Investigation of follow-up needs and its influencing factors of postoperative patients with thyroid cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CAI Ming ^1,2 , HU Ziyi ^1,2 , ZHANG Kun ¹ , TANG Yuan ³ ,  GOU Juxiang ^1,2

1. Department of Thyroid Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Nursing, Sichuan University, Chengdu 610041, P. R. China;
3. Department of Head and Neck Surgical Oncology, Sichuan Cancer Hospital, Chengdu 610041, P. R. China;

Corresponding?author：

GOU Juxiang, Email: goujuxiang@126.com

Keywords：

thyroid cancer; postoperative; follow-up need; influencing factor

DOI：

10.7507/1007-9424.202012075

Video：

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Objective To understand the follow-up needs of postoperative patients with thyroid cancer and analyze its influencing factors, so as to provide a reference for the establishment of a follow-up management system for patients with thyroid cancer.Methods Convenience sampling was used to conduct a questionnaire survey on the follow-up need, recovery, anxiety, and stress of patients after thyroid cancer surgery in 2 tertiary A hospitals from March to April in 2020. The self-designed follow-up needs questionnaire, the Quality of Recovery Questionnaire 15 (QoR-15), the Generalized Anxiety Disorder-7 (GAD-7), and the Perceived Stress Scale (PSS-4) were scored. The higher score, the higher need, the better recovery, and the more serious anxiety and stress.Results In this study, 382 questionnaires were distributed, which of 351 were returned and of 349 were valid, the valid callback rate was 99.4% (349/351). ① Follow-up needs. Follow-up form: Online platform was the preferred follow-up method (72.2%), the most patients hoped that the follow-up would be conducted by a doctor (82.5%) and hoped to start the follow-up at 1 month after the operation (67.6%) and in the afternoon (50.7%), the duration of each follow-up was 10–15 min (47.3%), and accepted the follow-up frequency of 1 times per month (41.3%) and the lifetime follow-up (69.9%). Needs degree of follow-up contents: There were 13 follow-up items requiring more than 80% of patients. The top 5 items with the higher follow-up needs score were the question on test results, returning visit guidance, knowledges of metastasis and recurrence, medication guidance, and issuance of inspection orders, and their scores were 4.78±0.47, 4.70±0.51, 4.70±0.57, 4.65±0.59, 4.57±0.64, respectively. The results of multiple linear regression analysis were found that the age (young), marital status (unmarried), medical payment method (with medical insurance), and postoperative interval (<1 month) were closely related to the follow-up needs score (P<0.05). ② Recovery, anxiety, and stress statuses: The total QoR-15 score of patients was 79.87±29.95, which was positively correlated with the total score of follow-up needs (72.93±8.52, r=0.131, P=0.014). No significant correlation was found between the total score of GAD-7 (4.77±3.59) or PSS-4 (6.51±3.10) and the total score of follow-up needs (r=0.068, P=0.207; r=0.008, P=0.881).Conclusions Young, unmarried, medically insured, and early postoperative patients with thyroid cancer have higher follow-up needs. Patients with better recovery after surgery have a higher follow-up needs. Medical staff should pay attention to follow-up services after discharge, rationally arrange content, frequency, and time period of follow-up according to follow-up needs of patients, so as to improve quality of medical services.

Citation： CAI Ming, HU Ziyi, ZHANG Kun, TANG Yuan, GOU Juxiang. Investigation of follow-up needs and its influencing factors of postoperative patients with thyroid cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(9): 1193-1199. doi: 10.7507/1007-9424.202012075 Copy

