Determinants of Quality of Life in Patients After Thyroidectomy: Electrolyte Imbalance, Sleep Problems, and Fatigue
Abstract
Aim: The study was conducted to determine the effects of electrolyte levels, sleep problems, and fatigue on quality of life in patients undergoing thyroidectomy.
Method: The study involved 93 participants who underwent thyroidectomy from April 2023 to August 2024. The study was conducted in a descriptive design. The data of the study were collected with the Descriptive Characteristics Questionnaire Form, Fatigue Severity Scale, Richard Campbell Sleep Scale, and SF-12 Quality of Life Scale. Independent sample t-test, one-way analysis of variance, dependent sample t-test, Pearson correlation and linear regression analysis were used to evaluate the data. Ethical approval, institutional permission, academic board permission, and informed consent were obtained. Electrolyte levels, quality of life, fatigue severity and sleep scale total scores of thyroidectomy patients were evaluated face to face before discharge and by phone first month post-discharge.
Results: Quality of life, fatigue and sleep quality scale scores were determined as 29.83±3.99, 38.41±20.61, and 35.77±14.17 respectively in the first month post-discharge. A significant, negative correlation was found between the quality of life and fatigue scale and the total score of the fatigue and sleep scale during the initial month following post-discharge. In the study, fatigue, sleep quality, calcium, phosphorus and magnesium levels explained 55% of the increase in quality of life after thyroidectomy.
Conclusion: At the conclusion of the study, it was ascertained that there was a decrease in sleep quality and quality of life, alongside an increase in fatigue levels in patients after thyroidectomy. The study helps healthcare professionals to provide better counseling to their patients and provides an up-to-date synthesis of quality of life, fatigue and sleep quality that may allow a more personalized approach.
Keywords
References
- 1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal For Clinicians. 2018;68(6):394-424. doi: 10.3322/caac.21492.
- 2. Elsamna ST, Suri P, Mir GS, Roden DF, Paskhover B. Evaluating the impact of metabolic syndrome on postoperative thyroidectomy outcomes. Head & Neck. 2021;43(4):1271-1279. doi: 10.1002/hed.26588.
- 3. Liu Z, Masterson L, Fish B, Jani P, Chatterjee K. Thyroid surgery for graves' disease and graves' ophthalmopathy. Cochrane Database of Systematic Reviews. 2015;11:CD010576. doi: 10.1002/14651858.CD010576.pub2.
- 4. Gamper EM, Wintner LM, Rodrigues M, et al. Persistent quality of life impairments in differentiated thyroid cancer patients: Results from a monitoring programme. Eur J Nucl Med Mol Imaging. 2015;42(8):1179-1188. doi: 10.1007/s00259-015-3022-9.
- 5. Baloch N, Taj S, Anwer M, Naseem M. Frequency of hypocalcaemia following total thyroidectomy. Pakistan Journal of Medical Sciences. 2019;35(1):262-265. doi: 10.12669/pjms.35.1.93.
- 6. Kumsar AK, Yılmaz FT. Troidektomi sonrası hipoparatiroidizm ve etkileri. Balıkesir Sağlık Bilimleri Dergisi. 2019;8(1):41-48.
- 7. Garrahy A, Murphy MS, Sheahan P. Impact of postoperative magnesium levels on early hypocalcemia and permanent hypoparathyroidism after thyroidectomy. Head & Neck. 2016;38(4):613-619. doi: 10.1002/hed.23937.
- 8. Ramouz A, Hosseini M, Hosseinzadeh SS, Rasihashemi SZ. Preoperative Vitamin D supplementation in patients with Vitamin D deficiency undergoing total thyroidectomy. The American Journal of the Medical Sciences. 2020;360(2):146-152. doi: 10.1016/j.amjms.2020.04.036.
- 9. Peker Y, Cin N, Kar H, Tatar F, Kahya MC, Baran NG. Prospective evaluation of perioperative biochemical tests to predict hypocalcemia after total thyroidectomy. Indian Journal of Surgery. 2020;82(2):187-190. doi: 10.1007/s12262-019-01926-z.
- 10. Azadbakht M, Emadi-Jamali SM, Azadbakht S. Hypocalcemia following total and subtotal thyroidectomy and associated factors. Annals of Medicine and Surgery. 2021;66:102417. doi: 10.1016/j.amsu.2021.102417.
- 11. Singer S, Husson O, Tomaszewska IM, et al. Quality-of-life priorities in patients with thyroid cancer: A multinational European organisation for research and treatment of cancer phase I study. Thyroid. 2016;26(11):1605-1613. doi: 10.1089/thy.2015.0640.
- 12. Lumpkin ST, Button J, Stratton L, Strassle PD, Kim LT. Chronic fatigue after thyroidectomy: A patient-centered survey. The American Surgeon. 2021;88(2):260-266. doi: 10.1177/0003134821989054.
