The effect of a stress ball on pain and anxiety during sharp debridement in patients with diabetic foot ulcers: A randomized controlled, single-blind study

Abstract

Objective: The aim of this study was to investigate the effect of using a stress ball during sharp debridement on the pain and anxiety in patients with diabetic foot ulcers. Methods: This study with a randomized, controlled and single-blind design was conducted at a single-center on patients diagnosed with diabetic foot ulcers who were being treated at the endocrinology and metabolic diseases clinic of a university hospital. Patients in the intervention group started using a stress ball before the debridement procedure and continued to use it until the procedure ended. No intervention was made to the patients in the control group. Data were collected by using the Descriptive Information Form, Diabetic Foot Meggit-Wagner Classification, Visual Analogue Scale (VAS), and State Anxiety Inventory (STAI). Results: The study was completed with a total of 76 patients, 38 each in the intervention and control groups. The use of stress balls led to a reduction in anxiety and pain symptoms in the intervention group. The anxiety score of the patients in the intervention group was also found to be statistically significantly lower than those in the control group after the procedure (p = 0.008; η2 = 0,091). The VAS scores of the patients in the intervention group were found to be statistically significantly lower than those in the control group both during (p < 0.001; η2 = 0.348) and after (p < 0.001; η2 = 0.438) the procedure. Conclusions: The use of a stress ball was found to be an effective method of reducing the level of pain and anxiety that occurs during the sharp debridement procedure. Stress ball application is a practical, easy, and cost-effective non-pharmacological method. Clinical trial number: The study was recorded in the ClinicalTrials.gov website with the number NCT06316115. © 2025 The Authors