Effect of a Nature-View Curtain on Pain, Anxiety, and Fear During Thyroid Biopsy

August 25, 2026 updated by: Hamdiye ARDA SÜRÜCÜ, Dicle University

Effect of a Nature-View Curtain Used as a Distraction Method on Pain, Anxiety, and Fear During Ultrasound-Guided Thyroid Fine-Needle Aspiration Biopsy: A Randomized Controlled Trial

Thyroid fine-needle aspiration biopsy (FNAB) may cause procedure-related pain, anxiety, and fear. This randomized controlled trial evaluated whether visual distraction with a nature-view curtain could reduce these outcomes. A total of 100 adults undergoing ultrasound-guided thyroid FNAB were randomly assigned in a 1:1 ratio to a nature-view curtain group or a standard-care control group. Participants in the intervention group were instructed to focus on a ceiling-mounted nature-view curtain throughout the biopsy, whereas participants in the control group underwent routine biopsy without this visual distraction. Pain intensity was the primary outcome; anxiety and fear of pain were secondary outcomes. Outcomes were assessed approximately 15 minutes before and approximately 15 minutes after the procedure.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This completed, two-arm, parallel-group, randomized controlled trial was conducted at Adana City Training and Research Hospital in Adana, Türkiye, between June 1, 2025, and February 28, 2026.

The study included 100 adults scheduled to undergo ultrasound-guided thyroid fine-needle aspiration biopsy because of a suspected thyroid nodule or mass. Participants were stratified by sex and assigned in a 1:1 ratio to the nature-view curtain group or the standard-care control group using blocks of two. Within each sex stratum, the first participant in each block was assigned by coin toss, and the second was allocated to the other group.

Both groups underwent routine ultrasound-guided thyroid fine-needle aspiration biopsy. Participants in the intervention group were instructed to focus throughout the procedure on a ceiling-mounted, 195 × 135 cm curtain displaying a nature scene. Participants in the control group underwent the routine biopsy procedure without nature-view curtain distraction. The biopsy procedure lasted approximately 5 to 10 minutes.

Pain intensity, anxiety, and fear of pain were assessed approximately 15 minutes before and approximately 15 minutes after the procedure. Pain intensity assessed using the Visual Analog Scale was the primary outcome. Anxiety assessed using the Beck Anxiety Inventory and fear of pain assessed using the Fear of Pain Questionnaire-III were secondary outcomes.

Because of the nature of the intervention, participants and study personnel were not masked. Statistical analyses were conducted by an independent statistician who received coded group data and was unaware of the group identities.

Study Type

Interventional

Enrollment (Actual)

100

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Adana, Turkey (Türkiye), 01230
        • Adana City Training and Research Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Suspicion of a mass in the thyroid
  • No vision problems

Exclusion Criteria:

  • Mental health problems

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Nature-View Curtain Group
Participants underwent routine ultrasound-guided thyroid fine-needle aspiration biopsy and were instructed to focus throughout the procedure on a ceiling-mounted, 195 × 135 cm curtain displaying a nature scene. The procedure lasted approximately 5 to 10 minutes.
Behavioral: Nature-View Curtain Visual Distraction
Visual distraction was provided by instructing participants to focus on a ceiling-mounted curtain displaying a nature scene throughout the ultrasound-guided thyroid fine-needle aspiration biopsy procedure.
No Intervention: Standard-Care Control Group
Participants underwent routine ultrasound-guided thyroid fine-needle aspiration biopsy without nature-view curtain distraction.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual Analogue Scale
Time Frame: Approximately 15 minutes before and approximately 15 minutes after the ultrasound-guided fine-needle aspiration biopsy procedure.
The Visual Analogue Scale (VAS) is a 10-cm (100-mm) scale used to assess pain intensity. Scores range from 0 ("no pain") to 10 ("worst imaginable pain"), with higher scores indicating greater pain intensity. Assessments were performed approximately 15 minutes before the ultrasound-guided fine-needle aspiration biopsy procedure and approximately 15 minutes after completion of the procedure.
Approximately 15 minutes before and approximately 15 minutes after the ultrasound-guided fine-needle aspiration biopsy procedure.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The Beck Anxiety Inventory (BAI)
Time Frame: Approximately 15 minutes before and approximately 15 minutes after the ultrasound-guided fine-needle aspiration biopsy procedure.
The Beck Anxiety Inventory (BAI) is a 21-item self-report questionnaire used to assess the severity of anxiety symptoms. Total scores range from 0 to 63, with higher scores indicating greater anxiety severity. Assessments were performed approximately 15 minutes before the ultrasound-guided fine-needle aspiration biopsy procedure and approximately 15 minutes after completion of the procedure.
Approximately 15 minutes before and approximately 15 minutes after the ultrasound-guided fine-needle aspiration biopsy procedure.
Fear of Pain Questionnaire-III (FPQ-III)
Time Frame: Approximately 15 minutes before and approximately 15 minutes after the ultrasound-guided fine-needle aspiration biopsy procedure.
The Fear of Pain Questionnaire-III (FPQ-III) is a 30-item instrument assessing fear of pain across three domains: severe pain, minor pain, and medical pain. Items are scored on a 5-point Likert scale, yielding a total score ranging from 30 to 150, with higher scores indicating greater fear of pain. Assessments were performed approximately 15 minutes before the ultrasound-guided fine-needle aspiration biopsy procedure and approximately 15 minutes after completion of the procedure.
Approximately 15 minutes before and approximately 15 minutes after the ultrasound-guided fine-needle aspiration biopsy procedure.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Dicle University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 1, 2025

Primary Completion (Actual)

February 28, 2026

Study Completion (Actual)

February 28, 2026

Study Registration Dates

First Submitted

January 18, 2025

First Submitted That Met QC Criteria

January 24, 2025

First Posted (Actual)

January 27, 2025

Study Record Updates

Last Update Posted (Actual)

August 27, 2026

Last Update Submitted That Met QC Criteria

August 25, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • DICLE-ARDASURUCU-004

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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