Journal List > Asian Oncol Nurs > v.15(2) > 1081858

Yang and Yi: Factors Influencing Quality of Life in Thyroid Cancer Patients with Thyroidectomy

Abstract

Purpose

The purpose of the study was to examine the relationships among anxiety, depression, self-esteem, and quality of life in thyroid cancer patients with thyroidectomy and to identify factors influencing their quality of life.

Methods

A cross-sectional survey was conducted to measure anxiety, depression, self-esteem, and quality of life of 129 thyroid cancer patients between 2011 and 2012. The data were analyzed with t-test, one-way ANOVA, post-hoc comparison (Duncan), Pearson's correlation coefficients, and multiple regression analysis.

Results

The mean age of the participants was 49.8, and most of them were female and married. The mean time since diagnosis of the participants was two years. The mean score for quality of life was 74 out of 108. Quality of life was significantly different by gender, employment and the stage of cancer at diagnosis. Anxiety, depression and self-esteem were all correlated to quality of life. As a result of stepwise multiple regression analysis, depression, self-esteem, and gender were discovered to account for 58.1% of the variance in quality of life. Depression was the most influential factor.

Conclusion

The results of the study indicate that depression and self-esteem should be integrated when developing psychosocial intervention to promote quality of life among thyroid cancer patients.

Figures and Tables

Table 1

Demographic and Illness-related Characteristics and Quality of Life (N=129)

aon-15-59-i001
Characteristics Categories n (%) or M ± SD Quality of life (M±SD) F or t p Duncan
Gender Male 21 (16.4) 83.56 ± 11.33 -3.24 .002
Female 107 (83.6) 72.19 ± 15.24
Age (year) (M ± SD = 49.78 ± 11.59) < 30 6 (4.7) 85.06 ± 13.06 1.10 .358
30~39 18 (14.0) 76.48 ± 14.40
40~49 37 (28.7) 73.53 ± 16.41
50~59 44 (34.1) 72.12 ± 14.22
≥ 60 24 (18.6) 73.54 ± 15.79
Education ≤ Middle school 14 (10.9) 71.22 ± 15.02 0.69 .503
High school 38 (29.5) 72.46 ± 15.14
≥ College 77 (59.7) 75.26 ± 15.30
Religion Yes 93 (72.1) 73.79 ± 15.81 -0.25 .803
No 36 (27.9) 74.54 ± 13.62
Marital status Single 13 (10.1) 79.82 ± 13.01 1.67 .193
Married 109 (84.5) 73.73 ± 15.30
Others 7 (5.4) 67.31 ± 15.46
Employment Yes 62 (48.1) 78.16 ± 14.23 3.09 .002
No 67 (51.9) 70.15 ± 15.12
Economic status High 21 (16.4) 79.96 ± 17.92 2.07 .130
Middle 95 (74.2) 72.57 ± 14.54
Low 12 (9.4) 73.60 ± 13.66
Time since diagnosis (month) < 6 42 (32.8) 74.22 ± 16.81 0.90 .464
6~11 19 (14.8) 75.38 ± 14.18
12~23 37 (28.9) 73.01 ± 14.07
24~35 11 (8.6) 80.61 ± 9.85
≥ 36 19 (14.8) 70.11 ± 17.27
Stage of cancer at diagnosis Stage 1 41 (68.3) 78.72 ± 15.60 3.81 .012 A
Stage 2 8 (13.3) 68.31 ± 9.54 AB
Stage 3~4 11 (18.3) 63.17 ± 19.76 B
Do not know 68 (53.1) 73.84 ± 13.63 AB
Previous treatment Thyroidectomy only 74 (58.3) 75.27 ± 15.13 0.97 .333
Thyroidectomy + RIT 53 (41.7) 72.61 ± 15.40
Types of surgical incision Neck incision 105 (84.7) 73.60 ± 15.38 -0.86 .392
Minimally invasive surgery 19 (15.3) 76.88 ± 14.91
Other disease Yes 45 (34.9) 71.79 ± 16.45 1.21 .228
No 84 (65.1) 75.18 ± 14.42
Self-help group activity Yes 73 (56.6) 75.51 ± 14.10 -1.30 .198
No 56 (43.4) 72.03 ± 16.41

RIT=Radioactive iodine therapy.

