Study On Cosmetic Satisfaction And Psychological Feeling Situation Of Incision Scar In Patients With Thyroid Surgery And Its Influencing Factors

Objective(1)To understand the satisfaction of patients with thyroid surgery with incision scar and analyze its influencing factors;To understand the acceptability of four types of incision scars and the concerns of scar-related characteristics in patients undergoing thyroid surgery;To understand the willingness of patients with thyroid surgery to choose endoscopic thyroid cosmetic surgery and analyze its influencing factors.(2)To understand the perioperative cognition of young female patients with thyroid surgery for cervical incision scar and their psychological experience of postoperative incision scar.Methods(1)Based on literature review and experts’ discussion,a questionnaire on the cosmetic status of incision scar after thyroidectomy was formed.A self-designed online questionnaire was used to conduct a cross-sectional survey on the satisfaction of postoperative incision scar beauty and the willingness to accept endoscopic surgery in 135 patients with thyroid surgery who were followed up in the thyroid surgery clinic of Guizhou Provincial People’s Hospital from June 2019 to December2019.The influencing factors were analyzed.(2)A semi-structured interview was conducted with 15 young female patients with thyroid cancer after operation.The phenomenological research method was used to analyze the cognition and psychological experience of young female patients with neck incision scar during perioperative period.Results(1)The proportion of "very dissatisfied" and "dissatisfied" with the cosmetic effect of incision scar in 135 patients after thyroidectomy was about 22.2%(30/135).Statistical analysis showed that the main factors affecting patients’ satisfaction with scar beauty were age,gender,marital status,education level and preoperative beauty expectations.Logistic regression analysis showed that preoperative cosmetic expectation was an independent risk factor affecting patients’ satisfaction with postoperative incision scar(P < 0.05).74.1%(100/135)of the patients indicated that they could accept the class 1 scar with no obvious appearance,while the acceptability of class 2-4 scar decreased significantly(22.2%,17% and 2.9% respectively),which was significantly different from that of class 1 scar(P < 0.001).Some patients showed some concern about the relevant characteristics of postoperative scar(length,width,color,symmetry,keloid and scar discomfort symptoms,etc.)(the proportion ranged from 62.96% to 77.78%),but there was no significant difference in the degree of concern among various characteristics of scar(P > 0.05).61.5%(83/135)of the patients indicated that they were willing to accept neck scarless endoscopic thyroid surgery.The main factors affecting the patients’ acceptance of endoscopic surgery were age,nationality and preoperative beauty expectations,but there were no significant differences in gender,education,residence and marital status.Among the patients who were willing to accept the cervical scarless endoscopic thyroidectomy,56.63%(47/83)were willing to choose the axillary approach,while 43.37%(36/83)and 30.12%(25/83)were willing to choose the thoracolumbar approach and the oral vestibular approach,respectively.The difference was statistically significant between the three groups(P < 0.05).(2)For the scar of neck incision,the psychological experience of young female patients with thyroid cancer can be summarized into five themes: preoperative inner contradictions and choice difficulties;postoperative loss and pain;feeling of disease shame;remorse,as well as the desire to hide and improve the scar.Conclusion(1)Patients with conventional open thyroid surgery have low satisfaction with wound scar beauty;Before thyroid surgery,attention should be paid to the patients’ expectations for the beauty of incision scar.At the same time,combined with the patients’ gender,age,marital status and educational level,the beauty needs of patients with incision scar should be evaluated,and the appropriate treatment methods should be selected for patients.Endoscopic thyroidectomy still has a lot of application space,so it is necessary to provide preoperative guidance and choice for patients,especially endoscopic thyroidectomy via axillary approach.(2)Young female patients with thyroid surgery have a strong demand for incision scar beauty.