Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Ventrogluteal Bölgeye Yapılan İntramusküler Enjeksiyonda Aspirasyon İşleminin Enjeksiyona Bağlı Ağrı ve Konfor Düzeyi Üzerine Etkisi
The Effect of Aspiration During Intramuscular Injection Into the Ventrogluteal Region on the Level of Pain and Comfort Associated with the Injection
Tuba KARABEYa, Şerife KARAGÖZOĞLUb
aGaziosmanpaşa Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü Hemşirelik Esasları ABD, Tokat, TÜRKİYE
bCumhuriyet Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü Hemşirelik Esasları ABD, Sivas, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2021;13(2):303-9
doi: 10.5336/nurses.2020-77248
Article Language: TR
Full Text
ÖZET
Amaç: Bu araştırma, ventrogluteal bölgeye yapılan intramusküler (IM) enjeksiyonda aspirasyon işleminin enjeksiyona bağlı ağrı ve konfor düzeyi üzerine etkisini belirlemek amacıyla deneysel nitelikte tek kör randomize kontrollü bir klinik çalışmadır. Gereç ve Yöntemler: Araştırma Sivas İlinde bulunan Sivas Merkez TOKİ Aile Sağlığı Merkezi'nde 15 Temmuz 2019-15 Aralık 2019 tarihleri arasında yürütülmüştür. Araştırmanın örneklemine, Siyanokobalamin enjeksiyon tedavisi alan, araştırmaya alınma kriterlerine uyan 200 hasta alınmış ve örneklem grubunda yer alan hastalar araştırmanın hem kontrol hem de müdahale grubunu oluşturmuştur. Hastaların ardışık IM enjeksiyon uygulamalarının birincisinde aspirasyon işlemi yapılmış olup, ikinci enjeksiyon uygulamasında aspirasyon işlemi uygulanmamıştır. Tüm enjeksiyon uygulamalarının sonrasında vizüel analog skala (VAS) ve konfor skalası uygulanmıştır. Bulgular: Araştırma bulgularına göre hastaların aspirasyon uygulaması yapılmadan uygulanan IM enjeksiyon sonrası ağrı puanları 3,00 (1,00, 7,00) ve konfor puanları 8,00 (4,00, 10,00) iken aspirasyon uygulaması yapılarak uygulanan IM enjeksiyon sonrası ağrı puanları 5,00 (0,00, 9,00) ve konfor puanları 6,00 (3,00, 9,00) olarak saptanmıştır. Ağrı ve konfor puanları arasındaki korelasyon incelendiğinde, aspirasyon uygulanan grupta (r=-0,682 p=0,001), aspirasyon uygulanmayan grupta (r=-0,669, p=0,001) ilişki saptanmış olup, ilişkinin istatistiksel olarak önemli ve kuvvetli olduğu saptanmıştır. Hastaların IM enjeksiyona bağlı yaşadıkları ağrı azaldıkça, konfor düzeyinin arttığı belirlenmiştir. Sonuç: Sonuç olarak, hastaların IM enjeksiyona bağlı ağrısı azaldıkça konfor düzeyinin arttığı, IM enjeksiyon uygulamalarında ventrogluteal bölge enjeksiyon bölgesi olarak seçildiğinde, yapılan aspirasyon işleminin hastanın enjeksiyona bağlı yaşadığı ağrıyı artırdığı ve buna bağlı olarak hastanın konfor düzeyini düşürdüğü söylenebilir. Bu bağlamda ventrogluteal alana yapılan enjeksiyon uygulamalarında, aspirasyon işleminin yapılmaması önerilmektedir.

Anahtar Kelimeler: İntramusküler enjeksiyon; aspirasyon uygulaması; ağrı; konfor
ABSTRACT
Objective: This research is an experimental one-blind randomized controlled clinical study in order to determine the effect of aspiration procedure on injection-related pain and comfort level in IM into the ventrogluteal region. Material and Methods: The research was carried out between 15 July 2019-15 December 2019 in Sivas Center TOKI Family Health Center in Sivas Province. In the sample of the study 200 patients in the sample group were both the control and the intervention groups. Aspiration procedure was performed in the first consecutive IM injection applications of the patients aspiration procedure was not applied in the second injection application. Results: The mean score of pain after IM injection applied without aspirating was 3.00 (1.00, 7.00) and the mean score of comfort was 8.00 (4.00, 10.00) the mean score after IM injection applied aspiration was 5.00 (0.00, 9.00) and the mean of comfort score was 6.00. (3.00, 9.00). When the correlation between the mean scores of pain and comfort was examined, a relation was found in the group that was applied aspiration and in the group where no aspiration was applied it was found that the relationship was statistically significant and strong. It was determined that as the pain experienced by patients with IM injection decreases, the level of comfort increases. Conclusion: The level of comfort increases as the IM injection-related pain decreases, the aspiration performed when the ventrogluteal region is selected as the injection site in intramuscular injection applications, increases the pain experienced by the patient and accordingly decreases the patient's comfort level. In this context, it is recommended not to perform aspiration in injection applications to the ventrogluteal area. In this context, it is recommended not to perform aspiration in injection applications to the ventrogluteal area.

