What Are Thyroidectomy Patients Really Concerned About?

Abstract

Objective. To better appreciate perioperative concerns affecting patients considering thyroidectomy and to understand how they may vary according to patient characteristics.Study Design. Cross-sectional analysis. Setting. Tertiary referral center.Subjects and Methods. The authors recruited patients scheduled for thyroid surgery at the McGill University Thyroid Cancer Center. A total of 148 patients completed the 18-item Western Surgical Concern Inventory-Thyroid (WSCI-T) questionnaire. Psychometrics of the WSCI-T were assessed through a principal component analysis with varimax rotation and reliability analyses. Independentsamples t tests and 2-tailed Pearson correlations were ran, identifying areas of elevated concerns and their relationship to gender, age, and surgical procedure (total vs hemithyroidectomy).Results. The principal component analysis revealed the presence of 3 domains of presurgical concerns on the WSCI-T: Surgery-Related Concerns, Psychosocial Concerns, and Daily-Living Concerns. Reliability coefficients for the WSCI-T Total and subscales were satisfactory. Responses on the WSCI-T indicated on average a moderate overall level of concerns before thyroidectomy. Surgery-Related Concerns was the highest domain of concerns, followed by Daily-Living and Psychosocial Concerns, respectively. Patients were mainly worried about the nodule being cancerous, experiencing a change in voice, and surgical complications. Areas of minor concern included being judged or treated differently, becoming depressed, and feeling embarrassed. Women had higher overall levels of concern than men did. Although there were no significant differences in overall levels of concern according to age and surgical procedure, differences were noted at a subscale and item level.Conclusion. This study establishes a mean that will permit adequate physician counseling and a better management of patients' perioperative worries.

Faces Anxiety Scale as a screening measure of preoperative anxiety: Validation and diagnostic accuracy study

“…The STAI-S, although considered to be the instrument of the first choice for anxiety assessment, has the most items (20) of all measures used in the study, and therefore, it could be too long for some patients in our sample, threatening the validity of the results. In accordance to the previous findings (Chlan, 2004;Romanik et al, 2009), we conclude that the STAI-S, due to its length, may be less accurate in some specific samples. The…”

“…Instruments like the State-Trait Anxiety Inventory (STAI, Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983) and the anxiety subscale of Hospital Anxiety and Depression Scale (HADS-A, Zigmond & Snaith, 1983), although well known, are too lengthy for use on a busy surgery ward (Chlan, 2004;Gustad, Chaboyer, & Wallis, 2008;Romanik, Kański, Soluch, & Szymańska, 2009).…”

Morbidity after thyroid surgery: Patient perspective

“…A preoperative assessment of 148 patients scheduled for thyroid surgery at the McGill University Thyroid Cancer Center revealed the presence of three domains of concern: surgery‐related concerns, psychosocial concerns, and daily living concerns. In their practice, surgery‐related concerns were found to be most distressing, as patients were mainly worried about the nodule being cancerous, experiencing a change in voice, and surgical complications . These concerns have never before been assessed in the postoperative period.…”

A systematic review of quality of thyroid-specific health-related quality-of-life instruments recommends ThyPRO for patients with benign thyroid diseases

“…A vast majority (8/14, 57.1%) of the HRQOL instruments evaluated were for thyroid dysfunctions (3 for hypothyroidism [34][35][36][37][38][39], 1 for hyperthyroidism [40] and 4 for GO [30-33, 38, 39, 41, 42]). One was for benign thyroid disease [24][25][26][27][28][29] and another one was for awaiting thyroidectomy [43])…”

“…Characteristics of 23 eligible articles included in this review are summarized in Table 2. Articles were predominately conducted in counties located in Europe [24-32, 34-37, 40, 45] and North America [38,[41][42][43][44], and the only one was conducted in Asia [39]. Most of the instruments were evaluated in the language versions of English [34-38, 43, 44], Danish [24][25][26][27][28][29] and Dutch [30-32, 40, 45].…”