Distress, illness perception and coping style among thyroid cancer patients after thyroidectomy: A cross-sectional study

Effect of Psychosomatic Symptom Intervention on Psychosomatic Symptoms During Initial Treatment in Patients With Differentiated Thyroid Cancer: A Single-blind Randomized Controlled Trial

BACKGROUND

There is increasing evidence suggesting that patients with thyroid cancer may experience prolonged anxiety and depression postsurgery, which could potentially impact their treatment outcomes adversely.

OBJECTIVES

To investigate the impact of a psychosomatic symptom intervention program on the psychological and physical health of patients with differentiated thyroid cancer (DTC).

METHODS

Eighty-four patients with DTC were recruited from one cancer hospital and were randomly assigned to either the experimental (n = 42) or control group (n = 42). The intervention group received a 12-week psychosomatic symptom intervention. Anxiety and depression, thyroid-stimulating hormone attainment rate, self-management efficacy, and shoulder joint function were evaluated before intervention, after intervention, and during follow-up.

RESULTS

The generalized estimating equation showed that the intervention group had significantly lower levels of anxiety and depression at T1 and T2 compared with the control group (P < .001). The time, group, and interaction effects were significant (P < .001). The thyroid-stimulating hormone target rate in the intervention group (59.5%) was higher than that in the control group (26.2%) (P = .008). There were significant differences in self-management efficacy and shoulder joint function between the 2 groups (P < .001).

CONCLUSIONS

These findings hold significant implications for the psychological and physical symptoms of DTC patients. It suggests that early interventions can expedite patient recovery during the initial treatment phase.

IMPLICATION FOR PRACTICE

During the initial treatment phase, nurses can implement interventions targeting psychological and physical symptoms in DTC patients, aimed at facilitating postoperative self-care and promoting expeditious recovery of overall health.

Illness cognition, illness perception and related factors in patients with lymphangioleiomyomatosis

PURPOSE

To explore the self-perceived illness cognition and perception status, as well as the relevant factors among lymphangioleiomyomatosis (LAM) patients.

METHODS

A web-based questionnaire survey was conducted in September 2023. A total of 121 LAM patients participated (including 16 patients with TSC-LAM), and the survey collected general demographic information, responses to a disease cognition questionnaire, and a simplified disease perception questionnaire.

RESULTS

LAM patients have a higher level of negative illness cognition and a lower level of positive illness cognition, specifically characterized by helplessness (15.74 ± 4.68 points), acceptance (16.00 ± 3.28 points), and perceived benefits (16.92 ± 3.86 points). Single-factor analysis of variance found significant correlations between cultural level, age, family average monthly income, use of rapamycin, use of home oxygen therapy, hospitalization frequency, disease duration, severity of respiratory distress, activity limitation, and the helplessness score of LAM patients (p ≤ 0.05); the number of children was significantly associated with acceptance scores of LAM patients (p ≤ 0.05); and whether surgery had been performed was significantly associated with acceptance and perceived benefits scores of LAM patients (p ≤ 0.05). Disease duration and activity limitation entered the regression equation for helplessness dimension, while whether surgery had been performed entered the regression equation for perceived benefits dimension, but no factor entered the regression equation for acceptance dimension. Applying the same analysis to disease perception, we found that the average score of the Illness Perception Questionnaire was 45.43 ± 8.97, with lower scores in the reverse-scored items of individual control, treatment, and understanding.

CONCLUSIONS

LAM patients exhibit higher levels of helplessness, particularly among those with longer disease duration and greater activity limitations, leading to a more negative perception of the disease. Additionally, patients who have undergone surgical procedures tend to perceive fewer benefits. Furthermore, there is a significant correlation between illness perception and factors such as rapamycin usage, home oxygen therapy, disease duration and activity limitations caused by LAM. This indicates that clinical healthcare providers should pay more attention to LAM patients and their associated groups, providing both informational and psychological support.

Evaluation of the Effect of a New Surgical Medical Drain Anti-Dislodgement Fixation Patch and Fixation Method in Postoperative Thyroid Care: A Randomized Trial

Participants

This study enrolled 294 patients admitted to the Thyroid Surgery Department of the First Hospital of Shanxi Medical University between April and July 2024. Patients were randomly assigned to either the control group (145 patients) or the experimental group (149 patients).

Interventions

The control group received traditional adhesive tape fixation for drains, while the experimental group utilized a newly developed fixation patch combined with a unique "C" and "S" fixation method. Both groups employed vertical negative pressure drainage.