Keywords: Intramuscular injection; aspiration application; pain; comfort
REFERENCES:
  1. Nicoll LH, Hesby A. Intramuscular injection: an integrative research review and guideline for evidence-based practice. Appl Nurs Res. 2002;15(3):149-62. [Crossref] [PubMed] 
  2. Harkreader H, Hogan MA. Fundamentals of Nursing: Caring and Clinical Judgment. St. Louis, MO: Saunders; 2004.
  3. Zore G, Dias R. Effectiveness of nursing interventions on pain associated with intramuscular injection. International Journal of Science and Research ISSN (Online): 2012;2319-7064. [Link] 
  4. Therese AM, Devi S. Effectiveness of Helfer skin tap technique and routine technique on pain reduction among patients receiving intramuscular injection at Government General Hospital. Puducherry. Int J Sci Res. 2012;3(10). [Link] 
  5. Karabey T, Karagözoğlu Ş. Use of non-pharmacological methods for pain control in intramuscular injection applications: a systematic review. IOSR-JNHS. 2020;9(2):01-06. [Link] 
  6. Akcimen M, Bedel C, Selvi, F. Application of ice and vapocoolant spray to reduce tetanus vaccine pain: A prospective, randomized controlled clinical study. Annals of Medical Research. 2019;26(6):995-8. [Link] 
  7. Yapucu Güneş Ü, Zaybak A, Biçici B. Hemşirelerin intramüsküler enjeksiyon işlemine yönelik uygulamalarinin incelenmesi [Examination of nurses applications for intramuscular injection procedure]. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2009;12(4):84-90. [Link] 
  8. Kara D. İntramüsküler enjeksiyona bağli gelişen ağrinin azaltilmasina yönelik yöntemler [Methods to reduce pain associated with intramuscular injection]. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2013;2(2):275-289. [Link] 
  9. Göl İ. İntramüsküler aşi uygulamalarinda ağri yönetimi: aspirasyonsuz hizli enjeksiyon tekniği [Pain management in intramuscular vaccine applications: rapid injection techniques without aspiration]. Eurasian JHS. 2020;3(2):48-54. [Link] 
  10. WHO. [Immunization in practice: a practical guide for health staff]. (Erişim tarihi: June 1 2019). 2014. Module 6. Holding an Immunization Session. Erişim linki: [Link] 
  11. Göl İ, Altuğ Özsoy S. Effects of Rapid Vaccine Injection Without Aspiration and Applying Manual Pressure Before Vaccination on Pain and Crying Time in Infants. Worldviews Evid Based Nurs. 2017;14(2):154-162. [Crossref] [PubMed] 
  12. Selby PJ, Chapman JA, Etazadi-Amoli J, Dalley D, Boyd NF. The development of a method for assessing the quality of life of cancer patients. Br J Cancer. 1984;50(1):13-22. [Crossref] [PubMed] [PMC] 
  13. Eti Aslan F. Ağrı Doğası ve Kontrolü. 2. Baskı. İstanbul: Akademisyen Kitapevi; 2006.
  14. Cline ME, Herman J, Shaw ER, Morton RD. Standardization of the visual analogue scale. Nurs Res. 1992;41(6):378-80. [Crossref] [PubMed] 
  15. Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain. 1997;72(1-2):95-7. [Crossref] [PubMed] 
  16. Ogston-Tuck S. Intramuscular injection technique: an evidence-based approach. Nurs Stand. 2014;29(4):52-9. [Crossref] [PubMed] 
  17. Hasanpour M, Tootoonchi M, Aein F, Yadegarfar G. [The effect of two non-pharmacologic pain management methods for ıntramuscular ınjection pain in children]. Acute Pain, 2006;(8):7-12. [Crossref] 
  18. Şahin M, Eşer İ. Effect of the Buzzy Application on Pain and Injection Satisfaction in Adult Patients Receiving Intramuscular Injections. Pain Manag Nurs. 2018;19(6):645-51. [Crossref] [PubMed] 
  19. Khanra S, Lenka A. Helfer skin tap technique on pain associated with intramuscular injection among adult patients. International Journal of Nursing Education. 2018;10(3):12. [Crossref] 
  20. Nisbet AC. Intramuscular gluteal injections in the increasingly obese population: retrospective study. BMJ. 2006;332(7542):637-8. [Crossref] [PubMed] [PMC] 
  21. Cocoman A, Murray J. Intramuscular injections: a review of best practice for mental health nurses. J Psychiatr Ment Health Nurs. 2008;15(5):424-34. [Crossref] [PubMed] 
  22. Ergün A, Eti Aslan F, Vatan F, Olgun N, Kuğuoğlu S. Sağlık bakımında gelişmeler ve bakım uygulamaları. Karadakovan A, Eti Aslan F, editörler. Dahili ve Cerrahi Hastalıklarda Bakım. Adana: Nobel Kitabevi; 2010. p.1-21.
  23. Thomas CM, Mraz M, Rajcan L. Blood Aspiration During IM Injection. Clin Nurs Res. 2016;25(5):549-59. [Crossref] [PubMed] 

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