Application of animated cartoons in reducing the pain of dressing changes in children with burn injuries

Abstract

Background: Nonpharmacological management remains one of the central pain interventional therapies in the burn unit. VR and other distraction treatments for adults have achieved great advantages in pain relief.

Methods: A within-subject study was conducted to evaluate 54 participants aged from 3 to 7. In the control group, a standard analgesic, ibuprofen, was used over the period of dressing change, whereas animated cartoons were played simultaneously in the intervention-group condition. We adopted the Wong-Baker faces pain rating scale, COMFORT scale, FLACC scale and POCIS to assess the pain rating 5 min before, during and 5 min after dressing changes, respectively.

Results: Compared with the control group, FLACC scale and POCIS scores in the intervention group were not significantly different (P>0.05) throughout the observation period; outcomes measured using the Wong-Baker faces pain rating scale and COMFORT scale 5 min before and during dressing changes were also not different between the groups (P>0.05). Nevertheless, 5 min after that period, subjects in the intervention group had reduced pain behavior according to scores on the Wong-Baker faces pain rating scale (control-group scores: 7.231±0.403; intervention-group scores: 6.026±0.501, P<0.05) and COMFORT scale (control-group scores: 21.602±1.316; intervention-group scores: 19.040±1.204, P<0.05).

Conclusion: This study supports that watching animated cartoons appears to be a practical way to ease the pain behavior of children in the burn unit after replacing wound dressings, although its effectiveness remains insufficient before and during the dressing change procedure.

Significance: Conducting a thorough study and exploring the efficacy of animated cartoons in reducing the pain of dressing changes for pediatric patients may surely result in practical value, especially in developing countries.

Keywords: Animated cartoon; burn; pain behavior.

Figure 1

The downward trend of the treatment and control groups. The trend that mean scores in the of intervention group judging by Wong-Baker faces pain rating scale declined more dramatically than in the control group with an independent t-test (P<0.05); the COMFORT scale comparison resulted in the coming to the same findings.

Figure 2

Comparison of scores of each separate category included in the COMFORT behavior scale between treatment and control groups. The grading scores of the intervention group experienced a sharper more sharply downward trend than the control group (P<0.05) within respect to of Alertness, Calmness/agitation, Crying, Physical movement and Facial tension. Nevertheless, there was no difference between the groups in the when speaking of the Muscle tone category, that finding turned to remain not that evident (P>0.05).