Virtual Reality Therapy to Control Burn Pain: Systematic Review of Randomized Controlled Trials.

Virtual reality therapy has been shown to be an excellent alternative to non-pharmacological treatment for the control of burn pain. The objective was to evaluate the effects of virtual reality therapy on pain control in people who have suffered burns published in the scientific literature. Systematic review carried out as recommended by Cochrane. The search was carried out in the Embase, PubMed, Lilacs, and Cochrane Library databases, in the period from March 2021. Randomized clinical trials were included without language restriction and year of publication. The risk of bias was assessed using the Cochrane tool. Of the 3755 articles found, only 17 articles were selected for reading in full. Of these, only four articles met the inclusion criteria. The results of the studies showed that the use of virtual reality therapy reduced the intensity of pain in children and adolescents with burns, despite the fact that most results are not statistically significant. No selected study had a high risk of bias. Virtual reality therapy has been shown to be effective in controlling pain, reducing the time spent thinking about it and greater distraction during the procedures. However, most randomized clinical trials results were not statistically significant in at least one of the moments when pain was assessed. It is noteworthy that randomized clinical trials are still necessary to administer virtual reality therapy, especially in adults.

Cultural Adaptation and Validation of the Ostomy Adjustment Inventory-23 for Brazil.

The Ostomy Adjustment Inventory-23 (OAI-23) was developed in English to measure the social and psychological adaptation of individuals who underwent ostomy surgeries. PURPOSE: The aim of the current study was to culturally adapt and test the measurement properties of a Brazilian Portuguese adapted version of the OAI-23. METHODS: The original version of the OAI-23 was composed of 23 questions distributed into the following 4 factors: acceptance, anxiety/preoccupation, social engagement, and anger. The OAI-23 was translated into Portuguese, reviewed by a committee of expert reviewers, pretested on a focus group, and back-translated. Using convenience sampling methods, patients who were treated at specialized health centers located in different parts of Brazil were invited to complete a demographic and health history questionnaire, the Janis and Field Self-Esteem Scale, and the adapted version of OAI-23 to assess its reliability, convergent construct validity, and discriminant construct validity. RESULTS: A total of 191 patients with a mean age of 58.9 years (SD = 14.7) (74.1% with colostomies, 19.6% with ileostomies, and 6.3% with urostomies) participated in the study. The Brazilian Portuguese adapted version of the OAI-23 had a Cronbach's alpha coefficient of 0.846 and an intra-class correlation coefficient of 0.903 (P < .001). Significant correlations between OAI-23 scores and self-esteem scale scores confirmed the convergent construct validity, and the instrument was able to discriminate patients' adjustment according to age. CONCLUSION: The adapted version of the OAI-23 proved to be reliable and valid for use in Brazil; this represents the first instrument capable of assessing psychosocial adaptation of patients with stomas in that country.

Comparison of the perceived stigmatization measures between the general population and burn survivors in Brazil.

OBJECTIVES: To compare perceived stigmatization, symptoms of depression and self-esteem of adults from Brazilian general population with Brazilian burns survivors and to verify the possible correlations between these populations. METHOD: The general population and burn survivors administered the adapted Brazilian versions of the Perceived Stigmatization Questionnaire (BR-PSQ-R), Beck Depression Inventory (BDI) and Rosenberg Self-Esteem Scale (RSES). The Student's t-test for independent samples was employed to identify significant differences between the means of the results from the BR-PSQ-R, BDI and RSES instruments, and the Pearson correlation was used to detect correlations between constructs. The significance level was set at 0.05. RESULTS: Participants of this study included: 102 individuals from the general population and 240 burn survivors. The difference between the BR-PSQ-R mean scores of the two groups was not statistically significant (p = 0.077). The mean scores for the BDI (p = 0.001) and RSES (p = 0.001) where found to be lower in the general population, when compared to burn survivors. Moderate correlations were identified between the perceived stigmatization and depression (r = 0.43; p < 0.001) and perceived stigmatization and self-esteem (r = -0.35; p < 0.001). CONCLUSIONS: Participants from the general population and burn survivors exhibit similar levels of perception of stigmatization; the general population presented fewer symptoms of depression and a higher self-esteem when compared to burn survivors.