1.	Chen W, Zheng R, Zhang S, et al. Cancer incidence and mortality in China in 2013: an analysis based on urbanization level. Chin J Cancer Res, 2017, 29(1): 1-10.
2.	Banerjee M, Muenz DG, Chang JT, et al. Tree-based model for thyroid cancer prognostication. J Clin Endocrinol Metab, 2014, 99(10): 3737-3745.
3.	Fitzmaurice C, Akinyemiju TF, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: A systematic analysis for the global burden of disease study. JAMA Oncol, 2018, 4(11): 1553-1568.
4.	程若川, 劉文. 中國甲狀腺癌術后隨訪和臨床研究現狀反思. 中國普通外科雜志, 2017, 26(11): 1375-1382.
5.	Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid nodules and differentiated thyroid cancer. Thyroid, 2016, 26(1): 1-133.
6.	Beekers N, Husson O, Mols F, et al. Symptoms of anxiety and depression are associated with satisfaction with information provision and internet use among 3 080 cancer survivors: Results of the PROFILES registry. Cancer Nurs, 2015, 38(5): 335-342.
7.	周嫣, 季夢婷, 張雁冰. 出院后患者隨訪服務現狀與研究進展. 齊魯護理雜志, 2014, 20(13): 53-55, 56.
8.	馮翔, 田俊, 展陽妮, 等. 護士主導的隨訪護理研究現狀. 中國臨床護理, 2018, 10(6): 546-549.
9.	郭穎, 鄭蕾, 張世瑜, 等. 甲狀腺微小乳頭狀癌根治術后的專科隨訪. 外科理論與實踐, 2019, 24(3): 254-258.
10.	劉志超, 曹家燕, 陳昌連. 以家庭為中心的健康教育在提高甲狀腺癌術后患者甲狀腺素服藥依從性中的應用. 解放軍護理雜志, 2017, 34(7): 65-67, 71.
11.	范素云, 賈彥彥. 無縫隙健康教育在放射性¹³¹I治療甲狀腺癌患者中的應用. 上海護理, 2016, 16(6): 16-19.
12.	於麗紅, 蘇勝偶, 葛艷紅, 等. 電話隨訪干預對亞臨床甲狀腺功能減退癥病人血脂和促甲狀腺激素的影響. 護理研究, 2016, 30(13): 1611-1614.
13.	張璟, 劉東玲, 高喬喬, 等. 甲狀腺癌患者信息需求的研究進展. 中華護理教育, 2018, 15(9): 703-707.
14.	張彩麗, 李冰, 楊杰, 等. 慢性乙肝病毒性肝炎病人隨訪需求調查及對策. 護理研究, 2014, 28(19): 2336-2338.
15.	段丹, 寧寧, 陳佳麗, 等. 頸椎病術后患者隨訪服務的需求現狀及影響因素的調查研究. 華西醫學, 2019, 34(9): 1010-1016.
16.	劉永兵, 竇新芝, 王淑霞, 等. 養老機構老年人健康素養與自我護理能力的典型相關分析. 中國老年學雜志, 2014, 34(5): 1349-1352.
17.	林雨軒, 徐軍美. 恢復質量量表QoR-15用于肝切除術后患者早期恢復質量的評估. 中南大學, 2014.
18.	Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med, 2006, 166(10): 1092-1097.
19.	何筱衍, 李春波, 錢潔, 等. 廣泛性焦慮量表在綜合性醫院的信度和效度研究. 上海精神醫學, 2010, 22(4): 200-203.
20.	Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav, 1983, 24(4): 385-396.
21.	楊廷忠, 黃漢騰. 社會轉型中城市居民心理壓力的流行病學研究. 中華流行病學雜志, 2003, 24(9): 760-764.
22.	夏冰洋, 陳智群, 薛春梅, 等. 江蘇省濱湖區2007-2016年育齡婦女死亡監測分析. 中國婦幼健康研究, 2018, 29(9): 1112-1115.
23.	張璟, 李利梅, 李嘉音, 等. 甲狀腺癌病人健康信息獲取與需求狀況調查. 護理研究, 2019, 33(22): 3872-3878.
24.	Goldfarb M, Casillas J. Unmet information and support needs in newly diagnosed thyroid cancer: comparison of adolescents/young adults (AYA) and older patients. J Cancer Surviv, 2014, 8(3): 394-401.
25.	Morley S, Goldfarb M. Support needs and survivorship concerns of thyroid cancer patients. Thyroid, 2015, 25(6): 649-656.
26.	Lamers RE, Cuypers M, Husson O, et al. Patients are dissatisfied with information provision: perceived information provision and quality of life in prostate cancer patients. Psychooncology, 2016, 25(6): 633-640.
27.	高學珍, 姚薇, 賈艷慶. 頭頸部腫瘤患者對延續護理服務需求的調查分析. 護理研究, 2017, 31(35B): 4588-4590.
28.	趙延慧, 李曉玲, 戴燕, 等. 日間手術患者延續性護理服務需求調查. 護理學雜志, 2018, 33(9): 88-91.
29.	李小梅, 孫玉倩. 放療癌癥患者的應對方式及其社會支持的相關性. 中國慢性病預防與控制, 2011, 16(7): 557-559.
30.	張靜, 馬小琴. 大腸癌患者的心理一致感、社會支持及生活質量的研究進展. 解放軍護理雜志, 2013, 30(8): 39-41.
31.	Molisani A, Dumenci L, Matsuyama RK. Influences of patient sociodemographics on cancer information received through the first 9 months of treatment. J Cancer Educ, 2014, 29(1): 158-166.
32.	Martinez-Donate A P, Halverson J, Simon N J, et al. Identifying health literacy and health system navigation needs among rural cancer patients: Findings from the rural oncology literacy enhancement study (ROLES). J Cancer Educ, 2013, 28(3): 573-581.
33.	Ryu J, Ryu YM, Jung YS, et al. Extent of thyroidectomy affects vocal and throat functions: a prospective observational study of lobectomy versus total thyroidectomy. Surgery, 2013, 154(3): 611-620.

