The feasibility of a novel electrical stimulation device for painful hand burns — YRD
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The feasibility of a novel electrical stimulation device for painful hand burns (1876)

Katrina Liddiard 1 , Janet Richmond 1 , Fiona Wood 2
  1. Edith Cowan University, Karrinyup, WA, Australia
  2. Burns Unit, Fiona Stanley Hospital, Murdoch, WA, Australia

Background:  Transcutaneous electrical nerve stimulation is used successfully in a range of conditions1,2 and may have potential to reduce pain and analgesic consumption for hand burn patients; however, motivation of patients and nursing staff to use electrical stimulation is unclear. Partial thickness hand burns are common due to use of hands in functional tasks, and instinctive use of hands for protection3. Burns are one of the most painful injuries experienced4,5 and poorly controlled burn pain has been linked to poor psychological adjustment, reduced quality of life, and increased risk of developing a chronic pain state6,7.

Aims:  This single case experimental design study aimed to determine the feasibility of engaging patients and staff in the use of a novel electrical stimulation device for pain therapy during hand burn care.

Method:  Four patients with <4% TBSA partial thickness hand burns were recruited to use a novel electrical stimulation device at home and during dressings.  Data collected included Visual Analogue Scale measures and the Model of Human Occupation Volitional Questionnaire from patients and staff, before and after dressings, and in a daily patient diary.

Results:  Trends in measures of pain, anxiety, confidence, ease of use and motivation were analyzed.

Conclusion: Occupational therapists offer a unique perspective of the complex human construct of motivation where a high burden of pain and stress may impact on use of a potentially beneficial treatment. Implications of the study findings for self-management of post-burn, and post-operative hand pain will be discussed, along with future research plans.

  1. Bjordal, J. M., Johnson, M. I., & Ljunggreen, A. E. (2003). Transcutaneous electrical nerve stimulation (TENS) can reduce postoperative analgesic consumption. A meta-analysis with assessment of optimal treatment parameters for postoperative pain. European Journal of Pain, 7(2), 181-188. doi: 10.1016/S1090-3801(02)00098-8
  2. Sbruzzi, G., Silveira, S. A., Silva, D. V., Coronel, C. C., & Plentz, R. D. M. (2012). Transcutaneous electrical nerve stimulation after thoracic surgery: systematic review and meta-analysis of randomised trials. Revista Brasileira de Cirurgia Cardiovascular, 27, 75-87.
  3. Edwards, J., & Mason, S. (2013). Hand burn management: minimising pain and trauma at dressing change. British Journal of Nursing, 22(20), S46, S48.
  4. Connor-Ballard, P. A. (2009). Understanding and managing burn pain: part 1. AJN The American Journal of Nursing, 109(4), 48-56.
  5. Lončar, Z., Braš, M., & Mičković, V. (2006). The relationships between burn pain, anxiety and depression. Collegium Antropologicum, 30(2), 319-325.
  6. Edwards, R. R., McKibben, J., Fauerbach, J. A., Smith, M. T., Klick, B., Magyar-Russell, G., . . . Lezotte, D. C. (2007). Symptoms of depression and anxiety as unique predictors of pain-related outcomes following burn injury. Annals of Behavioral Medicine, 34(3), 313-322. doi: 10.1007/BF02874556
  7. Summer, G. J., Puntillo, K. A., Miaskowski, C., Green, P. G., & Levine, J. D. (2007). Burn injury pain: the continuing challenge. The Journal of Pain, 8(7), 533-548.