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      Analysis of the risk factors of negative emotions in patients undergoing microwave ablation of thyroid nodules during the perioperative period and its impact on prognosis: a prospective cohort study

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          Abstract

          Background

          Thyroid nodule (TN) is one or more abnormal lump structures in the thyroid gland parenchyma caused by genetic, environmental, and other factors. It is the most common thyroid disease in clinics. Microwave ablation (MWA) can significantly reduce the nodule volume and effectively reduce the symptoms caused by nodules. However, the patient’s negative emotions during the perioperative period may affect the postoperative recovery. This study explored the risk factors of negative emotions in patients during the perioperative period and its impact on patient prognosis. This data provides a basis for clinical psychological interventions before MWA, so as to improve the quality of life of patients with TN.

          Methods

          A total of 238 patients who were hospitalized for TNs in The First Affiliated Hospital of Soochow University from January 2017 to January 2022, and who received MWA therapy were enrolled in this study. The patients were evaluated with a general situation questionnaire, a Self-rating Anxiety Scale (SAS), and a Self-rating Depression Scale (SDS). The TN volume was followed up to evaluate the prognosis of patients. Binary logistic regression was used to analyze the risk factors of perioperative negative emotions and the impact of negative emotions on the prognosis.

          Results

          The results of binary logistic regression analysis showed that education, income, hypertension, hyperglycemia, and solid nodule volume were independent influencing factors of anxiety (P<0.05). Age, income, hypertension, hyperglycemia, and solid nodule volume were independent influencing factors of depression (P<0.05). The prognosis of patients with no negative emotions at the first, third, and sixth months after surgery was significantly better than that of patients with negative emotions (P<0.05).

          Conclusions

          Negative emotions have a significant impact on the prognosis of TNs. According to individual differences, targeted nursing intervention should be supplemented to stabilize a patient’s emotions, improve compliance, and enhance quality of life.

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          Most cited references35

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          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 nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer.
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            A rating instrument for anxiety disorders.

            W W Zung (1971)
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              Screening for anxiety and depression: reassessing the utility of the Zung scales

              Background While the gold standard for the diagnosis of mental disorders remains the structured clinical interview, self-report measures continue to play an important role in screening and measuring progress, as well as being frequently employed in research studies. Two widely-used self-report measures in the area of depression and anxiety are Zung’s Self-Rating Depression Scale (SDS) and Self Rating Anxiety Scale (SAS). However, considerable confusion exists in their application, with clinical cut-offs often applied incorrectly. This study re-examines the credentials of the Zung scales by comparing them with the Depression Anxiety Stress Scale (DASS) in terms of their ability to predict clinical diagnoses of anxiety and depression made using the Patient Health Questionnaire (PHQ). Method A total sample of 376 adults, of whom 87 reported being in receipt of psychological treatment, completed the two-page version of the PHQ relating to depression and anxiety, together with the SDS, the SAS and the DASS. Results Overall, although the respective DASS scales emerged as marginally stronger predictors of PHQ diagnoses of anxiety and depression, the Zung indices performed more than acceptably in comparison. The DASS also had an advantage in discriminative ability. Using the current recommended cut-offs for all scales, the DASS has the edge on specificity, while the Zung scales are superior in terms of sensitivity. There are grounds to consider making the Zung cut-offs more conservative, and doing this would produce comparable numbers of ‘Misses’ and ‘False Positives’ to those obtained with the DASS. Conclusions Given these promising results, further research is justified to assess the Zung scales ability against full clinical diagnoses and to further explore optimum cut-off levels.
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                Author and article information

                Journal
                Gland Surg
                Gland Surg
                GS
                Gland Surgery
                AME Publishing Company
                2227-684X
                2227-8575
                14 January 2023
                01 January 2023
                : 12
                : 1
                : 81-92
                Affiliations
                [1]deptDepartment of Anesthesiology , The First Affiliated Hospital of Soochow University , Suzhou, China
                Author notes

                Contributions: (I) Conception and design: Y Zhang, J Mao; (II) Administrative support: H Liu, Y Cheng; (III) Provision of study materials or patients: X Zhao; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

                [#]

                These authors contributed equally to this work.

                Correspondence to: Hong Liu. A6 East in Department of Anesthesiology, The First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Pingjiang District, Suzhou 215031, China. Email: liuhong_sz87@ 123456163.com ; Yan Cheng. A6 East in Department of Anesthesiology, The First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Pingjiang District, Suzhou 215031, China. Email: shuangzi43@ 123456163.com .
                Article
                gs-12-01-81
                10.21037/gs-22-696
                9906096
                d51c63d0-c7af-492f-9dd8-e675392776a3
                2023 Gland Surgery. All rights reserved.

                Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

                History
                : 08 November 2022
                : 05 January 2023
                Categories
                Original Article

                thyroid nodule (tn),microwave ablation (mwa),perioperative period,anxiety,prognosis

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