Factors Influencing Quality of Life in Thyroid Cancer Patients with Thyroidectomy

Jiyeon Yang; Myungsun Yi

doi:10.5388/aon.2015.15.2.59

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

Original Article

Asian Oncology Nursing 2015; 15(2): 59-66.

Published online: 30 June 2015

DOI: https://doi.org/10.5388/aon.2015.15.2.59

Factors Influencing Quality of Life in Thyroid Cancer Patients with Thyroidectomy

Jiyeon Yang¹, Myungsun Yi²

¹QA Team, Seoul National University Hospital, Seoul, Korea.

²College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Korea.

Address reprint requests to: Yi, Myungsun. College of Nursing, Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Tel: +82-2-740-8829, Fax: +82-2-765-4103, donam@snu.ac.kr

Received 26 January 2015 Revised 13 April 2015 Accepted 2 June 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Thyroid Neoplasms, Quality of Life, Anxiety, Depression, Self-Concept

Figures and Tables

Table 1

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

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
Gender	Female	107 (83.6)	72.19 ± 15.24	-3.24	.002
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
Religion	No	36 (27.9)	74.54 ± 13.62	-0.25	.803
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
Employment	No	67 (51.9)	70.15 ± 15.12	3.09	.002
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
Previous treatment	Thyroidectomy + RIT	53 (41.7)	72.61 ± 15.40	0.97	.333
Types of surgical incision	Neck incision	105 (84.7)	73.60 ± 15.38	-0.86	.392
Types of surgical incision	Minimally invasive surgery	19 (15.3)	76.88 ± 14.91	-0.86	.392
Other disease	Yes	45 (34.9)	71.79 ± 16.45	1.21	.228
Other disease	No	84 (65.1)	75.18 ± 14.42	1.21	.228
Self-help group activity	Yes	73 (56.6)	75.51 ± 14.10	-1.30	.198
Self-help group activity	No	56 (43.4)	72.03 ± 16.41	-1.30	.198

RIT=Radioactive iodine therapy.

Table 2

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

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)

Variables	Anxiety	Depression	Self-esteem	Quality of life
Variables	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)

Variables	Quality of life
Variables	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.

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