CoDAS
https://codas.org.br/article/doi/10.1590/2317-1782/20232022099en
CoDAS
Artigo Original

Quality of life in dysphagia and anxiety and depression symptoms pre and post-thyroidectomy

Qualidade de vida em disfagia e sintomas de ansiedade e depressão pré e pós-tireoidectomia

Gabriel Trevizani Depolli; Gustavo Batista de Oliveira; Thais Jejesky de Oliveira; Marco Homero de Sá Santos; Ricardo Mai Rocha; Michelle Ferreira Guimarães; Elma Heitmann Mares Azevedo

Downloads: 1
Views: 426

Abstract

Purpose

To correlate the dysphagia quality of life and symptoms of anxiety and depression before and after thyroidectomy.

Methods

Observational, longitudinal, prospective, and experimental study. Twenty patients participated, with a mean age of 54 years, prevalence of females (n=17; 85%) and partial thyroidectomy (n=14; 70%). All subjects underwent laryngeal visual examination and answered the MD Anderson Dysphagia Questionnaire (MDADI) and the Hospital Anxiety and Depression Scale (HADS) in three different moments: preoperatively, immediately postoperatively (maximum one week) and three months after surgery.

Results

There was a significant difference in dysphagia quality of life for the physical and total domains in the three different moments. Regarding anxiety and depression, a statistically significant difference was observed between the scores in all domains, with a greater difference observed between the preoperative period and after 1 week. Higher values were observed in the preoperative period for mild anxiety traits, being more frequent in relation to depression, with a reduction after 1 week and an increase after three months of surgery. There was no significant correlation between the MDADI and HADS protocols.

Conclusion

Patients undergoing thyroidectomy self-report better quality of life in dysphagia and reduced anxiety/depression scores after three months of surgery. There was no correlation between anxiety, depression and quality of life in dysphagia at the moments evaluated.

Keywords

Thyroidectomy; Deglutition Disorders; Quality of Life; Anxiety; Depression

Resumo

Objetivo

Correlacionar a qualidade de vida em disfagia e sintomas de ansiedade e depressão pré e pós-tireoidectomia.

Método

Estudo observacional, longitudinal, prospectivo e quantitativo. Participaram 20 pacientes, com média de idade de 54 anos, maior prevalência do sexo feminino (n=17; 85%) e de tireoidectomia parcial (n=14; 70%). Todos realizaram exame visual laríngeo e responderam ao Questionário de Disfagia M. D. Anderson (MDADI) e à Escala Hospitalar de Ansiedade e Depressão (HADS), no pré-operatório, pós-operatório recente (máximo uma semana) e três meses pós-operatório.

Resultados

Houve diferença significante na qualidade de vida em disfagia, para os domínios físico e total, nos três momentos. Quanto à ansiedade e depressão foi observada diferença estatisticamente significante entre as pontuações em todos os domínios, com maior diferença observada entre o pré-operatório e pós-operatório recente. Foram observados valores mais altos no pré-operatório para traços leves de ansiedade, sendo mais frequentes em relação à depressão, com redução após 1 semana e aumento após três meses de cirurgia. Não houve correlação significante entre os protocolos MDADI e HADS.

Conclusão

Os pacientes submetidos à tireoidectomia autorreferem melhor qualidade de vida em disfagia e redução dos escores de ansiedade/depressão após três meses de cirurgia. Não houve correlação entre ansiedade, depressão e qualidade de vida em disfagia nos momentos avaliados.

Palavras-chave

Tireoidectomia; Transtornos de Deglutição; Qualidade de Vida; Ansiedade; Depressão

