Study on the correlation between postoperative mental flexibility, negative emotions, and quality of life in patients with thyroid cancer

Gland Surg. 2021 Aug;10(8):2471-2476. doi: 10.21037/gs-21-424.

Abstract

Background: In recent years, the global incidence of thyroid cancer has increased year by year. The purpose of this study is to investigate the post-surgical psychological flexibility and negative feelings of patients with thyroid cancer and their association with quality of life.

Methods: A total of 82 patients with thyroid cancer were selected. The study utilized the Acceptance and Action Questionnaire 2nd edition (AAQ-II), the Cognitive Fusion Questionnaire (CFQ), and the Meaning in Life Questionnaire-the Presence of Meaning (MLQ-P). By quantifying psychological flexibility, we assessed the patient's experiential avoidance, cognitive fusion, and sense of life meaning. The Self-rating Depression Scale (SDS) and the Self-rating Anxiety Scale (SAS) were employed to evaluate depression and anxiety, respectively. Quality of life was evaluated with the Functional Assessment of Cancer Therapy-General (FACT-G).

Results: The mean AAQ-II, CFQ, MLQ-P, SAS, and SDS scores were 20.1±9.2, 27.5±10.7, 23.0±5.7, 47.7±13.3, and 43.3±12.8, respectively. In total, 24.4% and 45.1% of patients had depression and anxiety to some extent, respectively. The AAQ-II and CFQ scores were positively correlated with the SDS and SAS scores, and negatively correlated with the FACT-G score. The MLQ-P score was inversely correlated with the SDS and SAS scores, and was positively correlated with the FACT-G score. Logistic regression analysis indicated that the AAQ-II, CFQ, and MLQ-P were independent risk factors for quality of life.

Conclusions: Depression and anxiety are ubiquitous in patients with thyroid cancer following surgery. The psychological flexibility of patients is significantly negatively correlated with depression and anxiety and can dramatically influence quality of life.

Keywords: Thyroid cancer; negative feeling; psychological flexibility; quality of life.