title: Effectiveness of medical hypnosis for pain reduction and faster wound healing in pediatric acute burn injury: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Burns and the associated wound care procedures can be extremely painful and anxiety-provoking for children. Burn injured children and adolescents are therefore at greater risk of experiencing a range of psychological reactions, in particular posttraumatic stress disorder, which can persist for months to years after the injury. Non-pharmacological intervention is critical for comprehensive pain and anxiety management and is used alongside pharmacological analgesia and anxiolysis. However, effective non-pharmacological pain and anxiety management during pediatric burn procedures is an area still needing improvement. Medical hypnosis has received support as a technique for effectively decreasing pain and anxiety levels in adults undergoing burn wound care and in children during a variety of painful medical procedures (e.g., bone marrow aspirations, lumbar punctures, voiding cystourethrograms, and post-surgical pain). Pain reduction during burn wound care procedures is linked with improved wound healing rates. To date, no randomized controlled trials have investigated the use of medical hypnosis in pediatric burn populations. Therefore this study aims to determine if medical hypnosis decreases pain, anxiety, and biological stress markers during wound care procedures; improves wound healing times; and decreases rates of traumatic stress reactions in pediatric burn patients.
  
  
  METHODS
  This is a single-center, superiority, parallel-group, prospective randomized controlled trial. Children (4 to 16 years, inclusive) with acute burn injuries presenting for their first dressing application or change are randomly assigned to either the (1) intervention group (medical hypnosis) or (2) control group (standard care). A minimum of 33 participants are recruited for each treatment group. Repeated measures of pain, anxiety, stress, and wound healing are taken at every dressing change until ≥95 % wound re-epithelialization. Further data collection assesses impact on posttraumatic stress symptomatology, speed of wound healing, and parent perception of how easy the dressing change is for their child.
  
  
  CONCLUSIONS
  Study results will elucidate whether the disease process can be changed by using medical hypnosis with children to decrease pain, anxiety, and stress in the context of acute burn wounds.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12615000419561.
authors.affiliation: 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, Australia. sjackchester@gmail.com.|School of Medicine, Mayne Medical School, The University of Queensland, 288 Herston Road, Herston, Brisbane, QLD 4006, Australia. sjackchester@gmail.com.|Ochsner Clinical School, Ochsner Hospital, 1514 Jefferson Highway, New Orleans, LA, 70121, USA. sjackchester@gmail.com.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Chester
authors.affiliation: 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, Australia.
authors.forename: Kellie
authors.initials: K
authors.lastname: Stockton
authors.affiliation: 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, Australia.
authors.forename: Alexandra
authors.initials: A
authors.lastname: De Young
authors.affiliation: 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, Australia.
authors.forename: Belinda
authors.initials: B
authors.lastname: Kipping
authors.affiliation: 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, Australia.
authors.forename: Zephanie
authors.initials: Z
authors.lastname: Tyack
authors.affiliation: 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, Australia.
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Griffin
authors.affiliation: Horizon Behavioral Health, 2241 Langhorne Road, Lynchburg, VA, 24501, USA.
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Chester
authors.affiliation: 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, Australia.
authors.forename: Roy M
authors.initials: RM
authors.lastname: Kimble
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D001458:Bandages; D015415:Biomarkers / Q000378:metabolism; D002056:Burns / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D006990:Hypnosis; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D011793:Queensland; D062326:Re-Epithelialization; D012107:Research Design; D012463:Saliva / Q000378:metabolism; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing; D000516:alpha-Amylases / Q000378:metabolism
chemical_list: D015415:Biomarkers; D000516:alpha-Amylases; D006854:Hydrocortisone
keywords: Anxiety; Burns; Child; Hypnosis; Hypnotherapy; Pain; Posttraumatic stress disorder; Randomized controlled trial; Salivary α-amylase; Stress