Pediatric Trauma Society

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Feasibility, User Experience, and Preliminary Efficacy of a Portable Virtual Reality Pain Management Tool for Pediatric Burn Dressing Changes: A Pilot Randomized Controlled Trial
*Jiabin Shen, *Rajan Thakkar, *Renata Fabia, *Jonathan Groner, *Krista Wheeler, Dayle Radlinski, *Sarah Caupp, *Sheila Giles, *Henry Xiang
Nationwide Children's Hospital, Columbus, OH

Background (issue):
Burns are one of the leading causes of pediatric injuries. Effective pain management is essential for positive medical care experiences and long-term psychological health. Virtual reality (VR) has been increasingly used as a non-pharmaceutical analgesic method during medical procedures. This study aimed to evaluate the feasibility, user experience, and preliminary efficacy of an innovative portable VR pain management system for pediatric burn dressing changes.
Methods:
The VR system (Figure 1.) consisted of a lightweight VR viewer and two modes of a novel Virtual River Cruise game: active engagement and passive viewing. Twenty children with burns (ages 6-17) were randomized into active VR, passive VR, and control groups. Child/parent-reports and nurse-reports measured feasibility, VR experience, and perceived pain using 100mm VAS. Pain was also measured by FLACC-r (0-10). Covariates included anxiety-prone personality, expectation, and demographics.
Findings:
Parents/children reported unanimous satisfaction (100%) with the VR system. Nurses indicated that the system was both helpful (Mean(M)active=90.6, Mpassive=95.0) and easy to use during pediatric burn dressing changes (Mactive=89.6, Mpassive=96.5). Children reported high levels of fun (Mactive=86.2, Mpassive=88.0), engagement (Mactive=81.9, Mpassive=89.7), realism (Mactive=77.0, Mpassive=78.2), and low simulation sickness (Mactive=19.8, Mpassive=16.8). ANCOVA controlling for covariates showed both VR groups experienced significantly less pain than the controls (p <0.05), suggesting positive efficacy.
Conclusions (implications for practice):
This pilot RCT demonstrated high feasibility, user experience, and potential efficacy in using VR for pain management during pediatric burn dressing changes.


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