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Original Articles
The Effect on Pain of Buzzy® and ShotBlocker® during the Administration of Intramuscular Injections to Children: A Randomized Controlled Trial
Birsen Sivri Bilgen, Serap Balcı
J Korean Acad Nurs 2019;49(4):486-494.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.4.486
AbstractAbstract PDF
Abstract Purpose

To investigate the effect of Buzzy® and ShotBlocker® on reducing pain induced by intramuscular penicillin injections in children.

Methods

This was a randomized controlled study. A total of 150 Turkish children aged 7~12 years who presented to our pediatric emergency clinic and met the inclusion criteria were recruited. The children were randomly assigned to each group (control=50, Buzzy®=50, ShotBlocker®=50). Data were collected using an information form, the State-Trait Anxiety Inventory for Children, Visual Analog Scale, and Faces Pain Scale-Revised.

Results

The children in the control group had significantly higher pain scores during the penicillin injection than the children in the ShotBlocker® and Buzzy® groups. The children in the Buzzy® group had significantly less pain than the children in both the ShotBlocker® and control groups (p<.001).

Conclusion

Buzzy® was more effective compared with ShotBlocker® in this study.

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The Effects of Guided Imagery on Nursing Students Performing Intramuscular Injections
Min Hyun Suk, Suk Yong Kil, Hye Ja Park
Journal of Korean Academy of Nursing 2002;32(6):784-791.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.6.784
AbstractAbstract PDF

PURPOSE: The anxiety and stress of nursing students on performance intramuscular injection diminished nursing skill performance. The purpose of this study was to identify the effects of the guided imagery program on anxiety, stress and nursing skill performance of nursing students. METHOD: The study design was time series with a nonequivalent control group pretest- posttest study. The Data were collected from the 30th of Oct. to the 6th of Nov. 2001. The objects of this study were 36 sophomores of university(18 for the experimental group, 18 for the control group). The Instruments used in this study were State Trait Anxiety Inventory developed by Spielberger (1972), Visual Analogue Scale for Stress and Nursing skill performance developed by the researcher. The guided imagery was provided through audiotapes to the subjects for 8 minutes. The pretest was given before the therapy to measure variables for both groups and the posttests were performed after intervention. The data were analyzed by the SAS program using t-test and paired t-test. RESULT: The results of this study are as follows. The level of anxiety of students who received the guided imagery were significantly lower than that of control group. the level of stress had a deeling tendency and the nursing skill performance level was significantly higher than that of control group. CONCLUSION: The guided imagery suggested as an effective nursing intervention did reduce the anxiety and promoted nursing skill performance of nursing students.

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The Effect of Cutaneous Stimulation and distraction on IV Injection Pain of Chemotherapy Patients
Jeong Sook Park
Journal of Korean Academy of Nursing 1998;28(2):303-318.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.2.303
AbstractAbstract PDF

Cutaneous stimulation and distraction are independent nursing interventions used in various painful conditions, which I explained by gate control theory. This study was aimed at identifying the effect of cutaneous stimulation, distraction and combination of cutaneous stimulation and distraction on the reduction of intravenous injection pain levels of chemotherapy patients. Repeated measurement post test research design was used for one group. Fifty-three cancer patients who received intravenous chemotherapy regular in outpatient injection rooms of D medical center and Y medical center in Taegu were studied from June 23, 1997 to July 12, 1997. First the intravenous injection pain level of the control period was measured. Second, the intravenous injection pain level of the experimental period using cutaneous stimulation was measured. Third, the intravenous injection pain level of the experimental period using distraction was measured. Fourth, the intravenous injection pain level of the experimental period using a combination of cutaneous stimulation and distraction was measured. The instruments used for this study were a visual analogue pain scale as subjective pain measurement and an objective pain behavior checklist. Analysis of data was done by use of repeated measure ANOVA, bonferni, t-test, and F-test. The results of this study were summarized as follows : 1) The first hypothesis that the subjective pain score of intraveneous injection pain in the experimental period with cutaneous stimulation will be lower than in the control period. 2) The second hypothesis that the objective pain behavior score of intravenous injection pain in the experimental period with cutaneous stimulation will be lower than in the control period was accepted(F=24.23, p=0.0001, Bornferni p<0.5). 3) The third hypothesis that the subjective pain score of intravenous injection pain in the experimental period with distraction will be lower than in the control period was rejected. 4) The fourth hypothesis that the objective pain score of intravenous injection pain in the experimental period with distraction will be lower than in the control period was accepted(F=24.23, p=0.0001, Bornferni p<.05). 5) The fifth hypothesis that the subjective pain score of intravenous injection pain in the experimental period with combination of cutaneous stimulation and distraction will be lower than in the control period was accepted(F=3.04, p=0.031), Bonferni p<.05). 6) The sixth hypothesis that the objective pain score of intravenous injection pain in the experimental period with combination of cutaneous stimulation and distraction will be lower than in the control period was accepted(F=24.23, p=0.0001, Bonferni p<.05).

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Guided Imagery Types on Stress and Performance of an Intramuscular Injection of Nursing Students
Minhyun Suk, Wonoak Oh, Sukyong Kil
Journal of Korean Academy of Nursing 2006;36(6):976-982.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.6.976
AbstractAbstract PDF
Purpose

The purpose of this study was to compare the feeling state guided imagery(FSGI) and end state guided imagery(ESGI) on stress and performance of an intramuscular injection of nursing students.

