RESEARCH Dissertation
PRESENTATION
GUIDE : PRESENTED BY :
Mr. Aqib Mushtaq
Dr. Israel Jeba Prabu.D
[Link]. Nursing 2nd Year
Vice Principal BECON
MSN DEPTT BECON
GATE CONTROL THEORY
Despite the simplicity, affordability, and ease of
implementation, the Helfer Skin Tap Technique is
underutilized in many healthcare settings.
In countries like India, where a large number of IM
injections are administered daily in both public and
private sectors, techniques like HSTT can
substantially improve patient satisfaction, comfort,
and compliance.
Hence, in light of the existing literature, global
injection statistics, and ethical responsibility to
minimize harm, I found a compelling need to
evaluate the effectiveness of the Helfer Skin Tap
Technique in reducing pain associated with
intramuscular injections.
A study to evaluate the effectiveness of
PROB Helfer skin tap technique on pain
associated with intramuscular injection
LEM among adults in Govt Sub District
STAT Hospital Tral Kashmir.
EMEN
T
REVIEW OF LITERATURE
Review of literature related to prevalence of pain
associated with intramuscular injection.
Review of literature related to effectiveness of
Helfer skin tap technique on pain associated with
intramuscular injection.
METHODOLOGY
RESEARCH QUANTITATIVE
RESEARCH
APPROACH APPROACH
QUASI
RESEARCH EXPRIMENTAL
POST-TEST ONLY
DESIGN CONTROL GROUP
DESIGN
ACCESSIBLE:
TARGET: ADULTS AGED 18 or > 18
POPULATION ADULTS AGED 18
YEARS GOING TO RECEIVE
IM INJECTION IN GOVT
or > 18 YEARS SUB DISTRICT HOSPITAL
TRAL KASHMIR
1. Adults aged 18 or above 18 years.
2. Adults who were receiving
INCLUSION
intramuscular injection.
CRITERIA
3. Adults who were willing to participate
in the study.
CRITERIA
FOR SAMPLE
SELECTION
1. Adults who were critically ill.
EXCLUSION
CRITERIA 2. Adults who were deaf and dumb.
3. Pilot study samples were excluded.
DESCRIPTIVE STATISTICS:
Frequency
Percentage
Mean
PLAN FOR DATA Standard deviation
ANALYSIS
INFERENTIAL STATISTICS:
Chi square test
T-test
Description of tool
Data was collected using a standardized tool as MCAFFERY
pain rating scale.
SECTION-A
Demographic and Clinical SECTION-B
Variables Pain assessment
Age, gender, educational (MCAFFERY pain rating
background, BMI, injection scale.)
volume, injection site etc.
SCORING PROCEDURE
0 No pain
1-3 Mild pain
4-6 Moderate pain
7-10 Severe pain
VALIDITY RELIABILITY
The reliability of the tool was
The content validity was done by 11 established by administering the tool to
experts. 6 adults undergoing intramuscular
injection at Govt Sub District Hospital
Tral.
5 experts were of speciality medical
surgical nursing. The remaining 6
experts were from other fields of Reliability was tested using the test–
nursing and physiotherapy department. retest method and Karl Pearson’s
correlation coefficient. The reliability
coefficient was found to be 0.82, which
As per the experts valid suggestion, indicates that the tool is highly reliable.
fewer modifications were made and
incorporated into the tool. The tool was
formulated in the English language and
was found valid.
ETHICAL CONSIDERATION
Written permission
Informed consent
for this study was
was secured from The privacy,
obtained from the All participants
each adult dignity, and
Block Medical were briefed
participant before confidentiality of
Officer Govt Sub- regarding the study
administering the every individual
District Hospital procedures in
Helfer Skin Tap were strictly
Tral and ethical language they
Technique and the maintained
clearance was could clearly
MCAFFERY throughout the
granted by the understand.
Numerical Pain research process
institutional ethical
committee. Rating Scale.
The Pilot study was conducted with 10% of the total
population, amounting to 6 adult participants who
met the eligibility criteria by purposive sampling.
After obtaining verbal and written informed consent
from participants, the Helfer Skin Tap Technique was
administered prior to intramuscular injection, and
pain levels were assessed using the standardized
PILOT MCAFFERY Numerical Pain Rating Scale.
STUDY The pilot study sample was excluded from the main
research. Subjects were assured of confidentiality and
privacy regarding all information provided. Analysis
of pilot data was performed according to the
objectives of the study.
The results confirmed that the research tool was both
feasible and reliable, supporting its implementation in
the main study on the effectiveness of the Helfer Skin
Tap Technique in reducing pain during intramuscular
injections
DATA COLLECTION PROCEDURE
The
experimental
Pain was
Permission was Eligible group received
Participants assessed
obtained from participants the Helfer Skin
were screened were randomly immediately
the Research Tap Technique
based on following the
Ethics assigned to during
predefined injection using
Committee and either the intramuscular
inclusion and the
the hospital control group injection, while
exclusion standardized
authority or experimental the control
criteria to McCaffery
before group, with 30 group received
ensure Numerical Pain
initiating the subjects in each the standard
eligibility. Rating Scale
study. group. intramuscular
(MNPRS).
injection
procedure.
