Differansiye Tiroid Kanseri Hastalarında Anksiyete Düzeylerinin Ölçülmesi

Öz

Bu çalışmada amacımız Diferansiye tiroid kanseri tanısı almış hastaların anksiyete düzeylerini belirlemek ve anksiyete ile yaş, cinsiyet, medeni durum, metastaz varlığı, hastalığın başlangıç zamanı, radyoaktif iyot tedavisi alıp almadıkları ve aldıkları radyoaktif iyot dozu gibi faktörler arasındaki ilişkileri araştırmaktır. Bu prospektif çalışma Ocak 2024- Haziran 2024 tarihleri arasında yürütülmüştür. Nükleer tıp polikliniğine başvuran 164 hastanın klinik bulguları ve demografik verileri kaydedildi ve anksiyete düzeyleri Beck Anksiyete Envanteri ile ölçüldü. İstatistiksel analizler SPSS 23.0 ile yapıldı. İstatistiksel anlamlılık düzeyi p<0,05 olarak kabul edildi. Hastaların cinsiyeti Beck anksiyete düzeyi ile karşılaştırıldığında istatistiksel olarak anlamlı ilişki bulundu (p=0.007). Medeni durum, metastaz varlığı, radyoaktif iyot tedavisi alma durumu veya histopatolojik alt tip ile Beck anksiyete düzeyi arasında anlamlı ilişki bulunmadı. Diferansiye tiroid kanserli hastalarda anksiyete düzeyleri kadınlarda erkeklere göre anlamlı olarak daha yüksek bulunmuştur.

Anahtar Kelimeler

• Tiroid kanseri
• Anksiyete
• Beck Anksiyete Envanteri

Measurement of Anxiety Levels in Differentiated Thyroid Cancer Patients

Öz

In this study, our aim was to determine the anxiety levels of patients diagnosed with DTC and to investigate the relationships between anxiety and factors such as age, sex, marital status, the presence of metastasis, time since diagnosis, whether they received RIT, and the dose of radioactive iodine they received. This prospective study was conducted between January 2024 and June 2024. Clinical findings and demographic data of 164 patients who applied to the nuclear medicine outpatient clinic were recorded, and anxiety levels were measured via the Beck Anxiety Inventory. Statistical analyses were performed via SPSS 23.0. The statistical significance level was accepted as p<0.05. When the gender of the patients was compared with the Beck anxiety level, a statistically significant relationship was found (p=0.007). No significant relationship was found between the marital status, the presence of metastasis, the status of receiving radioactive iodine treatment or histopathological subtype and the Beck anxiety level. Anxiety levels in patients with differentiated thyroid cancer were found to be significantly higher in females than in males.

Anahtar Kelimeler

• Thyroid cancer
• Anxiety
• Beck Anxiety Inventory

Etik Beyan

Before starting the study, ethical approval was obtained from the Pamukkale University Non-Interventional Clinical Research Ethics Committee (dated 26.12.2023 and numbered 21).

Teşekkür

We would like to thank Miyase Nur ATALAY, Mert CENGİZ and Yavuz ÖZLÜ for their data entry of patient information.

Kaynakça

1. 1. Lepore SJ, Coyne JC. Psychological interventions for distress in cancer patients: a review of reviews. Ann Behav Med. 2006;32(2):85- 92.
2. 2. Sloan PA, LaFountain P, Plymale M, Johnson M, Snapp J, Sloan DA. Cancer pain education for medical students: the development of a short course on CD-ROM. Pain Med. 2002;3(1):66-72.
3. 3. Tokgöz G, Yalu İ, Özdemir S, Yazıcı A, Uygun K, Aker T. Kanser hastalarında majör depresyon yaygınlığı ve ilişkili etkenler. Anadolu Psikiyatri Dergisi 2008;9:59-66.
4. 4. Berard RM. Depression and anxiety in oncology: the psychiatrist's perspective. J Clin Psychiatry. 2001;62 Suppl 8:58-61; discussion 62- 3.
5. 5. Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-63.
6. 6. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, 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.
7. 7. Brito JP, Ito Y, Miyauchi A, Tuttle RM. A Clinical Framework to Facilitate Risk Stratification When Considering an Active Surveillance Alternative to Immediate Biopsy and Surgery in Papillary Microcarcinoma. Thyroid. 2016;26(1):144-9.
8. 8. Albalawi IA, Mirghani HO. Lobectomy versus total thyroidectomy in differentiated thyroid carcinoma: A review. AMJ 2019;12(10):285– 91.

