain and mental health in this population. This systematic review and meta-analysis provide an update of Randomized Controlled Trials (RCTs) using music therapy or music medicine interventions in adult burn patients.

METHODS

A variety of databases were searched from their beginning to June 2020, including PsycINFO and PsycArticles (via APAsycNET), PubMed and MEDLINE (via OvidSP), Scopus, Web of Science, and the Cochrane Library. Data of all articles meeting the inclusion criteria were extracted, organized, and processed according to the PRISMA guidelines. Statistical analysis was performed using Q-test and I2 statistics.

RESULTS

10 RCTs with a total of 1061 participants were included. The results of the meta-analysis showed a statistically significant reduction of pain (I² = 96.03%, P < 0.001), anxiety (I² = 98.85%, P < 0.002), and improved relaxation (I² = 87.19%, P < 0.001) favoring music interventions compared to control groups.

CONCLUSIONS

This review provides preliminary evidence for the effectiveness of music interventions for adult burn patients. However, more high-quality RCTs are needed to safely establish guidelines for music therapists and other health care professionals in using music for health purposes with this population.

The effect of reflexology massage and passive music therapy intervention before burn dressing on pain, anxiety level and sleep quality

BACKGROUND

The pain, anxiety, and sleep disorders that burn patients experience due to burn dressing negatively affect their treatment process. The aim of this study was to determine the effect of reflexology massage and passive music therapy intervention before burn dressing on pain, anxiety level and sleep quality.

METHODS

This study was a randomized controlled trial. The study sample consisted of 36 patients who were hospitalized in the Burn Center of a University Hospital. After obtaining written consent, patients were enrolled to study according to inclusion criteria and then, divided into Reflexology Massage (n = 12), Reflexology Massage with Passive Music Therapy (n = 12) and Control (n = 12) groups using simple random allocation. In the experimental groups, in addition to standard care, interventions were performed for consecutive three days. Interventions were done before dressing for 40 min in the patient's room. The control group received only standard care during this time. Severity of pain in three groups was measured using "Visual Analog Scale" twice a day (before dressing change and 2 h after dressing change). Severity of state anxiety and sleep quality in three groups was measured using "State Anxiety Scale" and "Richards-Campbell Sleep Questionnaire" once a day (before dressing change). Severity of trait anxiety in three groups was measured using "Trait Anxiety Scale" for two times (before and after study). The drugs used by the patients for 3 days were recorded in the "Opioid and Analgesic Drug Form." Data were analyzed using Pearson Chi-square, Independent Samples T-test, One-Way ANOVA, Bonferroni, Paired Sample T-Test, Repeated Measures ANOVA tests were used.

RESULTS

The results showed no significant difference in severity of pain, anxiety, and sleep quality (p > 0,05) between the three groups on the first day. However, the mean pain scores showed a significant difference between the experimental and control groups in the third (p < 0,05) and fourth (p < 0001) days after intervention. Anxiety scores also showed a significant difference between the experimental and control groups on the fourth (p < 0001) day. Sleep quality of the experimental groups was higher than the control group on the fourth day (p < 00001). No significant difference using of opioid and analgesic drugs between the three groups (p > 0,05).

CONCLUSIONS

Our results showed reflexology massage and passive music therapy before burn dressing reduced pain and anxiety level, and increased sleep quality.