Efficacy of hypnosis on pain, wound-healing, anxiety, and stress in children with acute burn injuries: a randomized controlled trial

被引:37
作者
Chester, Stephen J. [1 ,2 ,3 ,4 ]
Tyack, Zephanie [1 ,2 ]
De Young, Alexandra [1 ,2 ]
Kipping, Belinda [1 ,2 ]
Griffin, Bronwyn [1 ,2 ]
Stockton, Kellie [1 ,2 ]
Ware, Robert S. [5 ,6 ]
Zhang, Xi [7 ]
Kimble, Roy M. [1 ,2 ,3 ]
机构
[1] Univ Queensland, Childrens Hlth Res Ctr, Ctr Childrens Burns & Trauma Res, Level 7, South Brisbane, Qld, Australia
[2] Lady Cilento Childrens Hosp, Pegg Leditschke Childrens Burns Ctr, Level 5, South Brisbane, Qld, Australia
[3] Univ Queensland, Fac Med, South Brisbane, Qld, Australia
[4] Ochsner Clin Fdn, Ochsner Clin Sch, New Orleans, LA USA
[5] Griffith Univ, Menzies Hlth Inst Queensland, Brisbane, Qld, Australia
[6] Univ Queensland, UQ Child Hlth Res Ctr, South Brisbane, Qld, Australia
[7] Queensland Univ Technol, Sch Biomed Sci, Inst Hlth & Biomed Innovat, Brisbane, Qld, Australia
关键词
Burns; Child; Hypnosis; Pain; Wound-healing; Stress; Anxiety; Posttraumatic stress disorder; Salivary alpha-amylase; Randomized controlled trial; PEDIATRIC BURNS; SELF-REPORT; PSYCHOMETRIC PROPERTIES; CLINICAL HYPNOSIS; PROCEDURAL PAIN; YOUNG-CHILDREN; SCALE; REDUCTION; DISTRACTION; ADOLESCENTS;
D O I
10.1097/j.pain.0000000000001276
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
No randomized controlled trial has investigated the efficacy of hypnosis for reducing pain and improving wound-healing in children with burns. This randomized controlled trial aimed to investigate whether hypnosis decreases pain, anxiety, and stress and accelerates wound-healing in children undergoing burn wound procedures. Children (4-16 years) with acute burns presenting for their first dressing change were randomly assigned to a Hypnosis Group who received hypnosis plus standard care or a Standard Care Group who received standard pharmacological and nonpharmacological intervention. Repeated measures of pain intensity, anxiety, stress, and wound-healing were taken at dressing changes until >= 95% wound re-epithelialization. Data for 62 children were analyzed on an intent-to-treat basis using Generalized Estimating Equations (n = 35 Standard Care Group; n 5 27 Hypnosis Group). An effect on the primary outcomes of pain and wound healing was not supported {self-reported pain intensity largest Mean Difference [MD] = -0.85 (95% confidence interval [CI]: -1.91 to 0.22), P = 0.12; MD for re-epithelialization = -0.46 [95% CI: -4.27 to 3.35], P = 0.81}. Some support was found for an effect on the secondary outcomes of preprocedural anxiety (MD = -0.80 [95% CI: -1.50 to -0.10], P = 0.03 before the second dressing change) and heart rate as a measure of stress (MD = -15.20 [-27.20 to -3.20], P = 0.01 and MD = -15.39 [-28.25 to -2.53], P = 0.02 before and after the third dressing change). Hypnosis may be effective for decreasing preprocedural anxiety and heart rate in children undergoing repeated pediatric wound care procedures but not for reducing pain intensity or accelerating wound healing.
引用
收藏
页码:1790 / 1801
页数:12
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