Evaluation of the effects of different methods used in subcutaneous heparin applications on pain and satisfaction of patients

Introduction and Objective: Anticoagulant therapy (Heparin) is a prophylactic treatment for the prevention of venous thromboembolism. Some problems such as pain, hematoma and ecchymosis may develop due to this treatment given subcutaneously. Pain at the injection site causes physical and psychological discomfort to the patient. It is very important for nurses to minimize the problems that may arise as a result of subcutaneous heparin injection in order to ensure the comfort and convenience of the patient. This study was conducted to determine the effects of prolonging the injection time, using the Palm Stimulator apparatus, and using the injection time and Palm Stimulator apparatus together on the pain felt during injection and patient satisfaction in patients with subcutaneous heparin injection in the treatment protocol. Materials and Methods: This study is a randomized controlled intervention study. The study was conducted with 112 patients hospitalized in the internal and surgical clinics of a university hospital between 20.08.2024-23.09.2024 and whose treatment protocol included subcutaneous heparin injection. Four groups of patients were included in the study: prolonged injection time (n=28), use of Palm Stimulator apparatus (n=28), combined use of prolonged injection time and Palm Stimulator apparatus (n=28) and control group (n=28). Patients in the prolonged injection time group were injected with an injection duration of 30 seconds. Patients in the group in which the Palm Stimulator apparatus was used were injected with an injection time of 10 seconds and the patient was instructed to squeeze the apparatus in the palm of the hand during the injection. Patients in the group in which prolonged injection time and Palm Stimulator apparatus were used together were injected with an injection time of 30 seconds and the patient was allowed to squeeze the apparatus in the palm of his/her hand during the injection. Patients in the control group underwent standard clinical practice with an injection duration of 10 seconds. "Patient Description Form", 'Visual Comparison Scale for Pain', 'Visual Comparison Scale for Satisfaction' were used for data collection. The data were analyzed by using descriptive statistics, Variance, Kruskal Wallis, dependent groups t Test, Chi-square Test, Kurtosis and Skewness coefficients in SPSS for Windows 22 package program. p<0.05 value was considered statistically significant. Results: The patients in this study had similar characteristics in terms of age, gender, educational status, occupation, clinic of treatment and presence of chronic diseases. The pain and satisfaction status of the patients in terms of different methods used on Day 1 were similar. In the Day 2 evaluations of the patients, it was found that the different methods applied decreased their pain and increased their satisfaction compared to the control group. It was determined that the method that reduced the pain the most was the group in which the injection time was kept longer and the Palm Stimulator apparatus was used together. The method that increased patient satisfaction the most was found to be the method of keeping the injection time long (p<0.05). Conclusion: As a result of the study, during subcutaneous heparin injection, prolonging the injection time, using the Palm Stimulator apparatus, and using the Palm Stimulator apparatus together with prolonging the injection time decreased pain and increased satisfaction. Keeping the injection time long and using the Palm Stimulator apparatus together to decrease pain was found to be more effective than keeping the injection time long and using the Palm Stimulator apparatus. Keeping the injection time longer and using the Palm Stimulator apparatus to increase satisfaction was more effective than keeping the injection time longer and using the Palm Stimulator apparatus together. Keywords: subcutaneous heparin, injection, Palm Stimulator apparatus, injection time, pain, patient satisfaction