The Effect of Mobile-Based Education on Postoperative Recovery and Quality of Life in Thyroidectomy Patients

Thyroid diseases constitute one of the most common health problems around the world and in our country. In its treatment; Drug therapy, radioactive iodine therapy and surgical treatment can be applied alone or together. Advances in the diagnosis of thyroid diseases have led to an increase in the number of thyroidectomies. When there are no complications after thyroidectomy, patients are discharged from the hospital on the day of surgery or are hospitalized for only a few days. In this context, since technical care is given priority, discharge training remains incomplete.

Patients who have had thyroidectomy are discharged within 1-2 days after surgery if no problems occur. For this reason, patient education provided by health professionals and especially nurses may be insufficient. Post-discharge patient education in surgical services can sometimes be ignored, and it is noteworthy that this situation is not given importance due to the busy nature of surgical services. Although short hospital stays after surgery are beneficial in many ways, it increases the need for patient education.

In this study, a mobile application that covers the entire perioperative process and includes education will be developed for patients undergoing thyroidectomy. This developed mobile application aims to manage post-operative problems such as neck pain and discomfort and voice changes experienced by patients, and to improve post-operative recovery, voice quality and, accordingly, quality of life. In this context, it is believed that even in cases where patients cannot access health care professionals, their educational needs will be met, problem management will be provided with applications for the problems they experience, and accordingly, their post-operative recovery, voice and quality of life will increase, starting from the hospital before the surgery until the end of the recovery period, including the home care process after discharge.When the literature on the subject is examined, studies involving education in patients with thyroidectomy are limited. However, no studies have been found on mobile health applications that include training to reduce neck pain and discomfort experienced by thyroidectomy patients, ensure postoperative recovery, and improve voice quality and quality of life.

Thyroid diseases constitute one of the common health problems around the world. In treatment according to the patient's condition; Drug treatment, radioactive iodine treatment and surgical treatment can be applied alone or together. Thyroid surgery; Although its morbidity and mortality rates are low, it is one of the risky and very important surgeries for patients due to the anatomical location and function of the thyroid and the life-threatening complications that may occur. The purpose of thyroid surgery is; It is to complete the surgery with the lowest complications without negatively affecting the success of the surgery and the quality of life. Preoperative patient preparation and meticulous postoperative nursing care are required to prevent complications that may occur during and after thyroidectomy. Focus of post-thyroidectomy care; It is to minimize, prevent or early identify complications and problems that may develop specific to the surgery. When complications do not occur after thyroidectomy, patients are discharged from the hospital on the day of surgery or are hospitalized for only a few days.

It is observed that there are shortenings in hospital stay with the use of ERAS Protocols in patient care. Although short hospital stays are beneficial in many respects, they prevent the patient and family from communicating with health care professionals, shorten the duration of nurse-patient communication and interaction, and increase the need for education and counseling. The ERAS protocol directs surgical nurses to patient education due to the short duration of hospital stay. For this reason, nurses prioritize technical care and discharge training remains inadequate. Having surgery is an important situation in every person's life. Patients need to receive information about the surgery period. It has been shown in the literature that patients' learning needs after thyroidectomy are high and the majority of patients do not have sufficient knowledge. A study found that the implementation of evidence-based nursing guidelines for thyroidectomy patients improved health outcomes and reduced the overall postoperative complication rate by significantly increasing patients' knowledge, practice, and compliance with discharge recommendations. Therefore, patient education after thyroidectomy; It should address the need for information about the surgical procedure, expected postoperative symptoms, wound care, monitoring prescribed medication use, head and neck stretching exercises to reduce neck pain and disability, improving voice quality, monitoring signs of complications, and scheduling follow-up appointments. The information given by the nurse during the surgery positively affects the patient's health outcomes. In order to increase patient comfort and satisfaction, it is very important to implement the education that begins before the surgery and continues until discharge, supported by different educational materials. With developing technology, written materials have been replaced by online platforms. Web-based training provided by nurses strengthens the patient-nurse relationship and draws attention to the educational role of nurses, who play a key role in the preoperative period.

As in patients after all surgical interventions, various postoperative physical, social, mental and functional problems may be observed in patients with thyroidectomy. Patients who undergo thyroid surgery often experience uncomfortable problems such as neck pain, shoulder stiffness, difficulty in shoulder movements, suffocation, feeling of pressure or discomfort, and hoarseness. These problems can continue for a long time after surgery and affect the daily life of patients in a holistic way. Such symptoms are often transient but can still negatively impact both disease-specific and overall quality of life. In this context, solving these problems is very important for the quality of care. In this regard, literature reviews on the subject have been made, and it has been observed that studies covering the entire perioperative process in patients with thyroidectomy and providing training on the problems experienced are limited and there is a significant gap regarding mobile education.It is seen that various applications have been developed in many different areas, considering that mobile-based applications will be useful in improving and maintaining health. However, no studies have been found on mobile health applications that include training to reduce patients' neck pain and discomfort levels, improve postoperative recovery, voice quality and quality of life. With the mobile-based training planned to be used in the study, it is aimed to reduce problems such as neck pain and discomfort and hoarseness experienced by patients after surgery, and to increase their recovery status and, accordingly, their quality of life.

Eligibility Criteria:
Inclusion Criteria:

1. Being 18 years or older
2. Knowing how to read and write
3. Having a planned thyroidectomy
4. Having a thyroidectomy for the first time
5. Not having a mental/visual/hearing or speech disability
6. Not having any psychiatric disease
7. Owning and using a smartphone
8. Accessing the internet at home or on the phone
9. Volunteering to participate in the study

Exclusion Criteria:

1. Not agreeing to participate in the study
2. Having a mental/visual/hearing and speech disability
3. Having a psychiatric illness
4. Having had thyroid surgery before
5. Having had complications after surgery