The Investigation of the Effects on Pain of the Three Different Nonpharmacological Methods in Peripheral Intravenous Catheter Insertion

This study was conducted with the aim of investigating the effect on pain of having healthy male individuals cough, blow into a spirometer or use a stress ball during the insertion of a peripheral intravenous catheter. The study was contucted between March and Semtemper 2015 at the Dr. Rasit Durusoy Blood Center of Uludag University Hospital in Bursa. The sample of the study consisted of 120 healthy male adults who were divided into four groups of 30 members each, having limitations of research, within the range of 30-40 years, and having pressure pain threshold average of 8-16 lb after three measurements. In the collection of the research data was used Baseline Algometer (66lb /30 kg) which to measure the pain pressure threshold of the indivuals, "Informed Volunteer Consent Form", "Individual Identification Form", Visual Analog Scale (VAS), spirometry and stress ball. Individuals who conformed to the research criteria were assigned to the experimental and control groups by a simple randomization method. After obtaining written informed consent of the individual, identifying information of individuals was saved the Individual Identification Form. Then, it was informed individuals about the use of a VAS. Before 5 minutes and immediately after the peripheral intravenous catheterization were measured the blood pressure, pulse rate and peripheral oxygen saturation of indivuals by a health personnel. All of peripheral intravenous catheterizations was applied by same researcher to the antecubital vein on left arm of indivuals. 20 G of peripheral intravenous catheter was used in all peripheral intravenous catheterization. Immediately after the peripheral intravenous catheterization, the pain felt by the individuals and their hemodynamic values during the application was evaluated. Then, 5-6 cc blood sample from individuals were taken through a sterile syringe inserted into the catheter in order to test the suitability of blood donate. The data of study was evaluated with Kruskal-Wallis test, Dunn's test, Wilcoxon signed rank test and Pearson's chi-square test. Those in the coughing group were asked to cough at a medium level twice with a gap of ten seconds, and the catheterization was performed during the second coughing. Those in the spirometer group were asked to take a deep breath and breathe out by blowing into a spirometer for 20 seconds, and catheterization was performed immediately after this. Those in the stress ball group were asked to squeeze and release the stress ball with the hand on the opposite side to that on which the catheterization would be performed, starting two minutes before the application and continuing until it was completed. Individuals in the control group were given only the standard peripheral intravenous catheterization procedure. The mean pain of the individuals in the coughing group was found to be 19.5±13.6, that of the spirometer group was 28.3±20.2, that of the stress ball group was 32.1±23.8, and that of the control group was 45.5±19.5. Statistical analysis showed a significant difference between the mean pain scores of individuals in the control group and those of individuals in the coughing, spirometer and stress ball groups. It can be said that the coughing technique, whose mechanism is the Valsalva maneuver and which serves to attract the attention elsewhere, reduced the pain of peripheral intravenous catheterization more effectively than the other methods. Key words: Pain; Pressure Pain Threshold; Nonpharmacologic Methods; Peripheral Intravenous Catheterization; Valsalva maneuver.