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Diabetic Foot Ulcer Associated With Type II Diabetes MellitusNCT07119983

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

A study testing Stress ball in people with Diabetic Foot Ulcer Associated With Type II Diabetes Mellitus, run by Cukurova University at 1 site in Turkey (Türkiye).

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

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… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Stress ball
Could I receive a placebo?
No, everyone receives an active treatment
How many people
84 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 Nov 2025to 1 Jul 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 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.

Who cannot join

  • 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.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Derya GEZER, Asisstant Professor contact

+905076990081

deryasahhin@hotmail.com

Ezgi Mutluay YAYLA, Asisstant Professor contact

ezgiyayla@tarsus.edu.tr

Turkey (Türkiye)1 site, 1 recruiting
  • Tarsus University

    Mersin, Tarsus, 33400

    Tarsus University University, +90 (324) 600 00 33, bilgi@tarsus.edu.tr

    Recruiting

Other trials in Turkey (Türkiye)

About this study

Official title: Effect of Stress Ball Applied During Surgical Debridement/Dressing on Pain, Distress, and Physiological Parameters in Patients With Diabetic Foot Ulcers: A Randomized Controlled Trial

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.

Being tested
Stress ball
Keywords
Diabetic foot ulcer, sharp debridement, pain, anxiety, stress ball, nursing care
Medical subject headings
Diabetic Foot, Pain, Anxiety Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Stress ballBehavioural

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

Study groups in NCT07119983
Study groupRoleWhat they receive
Stress ballExperimentalThe effects of stress balls on pain, distress and physiological parameters during surgical debridement in patients with diabetic foot ulcers will be investigated.
Receives: Behavioral: Stress ball
Control GroupNo interventionRoutine care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain assessment

    Visual Analogue Scale -VAS: The scale was developed by Price and colleagues in 1983 for use in assessing subjectively perceived pain. Eti-Aslan noted in his study that the VAS is more sensitive and better defined in assessing acute pain. It is a 10 cm (100 mm) ruler with the word "painlessness" written on one end and "the most severe pain" written on the other. Participants were asked to indicate the intensity of pain they were currently experiencing, explaining that "0" on the scale means "I feel no pain" and that increasing numbers indicate increased pain intensity. "10" means "I feel the most severe pain." A higher score on the scale indicates increased pain.

    Measured: Before the Procedure, during the Procedure (10th minute), and baseline, after an average of 20-30 minutes

  2. Anxiety Assesment (The Distress Thermometer)

    The Distress Thermometer was first developed by Roth and colleagues for use in identifying non-pathological distress in patients undergoing cancer treatment after answering the necessary questions. The distress level is rated from 0 to 10. The practitioner expresses the distress experienced using the numbers on the thermometer. A score of zero indicates no distress, while a score of 10 indicates the highest level of distress. The green zone encompasses scores from 0 to 3. Individuals experiencing distress within this range are capable of managing their distress. The yellow zone encompasses scores from 4 to 6. A distress score in this range indicates that the individual is unable to manage their distress and requires intervention to return them to the green zone. The red zone encompasses scores from 7 to 10. Individuals experiencing distress within this range require urgent and comprehensive intervention.

    Measured: Before the Procedure and baseline, after an average of 20-30 minutes

  3. Physiological Parameters (heart rate, systolic and diastolic blood pressure, oxygen saturation and respiratory rate)

    Heart rate, systolic and diastolic blood pressure, oxygen saturation, and respiratory rate will be recorded before, during, and after debridement. Systolic and diastolic blood pressure will be measured for patients in the study and control groups using the ERKA adult aneroid blood pressure monitor, while oxygen saturation and heart rate will be measured using the Masimo SET® Pulse Oximetry. Both devices will be calibrated before data collection.

    Measured: Before the Procedure, during the Procedure (10th minute), and baseline, after an average of 20-30 minutes

  4. Physiological Parameter: heart rate

    Heart rate will be measured using the Masimo SET® Pulse Oximetry. Devices will be calibrated before data collection.

    Measured: Before the Procedure, during the Procedure (10th minute), and baseline, after an average of 20-30 minutes

  5. Physiological Parameters: systolic and diastolic blood pressure

    Systolic and diastolic blood pressure will be measured for patients in the study and control groups using the ERKA adult aneroid blood pressure monitor

    Measured: Before the Procedure, during the Procedure (10th minute), and baseline, after an average of 20-30 minutes

  6. Physiological Parameter: oxygen saturation

    Oxygen saturation will be measured using the Masimo SET® Pulse Oximetry. Device will be calibrated before data collection.

    Measured: Before the Procedure, during the Procedure (10th minute), and baseline, after an average of 20-30 minutes

  7. Physiological Parameter: respiratory rate

    Respiratory rate will be monitored for one minute, with each inspiration and expiration counted as a breath.

    Measured: Before the Procedure, during the Procedure (10th minute), and baseline, after an average of 20-30 minutes

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Aug 2025
  2. Study start1 Nov 2025
  3. Primary completion1 Jan 2027 (estimated)
  4. Study completion1 Jul 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
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.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
84 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07119983
Sponsor's protocol ID
Stress Ball
Status last verified
Sep 2026
First submitted
28 Jul 2025
Last updated
15 Sep 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Results regarding the effects of stress ball use on pain, anxiety, and hemodynamic parameters surgical debridement in individuals with diabetic foot ulcers will be shared. However, your personal information will not be shared.

Publications

  • 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.

    PubMed 32304447
  • 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.

    PubMed 37804682
  • 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.

    PubMed 36880424
  • 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.

    PubMed 36548709
  • Jia H, Wang X, Cheng J. Knowledge, Attitudes, and Practices Associated With Diabetic Foot Prevention Among Rural Adults With Diabetes in North China. Front Public Health. 2022 May 20;10:876105. doi: 10.3389/fpubh.2022.876105. eCollection 2022.

    PubMed 35669753
  • 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.

    PubMed 37369610
  • 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.

    PubMed 37243880
  • 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.

    PubMed 39892227
  • 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.

    PubMed 33919683
  • 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.

    PubMed 36578870

Questions about this trial

What is this clinical trial studying?

A study testing Stress ball in people with Diabetic Foot Ulcer Associated With Type II Diabetes Mellitus, run by Cukurova University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 15 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Derya GEZER, Asisstant Professor (+905076990081, deryasahhin@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain assessment (time frame: Before the Procedure, during the Procedure (10th minute), and baseline, after an average of 20-30 minutes). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07119983, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Sep 2026.

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