E-ISSN 0976-2779 | ISSN 0975-8453
 

Review Article 


Non-pharmacological Management of Burn-related Pain and Distress in Children: A Systematic Review and Meta-Analysis Study

Hikmat Hadoush, Salam Alruz, Manal Kassab, Anit N Roy.

Abstract
Introduction: Pain and distress during burn-related painful procedures are common. Various non-pharmacological interventions are used to control pain and distress during burn-related painful procedures. Hereby, this study aimed to systematically review the recent literature regarding the efficacy of the non-pharmacological interventions to control pain perception and distress in children undergoing painful burn management procedures.
Methods: the data sources were Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, and Science
Direct databases were searched through 1989-2020. Data extraction was performed by two independent researchers.
Selection criteria: Participants included children from birth to nineteen years. Only randomized controlled trials
(RCTs) or RCT cross-overs that had a no-treatment control comparison were eligible for inclusion in the analyses.
Data analysis: The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials. Review
Manager 5.4 software was used to calculate standardized mean differences (SMDs) with 95% confidence intervals (CIs).
Results: Out of 244 studies found, 15 trials met the inclusion criteria for further review with non-pharmacological interventions that included distraction (n=8), VR (n=5), hypnosis (n=1), and massage therapy (n=1). However, 13 trials out of 15 were included in the meta-analysis with 685 participants. Meta-analysis showed large effects of distraction intervention on self-reported pain (SMD -1.64, 95% CI -3.16, -0.12), observer-reported pain (SMD -3.02, 95% CI -5.85, -0.19), and behavioral distress (SMD -2.82, 95% CI -5.50, -0.14). Besides, distraction intervention showed moderate effects on self-reported distress (SMD -0.33, 95% CI -0.58, -0.08), and no effect on behavioral pain (SMD -1.06, 95% CI -2.44, 0.31). On the other hand, VR reported a large effect on self-reported pain (SMD 1.41, 95% CI -2.52, -0.30), a moderate effect on observer-reported pain (SMD -0.56, 95% CI -0.90, -0.22), and no effect on the behavioral pain (SMD -0.48, 95% CI -1.04, 0.08). Overall, the quality of derived evidence was downgraded due to study limitations, inconsistency, and imprecision.
Conclusion: Distraction and VR are effective non-pharmacological interventions in reducing the pain perception and distress in children during painful burn management procedures.

Key words: Burn, Pain, Distress, Children, Non-pharmacological interventions.


 
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How to Cite this Article
Pubmed Style

Hikmat Hadoush, Salam Alruz, Manal Kassab, Anit N Roy. Non-pharmacological Management of Burn-related Pain and Distress in Children: A Systematic Review and Meta-Analysis Study. SRP. 2021; 12(3): 376-392. doi:10.31838/srp.2021.3.57


Web Style

Hikmat Hadoush, Salam Alruz, Manal Kassab, Anit N Roy. Non-pharmacological Management of Burn-related Pain and Distress in Children: A Systematic Review and Meta-Analysis Study. http://www.sysrevpharm.org/?mno=54753 [Access: March 04, 2021]. doi:10.31838/srp.2021.3.57


AMA (American Medical Association) Style

Hikmat Hadoush, Salam Alruz, Manal Kassab, Anit N Roy. Non-pharmacological Management of Burn-related Pain and Distress in Children: A Systematic Review and Meta-Analysis Study. SRP. 2021; 12(3): 376-392. doi:10.31838/srp.2021.3.57



Vancouver/ICMJE Style

Hikmat Hadoush, Salam Alruz, Manal Kassab, Anit N Roy. Non-pharmacological Management of Burn-related Pain and Distress in Children: A Systematic Review and Meta-Analysis Study. SRP. (2021), [cited March 04, 2021]; 12(3): 376-392. doi:10.31838/srp.2021.3.57



Harvard Style

Hikmat Hadoush, Salam Alruz, Manal Kassab, Anit N Roy (2021) Non-pharmacological Management of Burn-related Pain and Distress in Children: A Systematic Review and Meta-Analysis Study. SRP, 12 (3), 376-392. doi:10.31838/srp.2021.3.57



Turabian Style

Hikmat Hadoush, Salam Alruz, Manal Kassab, Anit N Roy. 2021. Non-pharmacological Management of Burn-related Pain and Distress in Children: A Systematic Review and Meta-Analysis Study. Systematic Reviews in Pharmacy, 12 (3), 376-392. doi:10.31838/srp.2021.3.57



Chicago Style

Hikmat Hadoush, Salam Alruz, Manal Kassab, Anit N Roy. "Non-pharmacological Management of Burn-related Pain and Distress in Children: A Systematic Review and Meta-Analysis Study." Systematic Reviews in Pharmacy 12 (2021), 376-392. doi:10.31838/srp.2021.3.57



MLA (The Modern Language Association) Style

Hikmat Hadoush, Salam Alruz, Manal Kassab, Anit N Roy. "Non-pharmacological Management of Burn-related Pain and Distress in Children: A Systematic Review and Meta-Analysis Study." Systematic Reviews in Pharmacy 12.3 (2021), 376-392. Print. doi:10.31838/srp.2021.3.57



APA (American Psychological Association) Style

Hikmat Hadoush, Salam Alruz, Manal Kassab, Anit N Roy (2021) Non-pharmacological Management of Burn-related Pain and Distress in Children: A Systematic Review and Meta-Analysis Study. Systematic Reviews in Pharmacy, 12 (3), 376-392. doi:10.31838/srp.2021.3.57





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