Burns Clinical Trial
Official title:
The Development of Interactive Virtual Reality System to Distract Burns Patients Away From Their Pain During Clinical Interventions
The aims and objectives of the clinical feasibility trial are:
- to investigate the potential for VR to reduced perceived pain and anxiety during painful
dressings changes in a small sample of burns patients;
- to measure the impact of the interventions on objective indicators of pain and distress
during dressing changes within the small sample
- to assess pain medication use during virtual reality interventions
- to compare the above effects and experiences across two conditions within each
participant: an active version of a virtual reality intervention, and a 'control'
condition of no intervention;
- to assess the perceived usability, acceptability, engagement with and enjoyment of the
virtual reality intervention to the patients
- to consider the apparent feasibility of the virtual reality intervention within a Burns
Unit inpatient setting during painful dressing changes 4. Design This is an exploratory
feasibility study with a small clinical sample of burns patients and staff caring for
them, in a single burns unit setting, employing mixed methods and a repeated measures
design to achieve the aims set out above.
The target sample for the clinical feasibility trial are adult burn patients (18+), who were
English-speakers, and therefore able to consent for themselves to participate in the
research. In order to avoid unnecessary psychological or physical distress, we excluded those
with active PTSD or psychotic symptoms, or high levels of distress as judged by Burns Unit
clinicians, where the use of VR might be contraindicated. People with mild-moderate or well
controlled mental health problems were not be excluded from the study. In addition, those
with head and neck burns were excluded as they were unable to wear the VR equipment during
dressing changes. The participants were in-patients receiving regular dressing changes during
the study period.
Materials used included the VR headset and the software developed using gaming environments,
a booklet of questionnaires for the participants to complete, a monitor to measure heart
rate, a brief interview schedule, a focus group schedule and digital recording equipment. An
active (participatory) gaming environment was developed for participants to trial On three
dressing change days participants were asked to complete the two 0-100 ratings 4 times -
before their dressing change and three afterwards: immediately after the dressing change and
then after 2 and 4 hours. They were also asked to complete the scales once on a non-dressing
day after the study, to allow assessment of the impact beyond dressing days of the VR
intervention. The researcher added in the dates and times for each participant in their
booklet. These outcomes were selected as especially important to the study, but also to
minimise participant burden. The booklet contained boxes and prompts for participants to add
free text responses about the experiences we being monitoring, should they wish.
Patients were not asked during dressing changes to make any comment about their experience,
so that they could concentrate on the VR environments and to avoid adding to patient burden
on the non-intervention condition.
After each VR intervention dressing change, patients were asked a few questions about their
experience of pain and the gaming environment, such as 'How was your pain during the dressing
change while you were in the VR environment?' 'How did you feel generally during the
experience?' 'How helpful did you find the VR during the dressing change?' etc. These short
interviews (max 10 minutes) were recorded on a password protected digital recorder.
After both interventions, on a non-dressing change day, another short interview (max 10
minutes) was conducted to enable the participant to make comparisons between the different VR
experiences and general comments about their effectiveness, usability and impact compared
with no VR. Questions included 'Which VR experience did you prefer and why?' 'From your
experience how does a dressing change under VR compare with one with no VR experience?' etc.
Nursing staff were interviewed in a focus group at the end of the study.
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