title: The Effect of Extended Injection of Subcutaneous Heparin on Pain Intensity and Bruising Incidence.
abstract: BACKGROUND
  Reducing patients' pain is one of the main goals of providing clinical services, which requires nursing skill. As a simple technique, increasing the duration of subcutaneous heparin injection may affect the intensity of pain and bruising.
  
  
  OBJECTIVE
  The aim of this study was to assess the effect of increasing the heparin injection time on pain intensity and bruising associated with subcutaneous injection.
  
  
  METHODS
  The present quasi-experimental study consisted of 86 patients, admitted to our hospital, who were treated with subcutaneous heparin injection. A McGill pain intensity questionnaire was used to measure pain severity in a purposive sampling. All of the subjects received subcutaneous heparin twice for 10 seconds. They also were injected twice with heparin infusion, although it was for 30 seconds this time. The interval between the two injections was 24 h, and the intensity of the pain was measured after each injection. The Pearson correlation coefficient was measured, and analysis of variance (ANOVA) and the t-test were used to analyze the data.
  
  
  RESULTS
  Eighty patients received heparin. The body mass indexes were reported as 52 (60%) and 34 (40%) for subjects within the age range of 18.5-24.9 and 25-29.9, respectively. Regarding the mean of pain intensity, there was a significant difference between the 10 and 30 s injections (p < 0.05). Additionally, there was a significant difference in bruising rates between the two methods 48 and 72 h after injection (p < 0.05). The ANOVA test showed a significant association between gender and bruising (p = 0.001).
  
  
  CONCLUSIONS
  According to the results, by elevating the duration of heparin injection, the severity of pain was reduced, and, therefore, the patients felt more comfortable.
  
  
  BACKGROUND
  The trial was registered at the Thai Clinical Trials Registry (TCTR) with the TCTR identification of TCTR20160221001.
  
  
  BACKGROUND
  This research was supported by the research cluster grant (88186-25/01/89) from Mashhad University of Medical Sciences, Mashhad, Iran. The authors received no financial support for the authorship and/or publication of this article.
authors.affiliation: Department of Cardiology, Qaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Ahmadi
authors.affiliation: Department of Gynecology, Sabzevar University of Medical Sciences, Sabzevar, Iran.
authors.forename: Raheleh
authors.initials: R
authors.lastname: Ahmadi
authors.affiliation: Department of Cardiology, Qaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Zoleykha
authors.initials: Z
authors.lastname: Saadati
authors.affiliation: Atherosclerosis and Coronary Artery Research Centre, Birjand University of Medical Science, Birjand, Iran; Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Science, Birjand, Iran.
authors.forename: Omid
authors.initials: O
authors.lastname: Mehrpour
keywords: Bruising; Extended injection time; Heparin; Pain intensity