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Kılıç Ü, Tural Büyük E. The Effect of Using Virtual Reality During Burn Dressing on Pain, Anxiety and Fear Felt in Children: A Randomized Controlled Trial. J Burn Care Res 2024; 45:949-957. [PMID: 38224569 DOI: 10.1093/jbcr/irae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Indexed: 01/17/2024]
Abstract
This study was conducted to determine the effect of using virtual reality (VR) during burn dressing on the level of fear, anxiety, and pain that children would experience. This randomized controlled trial was conducted in a pretest-posttest design. Randomization of the participants (n = 65) was performed with the block randomization method. Then, 33 children were included in the intervention and 32 children in the control group with simple sequential randomization. The study data were collected using the "Family and Child Personal Information Form," "Physiological Parameters Registration Form," "Wong-Baker Faces Pain Scale," "Children's Fear Scale," and "Children's Anxiety Meter-State." The chi-square test, t-test, Shapiro-Wilk, mean, and percentile distributions were used for the data analysis. After dressing, the physiological parameters of the children who used VR were found to be within normal limits (HR: 108.48 ± 12.43, O2: 98.39 ± 1.14) compared to the children who did not use (HR: 117.38 ± 15.25, O2: 97.81 ± 1.35) (P < .05). After the dressing, children using VR (0.85 ± 1.23) were determined to have less fear than those who did not use them (3.03 ± 1.06), and similarly, children who used VR (2.64 ± 2.73) experienced less anxiety than those who did not use them (5.84 ± 2.26). When the pain levels were evaluated, the VR group (1.79 ± 2.04) was reported to feel less pain compared to the control group (5.50 ± 2.36). The VR used by children aged 5-10 years during burn dressing has been found to affect their physiological parameters and is effective in reducing fear, anxiety, and pain levels.
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Affiliation(s)
- Ümmühan Kılıç
- R&D and Projects Specialist, Samsun Provincial Health Directorate, Ilkadim, 55060 Samsun, Turkey
| | - Esra Tural Büyük
- Department of Child Health Nursing, Faculty of Health Sciences, Ondokuz Mayıs University, Atakum, 55200 Samsun, Turkey
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Ma Y, Li Y, Wang C, Zhang Y, Wang L, Hu R, Yin Y, He F. Effects of non-pharmacological interventions on pain in wound patients during dressing change: A systematic review. Nurs Open 2024; 11:e2107. [PMID: 38391098 PMCID: PMC10830920 DOI: 10.1002/nop2.2107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/12/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Changes to the wound dressing frequently cause pain. Some adverse side effects of pharmacologic pain management may cause problems or even impede wound healing. There is no systematic study of non-pharmacologic therapies for pain during wound dressing changes, despite the gradual promotion of non-pharmacologic pain reduction methods. OBJECTIVES To give clinical wound pain management a new direction, locating and assessing non-pharmacological interventions regarding pain brought on by wound dressing changes are necessary. METHOD The researchers conducted a comprehensive literature review on non-pharmacological interventions for pain during wound dressing changes across five databases: PubMed, Web of Science, Medline, Embase, and the Cochrane Library spanning the period from January 2010 to September 2022. The evaluation of literature and data extraction was carried out independently by two researchers, and in cases of disagreement, a third researcher participated in the deliberation. To assess the risk of bias in the literature, the researchers utilised the Cochrane Handbook for Reviews of Interventions, version 5.1.0. RESULTS In total, 951 people were involved in 11 investigations covering seven non-pharmacological therapies. For pain triggered by dressing changes, virtual reality (VR) distraction, auditory and visual distractions, foot reflexology, religious and spiritual care, and guided imaging demonstrated partially positive effects, with hypnosis therapy and jaw relaxation perhaps having a weak effect. CONCLUSION The key to managing wounds is pain management. According to our review, there is some indication that non-pharmacologic interventions can help patients feel less discomfort when having their wound dressings changed. However, the evidence supporting this view is weak. It needs to be corroborated by future research studies with multicentre and large samples. To promote and use various non-pharmacologic interventions in the future, it is also necessary to build standardised and homogenised paths for their implementation.
