Nonpharmacological Management of Pain and Fear During Hormone Injection in Breast Cancer Patients

Objective This study aims to comparatively evaluate the effects of the ShotBlocker device and the Helfer Skin Tap Technique on pain and fear during intramuscular (IM) injection of premenopausal and postmenopausal hormone medications used in breast cancer patients. The study aims to increase patient comfort, support treatment compliance, and improve the quality of nursing care.

Type of Research This research will be conducted using a randomized controlled experimental design. Participants will be randomly assigned to three groups: the ShotBlocker group, the Helfer Skin Tap Technique group, and the control group.

Location and Time of the Study The study will be conducted in the oncology unit of Batman Training and Research Hospital between February and April 2026.

Participants/Sample The study population consists of premenopausal and postmenopausal breast cancer patients who apply to the hospital for hormone injection during the specified dates. Power analysis calculated a minimum of 93 patients; considering possible losses, a total of 99 patients is targeted. Participants will be distributed equally among the groups (ShotBlocker=33, Helfer=33, Control=33).

Method / Intervention ShotBlocker Group: The ShotBlocker device will be placed in the gluteal region prior to injection.

Helfer Skin Tap Technique Group: Points close to the injection site will be stimulated with rhythmic taps prior to injection.

Control Group: The standard IM injection protocol will be applied. All injections will be administered by the same nurse, using the same technique, in a standardized manner. Pain will be assessed using the Visual Analog Scale (VAS) after the injection, and fear will be assessed using the Injection Fear Scale before and after the injection.

Data Collection Tools Individual Identification Form: Participants' demographic characteristics and injection history.

Injection Fear Scale: 14-item Likert-type scale, 1-5 point range. Visual Analog Scale (VAS): Measurement of pain level after injection using a 0-10 cm line.

Expected Results/Significance The study is expected to determine and compare the effectiveness of ShotBlocker and the Helfer Technique in reducing injection-related pain and fear. The results have the potential to support the use of nonpharmacological methods in clinical practice, thereby increasing patient comfort, ensuring treatment compliance, and improving the quality of nursing care.

Inclusion criteria

• Patients aged between 18 and 65 years.
• Patients diagnosed with breast cancer.
• Requirement of intramuscular (IM) injection of premenopausal or postmenopausal hormonal medications as part of their prescribed treatment.
• Cognitive competence to provide informed consent for the injection procedure. Intact skin integrity and normal sensory perception at the injection site (gluteal region).

Exclusion criteria

• History of chronic pain disorders, neuropathic pain syndrome, or any disease requiring regular analgesic use.
• Presence of neurological or cognitive disorders that may alter pain or fear perception.
• Use of analgesics within the last 24 hours (or a specific timeframe relevant to your study).