The effect of stress ball use on stress, sleep quality, and comfort in individuals receiving hemodialysis: a randomized controlled trial.

Abstract

Background: Hemodialysis often leads to various physiological, psychological, and social challenges for individuals receiving this treatment. This study was conducted to determine the effects of stress ball use on stress, sleep quality, and comfort levels in individuals receiving hemodialysis.

Methods: This single-blind randomized controlled trial was conducted with 57 patients (28 experimental, 29 control) receiving treatment at a hemodialysis unit in western Türkiye between February and April 2024. Participants were selected using a simple random sampling method from the eligible patient population. The stress ball intervention was administered three times weekly during hemodialysis sessions for 15 min each session, totaling 12 sessions. The control group received standard hemodialysis treatment and nursing care. The study data were collected using a Patient Assessment Form, the Perceived Stress Scale, Pittsburgh Sleep Quality Index, and Hemodialysis Comfort Scale Version II.

Results: There was no significant difference in pre-test PSS scores between the experimental and control groups (p > 0.05), whereas post-test scores were significantly lower in the experimental group (p < 0.05). For the PSQI, pre-test scores differed significantly between the groups (p < 0.05), but no significant difference was found in post-test scores (p > 0.05). Within-group analysis showed a significant decrease in the experimental group (p < 0.05), while no change was observed in the control group (p > 0.05). ANCOVA confirmed that adjusted post-test PSQI scores were lower in the experimental group (p < 0.05), indicating improved sleep quality. No statistically significant differences were found between the groups in HDCS-II total or subscale scores at either measurement point (p > 0.05).

Conslusion: This study shows that the use of stress balls reduces the perceived stress levels of individuals receiving hemodialysis treatment while enhancing their sleep quality and comfort levels.

Trial registration: ClinicalTrials.gov (NCT06835998). The date of registration is 2025-02-19 (Retrospectively registered).