Computer-generated virtual reality to control pain and anxiety in pediatric and adult burn patients during wound dressing changes

Changing daily wound dressings provokes a substantial amount of pain in patients with severe burn wounds. Pharmacological analgesics alone often are inadequate to solve this problem. This study explored whether immersive virtual reality (VR) can reduce the procedural pain and anxiety during an entir...

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Bibliographic Details
Published in:Journal of burn care & research 2007-09, Vol.28 (5), p.694-702
Main Authors: VAN TWILLERT, Björn, BREMER, Marco, FABER, Albertus W
Format: Article
Language:English
Subjects:
Adaptation, Psychological
Adolescent
Adult
Age Factors
Aged
Anxiety - prevention & control
Anxiety - psychology
Attention
Bandages
Biological and medical sciences
Burns
Burns - physiopathology
Burns - psychology
Burns - therapy
Child
Cognition
Dermatology
Female
General aspects
Humans
Male
Medical sciences
Middle Aged
Pain - prevention & control
Pain - psychology
Pain Measurement
Perception
Psychological Tests
Psychometrics
Time Factors
Traumas. Diseases due to physical agents
User-Computer Interface
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Summary:Changing daily wound dressings provokes a substantial amount of pain in patients with severe burn wounds. Pharmacological analgesics alone often are inadequate to solve this problem. This study explored whether immersive virtual reality (VR) can reduce the procedural pain and anxiety during an entire wound care session and compared VR to the effects of standard care and other distraction methods. Nineteen inpatients ages 8 to 65 years (mean, 30 years) with a mean TBSA of 7.1% (range, 0.5-21.5%) were studied using a within-subject design. Within 1 week of admission, standard care (no distraction), VR, or another self-chosen distraction method was administered during the wound dressing change. Each patient received the normal analgesic regimen. Pain was measured with visual analog thermometer scores, and anxiety was measured with the state-version of the Spielberger State Trait Anxiety Inventory. After comparing different distraction methods, only VR and television showed significant pain reductions during wound dressing changes. The effects of VR were superior, but not statistical significant, to that of television. Thirteen of 19 patients reported clinically meaningful (33% or greater) reductions in pain during VR distraction. No side effects were reported. No correlations were found between the reduction in pain ratings and patient variables like age, sex, duration of hospital stay, or percentage of (deep) burns. There was no significant reduction of anxiety ratings.
ISSN:1559-047X
1559-0488
DOI:10.1097/BCR.0B013E318148C96F