- 13. Atasayar S, Guler DS. Determination of the problems experienced by patients post-thyroidectomy. Clinical Nursing Research. 2019;28(5):615-635. doi: 10.1177/1054773817729074.
- 14. Kurumety SK, Helenowski IB, Goswami S, Peipert BJ, Yount SE, Sturgeon C. Post-thyroidectomy neck appearance and impact on quality of life in thyroid cancer survivors. Surgery. 2019;165(6):1217-1221. doi: 10.1016/j.surg.2019.03.006.
- 15. Mirallié E, Borel F, Tresallet C, et al. Impact of total thyroidectomy on quality of life at 6 months: The prospective ThyrQoL multicentre trial. European Journal of Endocrinology. 2020;182(2):195-205. doi: 10.1530/EJE-19-0587.
- 16. Liu L, Xiang Y, Xiong L, et al. Assessment of preoperative health-related quality of life in patients undergoing thyroidectomy based on patient-reported outcomes. Frontiers in Psychology. 2024;15:1329175. doi: 10.3389/fpsyg.2024.1329175.
- 17. Krupp LB, Larocca NG, Muir-Nash J, Steinberg A. The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology. 1989;46:1121–1123. doi: 10.1001/archneur.1989.00520460115022.
- 18. Armutlu K, Korkmaz NC, Keser I, et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. International Journal of Rehabilitation Research. 2007;30(1):81-85. doi: 10.1097/MRR.0b013e3280146ec4.
- 19. Richards K. Techniques for measurement of sleep in critical care. Focus Crit Care. 1987;14:34-40.
- 20. Özlü ZK, Özer N. Richard-Campbell uyku ölçeği geçerlilik ve güvenilirlik çalışması. Journal of Turkish Sleep Medicine. 2015; 2: 29-32. doi: 10.4274/jtsm.02.008.
- 21. Ware JE, Kosinski M, Keller SD. SF-12: SF-36 physical & mental health summary scales: A manual for users of version 1. Quality Metric, 2001.
- 22. Soylu C, Kütük B. SF-12 Yaşam kalitesi ölçeği’nin türkçe formunun güvenirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi. 2021:1-9. doi: 10.5080/u25700.
- 23. Taşkaldıran I, İyidir ÖT, Toprak U, et al. The effect of age, sex, and indications for operation on the complications of total thyroidectomy. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2022;55(3):212-215.
- 24. Landry V, Siciliani E, Henry M, Payne RJ. Health-related quality of life following total thyroidectomy and lobectomy for differentiated thyroid carcinoma: A systematic review. Current Oncology. 2022;29(7):4386-4422. doi: 10.3390/curroncol29070350.
- 25. Jiang Y, Zhang P, Li G, et al. Effects of endoscopic lobectomy and conventional lobectomy on psychological and sleep quality in patients with papillary thyroid microcarcinoma—a prospective observational study. Endocrine. 2024;1-8. doi: 10.1007/s12020-024-04034-5.
- 26. Şahin S, Yazkan C, Dere Ö, Özcan Ö. Surgical outcomes of thyroidectomy patients: Single-center experience. Journal of Surgical Arts. 2024;17(2):30-35.
- 27. Yıldırım K, Özlem N. Tiroidektomi uygulanan hastaların retrospektif analizi. Ahi Evran Medical Journal. 2018;2(2):35-38.
- 28. Çiftçi F. Total tiroidektomi sonrası hipokalsemi. Kafkas Journal of Medical Sciences. 2018;8(1):36-44. doi: 10.5505/kjms.2017.82542.
- 29. He Y, Meng Z, Jia Q, et al. Sleep quality of patients with differentiated thyroid cancer. PloS one. 2015;10(6):e0130634. doi: 10.1371/journal.pone.0130634.
- 30. Hughes DT, Reyes-Gastelum D, Kovatch KJ, Hamilton AS, Ward KC, Haymart MR. Energy level and fatigue after surgery for thyroid cancer: A population-based study of patient-reported outcomes. Surgery. 2020;167(1):102-9. doi: 10.1016/j.surg.2019.04.068.
Tiroidektomi Sonrası Hastalarda Yaşam Kalitesinin Belirleyicileri: Elektrolit Dengesizliği, Uyku Problemleri ve Yorgunluk
Abstract
Amaç: Çalışma tiroidektomi uygulanan hastalarda elektrolit düzeyleri, uyku problemleri ve yorgunluğun yaşam kalitesi üzerine etkisinin belirlenmesi amacıyla yürütülmüştür.
