This randomized controlled trial aims to evaluate the effects of stress ball use and breathing exercises on procedural pain and vital signs during drain removal in patients undergoing total knee arthroplasty. Although drain removal is a short procedure, it is often associated with sudden and intense pain and may trigger physiological stress responses such as increased heart rate, blood pressure, and respiratory rate. A total of 105 patients will be randomly assigned to three groups: stress ball group, breathing exercise group, and standard care group. The interventions will be applied starting one minute before drain removal, continuing throughout the procedure, and for two minutes afterward. Pain levels will be assessed using the Numeric Rating Scale (NRS), and vital signs (heart rate, blood pressure, respiratory rate, and oxygen saturation) will be measured at predefined time points before, during, and after the procedure. The findings of this study are expected to provide evidence on the effectiveness of simple, non-pharmacological interventions in reducing procedural pain and improving physiological stability during drain removal
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Pain Intensity (Numeric Rating Scale, NRS
Timeframe: Baseline, immediately after drain removal, 15 minutes, and 30 minutes after the procedur
Heart Rate
Timeframe: Baseline, immediately after drain removal, 15 minutes, and 30 minutes after the procedur
Blood Pressure
Timeframe: Baseline, immediately after drain removal, 15 minutes, and 30 minutes after the procedur
Oxygen Saturation
Timeframe: Baseline, immediately after drain removal, 15 minutes, and 30 minutes after the procedur
Respiratory Rate
Timeframe: Baseline, immediately after drain removal, 15 minutes, and 30 minutes after the procedur