The originality of this study is the comparison of different distractibility techniques (hypnosis and virtual reality) in the very heterogenous contexts of pain management. This study will consider all types of care situations. The study's cross-over design will take into account this heterogenous context. The results will be representative of real-life situations where care for pain involves a wide range of contexts.
Pain is defined as an unpleasant sensorial and emotional experience related to a potential or existing tissue injury (psychological (affective) and physical dimension of pain). Since it can occur at any stage of care, pain concerns all healthcare teams working in acute care units or follow-up care centers. At the present time, pain management is mainly based on the use of analgesic agents that calm or suppress pain. Different types of analgesic agents are available in the therapeutic armamentarium (non-opioid analgesics and opioid analgesics as morphine). In this context where pain management is a priority and where the use of morphine is constantly on the rise exposing patients to significant risk (adverse effects, addictions, respiratory events….), the use of distractibility techniques as hypnosis and virtual reality could be an attractive alternative. * Hypnosis designates both a therapeutic technique and a modified state of consciousness also called trance (a state where the person is between a state of wakefulness and sleep). * Virtual reality designates a three-dimensional computer-controlled environment allowing immersion, interaction and multisensorial input. Thus, the originality of this study is the comparison of different distractibility techniques in the very heterogenous contexts of pain management. This study will consider all types of care situations. The study's cross-over design will take into account this heterogenous context. The results will be representative of real-life situations where care for pain involves a wide range of contexts.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
52
Every patient will receive : * The usual pain management of their ward (Treatment A), * The usual pain management of their ward with a hypnosis session (Treatment B) * The usual pain management of their ward with a virtual reality session (Treatment C)
Every patient will receive : * The usual pain management of their ward with a hypnosis session (Treatment B) * The usual pain management of their ward with a virtual reality session (Treatment C) * The usual pain management of their ward (Treatment A)
Hôpital Léon Bérard
Hyères, France
USSAP - Centre Bouffard Vercelli
Perpignan, France
Centre Mutualiste de Kerpape
Ploemeur, France
Pôle MPR Saint Hélier
Rennes, France
Fondation ILDYS - Site de Perharidy
Analgesia Nociception Index (ANI) during painful care interventions
This index is derived from heart rate variability and reflects the relative parasympathetic tone. An ANI value close to 100 corresponds to a prominent parasympathetic tone (low stress level, analgesia) and a value close to 0 corresponds to a prominent sympathetic tone (high stress level, nociception).
Time frame: one month
ANI's average score (Analgesia Nociception Index) 5 minutes after the care and the distractibility methods
A comparison between the ANI's score before and after the care and the distractibility methods. The average of the scores will be retained.
Time frame: one month
Visual Analog Scale (VAS)
The pain's level will be evaluated by the Visual Analog Scale (VAS). This scale measure the pain's intensity from 0 to 10.
Time frame: one month
Morphine equivalent
The opioid analgesics administered during the care will be converted into morphine equivalent by means of the opioid equi-analgesia table. The collection of analgesics will include all analgesics "in action" on the day of care.
Time frame: one month
Proportion of patients tolerance to distractibility techniques
All events leading to a discontinuation of the distractibility technique will be recorded: side effects /cybersickness (nausea, vertigo evaluated using the Speech, Spatial and Qualities (SSQ) of Hearing Scale prolonged procedure, dissociative disorders …), patient refusal, care-related elements preventing the use of the distractibility technique or leading to premature discontinuation of its use.
Time frame: one month
Correlation between patient age and tolerance
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Every patient will receive : * The usual pain management of their ward with a virtual reality session (Treatment C) * The usual pain management of their ward (Treatment A) * The usual pain management of their ward with a hypnosis session (Treatment B)
Roscoff, France
The impact of age on abandon (irrespective of the reason) will be noted to search for a link between age and tolerance.
Time frame: one month
Correlation between patient age and treatment efficacy
The impact of age on treatment effect on ANI score during the care procedure will be noted to search for a link between age and treatment efficacy.
Time frame: one months
Correlation between caregiver training level and hypnosis efficacy
Hypnosis training level will be determined by the duration of training (hours) and the professional level (1/2/3). Caregiver category (nurse/psychologist/rehabilitation specialist…) and the number of hypno-therapy sessions delivered during the six months preceding the study will also be considered.
Time frame: one month
Percentage of satisfaction concerning the distractibility techniques.
A questionnaire will evaluate patient perceptions concerning the distractibility techniques.
Time frame: one month
IPQ (Igroup Presence Questionnaire) scale
The IPQ is a 14-item self-administered questionnaire. This scale is used to measure the patient's feelings about spatial presence, the implication and sense of the reality perceived in the virtual reality.
Time frame: one month