Method

The design was a time series with a nonequivalent control group pretest-posttest study. Data was collected from the 23 rd to the 25th of Nov. 2004. The subjects of this study were 40 female sophomores (21 for the ESGI, 19 for the FSGI). The instruments used in this study were the Visual Analogue Scale for Stress and the Nursing Skill Performance Check-list on Intramuscular Injection developed by the researchers(10 items). Guided imagery was provided through audiotapes for 8 minutes. A pretest was given before applying the guided imagery, posttest 1 was performed after the intervention, posttest 2 was performed before the intramuscular injection and then evaluation of the performance of the intramuscular injection was done. Data was analyzed using t-test, and Repeated Measures ANOVA.

Result

The level of stress for those who received the ESGI and FEGI was not significant and the level of the nursing skill performance for those who received the ESGI was significantly higher than that of students who received the FEGI.

Conclusion

The use of ESGI has an effect on learning psychomotor nursing skills and further research is needed on stress.

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Prediction of Optimal Gluteal Intramuscular Needle Length by Skinfold Thickness Measurements in Korean Adults
Dong-Won Choi, Kyeong-Yae Sohng, Bum-Soo Kim
J Korean Acad Nurs 2010;40(6):844-851.   Published online December 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.6.844
AbstractAbstract PDF
Purpose

This study was conducted to assess optimal needle length for gluteal intramuscular injections (IM) via simple skinfold thickness (SFT).

Methods

For this study, 190 healthy adults were recruited and grouped into eight groups according to gender and body mass index (BMI) (kg/m2). The Korean Society for the Study of Obesity criteria defines a BMI under 20 as underweight, 20.1-22.9 as normal, 23-24.9 as overweight and over 25 as obese. For each participant, the SFT of dorsoguteal (DG) and ventrogluteal (VG) sites were measured using a caliper. Subcutaneous tissue thickness was acquired through ultrasonic images.

Results

For men in the overweight and obese groups at the DG site, for the obese group at the VG site, and for women in the normal weight, overweight and obese groups at both sites, the mean subcutaneous tissue thickness exceeded 1.84 cm, the minimal length for a 1 inch needle used for IM. At the DG site, optimal intramuscular needle length (OINL) was 1.4 times in women and 1.0 times in men compared to SFT. At the VG site, OINL was 1.3 times in women and 0.9 times in men compared to SFT.

Conclusion

The results of this study suggest that SFT is a reliable index to determine optimal needle length with minimal effort prior to IM.

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Gluteal Subcutaneous Fat Thickness Measured by Computed Tomography as an Estimate of Proper Gluteal Intramuscular Injections in Korean Adults
Gaeul Joo, Kyeong-Yae Sohng
J Korean Acad Nurs 2010;40(2):247-254.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.247
AbstractAbstract PDF
Purpose

To study the thickness of gluteal subcutaneous fat (SCF) and propose an adequate length for needle for gluteal intramuscular injections based on computed tomography (CT) measurements.

Methods

The thickness of gluteal SCF were measured and studied for 568 patients who visited a tertiary hospital in Seoul, Korea between January 2007 and February 2009 for routine health screening and who had abdominopelvic CT.

Results

The average thickness of gluteal SCF was 15.92±4.08 mm in males and 24.90±5.47 mm in females. The thickness of gluteal SCF differed significantly according to gender. The gluteal SCF thickness was greater than 20.4 mm for 54 (12.3%) of the 440 male patients and 99 (77.3%) of the 128 female patients.

Conclusion

The most common syringe needle used for gluteal intramuscular injections in Korea is a 23 G, 25.4 mm-needle. The SCF thickness must be less than 20.4 mm in order to reach the dorsogluteal muscles to a depth of at least 5 mm if this 25.4 mm needle is used. In many patients, especially in female patients, the 25.4 mm needles will result in improper intramuscular injections with the injection being into the SCF. Therefore an appropriate needle should be selected by considering the gender and SCF thickness of patients receiving gluteal intramuscular injections.

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A Comparison of the Effect of Lidocaine or Sodium Bicarbonate Mixed with Rocuronium on Withdrawal Movement, Mean Arterial Pressure and Heart Rate during Rocuronium Injection
Sung Suk Lee, Haesang Yoon
J Korean Acad Nurs 2009;39(2):270-278.   Published online April 28, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.2.270
AbstractAbstract PDF
Purpose

This study was performed to find out the effects of lidocaine or 8.4% sodium bicarbonate mixed with rocuronium on mean arterial pressure, heart rate and withdrawal movement.

Methods

Data collection was performed from December 15, 2006 through May 31, 2007. Seventy-five patients with American Society Anesthesiologist (ASA) physical status I & II, under general anesthesia, were randomly assigned to 1 of 3 groups: R group (RG) received rocuronium 0.6 mg/kg; RL group (RLG), rocuronium 0.6 mg/kg mixed with 2 mL of 2% lidocaine; RS group (RSG), rocuronium 0.6 mg/kg with the same volume of 8.4% sodium bicarbonate. Mean arterial pressure, heart rate and withdrawal movement were observed from its injection until 5 min after endotracheal intubation.

Results

The incidence of withdrawal movement with its corresponding injections was 72%, 40% and 4% in RG, RLG and RSG, respectively (p<.001). Score of withdrawal movement was the lowest in RSG of all groups (p<.001). While mean arterial pressure (p=.011) in RSG decreased significantly, and heart rate (p=.003) in RG increased more with its injection than before induction of anesthesia.

Conclusion

Administration of the equivalent volume of 8.4% sodium bicarbonate with rocuronium is more effective than that of lidocaine with rocuronium compared with rocuronium only, in preventing withdrawal movement and in stabilizing mean arterial pressure and heart rate.

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