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Updated: Mar 11, 2026

Psychophysiological Stress Assessment Using Biofeedback
Published on: July 31, 2009
Evaluation of Stress Scores Throughout Radiological Biopsies
Ozlem Turkoglu1, Hasan Huseyin Mutlu2
1Department of Radiology, Kartal Dr Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
Background:
Ultrasound-guided biopsy procedures are the most prominent methods that increase the trauma, stress and anxiety experienced by the patients.
Objectives:
Our goal was to examine the level of stress in patients waiting for radiologic biopsy procedures and determine the stress and anxiety level arising from waiting for a biopsy procedure.
Patients And Methods:
This prospective study included 35 female and 65 male patients who were admitted to the interventional radiology department of Kartal Dr. Lütfi Kirdar training and research hospital, Istanbul between the years 2014 and 2015. They filled out the adult resilience scale consisting of 33 items. Patients who were undergoing invasive radiologic interventions were grouped according to their phenotypic characteristics, education level (low, intermediate, and high), and biopsy features (including biopsy localization: neck, thorax, abdomen, and bone; and the number of procedures performed, 1 or more than 1). Before the biopsy, they were also asked to complete the depression-anxiety-stress scale (DASS 42), state-trait anxiety inventory scale (STAI-I), and continuous anxiety scale STAI-II. A total of 80 patients were biopsied (20 thyroid and parathyroid, 20 thorax, 20 liver and kidney, and 20 bone biopsies). The association between education levels (primary- secondary, high school and postgraduate) and the number of biopsies (1 and more than 1) with the level of anxiety and stress were evaluated using the above-mentioned scales.
Results:
Evaluation of sociodemographic and statistical characteristics of the patients showed that patients with biopsy in the neck region were moderately and severely depressed and stressed. In addition, the ratio of severe and extremely severe anxiety scores was significantly high. While the STAI-I and II scores were lined up as neck > bone > thorax > abdomen, STAI-I was higher in neck biopsies compared to thorax and abdomen biopsies. Regarding STAI-I and II scales, patients with neck biopsy had the highest anxiety score.
Conclusion:
We believe that active briefing of patients who need to undergo neck and bone biopsies and have high anxiety score by healthcare personnel is an effective method to control psychological mood and increase the efficiency of treatment.
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