Study On Psychological Health And Quality Of Life Of Patients With Thyroid Nodules

ObjectThe study aimed to explore the psychological health and the quality of life of patients with thyroid nodules especially papillary thyroid microcarcinoma(PTMC),to explore influential factors and correlation of those patients.Method1.Objects:From 2016 Oct to Dec,a total of 207 thyroid nodule patients in clinic and wards of Endocrinal and Thyroid surgery in Qilu Hospital,Shandong University,defined as thyroid nodule group.211 normal people were defined as control group,including healthy check-up crowd,our hospital staff,refresher doctors and interns.People were determined as our study objects after they signed the informed consent.The thyroid nodule group were divided into three groups by results of ultrasonography and fine needle aspiration biopsy:benign group,PTMC group and non-PTMC group(>1cm).2.Methods:Questionnaires of self-rating anxiety scales(SAS),self-rating depression scales(SDS),the MOS 36-item Short Form Health Survey,(SF-36),Eysenck Personality Questionnaire-Revised Short Scale for Chinese(EPQ-RSC),Medical Coping Modes Questionnaire(MCMQ)and General Condition Questionnaire were used to understand the psychological health,quality of life and influential factors,and to explore the correlation of patients' psychological status,quality of life with their personalities and medical coping modes.3.Data processing and statistical analysis:SPSS 21.0 was used to analyze the data,the criterion of significant difference was 0.05,p<0.05 was considered to be different significantly.Chi-square test was used to match the two groups.We used one variant linear regression and multiple stepwise regression to analyze factors with significant difference,and used Spearman correlation to analyze the correlation of patients' psychological status,quality of life,personality and medical coping modes.Result1.Frequency of anxiety in thyroid nodule patients was 10.63%(22/207),and frequency of depression was 13.04%(27/207).Frequency of anxiety and depression of control group was 1.90%(4/211).Scores of SAS and SDS of thyroid nodule patients were higher than control group,and the difference was statistically significant.Age,monthly income,quality of life and personalities were influential factors affecting the anxious emotions of thyroid nodule patients.Patients with younger age,low income,low quality of life and obvious neuroticism had more anxious emotions.Quality of life,personalities,monthly income and medical coping modes were influential factors affecting the depressive emotions of thyroid nodule patients.Patients with low quality of life,obvious neuroticism,low income and resignation coping mode had more depressive emotions.The anxious emotions of thyroid nodule patients were positively correlated with depressive emotions.The anxious and depressive emotions were negatively correlated with patients' quality of life,extraversion traits and hide traits,at the same time,those emotions were positively correlated with patients'neuroticism,avoidance and yield dimensions.2.Quality of life among thyroid nodule patients decreased and mainly mental health related quality of life based.Age,marriage,monthly income,nodule size,psychological status and personalities were influential factors of quality of life among thyroid nodule patients.Patients with younger age,married,low income,good psychological health and personalities had better quality of life.Quality of life among thyroid nodule patients were positively related with extraversion traits and hide traits,and were negatively related with neuroticism,avoidance and yield dimensions.3.Frequency of anxiety and depression in PTMC patients was 11%and 12%,respectively.Frequency of anxiety and depression in benign nodule patients was 9.62%and 11.54%,respectively.Frequency of anxiety and depression in N-PTMC patients was 10.90%and 14.55%,respectively.The SAS and SDS scores were significantly higher than healthy people,however,differences of scores among those three groups of thyroid nodule patients had no statistical significance.Influential factors affecting anxious emotions of PTMC patients included quality of life,and Influential factors affecting depressive emotions of PTMC patients included quality of life,personalities,yield dimension.Patients'anxious and depressive emotions were negatively related with quality of life,extraversion traits and hide traits,and positively related with neuroticism,avoidance and yield dimensions.4.Compared with healthy people,quality of life of three thyroid nodule patients were significantly different.Quality of life among three groups of patients decreased and mainly mental health related quality of life based.Differences among those three groups had no statistical significance.Factors affecting quality of life included marriage,time since diagnosis,mental health,personalities and medical coping modes.Patients who were single and had short time since diagnosis,bad mental health,unstable personalities and yield dimension had low quality of life.Patients' quality of life were positively related with extraversion and negatively related with neuroticism.Conclusion1.Some thyroid nodule patients including PTMC patients have anxious and depressive emotions,and the emotions are affected by their quality of life,personalities and medical coping modes.It is important to improve patients'negative emotions during the course of therapy.2.Quality of life among thyroid nodule patients including PTMC patients decreases and mainly mental health related quality of life based.Patients' quality of life are affected by many factors,we should pay attention to improve their mental health.3.Thyroid nodule patients including PTMC patients mainly take active coping modes,and their coping modes are related with psychological status and quality of life.It is important for patients to take active medical coping modes.4.Psychological health,quality of life among PTMC?N-PTMC and benign nodule patients had no significant difference,the status of thyroid nodules had no significant influence on patients' mental health and quality of life.Despite considering the biological behavior of thyroid nodules when we make treatment plans,giving proper psychological intervention is of great importance.