The Effects of Relaxation on Wound Healing

INTERVENTION: Intervention: Participating in a Brief Relaxation Session Participants will be exposed to a tape‐stripping procedure to measure skin barrier recovery (SBR), as an index of wound healing in humans. Tape‐stripping is a non‐invasive, simple and minimally painful procedure used to measure the rate at which the top layer of skin recovers after a disruption (i.e., SBR). After the tape‐stripping procedure, participants will be randomly assigned to one of three types of relaxation delivery methods: magazines (control), audiotapes, or a digital human. They will be asked to follow the instructions given by the audiotapes and digital human, or read magazines during a 20 minute recovery period to determine how each method influences the rate at which the skin barrier recovers. The researcher will not be in the room during this recovery period but will be nearby if participants need assistance. When alone in the room, participants will be video‐recorded to assess and monitor adherence to the audiotapes and digital human, as well as whether they touched their wound. Both the digital human and audiotapes condition follow the same relaxation script which includes deep breathing exercises and guided progressive muscle relaxation. This script is based on the script used in a previous study looking at relaxation before and after tape‐stripping (Robinson et al., 2015). The relaxation interventions will only be delivered in a one‐off, 90‐minute session at the Clinical Research Centre on Grafton Campus at the University of Auckland. Digital humans are a form of embodied conversational agent (ECA) that includes a computer‐based dialogue system and a virtual embodiment (Cassell et al., 2000; Sagar et al., 2014). A virtual embodiment refers to an animat CONDITION: Injuries and Accidents ‐ Other injuries and accidents Mental Health ‐ Studies of normal psychology, cognitive function and behaviour Skin ‐ Other skin conditions Wound Healing;Stress; ; Wound Healing ; Stress PRIMARY OUTCOME: Change in trans‐epidermal water loss (TEWL), measured by the Tewameter TM 300. ; ; The TWEL readings from the three time‐points determines the final SBR value for each site. [Baseline, immediately post tape‐stripping and immediately post‐recovery] INCLUSION CRITERIA: Participants will be eligible for inclusion if they: ‐ Are over the age of 18 ‐ Can speak, read, and write in fluent English. SECONDARY OUTCOME: Changes in current anxiety levels measured by a 100mm visual analogue scale [Baseline, immediately post tape‐stripping and immediately post‐recovery] Changes in current pain levels measured by a 100mm visual analogue scales[Baseline, immediately post tape‐stripping and immediately post‐recovery] Changes in current relaxation levels measured by a 100mm visual analogue scale [Baseline, immediately post tape‐stripping and immediately post‐recovery] Changes in current stress levels as measured by 100mm visual analogue scales [Baseline, immediately post tape‐stripping and immediately post‐recovery] Changes in heart rate: Participants will wear a wrist sensor (Empatica E4) which will continuously measure blood volume pulse for the duration of the session. A button will be pressed to timestamp the continuous data at each of the three time points. Blood volume pulse will be converted into a measure of heart rate. [Baseline, immediately post tape‐stripping and immediately post‐recovery] Changes in salivary alpha‐amylase [Baseline, immediately post tape‐stripping and immediately post‐recovery] Changes in salivary cortisol [Baseline, immediately post tape‐stripping and immediately post‐recovery] Changes in skin conductance: Participants will wear a wrist sensor (Empatica E4) which will continuously measure blood volume pulse for the duration of the session. A button will be pressed to timestamp the continuous data at each of the three time points. Electrodermal activity will be used to measure changes in electrical resistance in the skin (skin conductance)[Baseline, immediately post tape‐stripping and immediately post‐recovery] Relaxation Session Feedback as measured by two 100mm visual analogue scales and two open‐ended questions. The visual analogue scales will measure levels of satisfaction and relaxation after the relaxation session. The open‐ended questions have been adapted from Loveys and colleague's feasibility study investigating digital humans and CBSM (in prep). [Immediately post recovery ]