Authors (including presenting author) :
Wong TW, Lo KL, Chuk MY, Lai YK, Chu WY, Chui ST
Affiliation :
Burns Centre, Department of Surgery, Prince of Wales Hospital
Introduction :
Burn Injury is a traumatic experience. Pain control is a major challenge in caring of burn patients, starting from the moment of injury through the journey of rehabilitation. Most of treatments are associated with more pain, from daily wound dressing, skin grafting in acute phase and subsequent physiotherapy. Moreover, cleansing of wound and application of dressing are mandatory when sufficient epidermal living cells remain for spontaneous wound healing. In current practice, oral analgesics are administrated to patients before wound dressing to allow time to reach peak effect. However, the effectiveness of pain killers cannot be satisfied by most of them.
In the studies of Faber AW et al. (2013), Jeffs D et al. (2014), Kipping B et al. (2012) & Hoffman HG et al. (2008) reported uses of VR as adjunct therapy were effective in reduction of painful sensation and anxiety in treatment of burn wound. The more immersive the VR, the greater concentrated in VR environment, leading to pain reduction, reduced anxiety and treatment compliance.
With the support of QOCP, HypnoVR Immersive system include VR headset with software and headphone are supplied in Burns Centre for improving quality dressing change. Before dressing procedure, patients wear the headset to immerse into induction follow by hypnotic phase. They put on headphone to hear a soft voice for relaxation attentively. Then, dressing change will be started when they enter hypnotic phase.
Objectives :
To investigate the effectiveness of VR technology to burn patients during dressing change.
Methodology :
This is a single center prospective study during January 2021 to January 2023. Adult acute burn patients (except facial burn) with normal vision and aural comprehension were recruited and consented.
For each recruited patient, there will be assessment of dressing change as standard treatment, and another treatment assessment with the use of VR system in the following day. Same dosage of oral analgesic is administrated during both assessments. Data include Blood pressure, Pulse rate, Visual Analogue scale (VAS) and the Speilberger State-Trait Anxiety Inventory (STAI) are collected in both assessments. Also, patient satisfaction of VR (5-point scale) and willingness to use VR in future dressing change (5-point scale) are recorded in treatment day.
Result & Outcome :
Total 40 adult burn patients (55% male and 45% female) completed the study. Age ranged from 19 to 76 with mean age of 48. Total body surface area (TBSA) involved ranged from 1% to 33 % burn. These burn patients have significantly less pain when use VR in conjunction with oral analgesic during dressing change (Mean score from 7.75+/- 2.1 in no VR to 5.35+/- 2.5 with VR). They reported less anxiety (P< 0.01, paired t-test) when immersed into VR environment and able to relax when concentrated on the VR scene and soft voice. Therefore, their systolic blood pressure could be lowered (P< 0.01) and pulse rate could be decreased (P< 0.01) with use VR after completion of procedure.
All patients agreed use VR in conjunction with oral analgesic for dressing change were effective with a mean score of 4.1 out of 5. They also reported they would use VR for future dressing procedure with a mean score of 4.57 out of 5.
The implementation of VR technology made benefit to patients during dressing change. The result evidenced from both of their physiological change and emotion response.
