Effects of applications manual pressure and shotblocker to reduce needle-related pain and fear in children with type 1 diabetes mellitus

Abstract

BackgroundPain and fear associated with insulin injections can cause children with type 1 diabetes mellitus to avoid insulin injections and skip doses. ObjectiveTo evaluate and compare pain and fear levels in children aged 6–12 years receiving subcutaneous insulin injection using the manual pressure and ShotBlocker methods. MethodsA randomized controlled study was conducted with 90 children with type 1 diabetes who were allocated using block randomization to the manual pressure, ShotBlocker, and control groups (n = 30 in each group). Fear and pain levels were rated by the children, their parents, and a member of the study team immediately before and after insulin injection using the Children's Fear Scale and Wong-Baker Faces Pain Rating Scale, respectively. ResultsAll groups had similar self-, parent-, and researcher-reported levels of preprocedural pain and fear (p > 0.05). However, pain and fear scores were lower in the manual pressure and ShotBlocker groups than in the control group after injection (p = 0.0001). There was no significant difference in pain and fear scores between the two intervention groups (p > 0.05). ConclusionManual pressure and the ShotBlocker both reduced fear and pain associated with insulin injection in 6- to 12-year-old children with type 1 diabetes. Implications for practiceBoth the manual pressure and ShotBlocker methods can easily be applied in children receiving insulin injections. As manual pressure is completely cost- and equipment-free, it is a useful option to reduce pain and fear related to insulin injection.Clinical Trial Registration Number: National Institutes of Health (NIH), ClinicalTrials.gov, NCT05789810.