Specific Objectives or Hypotheses

The aim of this study was to assess the clinical effectiveness and patient satisfaction with a novel surgical drain fixation patch and method in the context of thyroid surgery. The hypothesis was that the novel fixation patch and method would reduce drain-related adverse events, improve patient comfort, and increase patient satisfaction.

Outcomes

The experimental group exhibited significantly lower rates of drain-related adverse events, including displacement, infection, and leakage, compared to the control group (3.40% vs 53.10%, P < 0.05). Additionally, patients in the experimental group reported lower neck/throat pain scores (mean score: 0.84 vs 1.40 in the control group, P < 0.05) and experienced no drain pulling pain (0% vs 1.16% in the control group, P < 0.05). Furthermore, the need for patch replacements was virtually eliminated in the experimental group (0% vs 70.86% in the control group, P < 0.05). Patient satisfaction with the fixation method was significantly higher in the experimental group (83.3% vs 46.9% in the control group, P < 0.05).

Randomization

Patients were randomly assigned to the control and experimental groups, ensuring the fairness and reliability of the study.

Trial Registration

The study was retrospectively registered with the China Clinical Trial Registry (ChiCTR2400087677) on August 1, 2024.

Knowledge and perception of medical students regarding remote-access thyroidectomy in Tabuk: the effects of extensive counseling-an interventional study

INTRODUCTION

Remote-access scarless thyroidectomies are relatively new surgical procedures, and their uptake for cosmetic concerns is rapidly evolving. However, demographic factors, previous thyroid surgery, and culture substantially influence the patient's choice. This is the first study to assess the extensive counseling effect on the patient's preference for remote-access thyroidectomies compared to conventional transcervical approaches. We aimed to assess the same among medical students at the University of Tabuk, Saudi Arabia.

METHODS

This interventional study was conducted from December 2023 to March 2024. A structured questionnaire was used to gather information about demographic factors, knowledge, and perception of the medical students regarding remote-access thyroidectomies before and after a slide presentation.

RESULTS

Of 394 medical students (age 22.65 ± 1.62 years), 53.8% were women. Initially, the majority of the students preferred remote-access thyroidectomy over the conventional approach (85.3% vs. 14.7%, respectively); however, a substantial change toward the cervical approach was evident after extensive counseling [odds ratio, 2.59; 95% confidence interval (CI), 1.58-4.27; and P-value <0.00]. Knowledge regarding remote-access thyroidectomy was poor (26.9%). The students were anxious regarding postoperative complications (3.22 ± 1.59/5), thyroid scar appearance (3.28 ± 1.36/5), and postoperative pain (3.17 ± 1.38/5). Concerns regarding body satisfaction and cost were lower.

CONCLUSION

Medical students at the University of Tabuk, Saudi Arabia, demonstrated low knowledge. The strong preference for remote-access thyroidectomy over transcervical thyroidectomy shifted substantially toward the conventional approach after counseling. The main factors were thyroid scar appearance, pain, and complications. Further larger-scale studies involving the general public and assessing the effect of extensive counseling on surgical choice are needed.

Advances in targeted therapy and biomarker research in thyroid cancer

Driven by the intricacy of the illness and the need for individualized treatments, targeted therapy and biomarker research in thyroid cancer represent an important frontier in oncology. The variety of genetic changes associated with thyroid cancer demand more investigation to elucidate molecular details. This research is clinically significant since it can be used to develop customized treatment plans. A more focused approach is provided by targeted therapies, which target certain molecular targets such as mutant BRAF or RET proteins. This strategy minimizes collateral harm to healthy tissues and may also reduce adverse effects. Simultaneously, patient categorization based on molecular profiles is made possible by biomarker exploration, which allows for customized therapy regimens and maximizes therapeutic results. The benefits of targeted therapy and biomarker research go beyond their immediate clinical impact to encompass the whole cancer landscape. Comprehending the genetic underpinnings of thyroid cancer facilitates the creation of novel treatments that specifically target aberrant molecules. This advances the treatment of thyroid cancer and advances precision medicine, paving the way for the treatment of other cancers. Taken simply, more study on thyroid cancer is promising for better patient care. The concepts discovered during this investigation have the potential to completely transform the way that care is provided, bringing in a new era of personalized, precision medicine. This paradigm shift could improve the prognosis and quality of life for individuals with thyroid cancer and act as an inspiration for advances in other cancer types.