Effect of stress ball use on cannulation-related invasive pain in Hemodialysis patients: a randomized controlled, single-blind study

TOSUN B., Berşe S., Dirgar E., ÖZEN N.

BMC Nephrology, vol.26, no.1, 2025 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 1
  • Publication Date: 2025
  • Doi Number: 10.1186/s12882-025-04071-w
  • Journal Name: BMC Nephrology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Keywords: Arteriovenous fistula, Cannulation, Hemodialysis, Pain, Stress ball
  • Istanbul University Affiliated: Yes

Abstract

Background: Stress ball usage is one of the non-pharmacological methods that help reduce pain and anxiety by diverting an individual’s attention elsewhere. Purpose: This study evaluates the impact of stress ball use on pain levels during cannulation in hemodialysis patients. Methods: A single-blind, randomized, controlled design was used. Sixty-four participants were divided into experimental (n = 32) and control groups (n = 32). The experimental group used a stress ball for 3 min before and during cannulation, while the control group received routine care without additional intervention. Pain was assessed using the Visual Analog Scale (VAS) after cannulation across 12 sessions. Statistical significance was set at p < 0.05. Results: The median VAS score in the intervention group was significantly lower than in the control group. The intervention group showed a significant decrease in VAS scores over 12 sessions (p < 0.01). Stress ball usage had an increasing effect over time (p = 0.016). Overall, median VAS scores differed significantly between groups (p < 0.01). Conclusion: Using stress balls during cannulation reduces pain intensity in hemodialysis patients, with increased effectiveness over multiple sessions. Nurses can recommend stress balls as a simple and cost-effective pain management method. Trial registration: This study was retrospectively registered at ClinicalTrials.gov (Registration No: NCT06237738) on 2024-01-12.