Effect of Stress Ball Use on Fear and Anxiety During Pediatric Casting Procedures

BACKGROUND: Pediatric trauma patients are often exposed to treatments that can result in pain, fear, and anxiety. While nonpharmacological distraction techniques like stress balls have been increasingly used in pediatric care, their effectiveness during casting procedures remains unexplored. OBJECTIVE: This study aims to evaluate the impact of stress ball distraction on fear and anxiety in pediatric extremity fracture patients during casting procedures. METHODS: This randomized controlled trial, with a parallel group design, was conducted from February to May 2023 in a hospital in Erzurum, Turkey, to evaluate stress ball distraction on fear and anxiety in children aged 6-12 years presenting to the emergency department with extremity fracture. RESULTS: Among 66 children randomized to the stress ball (n = 33) or control (n = 33) group during casting procedures (mean age 8.5 years, 47% female), both groups were comparable at baseline. The stress ball group showed decreased fear scores (mean [SD], 2.24 [1.25] to 1.30 [1.07], p < .001), while controls showed increases (2.42 [1.02] to 3.15 [1.08], p < .001). State anxiety scores decreased in the stress ball group (mean [SD], 4.97 [2.52] to 3.09 [1.79], p < .001) but remained unchanged in controls (3.93 [0.32] to 3.91 [0.29], p = .487). CONCLUSION: Our findings show that stress ball distraction reduced fear and anxiety in children during the casting procedures and is an easy and cost-effective intervention.