Factors Affecting Pain, Fear, and Comfort Levels After Intramuscular Injection and Nursing Strategies

Background Intramuscular (IM) injections are among the most frequently performed nursing interventions and are often associated with pain, fear, and reduced patient comfort. Although technical and individual factors influencing pain have been widely studied, limited evidence exists on the interrelationship between pain, fear, and comfort in adult patients receiving IM injections in emergency settings. Aim This study aimed to determine factors associated with pain, fear, and comfort and to examine the relationships among these outcomes after intramuscular injection. Design This study was a cross-sectional, descriptive study. Methods The study was conducted with 454 adult patients who received intramuscular injections in the Emergency Units of Atatürk University Research Hospital between September and November 2024. Data were collected using a Descriptive Information Form, the Visual Analog Scale (VAS) for pain, the Fear of Injection Scale, and the Comfort Scale for Injection. Results The mean scores for pain, fear, and comfort were 2.89 ± 3.07, 2.37 ± 0.98, and 4.55 ± 0.54, respectively. Pain was significantly associated with medication type, frequency of injection, fear level, and patient satisfaction. Fear was influenced by gender, presence of chronic disease, and satisfaction. Comfort was negatively associated with fear and positively associated with satisfaction; comfort scores differed by habits, with lower comfort among participants who reported alcohol consumption. A positive correlation was observed between pain and fear, while both pain and fear were negatively correlated with comfort. Conclusions Pain and fear emerged as key interrelated factors that negatively influence patient comfort during intramuscular injections. Higher fear was associated with higher pain scores and lower comfort scores. These findings highlight the importance of addressing both physical and psychological factors in nursing interventions to enhance patient comfort. Clinical Significance The study's findings emphasize that nurses should adopt patient-centered approaches in IM injection practices and support evidence-based practices to increase patient satisfaction.