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Affiliation(s)
- Yanfei Ma
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Yeping Li
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Chunyan Wang
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Yaqing Zhang
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Lihui Wang
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Rong Hu
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Yang Yin
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
| | - Fang He
- Mianyang Central Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaMianyangSichuanP.R. China
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Farzan R, Parvizi A, Haddadi S, Sadeh Tabarian M, Jamshidbeigi A, Samidoust P, Ghorbani Vajargah P, Mollaei A, Takasi P, Karkhah S, Firooz M, Hosseini SJ. Effects of non-pharmacological interventions on pain intensity of children with burns: A systematic review and meta-analysis. Int Wound J 2023; 20:2898-2913. [PMID: 36859758 PMCID: PMC10410361 DOI: 10.1111/iwj.14134] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 03/03/2023] Open
Abstract
Pain is one of the complications associated with burns, which can lead to anxiety and sleeplessness in children. Various studies evaluated the effects of non-pharmacological interventions on burn wound care. The present study was conducted to determine the effects of non-pharmacological interventions on pain intensity of children with burns. A comprehensive systematic search was conducted in various international electronic databases, such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as 'Non-pharmacological', 'Virtual reality', 'Pain', 'Burn', 'Wound' and 'Child' from the earliest to December 1, 2022. The risk of bias in the final articles was also assessed with the Version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2). Finally, a total of 1005 burn patients were included in 19 studies. The age range of the patients was from 0.5 to 19 years. Of the participants, 50.05% were in the intervention group. All studies had a randomised clinical trial design. The results found that non-pharmacological interventions significantly reduced pain intensity in children (ES: -0.73, 95% CI: -1.08 to -0.38, Z = 4.09, I2 :79.8, P < .001). Virtual reality (VR) (ES: -0.54, 95% CI: -1.19 to -0.18, Z = 2.90, I2 :72.9%, P = .004) and non-VR (ES: -0.86, 95% CI: -1.45 to -0.27, Z = 2.86, I2 :91.4%, P = .04) interventions decreased pain intensity significantly in children based sub-group analysis. Non-pharmacological interventions significantly reduced the pain intensity of dressing removal (ES: -0.77, 95% CI: -1.34 to -0.20, Z = 66.3, I2 :91.8%, P = .008), dressing application (ES: -0.53, 95% CI: -0.97 to -0.09, Z = 2.37, I2 :60.8%, P = .02), and physical therapy (ES: -1.18, 95% CI: -2.10 to -0.26, Z = 2.51, I2 :88.0%, P = .01). Also, interventions reduced the pain of burn wound care (ES: -0.29, 95% CI: -1.01 to 0.44, Z = 0.78, I2 :72.6%, P = .43), but it was statistically insignificant. In sum, the result of the present study indicated that using non-pharmacological interventions significantly reduced pain intensity in children. The reduction of pain intensity was greater in non-VR than in VR interventions. Future studies should focus on comparing VR interventions with non-VR and single versus multi-modal distraction to clarify the effectiveness of each.
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Affiliation(s)
- Ramyar Farzan
- Department of Plastic & Reconstructive SurgerySchool of Medicine, Guilan University of Medical SciencesRashtIran
| | - Arman Parvizi
- Anesthesiology Research Center, Department of AnesthesiologyAlzahra Hospital, Guilan University of Medical SciencesRashtIran
| | - Soudabeh Haddadi
- Anesthesiology Research Center, Department of AnesthesiologyAlzahra Hospital, Guilan University of Medical SciencesRashtIran
| | - Mansooreh Sadeh Tabarian
- Department of Medical‐Surgical NursingNorth Khorasan University of Medical SciencesNorth KhorasanIran
| | - Amirreza Jamshidbeigi
- Student Research Committee, Faculty of Nursing and MidwiferyMashhad University of Medical SciencesMashhadIran
| | - Pirouz Samidoust
- Razi Clinical Research Development UnitRazi Hospital, Guilan University of Medical SciencesRashtIran
| | - Pooyan Ghorbani Vajargah
- Department of Medical‐Surgical NursingSchool of Nursing and Midwifery, Guilan University of Medical SciencesRashtIran
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Amirabbas Mollaei
- Department of Medical‐Surgical NursingSchool of Nursing and Midwifery, Guilan University of Medical SciencesRashtIran
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Poorya Takasi
- Department of Medical‐Surgical NursingSchool of Nursing and Midwifery, Guilan University of Medical SciencesRashtIran
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Samad Karkhah
- Department of Medical‐Surgical NursingSchool of Nursing and Midwifery, Guilan University of Medical SciencesRashtIran
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Mahbobeh Firooz
- Department of NursingEsfarayen Faculty of Medical SciencesEsfarayenIran
- School of Nursing and MidwiferyGolestan University of Medical SciencesGorganIran
| | - Seyed Javad Hosseini
- Department of NursingEsfarayen Faculty of Medical SciencesEsfarayenIran
