Volume 27, Issue 3 (8-2019)                   Avicenna J Nurs Midwifery Care 2019, 27(3): 178-186 | Back to browse issues page

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Mosavi A, Asgari S, Rahimi Y, Mohammad gholi mezerji N. The effect of Directed medical play on the severity of pain during burn dressing change: Clinical Randomized trial. Avicenna J Nurs Midwifery Care 2019; 27 (3) :178-186
URL: http://nmj.umsha.ac.ir/article-1-1959-en.html
1- MSc, Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
2- MSc, Department of Nursing, Malayer School of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran , umsha.asgari@gmail.com
3- BSc, Department of Nursing, Malayer Imam Hossein Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
4- PhD, Department of Biostatistics, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
Abstract:   (5117 Views)
Introduction: Pain management in 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 patients. Therefore this study was conducted to investigate the effect of medical directed play on the severity of pain during burn dressing change.
Methods: To conduct this two-group clinical trial, 78 children of 3-6 years old with burn surface area ranging less than 25% who had referred to Shahid Motahari Medical Center for their first burn dressing change, were selected. After obtaining the ethics approval for conducting the study, the patients were placed as random allocation in control and intervention groups. For the intervention group, the pre-dressed directed medical play was done and routine care was taken for the control group. The FLACC scale was used in both groups to measure the severity of pain before and during the dressing; the arterial blood oxygen level and heart rate were also measured and compared. For data analysis, SPSS 20 was used. 
Results: There were significant differences between the two groups during burn dressing change of mean pain (P=0.041) and pulse (P=0.037), and the mean of both indices in the control group was high. The mean of the arterial blood oxygen level during burn dressing change did not differ significantly between the two groups (P=1).
Conclusion: Directed Medical play effectively reduces the pain of pediatric burn dressing change. This technique is cost-effective, so it can be widely used for pain management in pediatric department.
Keywords: Play, Pain, Burns, Child
Persian Full-Text [PDF 370 kb]   (1215 Downloads)    
Type of Study: Systematic Review | Subject: Nursing
Received: 2018/11/25 | Accepted: 2018/12/24 | Published: 2019/03/27

