The Effect of Virtual Reality on Pain, Anxiety, and Fear During Burn Dressing in Children
Condition: Fear and Anxiety
MeSH terms: Anxiety Disorders
Study type: Interventional

Summary: 
      This research was conducted to determine the effect of VR on the pain, anxiety, and fear
      levels experienced by patients during burn dressing. The experimental (VR group) (n=33) and
      the control group (n=32) were determined using the simple randomization method for the
      children participating in the study (n=65).
    

Detailed description: 
      Burn injuries are considered one of the most severe physical and psychosocial traumas a
      person can face. Burn injuries, especially in the childhood, are an important health problem
      that causes long-term psychological and physiological consequences and includes
      rehabilitation processes that continue for years.

      During burn treatment, wound debridement, daily dressing change, repair surgeries, and
      applications during hospitalization cause serious pain, physical stress, and psychological
      damage to the patient in burn injuries, as in all injuries. Anxiety, loss of control,
      hopelessness, disruption of body integrity, and pain during burns and procedures during the
      treatment process are early traumatic features of the burn.

      Since pain is not only a sensory experience but also an emotional and cognitive experience,
      using pharmacological treatment methods alone may not be sufficient. Using nonpharmacological
      methods in addition to pharmacological methods is recommended in order to control the pain
      that occurs during wound care and reduce the dose of analgesic administered. The distraction
      technique is one of the most frequently preferred nonpharmacological methods to reduce pain
      perception during dressing and control fear and anxiety in children hospitalized in the
      clinic due to burns. It is a method included in the Nursing Interventions Classification
      taxonomy.

      When the literature was examined, it was observed that there are a limited number of studies
      examining the effect of VR on pain and anxiety in children during burn dressing. However,
      there was no study evaluating the fear experienced during burn dressing in children. This
      study aimed to propagate the use of VR, which is a potentially important technology for
      nursing care and multidisciplinary healthcare team and has an important place in the
      treatment of burn patients by reducing the level of pain and anxiety experienced by patients.
      It is thought that the result of the research will shed light on how to reduce pain, fear,
      and anxiety experienced during dressing and contribute to the literature as an evidence-based
      nonpharmacological method.

      The research is a randomized controlled experimental study conducted between April 2019 and
      September 2020. The experimental (VR group) (n=33) and the control group (n=32) were
      determined using the simple randomization method for the children participating in the study
      (n=65). The data were collected using the Descriptive Information Form, Wong-Baker FACES Pain
      Rating Scale, Children's Fear Scale, and State-Trait Anxiety Inventory for Children. In
      addition, oxygen saturation and heart rate measurements were recorded before and after the
      procedure.
    

Intervention name(s): wearing virtual reality headsets
Intervention type(s): Device
Intervention description(s): When the patient adapted to the headset and started to play games, he was taken to the dressing room with the VR headset and the application continued until the process was completed. Before starting the study, a pilot study was conducted to determine the time to wear headsets in ten children. It was observed that the children who were taken to the dressing room without wearing VR headsets refused to wear it. In order to prevent the child from experiencing anxiety in the dressing room, the child was put on VR headset in the patient room and then taken to the dressing room. After the procedure was completed, the VR headset was removed and the patient's oxygen saturation and heart rate were recorded on the "Application Registration Form." The patients were asked regarding the pain and anxiety levels felt during dressing before and after the procedure and marked on the Wong Baker Scale, State-Trait Anxiety Inventory for Children and Children's Fear Scale.
Allocation: Randomized
Intervention model: Single Group Assignment
Intervention model description: parallel assigment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: anxiety; burn dressing; child; fear; pain; virtual reality