The use of Virtual Reality in pain management during the burn wound dressing change in children: systematic review and meta-analysis.

Abstract

Abstract Aims and objectives The present study had the objectives of evaluating and discussing the effectiveness of virtual reality to control pain intensity during dressing changes of burn wounds in children. Background Burns are the fifth most frequent nonfatal injuries in children and currently affect 11 million people globally who require medical care. The nature of this injury and its severity make its treatment extremely painful because it requires frequent dressing changes to avoid deterioration, promote comfort, and speed up recovery. Nurses must pay special attention to affected children in order to effectively manage their pain. Virtual reality is an innovative cognitive distraction technique that shows great potential for controlling and reducing procedural pain. It has the goal of reorienting children’s available attention to process the painful stimuli into a more pleasant experience by means of the virtual world. Design Systematic literature review with meta-analysis. Methods Twelve databases were searched, and studies from 2005 to 2021 were considered for inclusion. The PRISMA guidelines for study methodology were followed, RevMan software was used for statistical calculations and estimation of heterogeneity, the RoB 2 tool was used to assess risk of bias, the PEDro scale was applied to evaluate methodological quality, and funnel plots were obtained to check for publication bias. Results Eleven studies were selected that had a total of 299 participants, both children and adults, and seven publications that involved 218 exclusively paediatric participants were included in the meta-analysis. The results showed an important effect size (ES = 0.93) regarding pain reduction, with a confidence interval of 0.68–1.18 and a p-value < 0.00001. Conclusions Virtual reality is an effective nonpharmacological strategy to reduce pain during burn dressing wound changes and other painful interventions in paediatric and adult patients. Regarding future clinical research in this area, studies should focus on what type of virtual reality hardware is best and account for the evolution of this technology, as well as its appropriate use and the ways in which it should be applied. Relevance to clinical practice Virtual reality as a nonpharmacological strategy shows favourable evidence and had a positive impact on pain control in children with burn wound dressing. Therefore, its inclusion in clinical practice can be beneficial, reducing pain during this procedure, which is known to be highly painful, and facilitating its execution.