Child Life Therapy in Paediatric Burns Management

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Burns are unfortunately a very common childhood injury. The Burns and Plastics Treatment Centre (BPTC) at the Children’s Hospital at Westmead is the only children’s Burns Unit servicing the children of New South Wales (NSW) and the Australian Capital Territory (ACT). We undertake approximately 3500 burns dressings in our BPTC per year. When a child presents to our BPTC they are given pain medicines and then taken into a treatment room to have their burns dressing done. These can be extremely painful and anxiety provoking, despite medication. We are very lucky that our service has access to a Child Life Therapist (formerly known as a Play Therapist). This therapist provides patient and family education prior to the procedure, distraction during the procedure from the dressing change occurring independently by nursing staff, and ongoing support after the procedure. Many studies have shown that Child Life Therapy or distraction therapy may be useful in reducing pain and anxiety in children. None however have shown its benefits for burnt children. We aim by undertaking this study, to prove that Child Life Therapy is beneficial by reducing pain and anxiety experienced by children during their dressing changes. To do this, we aim to recruit 100 new burns patients, attending our BPTC for the first time, to our study. Approximately half of these patients will have a Child Life Therapist during their dressing change, the other half will not. Patients will be greeted in the waiting room and explained the study. They will then be asked to participate. If they choose to participate, they will then be given their regular pain medications. Whilst the pain medications are taking time to work, the parent/carer will be asked to fill out a survey about what they expect the pain and anxiety will be. The child will then be taken into the treatment room with their parent/carer to have their dressing done. During the dressing a medical person will be in the room, watching the dressing and recording pain and anxiety scores in 5 minute intervals. After the dressing is over, the child if >5 years old, the parent/carer, and the nurse involved in the procedure, will all fill out questionnaires about how painful or anxiety provoking they thought the dressing was. These questionnaires will be age appropriate. This data will then be collected and analysed by our hospital biostatistician. We hope to find that Child Life Therapy is beneficial and support its further use for reducing pain and anxiety associated with childhood procedures.

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