DATA ANALYSIS
DEMOGRAPHIC AND CLINICAL VARIABLES
25
66%
20 63% 63%
60% 60%
56% 56%
53% 53% 50% 50% 53% 53%
15 43% 43%
40% 40%
33%
10
0
E R I N N N E
AG E ND BM IO IO IO SIZ TH
E ND O U
C T C T C T
LE O N
G GR JE E E M
K IN INJ INJ ED R
C G F F NE PE
BA R IN E
O
E
O N
NAL DU SIT M T IO
O N LU JE
C
ATI IO VO IN
C SIT
DU IM
E PO O F
NCY
E
50 E QU
YEARS
FEMALE GRADUATE - ILLITERATE NORMAL BMI SITTING POSITION VENTRO/DORSO 2ML FR 21G
OR RARELY
CONTROL EXPERIMENTAL
ABOVE
OBJECTIVE 1:To assess the post test level of pain during intramuscular
injection among adults of the experimental and control group
Frequency & Percentage distribution level of Experimental & control Group of Pain scores.
CATEGORY SCORE EXPERIMENTAL f(%) CONTROL f(%)
SEVERE (7-10) 0(0%) 12(40%)
MODERATE (4-6) 11(36.7%) 11(36.7%)
MILD (1-3) 14(46.7%) 7(23.3%)
NONE (0) 5(16.7%) 0(0%)
Maximum =10 Minimum =0
OBJECTIVE 2:To evaluate the effectiveness of Helfer skin tap
technique on pain during intramuscular injection among adults of
the experimental group.
N= 30+30
Table
Unpaired t- P
UNPAIRED T TEST Mean S.D. N Mean %
test value
Value Result
at 0.05
EXPERIMENTAL 2.77 1.716 30 27.67
PAIN
6.129 0.005 2.002 Significant
SCORESS CONTROL 5.63 1.903 30 56.33
Maximum=10 Minimum=0
OBJECTIVE 3:To find the association between pain level and selected
baseline variables of adults of the experimental and control group.
EXPERIMENTAL CONTROL
GENDER GENDER
EDUCATION
EDUCATION
BMI
BMI
INJECTION
INJECTION SITE FREQUENCY
INJECTION SITE
VOLUME
VOLUME
NEEDLE SIZE
NEEDLE SIZE
DISCUSSION
Objective 1: To assess the post test level of pain during
intramuscular injection among adults of the
experimental and control group
These findings were consistent with the study done by
The findings of data analysis
Hirnisha Makwana and Dipti Chauhan who conducted a
revealed that the mean post-test
quasi-experimental study in 2024 with post-test-only
pain score in the experimental
design among 80 hospitalized adults in Gujarat.
group was 2.77, while in the
Participants were selected using convenient sampling.
control group it was 5.63,
Pain was measured using McCaffery’s 0–10 Numerical
indicating that the participants in
Pain Rating Scale. The study revealed that participants
the control group experienced
in the experimental group who received IM injections
more pain than the experimental
using the Helfer Skin Tap Technique had significantly
group.
lower mean pain scores than the control group.
Objective 2:To evaluate the effectiveness of Helfer skin
tap technique on pain during intramuscular injection
among adults of the experimental group.
The mean percentage pain score was 27.67% These findings are consistent with the study done by
in the experimental group and 56.33% in the Masrat Arif who conducted a study in 2024. The mean
control group, indicating a clear difference in percentage score was 17% in the experimental group
pain levels between the two groups. The and 37% in the control group, indicating a noticeable
unpaired t-test value was 6.129, which is difference in pain levels between the two groups. The
greater than the table value of 2.002 at the unpaired t-test value was 11.031, which is greater than
0.05 significance level, with a p-value of the table value of 2.002 at a 0.05 significance level,
0.005. Since the p-value was less than 0.05 with a p-value less than 0.001. This demonstrates a
and the calculated t-value was greater than statistically significant difference in pain levels
the table value, this demonstrates a between the two groups. These findings confirm that
statistically significant difference in pain the intervention used in the experimental group was
levels between the two groups. These effective in reducing pain compared to the control
findings confirm that the intervention used in group, which confirms the effectiveness of Helfer Skin
the experimental group was effective in Tap Technique in reducing pain among adults during
reducing pain compared to the control group. intramuscular injections
Objective 3:To find the association between pain level and
selected baseline variables of adults of the experimental and
control group.
These findings are consistent with the
study done by Eric Zijlstra and Annelie
Fischer who conducted a study in 2021 to
Regarding the association between pain level assess the effect of participant
and selected demographic variables, the characteristics and injection factors on pain
results revealed that gender, age, BMI, perception. The results revealed that that
injection site, needle size, volume of variables such as age, gender, BMI,
injection and position during injection had a injection site, injection volume, medicine
significant association with pain scores. administering speed and needle size had
statistically significant effects on pain
ratings.
CONCLUSION
The present study conclusively demonstrates that the Helfer Skin Tap
Technique is a simple, safe, and highly effective non-pharmacological
intervention for significantly reducing pain associated with intramuscular
injections in adults.
Given its ease of application, cost-effectiveness, and minimal resource
requirements, the Helfer Skin Tap Technique holds great promise for
widespread adoption in clinical nursing practice.
Integrating this evidence-based intervention into routine care not only aligns
with compassionate, patient-centered nursing but also supports improved
adherence to treatment and positive healthcare experiences.
This study reinforces the critical role of nurses in applying innovative,
scientifically grounded methods to alleviate procedural pain and underscores
the need for further research and education to expand its utilization.