Effect of Acupressure Therapy on Pain, Fear, and Post-Injection Satisfaction in Patients Undergoing IM Injection

Intramuscular (IM) injection is a parenteral drug application where large amounts of drugs are administered into the deep muscle layer. IM injections are frequently made into the Ventrogluteal (VG), Dorsogluteal (DG), Vastus Lateralis/LateroFemoral and Deltoid muscles. Studies conducted in recent years in particular have indicated that the DG region is a risky area due to its proximity to the gluteal artery and sciatic nerve, and therefore it is emphasized that it should not be preferred unless necessary. Although it is a frequently preferred application among drug administration methods, IM injections have serious risks such as "accidental administration of the drug into the vein and nerve damage, post-injection pain, ecchymosis, and swelling". One of the most common complications encountered in intramuscular injection applications is pain. Although pain is defined as a universal experience that every individual has encountered at least once in their life, there are individual differences in the perception and expression of pain. It is reported that the pain that occurs with IM injection is related to the mechanical trauma that occurs at the needle entry and the sudden pressure created by the drug while it is injected into the muscle. In IM injection applications, the patient's anxiety and fear level before the injection significantly affects the pain they feel. In IM injection applications, the pain that occurs when the needle is inserted into the muscle initiates anxiety and can also cause people to feel fear of IM injection applications throughout their lives. Due to the fear that develops due to IM injection, patients may postpone the injection application or do not have the injection. Injection applications may also cause an increase in pain, fear and anxiety levels and a decrease in comfort and satisfaction levels in individuals. For this reason, nurses are expected to take precautions or implement interventions that will reduce pain, increase comfort and satisfaction, and alleviate the patient's symptoms during drug applications. In the literature, there are applications such as using the appropriate injection technique, positioning the patient appropriately, slowly administering the drug to the tissue, using the Z technique, applying an air lock, diverting the patient's attention, and using different alternative therapy methods to reduce the pain that occurs due to injection applications. One of these alternative therapy methods is acupressure therapy.

Acupressure therapy is a technique that aims to relieve or prevent pain by applying pressure to certain points with fingers. The physiological effect of this method is associated with the stimulation of pain modulation through different mechanisms. It is accepted that the life energy called "Chi" flows along energy channels called "meridians" in the body, which are named according to the internal organs. There are 14 meridians in the human body, 12 of which are double and 2 are single. The pressure applied to the points on these channels reduces the tension in various parts of the body and the tension in the muscles, increases the secretion of endorphins and blood circulation. Acupressure application is based on applying manual pressure to the same point with the finger and palm for approximately 1 minute.

The American Pain Management Nursing Association has emphasized that correct and effective interventions should be applied to the patient, situation, environment and needs in order to manage pain/fear/anxiety and ensure patient satisfaction before, during and after interventional applications for patients. Before the intramuscular injection, most patients are afraid because they think they will feel pain, and they postpone or do not have the medication applied. This situation causes the treatment to be interrupted and the recovery to be delayed. At this point, the use of acupressure therapy can be effective in reducing the feeling of pain and alleviating/eliminating the fear felt against the injection and thus increasing the satisfaction after the injection. When the literature is examined, it is seen that the studies on the pain, fear of injection and the level of satisfaction after the injection in acupressure therapy in intramuscular injection applications are limited. In this context, this study was planned to examine the effect of acupressure therapy on pain, fear of injection and the level of satisfaction after the injection in patients who receive intramuscular injection.

Inclusion criteria

• The patient must be 18 years of age or older,

• Have the physical and mental capacity to correctly evaluate the Visual Analog Scale (VAS),
• Have the capacity to read and understand the research guidelines,
• Have a prescription from the physician that only requests Diclofenac Sodium by Intra Muscular,
• Have their treatment just started,
• Be within the normal weight-obese range according to the BMI determined by the World Health Organization,
• Have not received Intramuscular injections from the Ventrogluteal (VG) region in the last 6 months,
• Have no scars, scar tissue, etc. in the VG region

Exclusion criteria

• - Using any painkillers on the day of the injection