الفهرس 
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Abstract
Intramuscular injection is common procedure that nurses frequently carry out which causes pain and distress to the patient ,it has a negative impact on patient as well as affection of nursepatient relationship , Heifer skin tapping technique have positive effect to reduce intramuscular injection pain. Therefore ,the aim of the study was to assess effectiveness of Heifer skin tapping technique on pain associated with IM injection. Aquasiexperimental research design was conducted at medical and surgical units at Main Mansoura University Hospital. The data were collected from purposive sample (100 patients )of both sexes who correspond to inclusion criteria. Each patient was administered repeated intramuscular injections at the gluteal site. Then pain level with administration of intramuscular injection by traditional technique were compared with pain level by Heifer Skin Tapping Technique. Tool:- The tools used for the study were:1- Structured interview sheet consist of two parts:- To elicit the personal information of the respondents, interview technique was considered to be the best one. It also helps to identify misinterpretations and inconsistencies, if any. The data elicited through this technique included personal information and medical data of the respondents. 2- Universal pain assessment tool :- This tool was adopted to assess the pain level of the respondents before and after the procedure of IM injection by traditional and Heifer technique. This tool was thought to be a suitable one, because of multi dimension assessment due to subjective nature of pain which can be described adequately. It consists of three parts( verbal description scale, wong Baker fascial grimace scale and activity tolerance scale )Data gathering process: The period of data collection commenced from beginning of March 2014 to the end of August 2014. Prior to the commencement of the Pilot study, formal administrative permissions were obtained. The investigator introduced herself to the patient and health care worker.The investigator administer IM injection to each patient four time, two by traditional technique and two by Heifer technique, another clinical instructor participate on pain assessment by observing patient facial grimace scale to ensure the smooth functioning of the research process and to avoid bias.