Effects of Virtual Reality Interventions on Pain and Anxiety in Burn Care.

Abstract

Purpose: To compare the effects of high-immersion versus low-immersion virtual reality (VR) on pain, anxiety, and sense of presence during burn dressing changes in adult patients.

Design: A quasi-experimental, non-randomized crossover study.

Methods: The study was conducted in an inpatient burn center between September 2021 and August 2023. Adult patients undergoing routine nurse-led burn dressing changes experienced both high-immersion and low-immersion VR during two consecutive sessions, alongside standard care without VR. Pain intensity, anxiety, and sense of presence were assessed using validated self-report measures. Linear mixed-effects models were applied to analyze differences across conditions while accounting for repeated measurements and session-related factors.

Results: Sixty-seven patients completed both VR conditions. Use of VR during dressing changes was associated with significantly lower pain and anxiety compared with standard care. No statistically significant differences were found between high- and low-immersion VR for pain or anxiety outcomes. High-immersion VR, however, resulted in significantly higher levels of perceived presence.

Conclusions: Virtual reality is an effective nonpharmacological adjunct for reducing pain and anxiety during burn dressing changes. In this clinical context, increased immersion enhanced subjective presence but did not produce additional analgesic or anxiolytic benefits.

Clinical implications: Burn dressing changes are predominantly nurse-led procedures, placing nurses in a central role in procedural pain and anxiety management. These findings suggest that VR interventions, including low-immersion systems, can be feasibly implemented by nursing staff as part of routine care, indicating clinically relevant reductions in pain and anxiety without substantially increasing technical or workflow demands.