# Analysis of the Effect of Nursing Intervention for Thyroid Diseases Based on Family Nursing Methods

Authors: Xin Chen
Journal: Computational and Mathematical Methods in Medicine
 (2022)

---

## Abstract

Patients with thyroid disease must take long-term antithyroid drugs and go to the outpatient clinic for regular check-ups. This requires patients to have good compliance behaviors in order to better control their thyroid hormone levels. In order to improve patients’ compliance behavior and seek effective family care interventions, this paper combines family care methods to evaluate the nursing effect of thyroid disease and combines investigation and analysis and experimental methods to verify the effectiveness of the method proposed in this paper. In addition, this paper compares family nursing methods with conventional methods under the guidance of family philosophy and objectively analyzes and evaluates the application value of accelerated rehabilitation surgery concepts and methods in thyroid surgery. Finally, this paper sets up a control group and a test group to carry out the nursing effect of home nursing in thyroid diseases. Through comparative experiments, it can be seen that the nursing intervention for thyroid diseases based on home nursing in this paper has a good nursing effect.


---

## Body

## 1. Introduction

An increasing number of people are developing thyroid illness, which is a prevalent condition of the endocrine system. Thyroid illness is now more often linked to increased levels of mental and physical stress, as well as an unhealthy lifestyle. The detection rate of the thyroid nodule has steadily grown as ultrasound technology has advanced. Asian thyroid illnesses are reported to have a prevalence of 14.7 percent to 34.7 percent in the literature. The frequency of thyroid illness in adults over the age of 60 is more than 50%, and 86% of those with the condition have nonfunctional nodules. More than half of the lesions are benign, and the percentages are much greater in women than in males. Surgery is the most common therapy for thyroid nodules. Although this procedure may be stressful for the patient, numerous nodules are difficult to remove at one time, and normal gland tissue is often implicated. In addition, tiny nodules and hypothyroidism are common following surgery, and neck scars are difficult to remove. As a result, patients are often subjected to both physical and psychological stressors as a result of surgical trauma and postoperative self-image alterations. In particular, young female patients are less than enthusiastic about this treatment strategy. Physicians are advocating for increased preservation of thyroid function in light of the ever-changing medical paradigms. Patients, on the other hand, have a great desire to improve their own personal appearance after surgery. As a result, treating benign thyroid nodules with minimally invasive surgery has become the new standard of care.Thyroid cancer has steadily grown in occurrence in recent years, and it now ranks first among all endocrine cancers. Women have a greater incidence rate than males, and it is a more prevalent malignant tumor in women. Thyroid cancer is the fifth most common cancer, accounting for 1% of all malignant tumors, according to the most recent data. Thyroid cancer affects around 0.5 percent of males and 1.5 percent of women. Thyroid cancer is on the increase in many nations and areas throughout the globe, according to recent epidemiological studies [1]. Pathological data suggest that papillary carcinoma is the most frequent, followed by follicular carcinoma, medullary carcinoma, and undifferentiated carcinoma. The first two account for more than 90% of all cases, and the prognosis is favorable [2]. Thyroid cancer patients have a larger psychological load as a result of its onset and treatment, rendering them more vulnerable to negative psychological responses. According to several studies [3], the overall incidence of anxiety and depression in cancer patients ranges from 20% to 60%, which is roughly 2 to 5 times higher than the general population. According to a domestic survey, anxiety and depression affect 41.25 percent and 38.2 percent of cancer patients, respectively, with anxiety and depression coexisting in 32.2 percent of cases. Furthermore, investigations have shown that anxiety and depression have an influence on the body’s neuro-endocrine-immune system, triggering malignant transformation of normal cells or stimulation of nonmalignant tumor cells, culminating in significant consequences in the treatment of the disease [4]. As a result, psychological support is critical. Improving patients’ anxiety symptoms, relieving despair, removing negative feelings, boosting their confidence and capacity to manage with illnesses, and improving their quality of life via psychological treatment have become a pressing issue. Cognitive therapy is becoming increasingly commonly employed in the psychological treatment of patients with different ailments, thanks to the broad use of the biomedicine-psychology paradigm. However, present psychological therapy for cancer patients focuses mostly on reducing the patients’ worry and sadness, and there is a paucity of study on the carers’ feelings. Studies have shown that patient carers’ emotions and the support they offer play an important role in cancer patients’ recovery [5]. Encouraging the patient’s carers to take an active role in the patient’s rehabilitation may also assist caregivers cope with work stress and burnout. The caregiver’s synchronous cognitive nursing intervention idea is a set of nursing interventions based on cognitive therapy theory. Simultaneously, it is vital to pay attention to patients’ and carers’ levels of illness knowledge, to assist patients and caregivers in finding solutions in a targeted way, and to mobilize patients’ and caregivers’ enthusiasm. This article combines family nursing methods to evaluate the nursing effect of thyroid disease and combines investigation analysis and experimental methods to verify the effectiveness of the method proposed in this paper.