Table 2

Scores of Anxiety, Depression, Self-esteem, and Quality of Life (N=129)

aon-15-59-i002
Variables M ± SD Score n (%) Min~Max* M ± SD of item
Anxiety 5.37 ± 3.87 0~7 (Normal) 95 (73.6) 0~17
8~10 (Mild) 23 (17.8)
11~21 (Moderate-Severe) 11 (8.5)
Depression 5.47 ± 3.51 0~7 (Normal) 95 (73.6) 0~17
8~10 (Mild) 24 (18.6)
11~21 (Moderate-Severe) 10 (7.8)
Self-esteem 37.57 ± 5.64 0~50
Quality of Life 74.00 ± 15.19 0~108 2.74 ± 0.56
 Physical well-being 21.43 ± 5.52 0~28 3.06 ± 0.79
 Social/family well-being 16.55 ± 5.94 0~28 2.36 ± 0.85
 Emotional well-being 17.53 ± 4.78 0~24 2.92 ± 0.80
 Functional well-being 18.48 ± 5.98 0~28 2.64 ± 0.85

*Min=Minimum; Max=Maximum.

Table 3

Correlations among Quality of Life, Anxiety, Depression, and Self-esteem (N=129)

aon-15-59-i003
Variables Anxiety Depression Self-esteem Quality of life
r (p) r (p) r (p) r (p)
Anxiety 1
Depression .68 ( < .001) 1
Self-esteem - .63 ( < .001) - .62 ( < .001) 1
Quality of life - .60 ( < .001) - .69 ( < .001) .68 ( < .001) 1
Table 4

Factors Influencing Quality of Life (N=129)

aon-15-59-i004
Variables Quality of life
B SE β t p Tolerance VIF
(Constant) 50.26 9.10 5.53 < .001
Depression - 1.93 0.33 - .44 - 5.82 < .001 .60 1.66
Self-esteem 1.02 0.20 .38 5.10 < .001 .61 1.64
Gender - 4.80 2.42 - .12 - 1.99 .049 .95 1.05
R2 = .59, Adjusted R2 = .58, F = 58.46, p < .001

Notes

This article is based on a part of the first author's master's thesis from Seoul National University.