Referências

  1. Nam I-C, Park Y-H. Pharyngolaryngeal symptoms associated with thyroid disease. Curr Opin Otolaryngol Head Neck Surg. 2017;25(6):469-74. http://dx.doi.org/10.1097/MOO.0000000000000404 PMid:28759458.
  2. Kletzien H, Macdonald CL, Orne J, Francis DO, Leverson G, Wendt E, et al. Comparison between patient-perceived voice changes and quantitative voice measures in the first postoperative year after thyroidectomy: a secondary analysis of a randomized clinical trial. JAMA Otolaryngol Head Neck Surg. 2018;144(11):995-1003. http://dx.doi.org/10.1001/jamaoto.2018.0309 PMid:29710208.
  3. Hajiioannou JK, Sioka E, Tsiouvaka S, Korais C, Zacharoulis D, Bizakis J. Impact of uncomplicated total thyroidectomy on voice and swallowing symptoms: a prospective clinical trial. Indian J Surg. 2019;81(6):564-71. http://dx.doi.org/10.1007/s12262-019-01865-9
  4. Gumus T, Makay O, Eyigor S, Ozturk K, Cetin ZE, Sezgin B, et al. Objective analysis of swallowing and functional voice outcomes after thyroidectomy: a prospective cohort study. Asian J Surg. 2020;43(1):116-23. http://dx.doi.org/10.1016/j.asjsur.2019.04.013 PMid:31130500.
  5. Araújo LF, Lopes LW, Silva POC, Perrusi VJF, Farias VLF, Azevedo EHM. Sintomas sensoriais em pacientes submetidos à tireoidectomia. CoDAS. 2017;29(3):e20150294. http://dx.doi.org/10.1590/2317-1782/20172016294 PMid:28538821.
  6. Cruz JSS, Lopes LW, Alves GAS, Rodrigues DSB, Souza DX, Costa BI, et al. Frequência combinada de queixas relacionadas à deglutição e voz antes da tireoidectomia. Audiol Commun Res. 2019;24:e2180. http://dx.doi.org/10.1590/2317-6431-2019-2180
  7. Galluzzi F, Garavello W. Dysphagia following uncomplicated thyroidectomy: a systematic review. Eur Arch Otorhinolaryngol. 2019;276(10):2661-71. http://dx.doi.org/10.1007/s00405-019-05599-y PMid:31414222.
  8. Lan Y, Cao L, Song Q, Jin Z, Xiao J, Yan L, et al. The quality of life in papillary thyroid microcarcinoma patients undergoing lobectomy or total thyroidectomy: a cross-sectional study. Cancer Med. 2021;10(6):1989-2002. http://dx.doi.org/10.1002/cam4.3747 PMid:33638269.
  9. Yang Y, Ma H, Wang M, Wang A. Assessment of anxiety levels of patients awaiting surgery for suspected thyroid cancer: a case-control study in a Chinese-Han population. Asia-Pac Psychiatry. 2017;9(4):e12245. http://dx.doi.org/10.1111/appy.12245 PMid:27231037.
  10. Gorkhali B, Sharma S, Amatya M, Acharya D, Sharma M. Anxiety and depression among patients with thyroid function disorders. J Nepal Health Res Counc. 2020;18(3):373-8. http://dx.doi.org/10.33314/jnhrc.v18i3.2499 PMid:33210626.
  11. Gunes NA. Evaluation of anxiety and depression in patients with thyroid function disorder. Rev Assoc Med Bras. 2020;66(7):979-85. http://dx.doi.org/10.1590/1806-9282.66.7.979 PMid:32844932.
  12. Krekeler BN, Wendt E, Macdonald C, Orne J, Francis DO, Sippel R, et al. Patient-reported dysphagia after thyroidectomy: a qualitative study. JAMA Otolaryngol Head Neck Surg. 2018;144(4):342-8. http://dx.doi.org/10.1001/jamaoto.2017.3378 PMid:29522149.
  13. Park YM, Oh KH, Cho J-G, Baek S-K, Kwon S-Y, Jung K-Y, et al. Changes in voice- and swallowing-related symptoms after thyroidectomy: one-year follow-up study. Ann Otol Rhinol Laryngol. 2018;127(3):171-7. http://dx.doi.org/10.1177/0003489417751472 PMid:29298509.
  14. Hedman C, Strang P, Djärv T, Widberg I, Lundgren CI. Anxiety and fear of recurrence despite a good prognosis: an interview study with differentiated thyroid cancer patients. Thyroid. 2017;27(11):1417-23. http://dx.doi.org/10.1089/thy.2017.0346 PMid:28874092.
  15. Silva NDKC, Viana CC, Forte RS, Mazzinghy MCF. Avaliação dos sintomas de ansiedade, depressão e estresse em pacientes com carcinoma diferenciado da tireoide. Braz J Health Rev. 2021;4(5):23128-37. http://dx.doi.org/10.34119/bjhrv4n5-389
