Effects of applications manual pressure and shotblocker to reduce needle-related pain and fear in children with type 1 diabetes mellitus

• Published in: Journal of pediatric nursing Vol. 73; pp. 84 - 90
• Main Authors: Girgin, Burcu Aykanat, Göl, İlknur, Gözen, Duygu, Çarikçi, Fatma, Kirmizibekmez, Heves
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2023
• Subjects: Child; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - drug therapy; Fear; Humans; Insulin - therapeutic use; Insulin injection; Manual pressure; Pain; Pain - etiology; Pain - prevention & control; Pain Measurement - methods; Shotblocker; Fear; Shotblocker; Manual pressure; Pain; Child; Insulin injection
• ISSN: 0882-5963; 1532-8449
• DOI: 10.1016/j.pedn.2023.08.024

Pain and fear associated with insulin injections can cause children with type 1 diabetes mellitus to avoid insulin injections and skip doses. To evaluate and compare pain and fear levels in children aged 6–12 years receiving subcutaneous insulin injection using the manual pressure and ShotBlocker methods. A randomized controlled study was conducted with 90 children with type 1 diabetes who were allocated using block randomization to the manual pressure, ShotBlocker, and control groups (n = 30 in each group). Fear and pain levels were rated by the children, their parents, and a member of the study team immediately before and after insulin injection using the Children's Fear Scale and Wong-Baker Faces Pain Rating Scale, respectively. All groups had similar self-, parent-, and researcher-reported levels of preprocedural pain and fear (p > 0.05). However, pain and fear scores were lower in the manual pressure and ShotBlocker groups than in the control group after injection (p = 0.0001). There was no significant difference in pain and fear scores between the two intervention groups (p > 0.05). Manual pressure and the ShotBlocker both reduced fear and pain associated with insulin injection in 6- to 12-year-old children with type 1 diabetes. Both the manual pressure and ShotBlocker methods can easily be applied in children receiving insulin injections. As manual pressure is completely cost- and equipment-free, it is a useful option to reduce pain and fear related to insulin injection. Clinical Trial Registration Number: National Institutes of Health (NIH), ClinicalTrials.gov, NCT05789810. •Pain and fear associated with insulin injection should be treated as an important issue in pediatric diabetes management, as they negatively impact glycemic control and increase the risk of long-term complications.•At present, no previous study has investigated the efficacy of applying manual pressure and the ShotBlocker in the reduction of fear and pain in children with type 1 diabetes mellitus during insulin administration.•Manual pressure and the ShotBlocker were effective in relieving the fear and pain associated with insulin injection in children with type 1 diabetes mellitus. Both methods can be used to reduce children's fear and pain related to insulin injections.•Manual pressure is an especially useful option to reduce pain and fear related to insulin injection because it is simple, easy to apply, and cost-free.