References

1. National Cancer Information Center. Cancer information service. Accessed January 8, 2015. http://www.cancer.go.kr/mbs/cancer/subview.jsp?id=cancer_040102000000.
2. Youn YK, Oh SK, Kang KH, Jung HD. Thyroid cancer. Seoul: Academia;2007.
3. Giusti M, Sibilla F, Cappi C, Dellepiane M, Tombesi F, Ceresola E, et al. A case-controlled study on the quality of life in a cohort of patients with history of differentiated thyroid carcinoma. J Endocrinol Invest. 2005; 28(7):599–608.
crossref
4. Husson O, Haak HR, Buffart LM, Nieuwlaat WA, Oranje WA, Mols F, et al. Health-related quality of life and disease specific symptoms in long-term thyroid cancer survivors: a study from the population-based PROFILES registry. Acta Oncol. 2013; 52(2):249–258.
crossref
5. Yoon HJ, Seok JH. Clinical factors associated with quality of life in patients with thyroid cancer. J Korean Thyroid Assoc. 2014; 7(1):62–69.
crossref
6. Yoo SH, Choi-Kwon S. Changes in quality of life and related factors in thyroid cancer patients with radioactive iodine remnant ablation. J Korean Acad Nurs. 2013; 43:801–811.
crossref
7. Lee JI, Kim SH, Tan AH, Kim HK, Jang HW, Hur KY, et al. Decreased health-related quality of life in disease-free survivors of differentiated thyroid cancer in Korea. Health Qual Life Outcomes. 2010; 8:101–111.
crossref
8. Sheldon LK, Swanson S, Dolce A, Marsh K, Summers J. Putting evidence into practice: evidence-based interventions for anxiety. Clin J Oncol Nurs. 2008; 12(5):789–797.
crossref
9. Paek Y. Physical symptom, anxiety, depression and quality of life in colorectal cancer undergoing chemotherapy [Master's thesis]. Seoul: Seoul National University;2013.
10. Jung AR, Yi M. Predictive factors of supportive care needs in patients with hematologic malignancy. Korean J Adult Nurs. 2013; 23(5):460–471.
11. Greer JA, Solis JM, Temel JS, Lennes IT, Prigerson HG, Maciejewski PK, et al. Anxiety disorders in long-term survivors of adult cancers. Psychosomatics. 2012; 52(5):417–423.
crossref
12. Kim JS. Postoperative quality of life in patients with papillary thyroid cancer. J Korea Acad Industr Coop Soc. 2011; 12(3):1260–1269.
crossref
13. Lee SJ, Park JH, Park BY, Kim SY, Lee IH, Kim JH, et al. Depression and suicide ideas of cancer patients and influencing factors in South Korea. Asian Pac J Cancer Prev. 2014; 15(7):2945–2950.
crossref
14. Yi M, Kim JH, Park EY, Kim JN, Yu ES. Focus group study on psychosocial distress of cancer patients. Korean J Adult Nurs. 2010; 22(1):19–30.
15. Katz MR, Rodin G, Devins GM. Self-esteem and cancer: theory and research. Can J Psychiatry. 1995; 40:608–615.
crossref
16. Bertero CM. Affected self-respect and self-value: the impact of breast cancer treatment on self-esteem and QOL. Psychooncology. 2002; 11:356–364.
crossref
17. Choi Y, Lee JH, Kim YH, Lee YS, Chang HS, Park CS, et al. Impact of postthyroidectomy scar on the quality of life of thyroid cancer patients. Ann Dermatol. 2014; 26(6):693–699.
crossref
18. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6):361–370.
crossref
19. Oh SM, Min KJ, Park DB. A Study on the Standardization of the Hospital Anxiety and Depression Scale for Koreans: A Comparison of Normal, Depressed and Anxious Groups. J Korean Neuropsychiatr Assoc. 1999; 38(2):289–296.
20. Snaith RP. The hospital anxiety and depression scale. Health Qual Life Outcomes. 2003; 1:29–32.
21. Rosenberg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press;1965.
22. Jon BJ. Self-Esteem: a test of its measurability. Yonsei Nonchong. 1974; 11(1):107–130.
23. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol. 1993; 11(3):570–579.
crossref
24. Chun MS, Lee EH, Moon SM, Kang SH, Ryu HS. Medical-and-psychosocial factors influencing on the quality of life in patients with cervix cancer. J Korean Soc Ther Radiol Oncol. 2005; 23(4):201–210.
25. Kobayashi M, Ohno T, Noguchi W, Matsuda A, Matsushima E, Kato S, et al. Psychological distress and quality of life in cervical cancer survivors after radiotherapy: do treatment modalities, disease stage, and selfesteem influence outcomes? Int J Gynecol Cancer. 2009; 19(7):1264–1268.
crossref
26. Kim YS, Tae YS. The influencing factors on quality of life among breast cancer survivors. J Korean Oncol Nurs. 2011; 11(3):221–228.
crossref
27. Kim KH, Choi HL, Lee YS, Jo HJ, Lee SY, Lee SM. The factors influencing quality of life on head and neck cancer patients after surgery. Clin Nurs Res. 2006; 12(2):41–51.
28. Lee EO, Eom A, Song R, Chae YR, Lam P. Factors influencing quality of life in patients with gastrointestinal neoplasms. J Korean Acad Nurs. 2008; 38(5):649–655.
crossref
29. Shim HY, Park JH, Kim SY, Shin DW, Shin JY, Park BY, et al. Discordance between perceived and actual cancer stage among cancer patients in Korea: a nationwide survey. PLoS One. 2014; 9(5):e90483.
crossref
TOOLS
Similar articles