Stephen J. Chester1, Zephanie Tyack2, Alexandra De Young3, Bronwyn Griffin4, Belinda Kipping5, Kellie Stockton6, Roy M. Kimble7
1 Centre for Children’s Burns and Trauma Research, Level 7, Centre for Children’s Health Research, University of Queensland, 62 Graham Street, South Brisbane, QLD 4101, schester@post.harvard.edu
2 Centre for Children’s Burns and Trauma Research, Level 7, Centre for Children’s Health Research, University of Queensland, 62 Graham Street, South Brisbane, QLD 4101, z.tyack@uq.edu.au
3 Centre for Children’s Burns and Trauma Research, Level 7, Centre for Children’s Health Research, University of Queensland, 62 Graham Street, South Brisbane, QLD 4101, adeyoung@uq.edu.au
4 Centre for Children’s Burns and Trauma Research, Level 7, Centre for Children’s Health Research, University of Queensland, 62 Graham Street, South Brisbane, QLD 4101, b.griffin@uq.edu.au
5 Centre for Children’s Burns and Trauma Research, Level 7, Centre for Children’s Health Research, University of Queensland, 62 Graham Street, South Brisbane, QLD 4101, b.kipping@uq.edu.au
6 Bond University Institute of Health and Sport, 2 Promethean Way, Robina, QLD 4226, kellie.stockton@uchealth.com.au
7 Centre for Children’s Burns and Trauma Research, Level 7, Centre for Children’s Health Research, University of Queensland, 62 Graham Street, South Brisbane, QLD 4101, royk@uq.edu.au
Background
Non-pharmacological interventions are critical for comprehensive pain and anxiety management in paediatric burns and are linked with improved healing rates. However, non-pharmacological pain and anxiety management remains suboptimal. Although medical hypnosis (hypnotherapy) can be effective for decreasing pain and anxiety after adult burns and during various painful paediatric procedures, no randomised controlled trials (RCTs) have investigated hypnotherapy for paediatric burns patients.
Aims
This RCT aims to determine if hypnotherapy decreases pain, anxiety, and biological stress markers (i.e. heart rate) during wound-care procedures and accelerates wound-healing in paediatric burns patients.
Methods
Children (4-16 years) with acute burns presenting for their first dressing change were randomly assigned to either the (1) Intervention Group (hypnotherapy) or (2) Control Group (standard care). Repeated measures of pain, anxiety, heart rate, and wound-healing were taken at every dressing change until ≥95% wound re-epithelialisation (Chester et al., 2016).
Results
Data for 62 children were analysed on an intent-to-treat basis (n = 35 standard group; n = 27 hypnotherapy group). Immediately prior to their second dressing change, children in the hypnotherapy group reported significantly lower anxiety scores (-0.80 (CI: -0.05 to -1.55), p-value = 0.037) on a visual analog scale compared to those receiving standard care. At their third dressing change, children in the hypnotherapy group had significantly lower heart rates (bpm) pre- (-18.5 (CI: -5.1 to -31.9), p-value = 0.01) and post-procedure (-18.1 (CI: -2.3 to -33.9), p-value = 0.027). No adverse effects were observed.
Conclusions
Hypnotherapy appears to be effective for decreasing pre-procedural anxiety and heart rate during wound-care procedures.
Key Words
Burns, Child, Hypnosis, Hypnotherapy, Pain, Stress, Anxiety, Posttraumatic stress disorder, Salivary cortisol, Randomised controlled trial
References
CHESTER, S. J., STOCKTON, K., DE YOUNG, A., KIPPING, B., TYACK, Z., GRIFFIN, B., CHESTER, R. L. & KIMBLE, R. M. 2016. Effectiveness of medical hypnosis for pain reduction and faster wound healing in pediatric acute burn injury: study protocol for a randomized controlled trial. Trials, 17, 223-233.
Biography
Stephen Chester attended Harvard University where he received his Bachelor of Arts in Human Evolutionary Biology and Philosophy in 2010. After graduation, he worked in the University of Virginia’s Epilepsy Research Lab before matriculating into the University of Queensland – Ochsner Medical School Program. He is currently pursuing his PhD under Professor Roy Kimble in the Centre for Children’s Burns and Trauma Research at Lady Cilento Children’s Hospital before returning to the United States to begin his clinical rotations and finish medical school.