Comparison of Virtual Reality and Passive Distraction on Burn Wound Care Pain in Adolescents

Comparison of Virtual Reality and Passive Distraction on Burn Wound Care

Relief of severe burn wound care pain may require both medications to relieve pain and non-medication interventions,such as distraction. Little is known about distraction's effectiveness. Virtual reality may be an effective distraction. The aims of this study are 1)to evaluate the effect of virtual reality (VR), a newer interactive kind of distraction, compared to passive distraction (PD) by watching a movie, and usual care (SC) that is provided by the nurses, on pain experienced by adolescents during burn wound care and 2)to determine the relationship among anxiety, desire for distraction, and engagement with distraction on the pain.

Study Overview

• Status: Terminated
• Conditions: Pain; Burns; Wound Care
• Intervention / Treatment: Device: Virtual Reality; Other: Passive Distraction

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Arkansas
    • Little Rock, Arkansas, United States, 72202
      • Arkansas Children's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 10 years to 17 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• undergoing burn wound care in the Arkansas Children's Hospital (ACH) outpatient burn clinic;
• first time visit to the ACH outpatient burn clinic or first clinic visit without conscious sedation;
• adolescents ages 10 to 17 years;
• English speaking;
• absence of a history of motion sickness (motion sickness has been reported in some VR users);
• absence of a seizure disorder (because prolonged immersion in VR may lead to seizures and vertigo in individuals with seizure disorders, these individuals will be excluded from the study);
• absence of a cognitive developmental disability determined on prescreening by presence of a Section 504 accommodation plan or Title VIII individualized educational plan (IEP) in school. If the parent identifies the nature of the IEP or 504 plan as unrelated to a cognitive delay, then the child or adolescent will be included in the study.

Exclusion Criteria:

• Burns that would interfere with study procedures
• Incarcerated minors
• Children in foster care

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Virtual Reality; Virtual reality using a software program designed for burn patients during burn wound care	Device: Virtual Reality
Active Comparator: Passive distraction; watching a movie	Other: Passive Distraction
No Intervention: UC provided by the nurses

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-reported Wound Care Procedure Pain Score	The acute pain experienced during the burn wound care procedure was measured on a 100mm visual analog scale called the Adolescent Pediatric Pain Tool through self-report by adolescents ages 10-17 years receiving outpatient burn wound care. The scale ranges from 0mm (No Pain) to 100mm (Worst Pain).	Within the first 20 minutes following completion of the burn wound care procedure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Desire for Distraction	Participants were asked "I wanted to be distracted from during my treatment today." (Agree-Disagree) from the Post-Procedure Questionnaire	Post-procedure (approximately 30-75 minutes)
Engagement With Distraction and Belief in Distraction's Efficacy	For Engagement with Distraction,VR and PD participants were asked on the Post-testing Questionnaire: "Were you able to pay attention to the DVD or to the VR during your burn treatment?" (1=could not pay attention at all; 5=totally absorbed at all times) For Belief in Distraction's Efficacy, VR and PD participants were asked on the Post-Procedure Questionnaire: "I believe that the distraction lessened my pain during my burn treatment today." (on a scale of 1=Distraction did not help to lessen my pain at all; 5=Distraction completely helped to lessen my pain at all times)	Post-procedure (approximately 30-75 minutes)

Collaborators and Investigators

• Sponsor: University of Arkansas
• Collaborators: Arkansas Children's Hospital Research Institute; Arkansas Biosciences Institute; Arkansas Children's Hospital Burn Center
• Investigators: Principal Investigator: Debra A Jeffs, PhD, RN, Arkansas Children's Hospital Research Institute

Publications and helpful links

General Publications

• Askay SW, Patterson DR. What are the psychiatric sequelae of burn pain? Curr Pain Headache Rep. 2008;12(2):94-97. Das DA, Grimmer KA, Sparnon AL, et al. The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: a randomized controlled trial. BMC Pediatr. 2005;5(1):1471-2431. Patterson DR, Weichman SA, Jensen MP, et al. Hypnosis delivered through immersive virtual reality for burn pain: a clinical case series. Int J Clin Exp Hypn. 2006;54(2):130-142. Hoffman HG, Chambers GT, Meyer WJ, et al. Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Ann. Behav. Med. 2011;41(2):183-191. doi: 10.1007/s12160-010-9248-7. Smith JS, Smith KR, Rainey SL. The psychology of burn care. J Trauma Nurs. 2006;13(3):105-106.

Study record dates

Study Major Dates

• Study Start: June 1, 2010
• Primary Completion (Actual): April 1, 2012
• Study Completion (Actual): April 1, 2012

Study Registration Dates

• First Submitted: March 13, 2013
• First Submitted That Met QC Criteria: March 15, 2013
• First Posted (Estimate): March 18, 2013

Study Record Updates

• Last Update Posted (Estimate): August 6, 2013
• Last Update Submitted That Met QC Criteria: August 5, 2013
• Last Verified: August 1, 2013

More Information

Terms related to this study

• Keywords: pain; children; anxiety; adolescents; virtual reality; distraction; burn
• Additional Relevant MeSH Terms: Burns; Wounds and Injuries
• Other Study ID Numbers: 109422