Percepção da qualidade de vida e do estresse em mulheres com hipotireodismo crônico pós tireoidectomia total: um estudo quantitativo-qualitativo

Abstract

INTRODUCTION: thyroid cancer commonly appears in women over 40 years of age and its treatment is total thyroidectomy. The consequence of this is chronic hypothyroidism, which results in significant physiological and emotional changes that require the maintenance of health. OBJECTIVE: To analyze the existence of relationships between quality of life and stress in adult and elderly women after total thyroidectomy and their perceptions of health conditions. METHOD: This is a quantitative-qualitative study, carried out with 60 women who answered the ThyPro-39 questionnaire, which assesses the quality of life in the face of thyroid disease, and the Perceived Stress Scale (PSS 10), which measures the stress perception. At the end of the form, they received an invitation to participate in a semi-structured interview. The link to the form with the questionnaires was posted on Facebook pages about hypothyroidism in Brazil. The data received statistical treatment. All ethical precepts were respected. RESULTS: Of the 60 participants, 38.3% completed postgraduate studies and 63.3% were married, with a mean age of 53.09 years. Of these, 85% had papillary carcinoma, 71.7% underwent radioiodine therapy, with an average treatment time of 7.35 years after thyroidectomy, and 51.7% had COVID-19. As for the perception of quality of life, it appears that the average scores ranged from 48.93 to 61.95, with the highest scores in the domains: fatigue (m=61.95), cognitive problems (m=49, 83), emotional factors (m=52.42), anxiety (m=50.78) and depression (m=48.87), indicating worse perception of quality of life in these dimensions. As for the perception of stress, the mean total PSS-10 score was 27.47. The relationship between stress and the participants' quality of life was confirmed, with statistical significance in the following domains: fatigue (r=0.278; p=0.032), anxiety (r=0.537; p≤0.001), depression (r=0.620 ; p≤0.001), emotional factors (r=0.635; p≤0.001), impact on social life (r=0.601; p≤0.001) in everyday life (r=0.620; p≤0.001), appearance (r=0.286 ; p=0.027) and overall quality of life (r= 0.424; p=0.001). With regard to qualitative data, thirteen participants chose to participate in the interview, with these data we characterized, through the analysis of Bardin's speech, the perception of quality of life and stress. We built the analysis categories: “health condition and pandemic”, “daily life and diagnosis”, “post-thyroidectomy and self-perception of quality of life and stress”. CONCLUSION: It is concluded that there is a relationship between the perception of quality of life and the level of stress of the evaluated women, verifying a loss of quality of life in general, with the worsening of anxiety and the symptoms of hypothyroidism. In this sense, finding good reception in the doctor-patient relationship and the creation of coping strategies such as emotional, physical and nutritional self-care, with the aim of achieving the restoration of biopsychosocial well-being in the face of the experience of cancer treatment, is necessary.