## 2. Related Work

Clinical studies on anxiety and depression of patients with thyroid cancer have shown that anxiety and depression are more prominent in patients with thyroid cancer. Literature [6] studied anxiety and depression of 80 patients with thyroid cancer, showing that the patients had SAS (46.12±8.46) and SDS (45.98±8.38) before surgery; literature [7] evaluated the anxiety of 50 patients with thyroid cancer. The average score of SAS is relatively high (68.10±4.25), and literature [8] research on the anxiety of patients with thyroid cancer before surgery shows that the average score of SAS is 49.10±3.98. From the above research results, it can be seen that the average scores of anxiety and depression of thyroid cancer patients are higher than that of the general population. The abovementioned research, on the other hand, has largely focused on the average anxiety and sadness self-evaluation ratings of thyroid cancer patients. For analysis, the rate and severity descriptions are not coupled with basic demographic data. There are limited studies on the psychological condition of thyroid cancer patients treated with iodine 131. The anxiety and sadness of patients treated with 131 iodine internal radiation treatment after surgery for hyperdifferentiated thyroid carcinoma were studied in the literature [9]. A total of 60 patients were examined, with 22 men and females among them. 38 of the patients were between the ages of 22 and 50. The SAS and SDS scores of nonthyroid cancer postoperative patients in the control group were both higher. In addition, men’s anxiety and depression ratings are greater than women’s. Anxiety is an unpleasant feeling that is common when people are stressed. It will often display stress, concern, and other emotions. When humans anticipate danger, they experience fear, which is a kind of anxiety. Moderate anxiety will be beneficial in nonexcessive stress situations. It is a human defensive reaction. It may achieve mental stress via sympathetic nerve stimulation when confronted with an emergency, hence enhancing coping skills. They are more flexible to the environment and hence defend themselves as a result of this reaction. However, if this feeling is expressed excessively, it may have a detrimental influence, causing individuals to experience unpleasant emotions such as sadness and world weary. The predisposing factors for this emotion are often negative, such as unemployment or suffering some major setbacks, and induce excessive anxiety [10].Departments at all levels have been paying close attention to home care from its inception. Home care has matured as a result of family follow-up at big hospitals, and it has increasingly grown more organized, networked, and market-oriented. There is no universally accepted definition of home care. According to the literature [11], home care is a professional nursing service that employs all nursing processes and targets members of the whole family and family subsystems with varying degrees of health. The goal is to help the family system and its members achieve optimal health. In our nation, there is no standard definition of home care. According to the literature [12], home care is a comprehensive nursing paradigm. The unit is the family, and it stresses that nurses operate autonomously in the homes of their patients. Family health care, according to the literature [13], is a sequence of nursing activities in which the service object is the family, the guiding theory is the family nursing theory, the working technique is the nursing process, and the family and nurses collaborate to successfully ensure family health. Although there are several definitions for home care, the types and substance of home care are similar.


