Abstract
Children and adolescents with severe burns require medical and nursing interventions, associated with pain. As immersive virtual reality (VR) gained prominence as non-pharmacological adjuvant analgesia, we conducted a systematic review and meta-analysis on the efficacy of full immersive VR on pain experienced during dressing changes in hospitalized children and adolescents with severe burns. This exercise included quality and risk of bias assessment. The systematic review resulted in eight studies and 142 patients. Due to missing data, four studies were excluded from the meta-analysis. Fixed effects meta-analysis of the four included studies (n = 104) revealed a large effect size (ES) (Standardized Mean Difference = 0.94; 95% Confidence Interval = 0.62, 1.27; Z = 5.70; p < 0.00001) for adjuvant full immersive VR compared to standard care (SC). In conclusion, adjuvant full immersive VR significantly reduces pain experienced during dressing changes in children and adolescents with burns. We therefore recommend implementing full immersive VR as an adjuvant in this specific setting and population. However, this requires further research into the hygienic use of VR appliances in health institutions. Furthermore, due to the high cost of the hardware, a cost–benefit analysis is required. Finally, research should also verify the long term physical and psychological benefits of VR.
Highlights
Burn injuries are a major public health problem with a high mortality rate [1]
We summarized the main characteristics and results of studies retained in the systematic review in Figure 1 and Appendix A Tables A1–A4
Adjuvant virtual reality (VR) was compared to SC, except for Hoffman et al (2000) [28] who used standard care in combination with a video game as comparison intervention
Summary
Burn injuries are a major public health problem with a high mortality rate [1]. The incidence rate of burn injuries for children aged under sixteen is almost 25% [2]. Burned patients require frequent painful interventions, such as dressing changes to prevent infection and improve wound healing [4]. The frequency of dressing changes depends on the amount of exudate and type of dressing material, and varies between once a week, up to twice daily in hospitalized burn patients [5]. The process of dressing change is perceived by children to be the most distressing and painful moment during hospitalization [4,6,7]
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