9. 9. Nguyen QT, Lee EJ, Huang MG, Park YI, Khullar A, Plodkowski RA. Diagnosis and treatment of patients with thyroid cancer. Am Health Drug Benefits. 2015;8(1):30-40.
10. 10. Caruso R, Nanni MG, Riba MB, Sabato S, Grassi L. The burden of psychosocial morbidity related to cancer: patient and family issues. Int Rev Psychiatry. 2017;29(5):389-402.
11. 11. Badr H. Psychosocial Interventions for Patients With Advanced Cancer and Their Families. Am J Lifestyle Med. 2014;10(1):53-63.
12. 12. Nickel B, Tan T, Cvejic E, Baade P, McLeod DSA, Pandeya N, et al. Health-Related Quality of Life After Diagnosis and Treatment of Differentiated Thyroid Cancer and Association With Type of Surgical Treatment. JAMA Otolaryngol Head Neck Surg. 2019;145(3):231-8.
13. 13. Shah MD, Witterick IJ, Eski SJ, Pinto R, Freeman JL. Quality of life in patients undergoing thyroid surgery. J Otolaryngol. 2006;35(4):209- 15.
14. 14. Moon JH, Ryu CH, Cho SW, Choi JY, Chung EJ, Hah JH, et al. Effect of Initial Treatment Choice on 2-year Quality of Life in Patients with Low-risk Papillary Thyroid Microcarcinoma. J Clin Endocrinol Metab. 2021;106(3):724-35.
15. 15. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-7.
16. 16. Ulusoy M, Şahin N, Erkmen H. Turkish version of The Beck Anxiety Inventory : Psychometric properties. Journal of Cognitive Psychotherapy: An International quarterly 1998;12:163-72.
17. 17. van Velsen EFS, Massolt ET, Heersema H, Kam BLR, van Ginhoven TM, Visser WE, et al. Longitudinal analysis of quality of life in patients treated for differentiated thyroid cancer. Eur J Endocrinol. 2019;181(6):671-9.
18. 18. Goldfarb M, Casillas J. Thyroid Cancer-Specific Quality of Life and Health-Related Quality of Life in Young Adult Thyroid Cancer Survivors. Thyroid. 2016;26(7):923-32.
19. 19. Aschebrook-Kilfoy B, James B, Nagar S, Kaplan S, Seng V, Ahsan H, et al. Risk Factors for Decreased Quality of Life in Thyroid Cancer Survivors: Initial Findings from the North American Thyroid Cancer Survivorship Study. Thyroid. 2015;25(12):1313-21.
20. 20. 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- 21.
21. 21. Dogar IA, Azeem MW, Kiran M, Hussain I, Mehmood K, Hina I. Depression and anxiety in cancer patients in outpatient department of a tertiary care hospital in Pakistan. Pak J Med Sci 2009;25(5):734- 7.
22. 22. Papaleontiou M, Reyes-Gastelum D, Gay BL, Ward KC, Hamilton AS, Hawley ST, et al. Worry in Thyroid Cancer Survivors with a Favorable Prognosis. Thyroid. 2019;29(8):1080-8.
23. 23. Hedman C, Djärv T, Strang P, Lundgren CI. Fear of Recurrence and View of Life Affect Health-Related Quality of Life in Patients with Differentiated Thyroid Carcinoma: A Prospective Swedish Population-Based Study. Thyroid. 2018;28(12), 1609-17.
24. 24. Wang T, Jiang M, Ren Y, Liu Q, Zhao G, Cao C, et al. Health-Related Quality of Life of Community Thyroid Cancer Survivors in Hangzhou, China. Thyroid. 2018;28(8):1013-23.
25. 25. Li J, Xue LB, Gong XY, Yang YF, Zhang BY, Jin J, et al. Risk Factors of Deterioration in Quality of Life Scores in Thyroid Cancer Patients After Thyroidectomy. Cancer Manag Res. 2019;11:10593-8.
26. 26. Barbus E, Pestean C, Larg MI, Gabora K, Bonci EA, Badulescu C, et al. Psychological impact of 131I radioprotection measures on thyroid cancer patients. Clujul Med. 2018;91(4):441-7.
27. 27. Wang S, Huang H, Wang L, Wang X. A Psychological Nursing Intervention for Patients With Thyroid Cancer on Psychological Distress and Quality of Life: A Randomized Clinical Trial. J Nerv Ment Dis. 2020;208(7):533-9.
28. 28. Wu HX, Zhong H, Xu YD, Xu CP, Zhang Y, Zhang W. Psychological and behavioral intervention improves the quality of life and mental health of patients suffering from differentiated thyroid cancer treated with postoperative radioactive iodine-131. Neuropsychiatr Dis Treat. 2016;12:1055-60.