Yöntem: Çalışma Nisan 2023-Ağustos 2024 tarihleri arasında 93 tiroidektomi hastası ile tamamlanmıştır. Çalışma tanımlayıcı desende yürütülmüştür. Araştırmanın verileri tanıtıcı özellikler anket formu, Yorgunluk Şiddeti Ölçeği, Richard Campbell Uyku Ölçeği ve SF-12 Yaşam Kalitesi Ölçeği ile toplanmıştır. Verilerin değerlendirilmesinde bağımsız örneklem t-testi, tek yönlü varyans analizi, bağımlı örneklem t-testi, Pearson korelasyon ve doğrusal regresyon analizi kullanılmıştır. Etik onay, kurum izni, akademik kurul izni ve bilgilendirilmiş onam alınmıştır. Tiroidektomi hastalarının elektrolik düzeyleri, yaşam kalitesi, yorgunluk şiddeti ve uyku ölçeği toplam puanları taburculuk öncesi yüz yüze ve taburculuk sonrası 1 ayda telefon ile değerlendirilmiştir.
Bulgular: Taburculuk sonrası 1. ayda yaşam kalitesi, yorgunluk ve uyku kalitesi ölçek puanları sırası ile 29,83±3,99; 38,41±20,61 ve 35,77±14,17 olduğu belirlenmiştir. Taburculuk sonrası 1. ayda yaşam kalitesi ve yorgunluk ölçeği ile yorgunluk ve uyku ölçeği toplam puanı arasında anlamlı, negatif yönde bir ilişki bulunmuştur. Çalışmada yorgunluk, uyku kalitesi, kalsiyum, fosfor ve magnezyum düzeyleri tiroidektomi sonrası yaşam kalitesindeki artmanın %55’ini açıklamaktadır.
Sonuç: Çalışma sonunda tiroidektomi sonrası hastaların uyku kalitesinde ve yaşam kalitesinde azalma, yorgunluk düzeyinde artış olduğu belirlenmiştir. Çalışma sağlık çalışanlarının hastalarına daha iyi danışmanlık yapmasına yardımcı olurken, daha kişiselleştirilmiş bir yaklaşıma izin verebilecek güncel bir yaşam kalitesi, yorgunluk ve uyku kalitesi sentezi sunmaktadır.
Keywords
References
- 1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal For Clinicians. 2018;68(6):394-424. doi: 10.3322/caac.21492.
- 2. Elsamna ST, Suri P, Mir GS, Roden DF, Paskhover B. Evaluating the impact of metabolic syndrome on postoperative thyroidectomy outcomes. Head & Neck. 2021;43(4):1271-1279. doi: 10.1002/hed.26588.
- 3. Liu Z, Masterson L, Fish B, Jani P, Chatterjee K. Thyroid surgery for graves' disease and graves' ophthalmopathy. Cochrane Database of Systematic Reviews. 2015;11:CD010576. doi: 10.1002/14651858.CD010576.pub2.
- 4. Gamper EM, Wintner LM, Rodrigues M, et al. Persistent quality of life impairments in differentiated thyroid cancer patients: Results from a monitoring programme. Eur J Nucl Med Mol Imaging. 2015;42(8):1179-1188. doi: 10.1007/s00259-015-3022-9.
- 5. Baloch N, Taj S, Anwer M, Naseem M. Frequency of hypocalcaemia following total thyroidectomy. Pakistan Journal of Medical Sciences. 2019;35(1):262-265. doi: 10.12669/pjms.35.1.93.
- 6. Kumsar AK, Yılmaz FT. Troidektomi sonrası hipoparatiroidizm ve etkileri. Balıkesir Sağlık Bilimleri Dergisi. 2019;8(1):41-48.
- 7. Garrahy A, Murphy MS, Sheahan P. Impact of postoperative magnesium levels on early hypocalcemia and permanent hypoparathyroidism after thyroidectomy. Head & Neck. 2016;38(4):613-619. doi: 10.1002/hed.23937.
- 8. Ramouz A, Hosseini M, Hosseinzadeh SS, Rasihashemi SZ. Preoperative Vitamin D supplementation in patients with Vitamin D deficiency undergoing total thyroidectomy. The American Journal of the Medical Sciences. 2020;360(2):146-152. doi: 10.1016/j.amjms.2020.04.036.
- 9. Peker Y, Cin N, Kar H, Tatar F, Kahya MC, Baran NG. Prospective evaluation of perioperative biochemical tests to predict hypocalcemia after total thyroidectomy. Indian Journal of Surgery. 2020;82(2):187-190. doi: 10.1007/s12262-019-01926-z.
- 10. Azadbakht M, Emadi-Jamali SM, Azadbakht S. Hypocalcemia following total and subtotal thyroidectomy and associated factors. Annals of Medicine and Surgery. 2021;66:102417. doi: 10.1016/j.amsu.2021.102417.
- 11. Singer S, Husson O, Tomaszewska IM, et al. Quality-of-life priorities in patients with thyroid cancer: A multinational European organisation for research and treatment of cancer phase I study. Thyroid. 2016;26(11):1605-1613. doi: 10.1089/thy.2015.0640.