  16. Kirnap NG, İyidir ÖT, Bozkuş Y, Işildak ŞM, Anil C, Firat SN, et al. The effect of iatrogenic subclinical hyperthyroidism on anxiety, depression and quality of life in differentiated thyroid carcinoma. Turk J Med Sci. 2020;50(4):870-6. http://dx.doi.org/10.3906/sag-1902-176 PMid:32490648.
  17. Zeng Y, Yip J, Cui H, Guan L, Zhu H, Zhang W, et al. Efficacy of neuromuscular electrical stimulation in improving the negative psychological state in patients with cerebral infarction and dysphagia. Neurol Res. 2018;40(6):473-9. http://dx.doi.org/10.1080/01616412.2018.1451015 PMid:29726748.
  18. Juan W, Zhen H, Yan-Ying F, Hui-Xian Y, Tao Z, Pei-Fen G, et al. A comparative study of two tube feeding methods in patients with dysphagia after stroke: a randomized controlled trial. J Stroke Cerebrovasc Dis. 2020;29(3):104602. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.104602 PMid:31924485.
  19. Guedes RL, Angelis EC, Chen AY, Kowalski LP, Vartanian JG. Validation and application of the M.D. Anderson Dysphagia Inventory in patients treated for head and neck cancer in Brazil. Dysphagia. 2013;28(1):24-32. http://dx.doi.org/10.1007/s00455-012-9409-x PMid:22684923.
  20. Chen AY, Frankowski R, Bishop-Leone J, Hebert T, Leyk S, Lewin J, et al. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory. Arch Otolaryngol Head Neck Surg. 2001;127(7):870-6. PMid:11448365.
  21. Snaith RP, Zigmond AS. The hospital anxiety and depression scale. Br Med J (Clin Res Ed). 1986;292(6516):344. http://dx.doi.org/10.1136/bmj.292.6516.344 PMid:3080166.
  22. Botega NJ, Bio MR, Zomignani MA, Garcia C Jr, Pereira WAB. Transtornos do humor em enfermaria de clínica médica e validação de escala de medida (HAD) de ansiedade e depressão. Rev Saúde Pública. 1995;29(5):359-63. http://dx.doi.org/10.1590/S0034-89101995000500004 PMid:8731275.
  23. Hinkle DE, Wiersma W, Jurs SG. Applied statistics for the behavioral sciences. 5. ed. Boston: Houghton Mifflin; 2003. 756 p.
  24. Elbeltagy YM, Bassiouny SE, Sobhy TS, Ismail AE, Teaima AA. Swallowing problems after thyroidectomy. Int Arch Otorhinolaryngol. 2022;26(3):e327-33. http://dx.doi.org/10.1055/s-0041-1730302 PMid:35846825.
  25. Hadžibegović AĐ, Hergešić F, Babić E, Slipac J, Prstačić R. Thyroidectomy-related swallowing difficulties: review of the literature. Acta Clin Croat. 2020;59(Supl 1):38-48. PMid:34219883.
  26. Nascimento JR Jr, Angelis EC, Lima ENP. Short term quality of life related to voice and swallowing in patients undergoing 131I (Iodine) for differentiated thyroid carcinoma. Rev CEFAC. 2015;17(2):396-408.
  27. San SW, Ahmad A, Mahadevan B. The swallowing ability and psychosocial domains of patients with dysphagia among head and neck cancer population. Malaysian J Health Sci. 2019;17(1):1-8.
  28. Pápai A, Cozma MM, Cosa LE, Mihai A. Coping strategies in thyroid diseases. Acta Medica Transilvanica. 2020;25(2):29-32. http://dx.doi.org/10.2478/amtsb-2020-0024
     

29

Kemps GJ, Krebbers I, Pilz W, Vanbelle S, Baijens LW. Affective symptoms and swallow specific quality of life in total laryngectomy patients. Head Neck. 2020;42(11):3179-87. http://dx.doi.org/10.1002/hed.26365 PMid:32621568.
» http://dx.doi.org/10.1002/hed.26365

30

Yee K, Wong SM, Teo I, Loy J, Roche E, Tan YP, et al. Validity and reliability of the MD Anderson dysphagia inventory in English and Chinese in head and neck cancer patients. Asia Pac J Clin Oncol. 2020;16(6):372-9. http://dx.doi.org/10.1111/ajco.13384 PMid:32573112.
» http://dx.doi.org/10.1111/ajco.13384

65a87912a95395531f7fad53 codas Articles

CoDAS

Share this page
Page Sections