Immersive Virtual Reality in Occupational Therapy practice as a non-opioid analgesic during burn wound care procedures.

Mrs Amber Jones1, Miss Erin Molloy1, Associate Professor Paul Gray2,  Emeritus Professor Jenny Strong1, Mrs Sue Laracy1

1Occupational Therapy, The Royal Brisbane & Women’s Hospital, Herston, Brisbane, Australia, 2Professor Tess Cramond Multidisciplinary Pain Service, The Royal Brisbane & Women’s Hospital, Herston, Brisbane, Australia

Abstract:

Introduction: For daily burn wound-care procedures, opioid analgesics alone are often insufficient (1-3). Often, burn injured patients experience uncontrolled pain during dressing changes leading to poorer physical and psychological outcomes (1-3). Virtual reality’s (VR) immersive, entertaining effects are useful for redirecting attention away from painful treatment experiences (1-3). With the rapid and continuous changes in technology, low-cost, feasible and effective options for VR are now readily available but minimally implemented. It is the aim of this study to determine if low cost, immersive VR in a burn injured cohort provides a valuable adjunct to opioid analgesics during wound-care procedures.

Method: A single-case experimental, multiple baseline design will be used across subjects. The multiple baseline design involves the measurement of multiple persons both before and after the use of VR and will allow the research team to make inferences about behaviour change (4). Transitions of each subject from no VR use to VR use will establish a baseline for intra-subject comparison. Numerical pain and anxiety scores pre, during and post wound-care procedure will be recorded along with quantified opioid use and wound care procedure duration. Patient and staff experiences will be obtained using descriptive questionnaires.

Results: Data will be visually analysed for changes in mean, level, slope, variability, latency and for consistency in patterns.

Discussion: If VR is found to decrease pain and anxiety during burn wound care, its wider integration in patient care will be an important next step in burn patient management.

References
1. Dascal, J., et al., Virtual Reality and Medical Inpatients: A Systematic Review of Randomized, Controlled Trials. Innov Clin Neurosci, 2017. 14(1-2): p. 14-21.
2. Kipping, Rodger, Miller & Kimble (2012). Virtual reality for acute pain reduction in adolescents undergoing burn wound care: a prospective randomised controlled trial. Burns, 38 p.650-657
3. Motta, Bucolo, Cuttle, Mill ,Hilder, Miller, Kimble (2008). The efficacy of an augmented virtual reality system to alleviate pain in children undergoing burns dressing changes: a randomised controlled trial. Burns, 34 (6) pp 803-808
4. Ottenbacher, K.J., Introduction to Single System Designs for Neurorehabilitation Research. Neurorehabilitation and Neural Repair, 1997. 11(4): p. 199-206.


Biography:

Erin Molloy is a Senior Occupational Therapist working at the Professor Stuart Pegg Adult Burns Unit at the Royal Brisbane & Women’s Hospital. She is currently completing her PhD through the University of Queensland.