The objective of this study was to compare the effect of virtual reality to passive distraction and standard care on burn treatment pain in adolescents.This single-blinded, randomized controlled study enrolled 30 adolescents who were 10 to 17 years of age from the burn clinic of a large children's hospital. After providing informed consent/assent, these participants were randomly assigned to one of three groups during wound care: standard care, passive distraction watching a movie, or virtual reality (VR) using a tripod-arm device rather than an immersive helmet. Before wound care, participants completed the Spielberger's State-Trait Anxiety Inventory for Children and Pre-Procedure Questionnaire while blinded to group assignment. A total of 28 participants completed the study and rated treatment pain after wound care by using the Adolescent Pediatric Pain Tool and completed a Post-Procedure Questionnaire. The VR group reported less pain during wound care than either the passive distraction or standard care group as determined by multivariable linear regression adjusted for age, sex, preprocedure pain, state anxiety, opiate use, and treatment length. The VR group was the only group to have an estimated decrease in pain perception from baseline preprocedure pain to procedural pain reported. Adolescents pretreated with opiate analgesics and female adolescents reported more pain during wound care.This between-subjects clinical study provides further support for VR, even without requiring wearing of an immersive helmet, in lessening burn wound care pain in adolescents. Passive distraction by watching a movie may be less effective in reducing treatment pain. Additional between-subjects randomized controlled trials with larger samples of children and during other healthcare treatments may further support VR's effectiveness in pediatric procedural pain management.

This literature review aims to identify the impact of travel on cancer patients' experiences of treatment. With centralization of cancer services, patients may have to travel considerable distances from their homes and families, to receive specialist cancer treatment. Centralization of cancer services may have advantages in terms of concentrating clinical expertise, enhancing the range of ancillary facilities and rationalising the provision of expensive specialist equipment, but it is not known to what extent patients are affected by additional travel and the prospect of separation from their social networks. A systematic literature search using MEDLINE, SSCI, SOCA and PSYCHLIT, identified 11 relevant studies from six countries. The review showed a paucity of research on the implications of receiving cancer treatment far from home. Most studies can be criticised on methodological grounds. The evidence that travel distance and difficulty increases psychological distress, and reduces compliance with treatment and take up of treatment is largely inconclusive. However, travel to cancer treatment is described as inconvenient and a practical hardship for many patients. It may be perceived, or experienced as, a barrier to treatment. Future studies should evaluate the impact of travel to treatment on quality of life and perceived social support.

Purpose Preterm infants weighing <1500 grams routinely undergo a series of eye examinations to screen for retinopathy of prematurity (ROP). While these examinations are important for the prevention of blindness, infants may suffer adverse physiologic events during and after the examination. The procedure includes administration of mydriatic eye drops that may be absorbed systemically and physical manipulation of the eye that is accompanied by stress and pain. The purpose of the study was to monitor changes in infant health status and adverse physiologic events in the two days following ROP eye screening. Subjects The study used 50 preterm infants with a mean gestational age of 32 weeks, undergoing their first ROP examination in a NICU located in a university medical center. Design This pilot study used a prospective, descriptive design. Methods Physiologic changes and illness events were recorded before and for two days after the eye examination, using tools that tracked parameters of respiratory, cardiovascular, gastrointestinal, and neurological status. Data were collected directly from daily audits of medical records. McNemar’s test for comparing paired proportions and the signed rank test were used for comparing significance of physiologic changes before and after the ROP eye examination. Principal results Apnea events increased significantly (p=0.04) in the 24–48 hour period after the eye examination compared to apnea events before the eye examination. These results were based on 39 infants who were not receiving ventilator support. There was a significant difference in the frequency of oxygen desaturation events between infants with and without apnea (0–24 hours after examination p<0.002, 25–48 hours after examination, p<0.001). There were no significant differences in heart rate, cyanosis, gastric residuals, or seizures after the eye examinations. Conclusions ROP examinations may be associated with increased apnea, a clinically significant problem. Nursing implications include careful monitoring of infants during and after ROP eye examinations, discharge teaching for caregivers, and continued research on nursing interventions to prevent adverse physiologic events.