January - March 2024, Volume 20, Issue 1

Senoymak MC, Erbatur NH, Engin I, Yonem A

The Impact of Patient Anxiety and Pain Perception on the Adequacy of Thyroid Fine-Needle Aspiration Biopsy Samples: A Prospective Study

Acta Endo (Buc) 2024, 20 (1): 39-44
doi: 10.4183/aeb.2024.39

Background. Fine-needle aspiration biopsy (FNAB) is the most accurate diagnostic method to assess the malignancy risk of thyroid nodules. However, nondiagnostic results may delay diagnosis, cause unnecessary interventions, and distress patients. Aim. We aimed to determine whether a correlation exists between patients’ situational anxiety, pain perception and non-diagnostic cytology results. Methods. The prospective study included patients who underwent thyroid FNAB at the Endocrinology Clinic of Sultan Abdulhamid Training and Research Hospital between 11/2022 and 02/2023. The State-Trait Anxiety Inventory (STAI) questionnaire and visual analogue scale (VAS) assessed situational anxiety and pain in patients undergoing biopsy procedures. We evaluated whether the STAI-S and VAS score is related to non-diagnostic results. Results. Of the 119 patients included in the study, 98 were female, and 21 were male. 25 (21%) nodules were non-diagnostic. The patients' mean STAI-S score before the biopsy was 47.31±12.37, and the mean VAS score after the thyroid biopsy was 2.57±1.51. A statistically significant relation was found between the patient's STAI-S score and VAS score and the cytology result of non-diagnostic (p= 0.001 and p=0.008). In univariate logistic regression, high pre-procedural anxiety (OR:3.09, 95% CI:1.07-8.94, P =0.037) and VAS score (OR:1.57, 95% CI: 1.17-2.10, P =0.002) were associated with non-diagnostic cytology. In multivariate logistic regression analysis, VAS score (OR: 1.59, 95% CI: 1.07-2.34, p=0.019) was still an independent factor related to specimen adequacy. Conclusions. Anxiety level and pain perception during FNAB may be considered risk factors for nondiagnostic cytology. Thus, reducing anxiety and pain may decrease the incidence of non-diagnostic outcomes.

Keywords: anxiety, thyroid nodule, cytology, fine needle biopsy, pain.

Correspondence: Mustafa Can Senoymak MD, University of Health Sciences, Sultan Abdülhamid Han Training and Research Hospital, Selimiye, Tibbiye Street, 34668 Uskudar, Istanbul, Turkey, E-mail: senoymak@gmail.com.