The Effect of Medical-Directed Play on the Severity of Pediatric Pain During Burn Dressing Change in Children: A Clinical Randomized Trial

Abstract

Background: Pain management of children with burn is one of the most important issues in pediatric medicine. Non-pharmacological methods of pain control can play an important role in suitable patients. This study was conducted with the aim of investigating the effect of Medical directed play on the severity of pediatric pain during burn dressing change. Methods: A randomized controlled trial was conducted on 82, 3-to 6-year-old children referring to a burn center in Tehran, Iran, for their first burn dressing change. The children were assigned into control (n=41) and intervention (n=41) groups by random allocation method. The Face, Legs, Activity, Cry, Consolability (FLACC) scale was used to measure the severity of pain before and during the dressings. The arterial blood oxygen level and pulse rate were also measured by a pulse oximeter. In the intervention group, the children were taught about the dressing steps 15 minutes before starting the procedure using a doll. The control group received routine care. The pain intensity, pulse rate, and arterial blood oxygen were compared between the groups by the Independent t-test, Paired t-test, Chi-square, and Fisher's exact exact-test using in SPSS V. 20. Results: There was a significant difference between the groups between regarding the mean score of pain intensity during dressing between the groups (P=0.041). A significant difference was also found in the mean heart rate of the groups during dressing (P<0.001). No significant difference was seen in the arterial blood oxygen saturation between the groups. Conclusion: Medical-directed play effectively reduces pediatric procedural pain through children's cooperation during dressing changes. This cost-effective, non-invasive technique can be widely used for pain management in children with a burn.

Effect of Video games on Postoperative Pain among Preschool Children

“…The findings in the same line with Donnelly (2016) he was found that, there were significant differences between pain intensity before and after videogames distraction, where total pain level means decreased following video game distraction technique. Also, Moosavi et al, (2019) supported this finding and found that there were significant reductions in pain for those wearing the head-mounted displays and also for those playing by the mobile device. Meanwhile, Hassannia et al, (2021) supported this finding in a similar study entitled and found that the virtual reality as a distraction technique significantly reduced pain at the onset of circumcision, during anesthesia and at the end of the circumcision.…”

“…Additionally, these findings were in line with Mokble (2007) who found that there was significant difference between the study and control group regarding decreasing body temperature, heart rates and respiratory rate after using distraction technique. Also, this finding was supported by Moosavi et al, (2019) in study about "The Effect of Medical Directed Play on the Severity of Pediatric Pain" and found that, there was significant difference between the average heart rate of the experimental group and the control group. Concerning pain intensity for the studied children, the current study presented that, there were highly statistically significant differences between pain intensity pre-, during and post-playing video games intervention These findings also agreed with Gates et al, (2020) he found that, important reduction in pain mean score in the group used digital technology such as video games or virtual reality than the control group.…”