分化型甲状腺癌患者放射性碘治疗相关的心理状态与生活质量：医院焦虑抑郁量表及简明健康调查（36 项）结果
Psychological Status and Quality of Life Associated with Radioactive Iodine Treatment of Patients with Differentiated Thyroid Cancer: Results of Hospital Anxiety and Depression Scale and Short-Form (36) Health Survey.
作者信息
Banihashem Seyedshahab, Arabzadeh Mehdi, Jafarian Bahri Reyhaneh Sadat, Qutbi Mohsen
机构信息
Department of Psychosomatic Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Nuclear Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Indian J Nucl Med. 2020 Jul-Sep;35(3):216-221. doi: 10.4103/ijnm.IJNM_14_20. Epub 2020 Jul 1.
PURPOSE
The objective is to investigate psychological status and quality of life (QoL) using Hospital Anxiety and Depression Scale (HADS) and Short-Form (36) Health Survey (SF-36) questionnaires in patients with proven differentiated thyroid cancer (DTC) who are referred for radioactive iodine (RAI) ablation before, during, and after treatment.
METHODS
Of patients who underwent total thyroidectomy with a pathologically proven DTC (papillary and follicular types) referred for RAI treatment to our department in 2018, 150, in whom the diagnosis was newly established, were referred for the first course of RAI treatment and were consecutively enrolled in the study. The patients received an oral dose of radioiodine (3700 or 5550 MBq). For evaluation of anxiety, depression, and QoL, all patients are given two standard questionnaires, HADS, and SF-36 and are requested to answer them at four time points. First one was at 1 month before RAI, second was at the time of RAI treatment. Third and fourth ones were 1 week and 6 months later, respectively.
RESULTS
The mean age of patients was 39.17 (±12.95) years and 121 (80.7%) were female and 29 (19.3%) were male. Values of HADS and SF-36 scores at corresponding time points were significantly correlated using Pearson correlation (HADS and SF-36 scores at 1 month before RAI: = -0.56, < 0.001; at time of RAI: = -0.71, < 0.001; 6 months after RAI: = 0.19, = 0.021). Using paired-sample -test, for HADS, except for difference between time points of 1 month before RAI and time of RAI, pairwise difference between scores of other time points was statistically significant after Bonferroni correction. For SF-36, pairwise difference between scores of all three time points was statistically significant. Interaction of age, gender, RAI dose, and thyroid-stimulating hormone level at the time of RAI on HADS and SF-36 scores did not show statistical significance.
CONCLUSION
Trend in scores over several-months' time discloses gradual improvement of QoL and merits close observation but limited psychiatric intervention.
目的
本研究旨在通过医院焦虑抑郁量表（HADS）和简明健康调查问卷（SF-36），调查确诊为分化型甲状腺癌（DTC）且接受放射性碘（RAI）消融治疗的患者在治疗前、治疗期间及治疗后的心理状态和生活质量（QoL）。
方法
2018年，我院收治了150例经病理证实为DTC（乳头状和滤泡状）且首次接受RAI治疗的患者，这些患者均接受了甲状腺全切术。患者接受口服放射性碘（3700或5550MBq）治疗。为评估焦虑、抑郁和生活质量，所有患者均接受两份标准问卷（HADS和SF-36）调查，并要求在四个时间点作答。第一个时间点为RAI治疗前1个月，第二个时间点为RAI治疗时，第三个和第四个时间点分别为治疗后1周和6个月。
结果
患者的平均年龄为39.17（±12.95）岁，其中女性121例（80.7%），男性29例（19.3%）。使用Pearson相关性分析，相应时间点的HADS和SF-36评分值显著相关（RAI治疗前1个月的HADS和SF-36评分：r = -0.56，P < 0.001；RAI治疗时：r = -0.71，P < 0.001；RAI治疗后6个月：r = 0.19，P = 0.021）。采用配对样本t检验，对于HADS，除RAI治疗前1个月和RAI治疗时这两个时间点的差异外，经Bonferroni校正后，其他时间点评分的两两差异均具有统计学意义。对于SF-36，所有三个时间点评分的两两差异均具有统计学意义。RAI治疗时的年龄、性别、RAI剂量和促甲状腺激素水平对HADS和SF-36评分的交互作用未显示出统计学意义。
结论
数月内评分的变化趋势显示生活质量逐渐改善，值得密切观察，但精神科干预有限。
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