Randomized trial reveals that stress balls and 4-7-8 breathing reduce preprocedure fear and anxiety in elderly endoscopy patients, indicating nonpharmacological tools aid procedural comfort.
This study aimed to investigate the effect of two different practices (stress ball and 4-7-8 breathing technique) on preprocedure fear, anxiety, and physiological parameters in patients undergoing endoscopy. This randomized controlled trial randomly assigned 75 patients undergoing endoscopy to three groups: the stress ball ( n = 25), the 4–7-8 breathing technique ( n = 25), and the control ( n = 25). The data were collected using a Patient Information Form, the Visual Analog Scale, the State-Trait Anxiety Inventory, and a Physiological Parameters Form. While no significant difference was found between the fear scores ( p = .095) and anxiety scores ( p = .255) among the groups before the intervention, fear and anxiety scores were significantly lower in the stress ball and 4-7-8 breathing technique groups after the intervention ( p < .001). On the other hand, the rise in preintervention and postintervention fear ( p = .001) and anxiety ( p = .041) scores in the control group was statistically significant. The drop in the anxiety score of the stress ball group after the intervention was significantly lower than that of the 4-7-8 breathing technique group ( p < .001). The stress ball and the 4-7-8 breathing technique may be effective in alleviating the preprocedure fear and anxiety in the elderly patients undergoing endoscopy.
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Parlak et al. (2026) studied this question.
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