Fake Coughing During Bone Marrow Aspiration and Biopsy

1\. Voluntary Coughing Maneuver (Hileli Öksürük): Patients in this group were instructed to perform a voluntary coughing maneuver immediately prior to the percutaneous biopsy procedure. The maneuver was demonstrated by the clinician, and patients were asked to perform 2-3 forceful coughs while in the biopsy position, 30 seconds before needle insertion, to reduce anxiety and procedural pain perception.

2\. Stress Ball Intervention: Patients were given a standard-sized rubber stress ball to hold and repeatedly squeeze during the entire percutaneous biopsy procedure. The intervention began 1 minute before needle insertion and continued until the procedure was completed. The aim was to provide a behavioral distraction to alleviate anxiety and pain.