1. Chen W, Zheng R, Zhang S, et al. Cancer incidence and mortality in China in 2013: an analysis based on urbanization level. Chin J Cancer Res, 2017, 29(1): 1-10.
2. Banerjee M, Muenz DG, Chang JT, et al. Tree-based model for thyroid cancer prognostication. J Clin Endocrinol Metab, 2014, 99(10): 3737-3745.
3. Fitzmaurice C, Akinyemiju TF, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: A systematic analysis for the global burden of disease study. JAMA Oncol, 2018, 4(11): 1553-1568.
4. 程若川, 劉文. 中國甲狀腺癌術后隨訪和臨床研究現狀反思. 中國普通外科雜志, 2017, 26(11): 1375-1382.
5. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid nodules and differentiated thyroid cancer. Thyroid, 2016, 26(1): 1-133.
6. Beekers N, Husson O, Mols F, et al. Symptoms of anxiety and depression are associated with satisfaction with information provision and internet use among 3 080 cancer survivors: Results of the PROFILES registry. Cancer Nurs, 2015, 38(5): 335-342.
7. 周嫣, 季夢婷, 張雁冰. 出院后患者隨訪服務現狀與研究進展. 齊魯護理雜志, 2014, 20(13): 53-55, 56.
8. 馮翔, 田俊, 展陽妮, 等. 護士主導的隨訪護理研究現狀. 中國臨床護理, 2018, 10(6): 546-549.
9. 郭穎, 鄭蕾, 張世瑜, 等. 甲狀腺微小乳頭狀癌根治術后的專科隨訪. 外科理論與實踐, 2019, 24(3): 254-258.
10. 劉志超, 曹家燕, 陳昌連. 以家庭為中心的健康教育在提高甲狀腺癌術后患者甲狀腺素服藥依從性中的應用. 解放軍護理雜志, 2017, 34(7): 65-67, 71.
11. 范素云, 賈彥彥. 無縫隙健康教育在放射性¹³¹I治療甲狀腺癌患者中的應用. 上海護理, 2016, 16(6): 16-19.
12. 於麗紅, 蘇勝偶, 葛艷紅, 等. 電話隨訪干預對亞臨床甲狀腺功能減退癥病人血脂和促甲狀腺激素的影響. 護理研究, 2016, 30(13): 1611-1614.
13. 張璟, 劉東玲, 高喬喬, 等. 甲狀腺癌患者信息需求的研究進展. 中華護理教育, 2018, 15(9): 703-707.
14. 張彩麗, 李冰, 楊杰, 等. 慢性乙肝病毒性肝炎病人隨訪需求調查及對策. 護理研究, 2014, 28(19): 2336-2338.
15. 段丹, 寧寧, 陳佳麗, 等. 頸椎病術后患者隨訪服務的需求現狀及影響因素的調查研究. 華西醫學, 2019, 34(9): 1010-1016.
16. 劉永兵, 竇新芝, 王淑霞, 等. 養老機構老年人健康素養與自我護理能力的典型相關分析. 中國老年學雜志, 2014, 34(5): 1349-1352.
17. 林雨軒, 徐軍美. 恢復質量量表QoR-15用于肝切除術后患者早期恢復質量的評估. 中南大學, 2014.
18. Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med, 2006, 166(10): 1092-1097.
19. 何筱衍, 李春波, 錢潔, 等. 廣泛性焦慮量表在綜合性醫院的信度和效度研究. 上海精神醫學, 2010, 22(4): 200-203.
20. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav, 1983, 24(4): 385-396.
