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Treatment-resistant pain and distress during pediatric burn-dressing changes
C E Foertsch1, M W O'Hara, F J Stoddard
1Department of Psychology/Macy Villa, New York Hospital-Cornell Medical Center/Westchester Division, White Plains 10605, USA.
Insights
Hypnosis interventions showed no significant benefit for reducing distress in pediatric patients during burn dressing changes. Further research is needed to understand pain management in this vulnerable population.
Area of Science:
- Pediatric Psychology
- Pain Management
- Medical Hypnosis
Background:
- Hypnosis has shown potential for managing pain and distress in children during medical procedures.
- Burn dressing changes are particularly painful and distressing for pediatric patients.
- Assessing distress in children requires reliable and developmentally appropriate methods.
Purpose of the Study:
- To evaluate the efficacy of an imagery-based hypnosis intervention compared to a social-support control for distress reduction in pediatric burn patients.
- To assess the reliability of the Observational Scale of Behavioral Distress (OSBD) in this population.
- To explore factors contributing to treatment outcomes in pediatric pain management.
Main Methods:
- A sample of 23 pediatric subjects undergoing burn dressing changes were assigned to either an imagery-based or social-support treatment group.
- Distress behaviors were measured using the Observational Scale of Behavioral Distress (OSBD).
- Treatments were compared to each other and to baseline distress levels.
Main Results:
- The Observational Scale of Behavioral Distress (OSBD) demonstrated reliable measurement of distress behaviors in pediatric burn patients.
- No statistically significant difference in distress levels was found between the imagery-based treatment and the social-support control group.
- Neither treatment approach proved effective in reducing distress compared to baseline conditions.
Conclusions:
- Imagery-based hypnosis did not alleviate distress in pediatric patients during burn dressing changes.
- The significant pain and distress associated with burn care present challenges for psychological interventions.
- Further investigation into developmental considerations for pain and distress assessment in children is warranted.
Abstract:
Recent research has suggested some efficacy for the use of hypnosis in the control of pain and distress in a pediatric population undergoing painful medical procedures. Here, we study a sample (N=23) of pediatric subjects undergoing burn-dressing changes and receiving either an imagery-based or control (social-support) treatment. Subjects' levels of distress were assessed with the Observational Scale of Behavioral Distress. Results indicated that distress behaviors in this population can be measured reliably using this scale. However, no support was found for the main hypothesis that imagery treatment would be superior to control treatment in the alleviation of distress, nor were these treatments effective in comparison to baseline conditions. We discuss the formidable problem that burn and dressing-change pain presents, as well as the reasons why this treatment attempt might have failed to have the predicted effects. We also discuss important developmental considerations regarding the adequate assessment of pain and distress.