Keywords
post sectio caesarea
ball squeezing therapy
warm compress
How to Cite
Abstract
Pain following caesarean section is one of the problems that can hinder the recovery process if it is not properly managed. Non-pharmacological interventions such as ball squeezing therapy and warm compresses can be used to improve the effectiveness of pain management. The purpose of this study was to analyze the effectiveness of ball squeezing therapy and warm compresses on pain levels among post-sectio caesarea patients at Ngudi Waluyo Wlingi Regional Hospital. The study used a three-group quasi-experimental pretest-posttest design, consisting of two intervention groups and one control group, involving 54 respondents selected using purposive sampling, with 18 respondents in each group. Pain levels were measured using the Numeric Rating Scale five minutes before and after the intervention. Warm compress therapy was applied using a Warm Water Zak (WWZ) at a temperature of 45–50°C twice, with each session lasting 10 minutes. Ball squeezing therapy was performed by rhythmically grasping and releasing a rubber ball according to breathing patterns and was administered twice, with each session lasting 10 minutes. The Kruskal–Wallis test was used to compare pain levels among the three groups, while the Mann–Whitney U test was used for pairwise comparisons between two groups. The average pain reduction in the control group was 2.39 points. The average pain reduction in the ball squeezing therapy group was 2.50 points. The average pain reduction in the warm compress group was 3.89 points. The reduction in pain between the control and warm compress groups averaged 1.66 points, with a p-value of 0.001, while the reduction in pain between the control and ball squeezing therapy groups averaged 0.50 points, with a p-value of 0.117. Warm compresses work through vasodilation and reduce inflammatory mediators around the surgical area, thereby providing a faster analgesic effect. Meanwhile, ball squeezing therapy works through the Gate Control Theory mechanism, but its distraction effect makes it less optimal because it does not directly affect the painful area. It was concluded that warm compresses are more effective than ball squeezing therapy in reducing post-caesarean section pain.
References
Akbarzadeh, M., Nematollahi, A., Farahmand, M., & Amooee, S. (2018). The Effect of Two-Staged Warm Compress on the Pain Duration of First and Second Labor Stages and Apgar Score in Prim Gravida Women : a Randomized Clinical Trial. Tabriz University of Medical Sciences, 7(1), 21–26. https://doi.org/10.15171/jcs.2018.004
Aksoy, Y. E. (2025). The Effect of Hot Bag/Warm Application on Feet After Cesarean Delivery on Postpartum Comfort, Pain, and Flatus. National Library of Medicine.
Aryanti, D., & Fauziah, L. (2024). Asuhan Keperawatan Pada Ibu Post Sectio Caesarea Untuk Menurunkan Intensitas Nyeri Dengan Tindakan Foot Massage. Journal of Baja Health Science, 4(01), 72–81. https://doi.org/10.47080/joubahs.v4i01.2870
Aslan, F., Tosun, B., Altınok Ersoy, N., & Ozen, N. (2025). 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. Journal of Tissue Viability, 34(2), 0–5. https://doi.org/10.1016/j.jtv.2025.100861
Dinamiyanti, Wati, S. E., & Aizah, S. (2024). Penerapan Terapi Finger Hold ( Genggam Jari ) dengan Media Bola Squishy untuk Mengurangi Tingkat Nyeri Akut Pasien dengan Diagnosis Medis Post Sectio Caesarea di RS Muhammadiyah Ahmad Dahlan Kota Kediri. Seminar Nasional Sains, Kesehatan, Pembelajaran 2024, 476–484. https://doi.org/10.29407/y3b64529
Dinkes Jatim. (2020). Statistik Kesehatan Provinsi Jawa Timur 2020. In Laporan Provinsi Jawa Timur 2020 (Vol. 11, Issue 1).
Dwiningrum, E., Wahyuni, N. S., & Isro’in, L. (2020). Efektivitas Kompres Hangat Terhadap Perubahan Tingkat Nyeri Pada Pasien Post Operasi Turp Di Ruang Rawat Inap Rsi Siti Aisyah Madiun. Health Sciences Journal, 4(1), 43. https://doi.org/10.24269/hsj.v4i1.402
Giordano, N. A., Kent, M. L., Kroma, R. B., Rojas, W., Lindl, M. J., Lujan, E., Buckenmaier, C. C., & Highland, K. B. (2023). Acute Postoperative Pain Impact Trajectories and Factors Contributing to Trajectory Membership. Pain Medicine, 24(7), 829–836. https://doi.org/10.1093/pm/pnac203
Hall. (2019). Guyton and Hall Textbook of Medical Physiology (J. E. Hall (ed.); 13 th). Beijing da xue yi xue chu ban she.
