This research is a randomized controlled experimental study conducted to determine the effects of stress ball application and music playback during coronary angiography on patients' pain and anxiety levels and vital signs (systolic/diastolic blood pressure, pulse).

Objective: This research is a randomized controlled experimental study conducted to determine the effects of stress ball application and music listening during coronary angiography on patients' pain and anxiety levels and vital signs (systolic/diastolic blood pressure, pulse). Materials and Methods: The study sample consisted of 180 individuals who applied for coronary angiography at the cardiology laboratory of a city hospital between March and December 2025, including 60 control group, 60 stress ball group, and 60 music group, totaling 180 individuals. Data were collected using the "Patient Identification Form," "Visual Analog Scale (VAS)," "State-Trait Anxiety Scale (STAI-1)," and "Vital Signs Form." Patients in the intervention groups received the prescribed protocols (standard music playlist or stress ball placement in the dominant hand) throughout the procedure, while the control group received only routine clinical care.

Findings: Patients who used a stress ball and listened to music during coronary angiography had statistically significantly lower mean post-procedure pain and anxiety scores compared to the control group (p<0.05). Although there was a significant difference in anxiety and pain levels between the intervention groups, both methods were determined to be effective compared to standard care. Conclusion: It can be said that stress ball and music therapy methods applied during coronary angiography are effective, reliable, and cost-effective non-pharmacological nursing interventions in reducing patients' pain and anxiety levels and stabilizing hemodynamic parameters.

Inclusion Criteria:

• Those undergoing coronary angiography for the first time,
• Those undergoing groin angiography,
• Those over 18 years of age,
• Those who are not drug or alcohol dependent,
• Those who do not have hearing impairments,
• Those who have not used any medication that will produce an analgesic effect within 6 hours before the procedure,
• Those who are not prevented from using a stress ball in their left hand,
• Those who are oriented to the place and time,
• Those who do not have a history of serious psychological problems in the past 6 months,
• Those who do not use any medication that suppresses anxiety symptoms,
• Those who agree to participate in the study are included.

Exclusion Criteria:

• Patients with severe heart failure or serious cardiovascular disease,
• Patients who will require sedation or anesthesia during the procedure,
• Patients who dislike music for cultural reasons,
• Patients who require urgent treatment for cardiac dysrhythmias,
• Patients with hearing problems,
• Patients who cannot actively use their hands (such as those with hemiplegia, fractures, fistulas, etc.) are not included.

In this study, participants did not know which group they belonged to. The statistician performing the statistical analysis did not know the groups.