Efficacy of Helfer Skin Tap and Manual Pressure in reducing injection fear and pain in adults receiving intramuscular injections

Aim: This study aimed to investigate the effectiveness of the Helfer Skin Tap and Manual Pressure techniques in reducing injection-related fear and pain among adult patients receiving intramuscular injections. Materials and Methods: This randomized controlled trial was carried out in the emergency department of Adıyaman Gerger State Hospital between March 2025 and July 2026. A total of 165 participants were randomly assigned to three groups: the Helfer Skin Tap group (n = 55), the Manual Pressure group (n = 55), and the control group (n = 55). Data were collected using the Patient Information Form, the Injection Fear Scale, and the Numerical Rating Scale (NRS). Before the intervention, all participants completed the Patient Information Form and the Injection Fear Scale. Following the procedure, the Injection Fear Scale and the Numerical Rating Scale were administered again to assess post-intervention outcomes. Statistical analyses included descriptive statistics, the Chi-square test, one-way analysis of variance (ANOVA), the paired-samples t-test, the Wilcoxon signed-rank test, and the Kruskal-Wallis H test. Effect sizes were calculated using Eta-squared (η²) and Epsilon-squared (ε²), and statistical significance was established at p < 0.05. Results: No statistically significant differences were identified among the groups with respect to baseline fear scores (p > 0.05). However, post-intervention comparisons demonstrated a significant difference between the groups (p < 0.001). Within-group analyses revealed a significant reduction in fear scores after the intervention in both the Helfer Skin Tap and Manual Pressure groups (p < 0.001), whereas no significant change was observed in the control group (p > 0.05). Furthermore, post-intervention pain scores differed significantly among the groups, with the control group reporting higher pain levels than both intervention groups (p = 0.003). Conclusion: The findings indicate that the Helfer Skin Tap and Manual Pressure techniques are effective non-pharmacological interventions for alleviating fear and pain associated with intramuscular injections. The significant reduction in fear and pain observed in the intervention groups compared with the control group supports the incorporation of these techniques into routine clinical nursing practice. Owing to their simplicity, safety, and cost-effectiveness, these methods may serve as practical alternatives for improving patient comfort during intramuscular injection procedures. Keywords: Intramuscular injection; Fear; Pain; Helfer Skin Tap; Manual Pressure.