The effect of the Helfer technique and shotblocker application on pain, fear and anxiety in children aged 4-6 aged years receiving intramuscular injections: A randomized controlled trial

PURPOSE: This study was conducted to examine the effects of intramuscular injection administered using the Helfer Skin Tap Technique, ShotBlocker, and standard technique on pain, fear, anxiety, and satisfaction in children aged 4-6 years. MATERIALS AND METHODS: The study was randomized and controlled, and was conducted between April and August 2025 on 120 children who received injections at the Pediatric Emergency Clinic of an Education and Research Hospital. Data were collected using a Questionnaire, the Wong-Baker Facial Expression Rating Scale, the Children's Fear Scale, and the Children's Anxiety Scale-State. The Fear, Anxiety, and Pain scales were administered by the researcher before the IM injection, during the procedure, and five minutes after the procedure. The level of satisfaction was assessed five minutes after the injection. The data were transferred to IBM SPSS Statistics 26 and analyzed. P<0.05 was accepted for significance. FINDINGS: The sociodemographic characteristics of the groups are homogeneous. There are significant differences between the groups in terms of WB-YIDÖ pain scores, fear of the procedure, anxiety about the procedure, and satisfaction scores (p<0.05). Pain scores are highest in the control group during and after the procedure; additionally, pain scores are higher in the HSTT group than in the shotblocker group. Child fear and anxiety are also higher in the control group than in the other groups, both during and after the procedure; the HSTT group's fear and anxiety levels are higher than those of the shotblocker group. The satisfaction level is higher in the intervention groups than in the control group, with the highest satisfaction seen in the shotblocker group. CONCLUSION: The HSTT and ShotBlocker techniques were found to significantly reduce children's levels of pain, fear, and anxiety compared to the control group, with ShotBlocker being more effective than HSTT. In terms of participant satisfaction, both intervention groups reported higher satisfaction than the control group, with the highest satisfaction found in the ShotBlocker group. Keywords: Child, Helfer Skin Tap Technique, İntramuscular injection, Pain, ShotBlocker