Waiting for thyroid surgery: A study of psychological morbidity and determinants of health associated with long wait times for thyroid surgery

Eskander, Antoine; Devins, Gerald M.; Freeman, Jeremy L.; Wei, Alice C.; Rotstein, Lorne; Chauhan, Nitin; Sawka, Anna M.; Brown, Dale; Irish, Jonathan C.; Gilbert, Ralph W.; Gullane, Patrick; Higgins, Kevin; Enepekides, Danny; Goldstein, David P.

doi:10.1002/lary.23503

Cited by 26 publications

(20 citation statements)

References 37 publications

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“…Moreover, patients waiting for surgery or medical treatment are burdened with a significant amount of stress and anxiety [7, 8]. Patients with thyroid cancer show significantly increased perceived stress scores when compared to the normal population and similar or higher scores than other oncologic patients [9]. Therefore, health care providers should help the population with thyroid cancer alleviate stress and fatigue.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Guided Imagery on Stress and Fatigue in Patients with Thyroid Cancer Undergoing Radioactive Iodine Therapy

Lee

Kim

2013

Evidence-Based Complementary and Alternative Medicine

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This study was conducted to evaluate the effects of guided imagery on stress and fatigue in patients undergoing radioactive iodine therapy after thyroidectomy in Korea. Participants were 84 individuals (44 for experimental group and 40 for control group) with thyroid cancer. The experimental group listened to a guided imagery CD once a day for 4 weeks. Global Assessment of Recent Stress and Revised Piper Fatigue Scale were self-administered, and heart rate variability was measured at three time points; prior to intervention (T1), just before intervention (T2) and 1 week later after intervention (T3). Heart rate variability was consisted of Standard Deviation of all NN interval (SDNN), Total Power (TP), Low Frequency (LF), and High Frequency (HF). There were significant decreases in stress (F = 28.45, P < 0.001) and fatigue (F = 26.17, P < 0.001) over time in the experimental group compared to the control group. Heart rate variability changed over time in the experimental group relative to the control group; SDNN (F = 6.68, P = 0.002), TP (F = 5.29, P = 0.006), LF (F = 4.58, P = 0.012), and HF (F = 3.71, P = 0.026). From the results of this study guided imagery can be recommended as an effective intervention to thyroid cancer patients with stress and fatigue.

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Section: Introductionmentioning

confidence: 99%

The Effect of Guided Imagery on Stress and Fatigue in Patients with Thyroid Cancer Undergoing Radioactive Iodine Therapy

Lee

Kim

2013

Evidence-Based Complementary and Alternative Medicine

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“…It is believed that this rise in incidence may be attributable to more organic factors than simply advances in diagnostic techniques [7]. Despite thyroid cancer being among the least aggressive oncologic diagnoses, and a lack of evidence that prolonged wait times to treatment are associated with poorer outcomes, these patients experience as much or more psychological distress while waiting for treatment as other cancer populations [9,10]. This distress can also continue for years after long-term remission [11].…”

Section: Introductionmentioning

confidence: 99%

Expectantly waiting: A survey of thyroid surgery wait times among Canadian Otolaryngologists

Brake

Moore

Taylor

et al. 2013

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundOur objective is to highlight discrepancies between actual wait times and perceived appropriate wait times for various thyroid pathologies among Otolaryngology- Head and Neck Surgeons in Canada; and to identify specific diagnoses/pathologies where wait times could be improved.MethodsA questionnaire was distributed to all practicing CSO-HNS members. Questions focused on actual wait times for initial consults and surgery within individual practices, in the setting of various thyroid pathologies. Respondents were also asked to state wait times that they felt were appropriate for each scenario. Wilcoxon signed-rank tests were performed to determine statistically significant differences between actual and appropriate wait times.ResultsFor most scenarios, the actual wait times were significantly longer than most physicians felt were appropriate; these scenarios included time to initial consult for undiagnosed nodules, time to surgery for confirmed malignancies, and time to completion thyroidectomy for surgically confirmed malignancies.ConclusionsWait times for thyroid consults and surgeries in Canada are longer than physicians feel are appropriate. The authors hope that this survey may spur a move towards a national consensus on appropriate wait times for the treatment of thyroid pathology.

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“…For patients diagnosed with euthyroid nodules, access to specialist consultation and elective surgery varies widely between the United States and Canada . Patients waiting for thyroid surgery for lengthy periods of time may experience unnecessary stress and anxiety . The panel did not make a recommendation about the upper limit of wait times for elective surgery.…”

Section: Resultsmentioning

confidence: 99%

American Head and Neck Society Endocrine Section clinical consensus statement: North American quality statements and evidence‐based multidisciplinary workflow algorithms for the evaluation and management of thyroid nodules

et al. 2018

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Background Care for patients with thyroid nodules is complex and multidisciplinary, and research demonstrates variation in care. The objective was to develop clinical guidelines and quality metrics to reduce unwarranted variation and improve quality. Methods Multidisciplinary expert consensus and modified Delphi approach. Source documents were workflow algorithms from Kaiser Permanente Northern California and Cancer Care of Ontario based on the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Results A consensus‐based, unified preoperative, perioperative, and postoperative workflow was developed for North American use. Twenty‐one panelists achieved consensus on 16 statements about workflow‐embedded process and outcomes metrics addressing safety, access, appropriateness, efficiency, effectiveness, and patient centeredness of care. Conclusion A panel of Canadian and United States experts achieved consensus on workflows and quality metric statements to help reduce unwarranted variation in care, improving overall quality of care for patients diagnosed with thyroid nodules.

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Waiting for thyroid surgery: A study of psychological morbidity and determinants of health associated with long wait times for thyroid surgery

Cited by 26 publications

References 37 publications

The Effect of Guided Imagery on Stress and Fatigue in Patients with Thyroid Cancer Undergoing Radioactive Iodine Therapy

The Effect of Guided Imagery on Stress and Fatigue in Patients with Thyroid Cancer Undergoing Radioactive Iodine Therapy

Expectantly waiting: A survey of thyroid surgery wait times among Canadian Otolaryngologists

American Head and Neck Society Endocrine Section clinical consensus statement: North American quality statements and evidence‐based multidisciplinary workflow algorithms for the evaluation and management of thyroid nodules

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