## 3. Materials and Methods

Thyroid disease is a common surgical disease, including a variety of benign and malignant diseases. Thyroid cancer is currently the fastest growing solid tumor. The treatment of thyroid disease involves drug therapy, radionuclide therapy, and surgical treatment. There are open surgery and endoscopic surgery for thyroid surgery. However, regardless of the surgical method, thyroid surgery has the same internal requirements and quality control standards, including the appearance of the incision, functional protection, rapid recovery, and good prognosis [14]. At present, the concept of accelerated rehabilitation surgery has been penetrated and applied in various specialized surgery. The most reported application in general surgery is its application in colorectal surgery, but there are few reports on its application in thyroid surgery. Under the guidance of family philosophy, this topic optimizes the concept of accelerated rehabilitation surgery from various aspects such as hospital admission, preoperative preparation, surgical operation, anesthesia management, postoperative analgesia, and postoperative care. Moreover, this paper compares it with conventional methods and objectively analyzes and evaluates the application value of accelerated rehabilitation surgery concepts and methods in thyroid surgery [15].Inclusion criteria are as foloows: (1) All cases meet the “Diagnosis and Treatment Criteria for Thyroid Cancer” and have been diagnosed as thyroid cancer by clinical pathological examination, and (2) there is no contraindication to surgery in the case. Exclusion criteria are as follows: (1) Cases with other malignant tumors; (2) cases with diseases of the heart, brain and lung vital organs; and (3) cases with previous mental diseases [16]. This article selects 100 patients with thyroid cancer who were hospitalized in our hospital from January 1, 2019 to December 31, 2020. Moreover, this paper uses the envelope method to randomly divide the cases into an observation group and a control group with 50 cases each. There were no statistically significant differences in general information such as gender, age, pathological type, and educational level between the two groups (P>0.05). This research is submitted to the hospital ethics committee for permission, and it is carried out with the patients’ and their families’ informed consent [17].Patients in the control group receive routine psychological support, such as coordinating close cooperation among family members and friends, establishing a good nurse-patient relationship, rational use of psychotherapy, providing medical care information, and answering questions, among other things [18].Nursing intervention to promote family function and social support is introduced to the observation group. The following are the measures: (1) It is vital to enroll in a nursing program that emphasizes enhancing family functions. Family function refers to a family’s capacity to satisfy the requirements of its members as a whole, and it is linked to an individual’s health, illness incidence, and prognosis. Establishing a trust relationship with patients and their families is necessary, as is evaluating the patient’s family function, understanding the basic information of the patient’s family members, the family’s decision-making model, the division of roles among family members, and the family’s health values, among other things. Second, it is important to learn about the patient’s family’s financial situation, how medical bills are paid, if there have been any recent episodes that have created family stress, and to assess the patient’s self-care abilities and family relationships. Third, it is vital to teach them appropriate theoretical understanding of family roles as well as medical information education so that they realize that the sickness is not incurable. Fourth, patients and their families must be invited to engage in nursing, and patients must be supervised while taking medicine and exercising. Patients must also practice essential neck exercises as well as full-body aerobic and anaerobic activities after thyroid cancer surgery, and medical personnel must provide emotional support. (2) It is critical to focus nursing care on enhancing social support. Patients’ ability to adopt effective coping methods has historically been seen to be dependent on social support. It is necessary to use the Social Support Rating Scale (SSRS) to conduct a questionnaire survey on the social support structure of patients to understand the patient’s financial burden of treatment, as well as the pressures faced by work, children, family, and marriage. At the same time, it is necessary to understand what kind of psychological support the patient needs. In addition, it is necessary to choose opportunities to communicate with patients to understand whether the patient needs care from family members or work units, whether there are people and things that the patient is concerned about, so as to minimize the patient’s worries during the treatment and recuperation period [19].The observation group receives antithyroid drug treatment, adjuvant treatment, and life treatment to strengthen nutrition in the outpatient clinic. The intervention group receives family nursing intervention on this basis. The nursing measures are as follows: (1) Patients must be followed up at home for about 3 months after leaving the outpatient clinic, and nursing staff must be familiar with the patient’s home environment. Helping families develop their capacity to deal with illnesses, providing emotional support, obtaining support from family members, and providing family aid for patients’ compliance behavior are all essential. At the same time, patients should be instructed to contact nearby hyperthyroid patients and establish a good mutual help relationship. (2) From the sixth month or so, the disease tracking card will be sent out once a month to understand the patient’s compliance behavior and disease control problems, so that targeted guidance and help can be provided. (3) It is necessary to keep in touch with the patient by phone, asking about the patient’s compliance status from time to time. Simultaneously, to increase patients’ knowledge and recall of medical advice, it is required to gently explain and repeat explanations. The control group does not get any home care assistance.Observation indicators and evaluation criteria are evaluated for the two groups of patients 3 months before and after intervention. Inpatients will be distributed and collected on site, and discharged patients will be evaluated during return visits.For quality of life, Before and after the intervention, the two groups of patients are evaluated according to the World Health Organization Quality of Life Measurement Scale (WHOQOL-BREF).WHOQOL-BREF consists of 26 items, reflecting the quality of the four survival areas of physiology, psychology, social relations, and environment. The scale includes 26 items of four factors: physiological field, psychological field, social relationship field, and environmental field. Moreover, each item is evaluated according to the 1 ~ 5 level scoring method. When the quality score is converted to the score, the higher the score in each field, the better the QOL. The Cronbach alpha coefficient of the scale is 0.756.For psychological status, before the intervention, the two groups of patients are evaluated according to the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). Each scale of SAS and SDS includes 20 items, and each item is divided into 4 grades: “1” means no or very little time; “2” means a small part of the time; “3” means a lot of time; and “4” means most or all of the time. After the assessment, the 20 scores in the table are added to get a rough score, which is 20 to 80 points. After that, we multiply the obtained rough score by 1.25 to get the standard score. Normal is less than 50 points, 50-59 points are mild anxiety or depression, 60-69 points are moderate, and ≥70 points are severe.For statistical processing, the research data is analyzed using SPSS23.0 statistical software, the measurement data is expressed as (x¯±s), the t test was used, and the counting data is expressed as rate (%). Moreover, this paper uses the χ2 test, and P<0.05 is considered statistically significant.


