Scientific Papers

Effect of Music on Anxiety and Pain Levels of Patients Undergoing Thyroid Fine Needle Aspiration Biopsy: A Randomized Controlled Study

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Materials and Methods

In this randomized controlled single-blind study, a validated State-Trait Anxiety Inventory (STAI) consisting of 40 questions in total was used to evaluate patient anxiety rates. The STAI consists of two sections: the state anxiety scale (SAS) measuring instant anxiety and the trait anxiety scale measuring general anxiety. Patients were divided into two groups: Group 1 those who did not listen to music during a biopsy and group 2 those who listened to music. The Visual Analogue Scale was used to evaluate patient pain levels.


Group 1 consisted of 46 patients and Group 2 consisted of 45 patients. After the procedure, the mean SAS scores of Groups 1 and 2 were not significantly different (p = 0.24). However, The state anxiety scale differences, which represents the decrease in pre-procedure and post-procedure anxiety levels (SAS1-SAS2) was statistically different among the groups (p = 0.01). There was a significant difference between the two groups in terms of VAS score distribution (p = 0.01).


Music therapy is an easily applicable, cheap, and safe method that can be used to decrease anxiety and pain levels in patients during thyroid biopsy as evidenced by this research.

Section snippets


Thyroid nodules are a common clinical finding detected in 19–67% of individuals and malignancies are found in 5–15% of thyroid nodules 1, 2, 3. Thyroid fine needle aspiration biopsy (FNAB) is a method commonly used in distinguishing malignant and benign nodules (4). Though it is easy to apply, it is still considered an invasive procedure that can cause anxiety in patients (5). Anxiety felt during a needle biopsy can cause increased pain sensation, hypertension, and tachycardia 6, 7. Therefore,


This study was a randomized controlled prospective trial conducted in the Gaziosmanpasa Training and Research Hospital, Interventional Radiology Clinic obtaining the ethics committee approval. In this study, the effects of music on anxiety and pain levels in patients who underwent thyroid biopsy were investigated. The study included patients who requested a thyroid biopsy in the hospital’s interventional radiology clinic between August 2021 and December 2021. Inclusion criteria for this


A total of 143 patients were eligible for participation in this study. After the exclusion criteria, 94 patients in total (65.7%) were equally and randomly distributed into group 1 and group 2, with a total of 47 patients in each group. The biopsy procedure was canceled at the request of 1 patient in group 1. The biopsy procedure was canceled because a patient in group 2 experienced a heart palpitation. A patient was excluded from the study for murmuring the song and breaking the single blind


The present study aimed to determine the effect of music on the anxiety and pain caused by thyroid biopsy. The results revealed that music significantly decreases state anxiety levels pre- and post-biopsy, and the pain level was significantly lower in those who listened to music.

FNAB is an easy and quick minimally invasive interventional procedure with high patient compliance. It is frequently used for the evaluation of thyroid nodules (21). Music is an easily accessible, cost-free,


The results of this study demonstrate music therapy is an inexpensive, safe, and non-invasive method in thyroid biopsy patients for decreasing pain and anxiety levels during procedure.

Declaration of Competing Interest

The author(s) certify that they have no affiliation with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the manuscript (e.g. honoraria, consultancies, stock). Any research or project (e.g. Ministry of Science Research) support is identified in the ‘Acknowledgment’ section of the manuscript.


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