Observational Prospective Study Measuring the Impact of the Use of a Hypnotic Script Associated With Virtual Reality on the Pain of the Child's Sickle Cell During a Vaso-occlusive Crisis

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the effect of Virtual Reality induced Hypnosis on patients' pain scores, anxiety and the use of analgesics during a vaso-occlusive crisis

Detailed Description
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Virtual reality hypnosis could probably reduce vaso-occlusive crisis-related (vaso-occlusive crisis) anxiety and pain and provide the patient with means of optimizing the ability to cope with the painful and anxiety-provoking situations encountered in general pediatric unit. However, this non-pharmacological analgesic technique is little used in the context of vaso-occlusive crisis in children and adolescents in French pediatric services. Currently, the average pain scores of children and adolescents hospitalized for vaso-occlusive crisis after treatment in the emergency department is 6 out of 10 on a simple numerical scale (according to a preliminary study conducted on 30 files of sickle cell disease patients over 6 years of age hospitalized in general pediatrics, Trousseau AP-HP hospital over a period of 6 months in 2018), despite the implementation of optimal pharmacological means with regard to the HAS analgesia recommendations. The pain score stays high despite a well-conducted analgesic treatment. Our hypothesis is that virtual reality hypnosis could potentiate the effects of virtual reality by hypnotic suggestions specific to the pain of patients with vaso-occlusive crisis . This is a pain and anxiety reduction strategy that has, to our knowledge, never been evaluated. So this is innovative by the method but also of the pediatric target population suffering from recurrent and severe pain. A session of hypnoanalgesia suggestions associated with a virtual reality program will allow the patient to acquire the necessary competence to manage with his or her pain and thus be more autonomous in its management. The physiopathological hypothesis of the research is that the immersion of the patient with vaso-occlusive crises related pain during a hypnotic experience induced by virtual reality allows to saturate his sensoriality, thus reducing nociceptive perceptions and vaso-occlusive crisis -related anxiety. We hypothesize that this experiment is feasible and that it can produce decrease in pain and anxiety scores for children benefiting from a virtual reality hypnosis session during vaso-occlusive crisis within one hour of session.

Official Title
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Observational Prospective Study Measuring the Impact of the Use of a Hypnotic Script Associated With Virtual Reality on the Pain of the Child's Sickle Cell During a Vaso-occlusive Crisis

Conditions
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Sickle Cell Disease

Intervention / Treatment
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* Device: Virtual Reality


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Child over 6 years of age on the day of acceptance of the study (no upper limit) Suffering from sickle cell disease whatever genotype Admission in hospital for a VOC (vaso-occlusive crisis) Informed and signed consent by at least one legal guardian, if child is minor, and verbal agreement of the child himself. Exclusion Criteria: Deaf patient, visually impaired patient, claustrophobic and/or aquaphobic patient Patient not understanding French History of psychiatric illness such as paranoia, schizophrenia, manic-depressive psychosis, high suicide risk patient. The patient may be included several times in the study if he is hospitalized again during the inclusion period.

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: VRH (virtual reality hypnosis)<br> | Device: Virtual Reality<br>* The procedure will consist of a virtual reality program associated with suggestions of hypnoanalgesia, be added to usual care. Included patients will benefit from the Virtual Reality program combined with hypnoanalgesia suggestions for a period of 20 minutes. We will use a helmet with a built-in screen and an audio headset connected to a control room. Patients will watch an Virtual Reality sequence while listening to narratives designed for the hypnoanalgesia of the present pain.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain assessment with score (patient) | Measuring pain thanks to score pain by the patient 3 hours after a Virtual Reality session performed within the first 6 hours after arrival in the general pediatrics unit Patients will use le Faces Pain Scale - Revised. | hours 3 after a virtual reality | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain assessment with score (patient) | Measuring pain thanks to score pain by the patient 10 minutes before the Virtual Reality session performed within the first 6 hours after arrival in the general pediatrics unit Patients will use le Faces Pain Scale - Revised. | 10 minutes before HVR | 
| pain assessment with score (patient) | Measuring pain thanks to score pain by the patient 1 hour after a Virtual Reality session performed within the first 6 hours after arrival in the general pediatrics unit Patients will use le Faces Pain Scale - Revised. | 1 hour after a virtual reality | 
| pain assessment with score (health care personnel) | Measuring pain thanks to score pain by the health care personnel 10 minutes before the Virtual Reality session performed within the first 6 hours after arrival in the general pediatrics unit Health care personnel will use EVENDOL score (score between  0  corresponding to  no pain sign  and  15  corresponding to  maximum pain signs ). | 10 minutes before HVR | 
| pain assessment with score (health care personnel) | Measuring pain thanks to score pain by the health care personnel 1 hour after a Virtual Reality session performed within the first 6 hours after arrival in the general pediatrics unit Health care personnel will use EVENDOL score (score between  0  corresponding to  no pain sign  and  15  corresponding to  maximum pain signs ). | 1 hour after a virtual reality | 
| pain assessment with score (health care personnel) | Measuring pain thanks to score pain by the health care personnel 3 hours after a Virtual Reality session performed within the first 6 hours after arrival in the general pediatrics unit Health care personnel will use EVENDOL score (score between  0  corresponding to  no pain sign  and  15  corresponding to  maximum pain signs ). | 3 hour after a virtual reality | 
| anxiety assessment | To assess efficacy on anxiety 10 minutes before the session, we will use a numerical scale graduated from 0 to 10 ( 0  corresponding to  no anxiety  and  10  corresponding to  maximum anxiety ) | 10 minutes before HVR | 
| anxiety assessment | To assess efficacy on anxiety 1 hour after the session, we will use a numerical scale graduated from 0 to 10 ( 0  corresponding to  no anxiety  and  10  corresponding to  maximum anxiety ) | 1 hour after HVR | 
| anxiety assessment | To assess efficacy on anxiety 3 hours after the session, we will use a numerical scale graduated from 0 to 10 ( 0  corresponding to  no anxiety  and  10  corresponding to  maximum anxiety ) | 3 hour after HVR | 
| patient satisfaction assessment | We will use the Likert scale 3 hours after the session ( 0  corresponding to  no satisfaction  and  5  corresponding to  complete satisfaction  | 3 hour | 
| health care personnel satisfaction assessment | We will use the Likert scale 3 hours after the session ( 0  corresponding to  no satisfaction  and  5  corresponding to  complete satisfaction  | 5 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sickle cell disease, Pain, Virtual reality, Vaso occlusive crises, Hypnosis