title: The effect of the application of manual pressure before the administration of intramuscular injections on students' perceptions of postinjection pain: a semi-experimental study.
abstract: OBJECTIVE
  To evaluate the efficacy of applying manual pressure before intramuscular injection and compare it with the standard injection technique in terms of reducing the young adult student's postinjection pain.
  
  
  BACKGROUND
  The administration of intramuscular injections is a procedure performed by nurses and one that causes anxiety and pain for the patient. Nurses have ethical and legal obligations to mitigate injection-related pain and the nurses' use of effective pain management not only provides physical comfort to the patients, but also improves the patients' experience.
  
  
  METHODS
  Comparative experimental study.
  
  
  METHODS
  This study was conducted with first-year university students (n = 123) who were scheduled for hepatitis A and hepatitis B vaccination via deltoid muscle injection. Students were randomly assigned to the groups. Comparison group students (n = 60) were given an injection using the conventional method, that is without manual pressure being applied prior to the injection. The experimental group students (n = 63) received manual pressure at the vaccination site immediately before injection for a period of 10 seconds. The two techniques were used randomly. The subjects were given pressure to the injection site, and perceived pain intensity was measured using Numerical Rating Scale.
  
  
  RESULTS
  Findings demonstrate that students experienced significantly less pain when they received injections with manual pressure compared with the standard injection technique. The postinjection average pain score in the comparison group was higher than that in the experimental group (p < 0·05).
  
  
  CONCLUSIONS
  This study's results show that the application of manual pressure to the injection site before intramuscular injections reduces postinjection pain intensity in young adult students (p < 0·05). Based on these results before the injection, applying manual pressure to the adult's intramuscular injection site is recommended.
  
  
  CONCLUSIONS
  Applying pressure to the injection area is a simple and cost-effective method to reduce the pain associated with injection.
authors.affiliation: Nursing Department, Fundamentals of Nursing, Faculty of Health Sciences, Başkent University, Ankara, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Öztürk
authors.affiliation: Department of Nursing, Fundamentals of Nursing, Faculty of Health Science, Gazi University, Ankara, Turkey.
authors.forename: Zehra Gocmen
authors.initials: ZG
authors.lastname: Baykara
authors.affiliation: Faculty of Nursing, Koç University, Istanbul, Turkey.
authors.forename: Ayise
authors.initials: A
authors.lastname: Karadag
authors.affiliation: Department of Nursing, Fundamentals of Nursing, Faculty of Health Science, Gazi University, Ankara, Turkey.
authors.forename: Evrim
authors.initials: E
authors.lastname: Eyikara
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects / Q000379:methods*; D008297:Male; D010146:Pain / Q000503:physiopathology / Q000517:prevention & control*; D059408:Pain Management / Q000379:methods* / Q000451:nursing; D010147:Pain Measurement; D010465:Perception; D011312:Pressure; D011897:Random Allocation; D013334:Students; D055815:Young Adult
keywords: intramuscular injection; manual pressure; pain management