Non-pharmacological Pain Care using Virtual Reality Therapy or Music Therapy during complex wound care in adults

Wound-related pain is common and is usually experienced as both physically and
emotionally unpleasant. Pain can cause stress which can negatively affect wound
healing and the patient's quality of life. Opioids are mostly used for pain
management. However, opioids have side effects, risk of dose tolerance and risk
of drugs dependence. Therefore, it is important to be able to offer patients
effective alternatives, such as non-pharmacological pain relief through
distraction. Virtual Reality therapy and Music therapy are one of these
non-pharmacological interventions. Previous research has shown that Virtual
Reality therapy and Music therapy have a positive effect on pain, anxiety and
opioid use.

This study investigates the extent to which Virtual Reality glasses and Music
therapy can contribute to less pain, and less anxiety compared to patients who
receive no intervention during complex wound care. And to investigate to what
extent VRT can contribute to pain reduction compared to patients receiving MT.
In addition, it is examined which of the two interventions is preferable.

The main objectives of this study are to investigate to what extent:

1) VRT and MT can contribute to pain reduction compared to patients who receive
no VRT and MT intervention during complex wound care; and
2) VRT can contribute to pain reduction compared to patients receiving MT

In addition, it is examined which of the two interventions is preferable.

Randomized Clinical Trial

After the patient has decided to participate in the study, it is randomly
determined to which group the patient belongs:
- Group 1 (intervention group 1): The intervention group 1 wears Virtual
Reality glasses during the wound care moment, where they can choose from a
number of themes. This group wears the Virtual Reality glasses 10 minutes
before the start of the wound care, until 1 minute after the wound care has
ended.
- Group 2 (intervention group 2): The intervention group 2 wears a headphone
with music, where they can choose their own music. This group wears the
headphone with music 10 minutes before the start of the wound care, until 1
minute after the wound care has ended.
- Group 3 (control group): The control group receives neither Virtual Reality
glasses nor Music Therapy during wound care.

Patients who have experienced at least 1 wound care moment, where they have
indicated a VAS equal to 4 or higher, can participate in the study. After they
have decided to participate, they are examined during 1 to 3 wound care moments.
Before and after the wound care moment, both groups are asked to indicate the
pain score according to the VAS score, to complete the validated questionnaire
about anxiety (STAI-6) and the satisfaction questionnaire.
During the wound care moment, the mean heart rate, blood pressure, respiratory
rate and saturation are recorded for both groups.
Patients are prescribed the basic pain medication according to the WHO pain
ladder as standard: paracetamol and/or NSAIDs. At the request of the patient,
patients can receive escape pain medication.

Group 1 (intervention group 1): The intervention group 1 wears Virtual Reality
glasses during the wound care moment, where they can choose from a number of
themes. This group wears the Virtual Reality glasses 10 minutes before the
start of the wound care, until 1 minute after the wound care has ended.
Group 2 (intervention group 2): The intervention group 2 wears a headphone with
music, where they can choose their own music. This group wears the headphone
with music 10 minutes before the start of the wound care, until 1 minute after
the wound care has ended.
Group 3 (control group): The control group receives neither Virtual Reality
glasses nor Music Therapy during wound care.

Patients who decide to participate in the study will be asked to indicate their
pain score (VAS) before and after wound care, and asked to complete
questionnaires investigating anxiety (STAI-6) and satisfaction (patient
satisfaction questionnaire). Blood pressure, heart rate, saturation and
respiratory rate are measured 5 minutes before wound care. During wound care,
heart rate, satiety and respiration are measured every 5 minutes. These vital
signs are measured again 5 minutes after wound care has ended. In total, a
minimum of 1 to a maximum of 3 wound care procedures will be included in the
study.