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The Effect of Stress Ball Application on Anxiety During Conscious Surgical Interventions: A Systematic Review and
Seda Cansu Yeni̇ğün Akbulut1, Hatice Merve Alpteki̇n2, Seçil Taylan1
1Akdeniz University, Kumluca Faculty of Health Sciences, Department of Surgical Nursing, Antalya, Türkiye.
Purpose:
This study aimed to determine the effect of stress balls on anxiety experienced during conscious surgical interventions.
Design:
A systematic review and meta-analysis.
Methods:
Five electronic databases were searched to identify relevant studies published up to December 30, 2024. Three authors independently reviewed the literature, extracted data, and assessed the quality of the included studies. The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 and Cochrane 2021 recommendations. The Risk of Bias tool was used for assessment, and the heterogeneity of studies as well as publication bias were analyzed.
Results:
A search across five electronic databases identified 626 records. After reviewing the titles, removing duplicate articles, and excluding those that did not meet the research criteria based on abstracts, eight articles were included in the full-text analysis. Three researchers read the eligible studies (n = 8), and six studies that met all inclusion criteria were included in the meta-analysis. The selected studies were published between 2015 and 2024.
Conclusions:
This meta-analysis suggests that stress ball application, as a simple nonpharmacological distraction method, may provide a small but consistent benefit in reducing anxiety during elective surgical procedures. However, the limited number of studies, small sample sizes, wide confidence intervals, and variability in application protocols reduce the certainty and generalizability of the findings. Further well-designed randomized controlled trials with standardized protocols are needed to confirm the clinical effectiveness of stress ball use in anxiety management.