Iswani, R., Ernita, E., & Erlina, E. (2024). Efektivitas Aromaterapi Lemon dan Kompres Hangat terhadap Nyeri Post SC di RSIA ABBY Kota Lhokseumawe. MAHESA : Malahayati Health Student Journal, 4(6), 2230–2239. https://doi.org/10.33024/mahesa.v4i6.14377
Kaur, J., Sheoran, P., Kaur, S., & Sarin, J. (2020). Effectiveness of Warm Compression on Lumbo-Sacral Region in Terms of Labour Pain Intensity and Labour Outcomes among Nulliparous Women: An Interventional Study. Journal of Caring Sciences, 9(1), 9–12. https://doi.org/10.34172/jcs.2020.002
Kemenkes RI. (2018). Laporan Nasional Riskesdas 2018. In Laporan Nasional Riskesdas 2018 (Vol. 44, Issue 8).
Kemenkes RI. (2023). Survei Kesehatan Indonesia (SKI) tahun 2023. Laporan Nasional SKI 2023, 1–68.
Perry, & Potter. (2016). Buku Ajar Fundamental Keperawatan: Konsep, Proses dan Praktik (Vol 2). Elsevier Health Sciences.
Puspita, T., Widadi, S. Y., Alfiansyah, R., Rilla, E. V., Octavia, D., & Estria, S. (2023). Pengaruh kompres hangat terhadap nyeri pada penderita hipertensi. Jurnal Kesehatan Dan Kedokteran, 2(1), 8–11. https://doi.org/10.56127/jukeke.v2i1.514
Rohmawati, D. L., Nisak, R., & Lukitaningtyas, D. (2025). Kompres Hangat dalam Penatalaksanaan Hipertensi : Inovasi Berbasis Bukti (1st ed.). Nuansa Fajar Cemerlang.
Sari, D. P., Supardi, & Hamranani, S. S. T. (2019). Efektivitas Foot Massage dan Kompres Hangat terhadap Nyeri Post Operasi Sectio Caesarea di Rumah Sakit Islam Klaten. Jurnal Ilmu Kesehatan, 14(01), 93–112. https://doi.org/10.61902/motorik.v14i1.19
Septia, F., Lili, F., & Emil, H. (2024). Latihan Genggam Bola Karet pada Pasien Penyakit Ginjal Kronik (PGK) Post-Operasi AV Shunt Hemodialisis (1st ed.). Eureka Media Aksara.
Sulistyo, A. (2016). Konsep & Proses Keperawatan Nyeri. Ar-Ruzz.
Sun, R., Huang, J., Zhu, X., Hou, R., Zang, Y., Li, Y., Pan, J., & Lu, H. (2024). Effects of Perineal Warm Compresses during the Second Stage of Labor on Reducing Perineal Trauma and Relieving Postpartum Perineal Pain in Primiparous Women: A Systematic Review and Meta-Analysis. 12(7). https://doi.org/10.3390/healthcare12070702
Suwondo, B., Lucas, M., & Sudadi. (2017). Buku Ajar Nyeri. Perkumpulan Nyeri Indonesia.
Wahyu, & Lina, L. (2019). Terapi Kompres Hangat dengan Jasmine Essential Oil terhadap Penurunan Intensitas Nyeri pada Pasien Post Sectio Caesarea. Journal of Telenursing (JOTING), 11(2). https://doi.org/10.31539/joting.v1i2.860
WHO. (2021). C-Section Rates Continue to Rise Amid Growing Inequalities in Access. WHO News Item.
Xu, J., Liu, X., Zhao, J., Li, H., Ye, H., & Ai, S. (2025). Comprehensive Review on Personalized Pain Assessment and Multimodal Interventions for Postoperative Recovery Optimization. Journal of Pain Research, 18, 2791–2804. https://doi.org/10.2147/JPR.S516249
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) 2026 Alfinia Ni'ma Fitriasari, Taufan Arif, Fitriana Kurniasari Solikhah, Sulastyawati