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Hypnotherapy for procedural pain, itch, and state anxiety in children with acute burns: a feasibility and
Dali Geagea1,2, Bronwyn Griffin3,4,5, Roy Kimble3,6,4,5
1Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, Australia. d.geagea@uq.net.au.
Insights
This study explores hypnotherapy for children with burns, assessing its feasibility and acceptability for managing pain, anxiety, and itch. Findings will guide future trials on this non-pharmacological intervention.
Area of Science:
- Pediatric Burn Care
- Psychological Interventions
- Pain Management
Background:
- Burns cause significant distress and long-term issues for children.
- Non-pharmacological methods like distraction aid pain management but have limitations.
- Hypnotherapy shows promise for itch, pain, and anxiety in children, but research in pediatric burns is limited.
Purpose of the Study:
- To examine the feasibility and acceptability of screening for hypnotic suggestibility.
- To assess the potential of hypnotherapy as an adjunct for procedural pain, anxiety, and itch in pediatric burn patients.
- To inform future clinical trial designs for hypnotherapy in pediatric burn care.
Main Methods:
- An observational, mixed-methods study over 15 weeks.
- Inclusion of 30 children (aged 4-16) with acute burns and their parents, plus clinicians.
- Children with medium-to-high hypnotic suggestibility receive hypnotherapy during dressing changes.
Main Results:
- The study will evaluate feasibility and acceptability as primary outcomes.
- Secondary outcomes include implementation, reach, potential effectiveness, and adoption.
- Ethical approval obtained; results to be published.
Conclusions:
- Hypnotherapy screening and intervention are feasible and acceptable in pediatric burn care.
- Findings will guide future research on hypnotherapy effectiveness.
- Results support the development of child-centered hypnotic interventions for burn patients.
Background:
Burns and related procedures are painful and distressing for children, exposing them to acute and chronic sequelae that can negatively affect their physiological, psychological, and social functions. Non-pharmacological interventions such as distraction techniques are beneficial adjuncts to pharmacological agents for procedural pain, state anxiety, and itch in children with burns but have limitations (e.g. lack of research on burn-related itch, tailoring, and consensus on optimal treatment). Hypnotherapy is a non-pharmacological intervention that can be tailored for varied settings and populations with evidence of benefit for itch and superior effectiveness in comparison to other non-pharmacological interventions for children's procedural pain and state anxiety. Thus, children with burns can benefit from hypnotherapy as an adjunct to pharmacological agents. Yet, in paediatric burns, rigorous studies of effectiveness are limited and no studies have been identified that screen for hypnotic suggestibility, an important predictor of hypnotherapy outcomes. Considering potential barriers to the delivery of hypnotherapy in paediatric burns, the proposed study will examine the feasibility and acceptability of hypnotic suggestibility screening followed by hypnotherapy for procedural pain, state anxiety, and itch in children with acute burns.
Methods:
An observational mixed-methods feasibility and acceptability study will be conducted over 15 weeks. Eligible children (N = 30) aged 4 to 16 years presenting to a paediatric burns outpatient centre in a metropolitan children's hospital in Australia with acute burns requiring dressing changes will be included. Eligible parents of children (N = up to 30) and clinicians who perform dressing changes (N = up to 20) will also be included. Child participants screened as having medium to high suggestibility as assessed by behavioural measures will receive hypnotherapy during dressing changes. A process evaluation will target feasibility and acceptability as primary outcomes and implementation (i.e. fidelity in delivery), reach, potential effectiveness, and adoption of evaluation procedures and intervention as secondary outcomes.
Discussion:
Ethical approval was obtained from the Queensland Children's Hospital and Health Service ethics committee. Results will be published in peer-reviewed publications and conference proceedings. The findings will guide the design of future trials on the effectiveness of hypnotherapy and inform the development of child-centred hypnotic interventions in children with burns.
Trial Registration:
Australian New Zealand Clinical Trials Registry ACTRN12620000988954.