21. 楊廷忠, 黃漢騰. 社會轉型中城市居民心理壓力的流行病學研究. 中華流行病學雜志, 2003, 24(9): 760-764.
22. 夏冰洋, 陳智群, 薛春梅, 等. 江蘇省濱湖區2007-2016年育齡婦女死亡監測分析. 中國婦幼健康研究, 2018, 29(9): 1112-1115.
23. 張璟, 李利梅, 李嘉音, 等. 甲狀腺癌病人健康信息獲取與需求狀況調查. 護理研究, 2019, 33(22): 3872-3878.
24. Goldfarb M, Casillas J. Unmet information and support needs in newly diagnosed thyroid cancer: comparison of adolescents/young adults (AYA) and older patients. J Cancer Surviv, 2014, 8(3): 394-401.
25. Morley S, Goldfarb M. Support needs and survivorship concerns of thyroid cancer patients. Thyroid, 2015, 25(6): 649-656.
26. Lamers RE, Cuypers M, Husson O, et al. Patients are dissatisfied with information provision: perceived information provision and quality of life in prostate cancer patients. Psychooncology, 2016, 25(6): 633-640.
27. 高學珍, 姚薇, 賈艷慶. 頭頸部腫瘤患者對延續護理服務需求的調查分析. 護理研究, 2017, 31(35B): 4588-4590.
28. 趙延慧, 李曉玲, 戴燕, 等. 日間手術患者延續性護理服務需求調查. 護理學雜志, 2018, 33(9): 88-91.
29. 李小梅, 孫玉倩. 放療癌癥患者的應對方式及其社會支持的相關性. 中國慢性病預防與控制, 2011, 16(7): 557-559.
30. 張靜, 馬小琴. 大腸癌患者的心理一致感、社會支持及生活質量的研究進展. 解放軍護理雜志, 2013, 30(8): 39-41.
31. Molisani A, Dumenci L, Matsuyama RK. Influences of patient sociodemographics on cancer information received through the first 9 months of treatment. J Cancer Educ, 2014, 29(1): 158-166.
32. Martinez-Donate A P, Halverson J, Simon N J, et al. Identifying health literacy and health system navigation needs among rural cancer patients: Findings from the rural oncology literacy enhancement study (ROLES). J Cancer Educ, 2013, 28(3): 573-581.
33. Ryu J, Ryu YM, Jung YS, et al. Extent of thyroidectomy affects vocal and throat functions: a prospective observational study of lobectomy versus total thyroidectomy. Surgery, 2013, 154(3): 611-620.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Investigation of follow-up needs and its influencing factors of postoperative patients with thyroid cancer

Abstract Full text Figures/Tables Video References Cited by

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