- 12. Lumpkin ST, Button J, Stratton L, Strassle PD, Kim LT. Chronic fatigue after thyroidectomy: A patient-centered survey. The American Surgeon. 2021;88(2):260-266. doi: 10.1177/0003134821989054.
- 13. Atasayar S, Guler DS. Determination of the problems experienced by patients post-thyroidectomy. Clinical Nursing Research. 2019;28(5):615-635. doi: 10.1177/1054773817729074.
- 14. Kurumety SK, Helenowski IB, Goswami S, Peipert BJ, Yount SE, Sturgeon C. Post-thyroidectomy neck appearance and impact on quality of life in thyroid cancer survivors. Surgery. 2019;165(6):1217-1221. doi: 10.1016/j.surg.2019.03.006.
- 15. Mirallié E, Borel F, Tresallet C, et al. Impact of total thyroidectomy on quality of life at 6 months: The prospective ThyrQoL multicentre trial. European Journal of Endocrinology. 2020;182(2):195-205. doi: 10.1530/EJE-19-0587.
- 16. Liu L, Xiang Y, Xiong L, et al. Assessment of preoperative health-related quality of life in patients undergoing thyroidectomy based on patient-reported outcomes. Frontiers in Psychology. 2024;15:1329175. doi: 10.3389/fpsyg.2024.1329175.
- 17. Krupp LB, Larocca NG, Muir-Nash J, Steinberg A. The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology. 1989;46:1121–1123. doi: 10.1001/archneur.1989.00520460115022.
- 18. Armutlu K, Korkmaz NC, Keser I, et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. International Journal of Rehabilitation Research. 2007;30(1):81-85. doi: 10.1097/MRR.0b013e3280146ec4.
- 19. Richards K. Techniques for measurement of sleep in critical care. Focus Crit Care. 1987;14:34-40.
- 20. Özlü ZK, Özer N. Richard-Campbell uyku ölçeği geçerlilik ve güvenilirlik çalışması. Journal of Turkish Sleep Medicine. 2015; 2: 29-32. doi: 10.4274/jtsm.02.008.
- 21. Ware JE, Kosinski M, Keller SD. SF-12: SF-36 physical & mental health summary scales: A manual for users of version 1. Quality Metric, 2001.
- 22. Soylu C, Kütük B. SF-12 Yaşam kalitesi ölçeği’nin türkçe formunun güvenirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi. 2021:1-9. doi: 10.5080/u25700.
- 23. Taşkaldıran I, İyidir ÖT, Toprak U, et al. The effect of age, sex, and indications for operation on the complications of total thyroidectomy. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2022;55(3):212-215.
- 24. Landry V, Siciliani E, Henry M, Payne RJ. Health-related quality of life following total thyroidectomy and lobectomy for differentiated thyroid carcinoma: A systematic review. Current Oncology. 2022;29(7):4386-4422. doi: 10.3390/curroncol29070350.
- 25. Jiang Y, Zhang P, Li G, et al. Effects of endoscopic lobectomy and conventional lobectomy on psychological and sleep quality in patients with papillary thyroid microcarcinoma—a prospective observational study. Endocrine. 2024;1-8. doi: 10.1007/s12020-024-04034-5.
- 26. Şahin S, Yazkan C, Dere Ö, Özcan Ö. Surgical outcomes of thyroidectomy patients: Single-center experience. Journal of Surgical Arts. 2024;17(2):30-35.
- 27. Yıldırım K, Özlem N. Tiroidektomi uygulanan hastaların retrospektif analizi. Ahi Evran Medical Journal. 2018;2(2):35-38.
- 28. Çiftçi F. Total tiroidektomi sonrası hipokalsemi. Kafkas Journal of Medical Sciences. 2018;8(1):36-44. doi: 10.5505/kjms.2017.82542.
- 29. He Y, Meng Z, Jia Q, et al. Sleep quality of patients with differentiated thyroid cancer. PloS one. 2015;10(6):e0130634. doi: 10.1371/journal.pone.0130634.
- 30. Hughes DT, Reyes-Gastelum D, Kovatch KJ, Hamilton AS, Ward KC, Haymart MR. Energy level and fatigue after surgery for thyroid cancer: A population-based study of patient-reported outcomes. Surgery. 2020;167(1):102-9. doi: 10.1016/j.surg.2019.04.068.
Details
| Primary Language | English |
|---|---|
| Subjects | Surgical Diseases Nursing |
| Journal Section | Articles |
| Authors | |
| Early Pub Date | April 29, 2025 |
| Publication Date | April 29, 2025 |
| Submission Date | December 17, 2024 |
| Acceptance Date | March 6, 2025 |
| Published in Issue | Year 2025 Issue: 25 |
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