Burns, Pain, Sleep Disturbances
Conditions
Keywords
Virtual reality, Non-pharmacological intervention, Wound dressing, Tbsa
Brief summary
This study aims to evaluate whether virtual reality (VR) can reduce pain and improve sleep quality during wound dressing changes in burn patients with 25-60% total body surface area (TBSA) burns, compared to standard care.
Detailed description
Background: Burn injuries are extremely painful, especially during wound dressing changes. They also cause severe sleep problems, which can slow down healing. While medicines help, they often have side effects and don't fully solve these issues. Virtual reality (VR) is a new tool that distracts the brain from pain by immersing patients in a calming digital world. This study was designed to assess if VR could help with both pain and sleep in burn patients. Methods: We conducted a randomized controlled trial with 60 adult burn patients who had between 25% and 60% of their body burned. All patients were stable and able to understand instructions. We randomly assigned them into two groups: one group used VR headsets during their dressing changes, and the other group received standard care without VR. Pain was measured before and after the procedure using a simple 0-to-10 scale. Sleep quality was assessed using a standard questionnaire (PSQI) before and 24 hours after the treatment.
Interventions
BEHAVIORALVirtual Reality Distraction
Participants in the experimental group received immersive virtual reality distraction during their wound dressing change procedure. They wore an Oculus Quest 2 headset and were immersed in a calming, interactive virtual environment (e.g., a peaceful beach or forest) for the duration of the dressing change (approximately 30-45 minutes). The audio was enabled to enhance immersion. This intervention aimed to reduce procedural pain and improve sleep quality through cognitive distraction and relaxation.
OTHERStandard Care
Participants in the control group received standard care during their wound dressing change, which included verbal reassurance and routine analgesic administration as prescribed, without any additional distraction techniques such as virtual reality. No specific intervention was administered beyond standard clinical practice.
Sponsors
Abadan University of Medical Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Masking description
Blinding was not feasible due to the visible nature of the VR headset and the need for participants and care providers to be aware of group assignment during the intervention. However, data collection and analysis were performed by blinded personnel.
Intervention model description
This is a two-arm, parallel-group, randomized controlled trial comparing virtual reality intervention with standard care in burn patients.
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* \- Adult patients aged 18 to 60 years. * Deep partial-thickness or full-thickness burns covering 25% to 60% of total body surface area (TBSA). * Hemodynamic stability (systolic BP ≥90 mmHg, HR 60-100 bpm, no vasopressor use). * Ability to understand and comprehend Persian language. * Scheduled for at least one standardized, non-sedated wound dressing change procedure.
Exclusion criteria
* \- Diagnosed psychiatric or neurological disorder (e.g., schizophrenia, epilepsy). * Severe visual impairment (best-corrected visual acuity \<20/200) or auditory impairment. * History of motion sickness or VR intolerance. * Contraindications to VR use (e.g., active vertigo, uncontrolled hypertension).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pittsburgh Sleep Quality Index (PSQI) Total Score | 24 hours post-intervention | The primary outcome for sleep quality was the change in the total score of the Pittsburgh Sleep Quality Index (PSQI) from baseline to 24 hours post-intervention. The PSQI is a validated self-report questionnaire assessing seven components of sleep quality over the past month. A higher score indicates poorer sleep quality. The change score (post-intervention minus pre-intervention) was calculated, with negative values indicating improvement. |
| Change in Visual Analog Scale (VAS) Pain Score | Immediately before and after the dressing change procedure | The primary outcome for pain was the change in the Visual Analog Scale (VAS) score from immediately before to immediately after the wound dressing change procedure. The VAS is a 10-cm scale where 0 represents no pain and 10 represents worst pain imaginable. The change score (post-procedure minus pre-procedure) was calculated, with negative values indicating pain reduction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in individual components of the Pittsburgh Sleep Quality Index (PSQI) | 24 hours post-intervention | Secondary outcomes included changes in each of the seven individual components of the PSQI: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. These were assessed at baseline and 24 hours post-intervention. |
Countries
Iran
Outcome results
None listed