1. Ringo Y, Chilonga K. Burns at KCMC: epidemiology, presentation, management and treatment outcome. Burns. 2014 Aug 1;40(5):1024-9. [DOI:10.1016/j.burns.2013.10.019] [PMID]
2. Simons MA, Kimble RM. Pediatric Burns. International Encyclopedia of Rehabilitation. Available from cirrie. buffalo. edu/encyclopedia/en/article/119. 2012.
3. Dehghani M, Hakimi H, Mosazadeh S, Zeinali Z, Shafiepour SZ. Survey Related Factors to Burning of 1-6 Years Old Children Referred to Velayat's Health and Training Center of Burn in Rasht City. Pajouhan Scientific Journal. 2018 Apr 15;16(3):1-0. [DOI:10.21859/psj.16.3.1]
4. Forjuoh SN. Burns in low-and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention. Burns. 2006 Aug 1;32(5):529-37. [DOI:10.1016/j.burns.2006.04.002] [PMID]
5. De Jong AE, Gamel C. Use of a simple relaxation technique in burn care: literature review. Journal of advanced nursing. 2006 Jun;54(6):710-21. [DOI:10.1111/j.1365-2648.2006.03858.x] [PMID]
6. Jivad N, Moghni M, Karimi M, Esmaili S, Lalehgani H. The effect of deep-slow and regular breathing on pain intensity of burn dressing. Journal of Critical Care Nursing. 2014;6(4):223-228.
7. Yang HT, Hur G, Kwak IS, Yim H, Cho YS, Kim D, Hur J, Kim JH, Lee BC, Seo CH, Chun W. Improvement of burn pain management through routine pain monitoring and pain management protocol. Burns. 2013 Jun 1;39(4):619-24. [DOI:10.1016/j.burns.2012.10.025] [PMID]
8. Hasanpour M, Tootoonchi M, Aein F, Yadegarfar G. The effects of two non-pharmacologic pain management methods for intramuscular injection pain in children. Acute pain. 2006 Mar 1;8(1):7-12. [DOI:10.1016/j.acpain.2005.11.001]
9. Ullán AM, Belver MH, Fernández E, Lorente F, Badía M, Fernández B. The effect of a program to promote play to reduce children's post-surgical pain: with plush toys, it hurts less. Pain Management Nursing. 2014 Mar 1;15(1):273-82. [DOI:10.1016/j.pmn.2012.10.004] [PMID]
10. Guo SA, DiPietro LA. Factors affecting wound healing. Journal of dental research. 2010 Mar;89(3):219-29. [DOI:10.1177/0022034509359125] [PMID] [PMCID]
11. Walco GA. Needle pain in children: contextual factors. Pediatrics. 2008 Nov 1;122(suppl 3):S125-9. [DOI:10.1542/peds.2008-1055D] [PMID]
12. Aziznejad RP, Alhani F, Mohammadi E. Challenges and practical solutions for pain management nursing in pediatric wards.
13. Hoffman HG, Chambers GT, Meyer III WJ, Arceneaux LL, Russell WJ, Seibel EJ, Richards TL, Sharar SR, Patterson DR. Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Annals of Behavioral Medicine. 2011 Jan 25;41(2):183-91. [DOI:10.1007/s12160-010-9248-7] [PMID] [PMCID]
14. Sahiner NC, Bal MD. The effects of three different distraction methods on pain and anxiety in children. Journal of Child Health Care. 2016 Sep;20(3):277-85. [DOI:10.1177/1367493515587062] [PMID]
15. Moore ER, Bennett KL, Dietrich MS, Wells N. The effect of directed medical play on young children's pain and distress during burn wound care. Journal of Pediatric Health Care. 2015 May 1;29(3):265-73. [DOI:10.1016/j.pedhc.2014.12.006] [PMID] [PMCID]
16. Merkel S, Voepel-Lewis T, Malviya S. Pain Control: Pain Assessment in Infants and Young Children: The FLACC Scale. The American journal of nursing. 2002 Oct 1;102(10):55-8. [DOI:10.1097/00000446-200210000-00024]
17. Voepel-Lewis T, Merkel S, Tait AR, Trzcinka A, Malviya S. The reliability and validity of the Face, Legs, Activity, Cry, Consolability observational tool as a measure of pain in children with cognitive impairment. Anesthesia & Analgesia. 2002 Nov 1;95(5):1224-9. [DOI:10.1097/00000539-200211000-00020] [PMID]
18. Skarbek-Borowska S, Becker BM, Lovgren K, Bates A, Minugh PA. Brief focal ultrasound with topical anesthetic decreases the pain of intravenous placement in children. Pediatric emergency care. 2006 May 1;22(5):339-45. [DOI:10.1097/01.pec.0000216566.33747.5b] [PMID]
19. Li HC, Lopez V. Effectiveness and appropriateness of therapeutic play intervention in preparing children for surgery: A randomized controlled trial study. Journal for Specialists in Pediatric Nursing. 2008 Apr;13(2):63-73. [DOI:10.1111/j.1744-6155.2008.00138.x] [PMID]
20. Miller K, Rodger S, Bucolo S, Greer R, Kimble RM. Multi-modal distraction. Using technology to combat pain in young children with burn injuries. Burns. 2010 Aug 1;36(5):647-58. [DOI:10.1016/j.burns.2009.06.199] [PMID]
21. Kipping B, Rodger S, Miller K, Kimble RM. Virtual reality for acute pain reduction in adolescents undergoing burn wound care: a prospective randomized controlled trial. Burns. 2012 Aug 1;38(5):650-7. [DOI:10.1016/j.burns.2011.11.010] [PMID]
22. Brown NJ, Kimble RM, Rodger S, Ware RS, Cuttle L. Play and heal: randomized controlled trial of Ditto™ intervention efficacy on improving re-epithelialization in pediatric burns. Burns. 2014 Mar 1;40(2):204-13. [DOI:10.1016/j.burns.2013.11.024] [PMID]
23. Namnabati M, Abazari P, Talakoub S. Identification of perceived barriers of pain management in Iranian children: A qualitative study. International journal of nursing practice. 2012 Jun;18(3):221-5. [DOI:10.1111/j.1440-172X.2011.01981.x] [PMID]
24. Kozier B. Fundamentals of nursing: concepts, process and practice. Pearson Education; 2008.
25. Vosoghi N, Chehrzad M, Mousavi S, Atkar Rooshan Z, Akbari A, Survey the effect of distraction on average heart rate due to IV insertion in 3-6 years old hospitalized children in pediatric center in Rasht, Journal of Hayat, 2009;19(62):33-39
26. Lal MK, McClelland J, Phillips J, Taub NA, Beattie RM. Comparison of EMLA cream versus placebo in children receiving distraction therapy for venepuncture. Acta Paediatrica. 2001 Feb;90(2):154-9. [DOI:10.1080/080352501300049307]
27. Sajedi F, Kashaninia Z, Rahgozar M, Noghabi FA. The effect of Kangaroo care on physiologic responses to pain of an intramuscular injection in neonates. Iranian Journal of Pediatrics. 2007;17(4):339-44.
28. Mott J, Bucolo S, Cuttle L, Mill J, Hilder M, Miller K, Kimble RM. The efficacy of an augmented virtual reality system to alleviate pain in children undergoing burns dressing changes: a randomised controlled trial. Burns. 2008 Sep 1;34(6):803-8. [DOI:10.1016/j.burns.2007.10.010] [PMID]
29. Hasanpour M, Tootoonchi M, Aein F, Yadegarfar G. The effects of two non-pharmacologic pain management methods for intramuscular injection pain in children. Acute pain. 2006 Mar 1;8(1):7-12. [DOI:10.1016/j.acpain.2005.11.001]
30. Naderi F, Aghayi A, Mohammadzadeh M, Nazemi S, Salmani F, Rashvand M. Comparing the effect of music on pain threshold, anxiety, behavioral responses to pain and the hemodynamic parameters during dressing change in burn patients. Quarterly of the Horizon of Medical Sciences. 2014 Jan 1;20(1):63-8.
31. Alimohammadi H, Baratloo A, Abdalvand A, Rouhipour A, Safari S. Effects of pain relief on arterial blood o2 saturation. Trauma monthly. 2014 Feb;19(1): 1-4. [DOI:10.5812/traumamon.14034]

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