Effect of Stress Ball Applied During Surgical Debridement/Dressing on Pain, Distress, and Physiological Parameters in Patients With Diabetic Foot Ulcers

NCT ID: NCT07119983

Last Updated: 2025-12-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-11-01

Study Completion Date

2026-07-01

Brief Summary

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Diabetes mellitus (DM) is a common metabolic disease characterized by hyperglycemia, resulting from a deficiency or insufficiency of insulin. Diabetic foot ulcers (DFU), a late complication of diabetes, develop as a result of peripheral neuropathy, peripheral arterial disease, and trauma, negatively impacting individuals' quality of life and increasing the rate of hospitalization and amputation. While sharp debridement, one of the most effective methods in the management of diabetic foot ulcers, accelerates healing, it often causes pain and anxiety, which negatively impacts the treatment process. The physiological effects of anxiety include increased respiratory and heart rates, increased blood pressure, and prolonged procedure times. These effects can reduce patient compliance and complicate nursing care.

Non-pharmacological interventions offer important alternatives for pain and anxiety management. One such method, the use of a stress ball, is based on a distraction technique and is used to reduce individuals' emotional and physiological stress levels. The literature has demonstrated the positive effects of stress balls during endoscopy, biopsy, and skin procedures. However, there is insufficient evidence regarding the use of stress balls during sharp debridement. Therefore, this study aimed to evaluate the effects of stress balls on pain, distress, and physiological parameters during surgical debridement in patients with diabetic foot ulcers. The results of this study are expected to contribute to nursing care.

Detailed Description

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Conditions

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Diabetic Foot Ulcer Associated With Type II Diabetes Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This study is a randomized controlled experimental design aimed at evaluating the effects of stress ball use on pain, anxiety, distress, and physiological parameters during surgical debridement in individuals with diabetic foot ulcers.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Stress ball

The effects of stress balls on pain, distress and physiological parameters during surgical debridement in patients with diabetic foot ulcers will be investigated.

Group Type EXPERIMENTAL

Stress ball

Intervention Type BEHAVIORAL

The effects of stress balls on pain, distress and physiological parameters during surgical debridement in patients with diabetic foot ulcers will be investigated.

Control Group

Routine care

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Stress ball

The effects of stress balls on pain, distress and physiological parameters during surgical debridement in patients with diabetic foot ulcers will be investigated.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Patients who agree to participate in the study and sign the Informed Consent
* Form will be included in the study.
* They are over 18 years of age,
* They are literate in Turkish,
* They are undergoing surgical debridement for the first time,
* They are receiving inpatient treatment in the ward, and
* They have pain ≥1 on the Visual Analog Scale (VAS) before the procedure.

Exclusion Criteria

* Patients who have a diagnosed psychiatric or mental illness,
* Regular painkiller use and chronic pain,
* Visual, hearing, perception, or communication problems,
* Physically impaired (such as an open wound on the hand or lack of muscle strength to squeeze a stress ball),
* Decided to undergo an intervention to reduce pain before debridement (such as local anesthesia, nerve blockade, opioid analgesics, etc.),
* Used non-pharmacological methods to reduce pain before the procedure will not be included in the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cukurova University

OTHER

Sponsor Role lead

Responsible Party

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Derya Gezer

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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DERYA GEZER, Asisstant Professor

Role: STUDY_CHAIR

Tarsus University

EZGİ MUTLUAY YAYLA, Asisstant Professor

Role: STUDY_DIRECTOR

Tarsus University

DUDU ALPTEKİN, Dr

Role: STUDY_DIRECTOR

CUKUROVA UNİVERSİTY

Locations

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Tarsus University

Mersin, Tarsus, Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Derya GEZER, Asisstant Professor

Role: CONTACT

+905076990081

Ezgi Mutluay YAYLA, Asisstant Professor

Role: CONTACT

Facility Contacts

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Tarsus University University

Role: primary

+90 (324) 600 00 33

References

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Purcell A, Buckley T, King J, Moyle W, Marshall AP. Topical Analgesic and Local Anesthetic Agents for Pain Associated with Chronic Leg Ulcers: A Systematic Review. Adv Skin Wound Care. 2020 May;33(5):240-251. doi: 10.1097/01.ASW.0000658572.14692.fb.

Reference Type BACKGROUND
PMID: 32304447 (View on PubMed)

Hajimohammadi K, Parizad N, Bagheri M, Faraji N, Goli R. Maggot therapy, alginate dressing, and surgical sharp debridement: Unique path to save unresponsive diabetic foot ulcer. Int J Surg Case Rep. 2023 Oct;111:108907. doi: 10.1016/j.ijscr.2023.108907. Epub 2023 Oct 4.

Reference Type BACKGROUND
PMID: 37804682 (View on PubMed)

Shamloul G, Khachemoune A. Reappraisal and updated review of maggot debridement therapy in chronic lower extremity ulcers. Int J Dermatol. 2023 Jul;62(7):962-968. doi: 10.1111/ijd.16619. Epub 2023 Mar 7.

Reference Type BACKGROUND
PMID: 36880424 (View on PubMed)

McDermott K, Fang M, Boulton AJM, Selvin E, Hicks CW. Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers. Diabetes Care. 2023 Jan 1;46(1):209-221. doi: 10.2337/dci22-0043.

Reference Type BACKGROUND
PMID: 36548709 (View on PubMed)

Sriubolmas N, Panbangred W, Sriurairatana S, Meevootisom V. Localization and characterization of inclusion bodies in recombinant Escherichia coli cells overproducing penicillin G acylase. Appl Microbiol Biotechnol. 1997 Apr;47(4):373-8. doi: 10.1007/s002530050943.

Reference Type BACKGROUND
PMID: 9163951 (View on PubMed)

Alshammari L, O'Halloran P, McSorley O, Doherty J, Noble H. The effectiveness of foot care educational interventions for people living with diabetes mellitus: An umbrella review. J Tissue Viability. 2023 Aug;32(3):406-416. doi: 10.1016/j.jtv.2023.06.001. Epub 2023 Jun 16.

Reference Type BACKGROUND
PMID: 37369610 (View on PubMed)

van Netten JJ, Raspovic A, Lavery LA, Monteiro-Soares M, Paton J, Rasmussen A, Sacco ICN, Bus SA. Prevention of foot ulcers in persons with diabetes at risk of ulceration: A systematic review and meta-analysis. Diabetes Metab Res Rev. 2024 Mar;40(3):e3652. doi: 10.1002/dmrr.3652. Epub 2023 May 27.

Reference Type BACKGROUND
PMID: 37243880 (View on PubMed)

Aslan F, Tosun B, Altinok Ersoy N, Ozen N. 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. J Tissue Viability. 2025 May;34(2):100861. doi: 10.1016/j.jtv.2025.100861. Epub 2025 Jan 26.

Reference Type BACKGROUND
PMID: 39892227 (View on PubMed)

Najafi B, Mishra R. Harnessing Digital Health Technologies to Remotely Manage Diabetic Foot Syndrome: A Narrative Review. Medicina (Kaunas). 2021 Apr 14;57(4):377. doi: 10.3390/medicina57040377.

Reference Type BACKGROUND
PMID: 33919683 (View on PubMed)

Yang L, Rong GC, Wu QN. Diabetic foot ulcer: Challenges and future. World J Diabetes. 2022 Dec 15;13(12):1014-1034. doi: 10.4239/wjd.v13.i12.1014.

Reference Type BACKGROUND
PMID: 36578870 (View on PubMed)

Other Identifiers

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Stress Ball

Identifier Type: -

Identifier Source: org_study_id

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