- Department of Pediatric NursingSchool of Nursing and Midwifery, Mashhad University of Medical SciencesMashhadIran
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Ugucu G, Akdeniz Uysal D, Guzel Polat O, Artuvan Z, Polat Kulcu D, Aksu D, Gulgun Altintas M, Cetin H, Orekici Temel G. Effects of cartoon watching and bubble-blowing during venipuncture on pain, fear, and anxiety in children aged 6-8 years: A randomized experimental study. J Pediatr Nurs 2022; 65:e107-e114. [PMID: 35410736 DOI: 10.1016/j.pedn.2022.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/27/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to compare the effects of bubble-blowing (active distraction) and cartoon watching (passive distraction) techniques on pain, anxiety, and fear during venipuncture in children aged 6-8 years. DESIGN AND METHODS This experimental study randomly assigned 56 children aged 6-8 years to cartoon watching or bubble-blowing groups. The child, parent, and researcher assessed pain using the Wong-Baker FACES Pain Rating Scale, anxiety using the Children's State Anxiety Scale, and fear using the Children's Fear Scale. The study data were analyzed using the Chi-square tests and independent Sample t-tests. RESULTS The groups were similar in clinical and demographic characteristics. The scores on pain, anxiety, and fear during the procedure were lower in the cartoon watching group than in the bubble-blowing group (pain t(47) = 2.638, p = .013; anxiety t(47) = 2.358, p = .023; and fear t(47) = 2.784, p = .008). CONCLUSION This study revealed that cartoon watching as a passive distraction method was more effective in reducing pain, anxiety, and fear during venipuncture in children aged 6-8 years compared to bubble-blowing as an active distraction method. PRACTICE IMPLICATIONS The cartoon watching technique, which is affordable, easy to access, and effective (in reducing pain, anxiety, and fear), can be safely used during venipuncture in children aged 6-8 years.
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Affiliation(s)
- Guzide Ugucu
- Department of Pediatric Nursing, Faculty of Nursing, Mersin University, 33343 Mersin, Turkey.
| | | | | | | | - Didem Polat Kulcu
- Department of Nursing, Faculty of Health Sciences, Toros University, 33140 Mersin, Turkey.
| | - Done Aksu
- Mersin University Hospital, 33343 Mersin, Turkey
| | | | - Hacer Cetin
- Department of Pediatric Nursing, Faculty of Nursing, Mersin University, 33343 Mersin, Turkey.
| | - Gulhan Orekici Temel
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Mersin University, 33343 Mersin, Turkey
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Moradipoor Y, Rejeh N, Heravi Karimooi M, Tadrisi SD, Dahmardehei M, Bahrami T, Vaismoradi M. Comparing Auditory and Visual Distractions for Reducing Pain Severity and Pain Anxiety in Older Outpatients with Burn: A Randomized Controlled Trial. Geriatrics (Basel) 2022; 7:54. [PMID: 35645277 PMCID: PMC9149902 DOI: 10.3390/geriatrics7030054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/22/2022] [Accepted: 04/27/2022] [Indexed: 02/06/2023] Open
Abstract
Pain and anxiety are major issues among older patients with burn injuries. Complementary medicine and non-pharmacological methods can relieve pain and anxiety in older people, but comparison of the effects of these methods needs further research. This study aimed to compare the effects of auditory and visual distractions on pain severity and pain anxiety in older outpatients referred to a burn clinic for dressing change. In this randomized controlled clinical trial, older men were randomly assigned to three groups as auditory distraction, visual distraction, and control (n = 45 in each group). The Visual Analogue Scale (VAS) and the Burn Specific Pain Anxiety Scale (BSPAS) were used to asses pain severity and pain anxiety before and immediately after the interventions, and after wound dressing. Reduction in pain severity and pain anxiety after visual distraction was reported. Auditory distraction only reduced pain anxiety. Therefore, visual distraction had a better effect on alleviating pain anxiety compared with auditory distraction. Visual distraction is suggested to be used during dressing changes for older outpatients with burn injuries in outpatient clinics in order to reduce their burn-related suffering and improve their collaboration with the therapeutic regimen.
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Affiliation(s)
- Yaghob Moradipoor
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Nahid Rejeh
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Majideh Heravi Karimooi
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Seyed Davood Tadrisi
- Trauma Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran;
| | - Mostafa Dahmardehei
- Burn Research Center, Iran University of Medical Sciences, Tehran 1449614535, Iran;
| | - Tahereh Bahrami
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway;
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Bekar P, Erkul M, Efe E. The effect of using a kaleidoscope during central venous catheter dressing changes on pain and anxiety in children with cancer: A randomised controlled trial. Eur J Oncol Nurs 2022; 57:102114. [DOI: 10.1016/j.ejon.2022.102114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 02/08/2022] [Accepted: 02/16/2022] [Indexed: 11/27/2022]
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