Affiliation:
1. Department of Plastic & Reconstructive Surgery School of Medicine, Guilan University of Medical Sciences Rasht Iran
2. Anesthesiology Research Center, Department of Anesthesiology Alzahra Hospital, Guilan University of Medical Sciences Rasht Iran
3. Department of Medical‐Surgical Nursing North Khorasan University of Medical Sciences North Khorasan Iran
4. Student Research Committee, Faculty of Nursing and Midwifery Mashhad University of Medical Sciences Mashhad Iran
5. Razi Clinical Research Development Unit Razi Hospital, Guilan University of Medical Sciences Rasht Iran
6. Department of Medical‐Surgical Nursing School of Nursing and Midwifery, Guilan University of Medical Sciences Rasht Iran
7. Burn and Regenerative Medicine Research Center Guilan University of Medical Sciences Rasht Iran
8. Department of Nursing Esfarayen Faculty of Medical Sciences Esfarayen Iran
9. School of Nursing and Midwifery Golestan University of Medical Sciences Gorgan Iran
10. Department of Pediatric Nursing School of Nursing and Midwifery, Mashhad University of Medical Sciences Mashhad Iran
Abstract
AbstractPain is one of the complications associated with burns, which can lead to anxiety and sleeplessness in children. Various studies evaluated the effects of non‐pharmacological interventions on burn wound care. The present study was conducted to determine the effects of non‐pharmacological interventions on pain intensity of children with burns. A comprehensive systematic search was conducted in various international electronic databases, such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as ‘Non‐pharmacological’, ‘Virtual reality’, ‘Pain’, ‘Burn’, ‘Wound’ and ‘Child’ from the earliest to December 1, 2022. The risk of bias in the final articles was also assessed with the Version 2 of the Cochrane risk‐of‐bias tool for randomised trials (RoB 2). Finally, a total of 1005 burn patients were included in 19 studies. The age range of the patients was from 0.5 to 19 years. Of the participants, 50.05% were in the intervention group. All studies had a randomised clinical trial design. The results found that non‐pharmacological interventions significantly reduced pain intensity in children (ES: −0.73, 95% CI: −1.08 to −0.38, Z = 4.09, I2:79.8, P < .001). Virtual reality (VR) (ES: −0.54, 95% CI: −1.19 to −0.18, Z = 2.90, I2:72.9%, P = .004) and non‐VR (ES: ‐0.86, 95% CI: −1.45 to −0.27, Z = 2.86, I2:91.4%, P = .04) interventions decreased pain intensity significantly in children based sub‐group analysis. Non‐pharmacological interventions significantly reduced the pain intensity of dressing removal (ES: −0.77, 95% CI: −1.34 to −0.20, Z = 66.3, I2:91.8%, P = .008), dressing application (ES: −0.53, 95% CI: −0.97 to −0.09, Z = 2.37, I2:60.8%, P = .02), and physical therapy (ES: −1.18, 95% CI: −2.10 to −0.26, Z = 2.51, I2:88.0%, P = .01). Also, interventions reduced the pain of burn wound care (ES: −0.29, 95% CI: −1.01 to 0.44, Z = 0.78, I2:72.6%, P = .43), but it was statistically insignificant. In sum, the result of the present study indicated that using non‐pharmacological interventions significantly reduced pain intensity in children. The reduction of pain intensity was greater in non‐VR than in VR interventions. Future studies should focus on comparing VR interventions with non‐VR and single versus multi‐modal distraction to clarify the effectiveness of each.