Correlation Study Between The Type Of Stress Response And Quality Of Life In Patients With Thyroid Cancer

Objective:To identify thyroid cancer patients' stress response types by the latent class analysis based on the experience of anxiety,depression,fatigue,stress and post-traumatic growth.To compare the quality of life among different types during perioperative period.Methods:The study recruited 190 thyroid cancer inpatients prepared for operation from May 2017 to November 2017 at two time points:on admission(T1),before discharge(T2).A questionnaire survey was carried out to investigate the general condition,anxiety,depression,fatigue,stress,post-traumatic growth and their quality of life.Survey tools include general information questionnaire,the Patient Health Questionaire(PHQ-9),the Generalised Anxiety Disorder Questionaire(GAD-7),the 4-item Perceived Stress Scale(PSS-4),the Brief Fatigue Inventory(BFI),the Short Form of the Posttraumatic Growth Inventory(PTGI-SF),the Functional Living Index-Cancer(FLIC).SPSS22.0 statistical software was used to analyze data,statistical methods include:descriptive analysis,independent sample t-test and paired sample t test,analysis of variance,chi-square,latent class analysis,and mixed effects model.Results:1.In the T1 stage,the FLIC total score of 170 thyroid cancer patients was 122.54± 20.35;the physical health score was 51.26 ± 9.77;the mental health score was 30.58 ± 6.68;the cancer burden score was 16.33 ± 3.77;the social health score was 11.66±2.99;the nausea score was 12.75 ± 2.14.The depression score was 5.52 ± 5.31,and the positive rate of depression was 52.9%.The average score of anxiety was 6.45± 5.48,the positive rate was 59.4%.The pressure score was 6.08 ± 2.41,with the patients above the average score of 43.5%.The fatigue score was 4.49±2.30,with the patients above the average score of 51.8%,the score of posttraumatic growth was 27.76±13.45,with the patients above the average score of 57.6%.2.In the T2 stage,FLIC total score of 85 patients with thyroid cancer was significantly lower than that in T1 stage(t=3.289,P=0.001).The physical health score of T2 was significantly lower than that of T1(t=2.977,P=0.004).The score of cancer burden in T2 was significantly lower than that of T1(t=3.665,P<0.001).The T2 stage of nausea was significantly lower than T1(t=2.827,P=0.006).3.The 170 samples are divided into three types according to the anxiety,depression,fatigue,stress and posttraumatic growth,respectively named "high distress low growth group(group 1)","moderate distress high growth group(group 2)" and "low distress and moderate growth(group 3)".Depression,stress and fatigue were significantly higher in group 1 than in group 2 and group 3;anxiety,depression,stress and fatigue in group 2 were significantly higher than group 3.Post-traumatic growth score in group 1 was significantly higher than group 2 and group 3.4.In the T1 stage,the physical health score and FLIC total scores of group 3 were significantly higher than that of group 2 and group 1;mental health and cancer burden in group 3 were significantly higher than group 2 and group 1;social health and nausea in group 3 were significantly higher than group 1.In the T2 stage,the physical health,mental health score and FLIC total score of group 3 were significantly higher than group 1 and group 2.The cancer burden of group 3 was significantly higher than group 2,and social health was significantly higher than group 1.Conclusion:1.The incidence of negative symptoms of thyroid cancer patients is high,and the symptoms of patients are severe,while the post-traumatic growth level is low.2.Quality of life of thyroid cancer patients during perioperative period is low,and the patient's quality of life,physical health,cancer burden and nausea scores after the operation ability,the burden of cancer and nausea were lower than the preoperation period.3.Three types thyroid cancer were identified based on negative symptoms and positive change-posttraumatic growth:"high distress low growth group","moderate distress high growth group" and "low distress and moderate growth".The three types of thyroid cancer patients have significant difference in quality of life at different time points,and the quality of life of thyroid cancer patients can be predicted through the analysis of potential categories.