| Objective: to investigate anxiety, depression, sleep status and the quality of life of the patients with thyroid carcinoma which accepted operation; and then the progressive muscle relaxation training was applied in these patients, the improvement effects on anxiety, depression, sleep status and the quality of life were observed.Methods: This study was a class experimental research. We selected 85 cases of thyroid carcinoma patients who accepted operations in mammary and thyroid gland surgery department and ENT head and neck surgery department of the First People’s Hospital of Changde City during April to November in 2015, these patients were divided into intervention group which contain 42 patients in mammary and thyroid gland surgery department and control group which contain 43 patients in ENT head and neck surgery department. Two groups of patients were performed thyroid cancer radical operation and neck lymph node dissection and routine peri-operative nursing care without other treatments, such as chemotherapy, radiotherapy, biological therapy during hospitalization. The intervention group was performed an extra progressive muscle relaxation training which lasted 30 minutes every time and 2 times every day on the basis of the treatment and nursing,which lasted from second day after admitted to one month after discharge from hospital. Anxiety and depression, and sleep quality amount were evaluated by anxiety self rating scale, self rating depression scale, Pittsburgh sleep quality index(PSQ I) questionnaire, the quality of life of all these patients were evaluated by EORTC QLQ-C30 table during our research. All data was analysed by spss20.0 statistical software, variables data was expressed with the mean ± standard deviation and analysed with t test and attributes data was analysed with Chi-Square test, P≤0.05 level was selected for a statistically significant difference.Results:1. 85 cases of thyroid carcinoma patients which include 29 cases of male, accounting for 34.12%, 56 cases of female, accounting for 65.88% participated in the study; the average age was 49.48±8.68. With comparing, the age, gender, occupation, education, marital status, economic status, medical expenses, negative events, trauma, history of surgical operation,general information on family relations,pathological classification,clinical stages, operation modes and hospital days of these patients distributed balanced, the difference was not statistically significant(P > 0.05).2. Before all of these 85 thyroid carcinoma patients were performed operations, the former SAS score is 47.76±9.38, SDS score is 47.44±10.75, PSQ I score is 6.75±249, QLQ-C30 score is 34.61±7.18, in accordance to the standard score of anxiety and depression severity index, Mild anxiety were 31 cases(36.5%), moderate anxiety were 20 cases(23.5%), severe anxiety were 17 cases(20%); mild depression were 25 cases(29.4%), moderate depression were 21 cases(24.7%), severe depression were 20 cases(23.5%) in patients with thyroid carcinoma before surgery. PSQ I scores were significantly higher than the average level(3.23 + 3.12), t=13.032, P < 0.05.3. Before intervention, SAS score is 46.51±8.88 and SDS score is 46.79±10.33, PSQ I score is 7.00±2.15, QLQ-C30 score is 33.28±6.62 of the control group. SAS score is 49.05±9.80 and SDS score is 48.12±11.25, PSQ I score is 6.50±2.80, QLQ-C30 score is 35.98±7.55 of the intervention group. SAS, SDS, PSQ I, QLQ-C30 of the two groups were compared before intervention, the differences were not statistically significant(t=1.251、0.567、0.924、1.753,P > 0.05).4. SAS score is 56.86±853, SDS score is 53.95±7.65, PSQ I score is 7.26±1.56, QLQ-C30 score is 31.77±5.21 of the control group after intervention. The former SAS, SDS, PSQ I and QLQ-C30 were compared with the latter ones in the control group, the differences in SAS and SDS were statistically significant(t=6.473、6.076,P < 0.05), the differences in PSQ I and QLQ-C30 were not statistically significant(t=0.805、1.889,P > 0.05).5. SAS score is 40.90±8.87, SDS score is 40.19±6.43, PSQ I score is 4.88±1.93, QLQ-C30 score is 39.21±6.46 of the intervention group after intervention. The former SAS, SDS, PSQ I and QLQ-C30 were compared with the latter ones in the intervention group, the differences in SAS, SDS, PSQ I and QLQ-C30 were statistically significant(t=4.721、6.792、4.531、4.758,P < 0.05).6. SAS, SDS, PSQ I, QLQ-C30 of the two groups were compared after intervention, the differences were statistically significant(t=8.453、8.967、6.235、5.855,P < 0.05).Conclusions:1. Anxiety, depression, bad sleep and poor quality of life were complained commonly in surgery patients with thyroid carcinoma.2. Progressive muscle relaxation training can alleviate the anxiety and depression and improve sleep and the quality of life in surgery patients with thyroid carcinoma to a certain extent. |
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