Effectiveness of Cold Application on Needle Stick Pain During Intramuscular Injection Among Adult Patients

Abstract

Background: Pain associated with intramuscular (IM) injections remains a significant concern in
clinical practice, and cold application, a simple non-pharmacological intervention, helps reduce pain by
decreasing nerve conduction velocity and inhibiting the transmission of pain impulses.
Objective: This study aimed to evaluate the effectiveness of cold application in reducing needle-stick
pain among adult patients receiving IM injections.
Methods: A quantitative approach with a quasi-experimental post-test-only control group design was
adopted, and a total of 60 participants were selected using purposive sampling and assigned to
experimental (n=30) and control (n=30) groups; pain intensity was measured using the Numerical Rating
Scale (NRS) following the intervention.
Results: The experimental group reported significantly lower pain levels, with 53.3% experiencing no
pain and only 3.3% reporting moderate pain, whereas in the control group, 50.1% reported moderate
pain and 6.6% severe pain; the mean pain score in the experimental group (0.93 ± 1.20) was markedly
lower than in the control group (3.5 ± 1.97), demonstrating a statistically significant difference (t = 6.153,
p < 0.01), and a significant association was also observed between educational status and pain perception
in the control group.
Conclusion: Cold application is an effective, economical, and easily implementable intervention for
reducing injection-related pain and can be incorporated into routine nursing practice to improve patient
comfort and quality of care.