Effect of nature-based sounds on pain and anxiety during dressing changes in hospitalized burn patients: A randomized controlled clinical trial.

Abstract

Burn injuries are associated with severe pain and anxiety, particularly during dressing changes. This study aimed to evaluate the effects of nature-based sounds (N-BSs) in alleviating pain intensity and anxiety levels in hospitalized burn patients. This single-center, randomized controlled clinical trial enrolled 86 adult burn patients in Arak, Iran, between December 2023 and June 2024. Of these, 84 patients completed the study (2 withdrawals). Participants were randomly assigned to an experimental group (a 30-minute N-BS session during dressing changes) or a control group (regular dressing changes). Pain intensity (Visual Analog Scale [VAS]) and anxiety (State-Trait Anxiety Inventory [STAI-S]) were assessed before and after the intervention. Data were analyzed using Chi-square, t-tests, and paired t-tests (P < 0.05). At baseline, there were no significant between-group differences in pain (P = 0.96; 95 % CI [-9.31, 0.98]) or anxiety (P = 0.63; 95 % CI [-4.96, 3.01]). Post-intervention, the N-BS group demonstrated a significant within-group reduction in pain (P < 0.001; 95 % CI [0.57, 1.90]; effect size=0.58), whereas the control group did not (P = 0.12; 95 % CI [-0.12, 0.97]). However, between-group analysis showed no statistically significant difference in post-intervention pain (P = 0.06; 95 % CI [-0.61, 1.72]) or anxiety (P = 0.80; 95 % CI [-4.36, 3.36]). Analgesic consumption was also comparable between the two groups (P > 0.49). A single-session N-BS intervention may offer limited clinical benefits for pain and anxiety during dressing changes in burn patients. Future studies should investigate extended exposure durations, repeated sessions, and personalized stimuli to optimize the efficacy of N-BS in burn pain and anxiety management.