## 4. Result

Before the intervention, there is no statistically significant difference in the scores of the four areas of the quality of life between the two groups (P>0.05). After the intervention, the observation group’s scores in the four areas of quality of life are significantly higher than those of the control group, and the difference is statistically significant (P<0.01), as shown in Tables 1–4 and Figures 1–4.Table 1
Evaluation data in the field of physiology.
No.Control groupTest group161.7075.55260.7677.28362.4576.49464.8976.97557.3379.45663.3777.17764.4378.18859.9676.93960.9375.921061.1375.111162.5078.171258.4375.801361.8878.801456.2377.961563.4976.281659.2376.211761.1576.611861.2279.511962.8675.902057.2075.742157.7377.482264.7380.562363.5380.542463.4176.832557.9379.832658.2079.472763.4775.492858.8679.302957.6379.323062.2178.563156.7480.423261.8175.833362.5680.233458.8477.903564.7175.073661.5478.223763.1777.353861.0177.053957.6177.794059.9478.304158.1977.944260.2678.824356.5377.264459.1675.164559.6977.154663.9077.024762.0179.024863.7780.244959.2576.595063.9578.29Table 2
Evaluation data of the psychological field.
No.Control groupTest group162.3373.56260.1281.67362.6379.82459.0179.09560.5377.70659.9779.31760.7173.84858.9282.78959.1776.151065.6782.511164.1678.641263.8976.661363.4478.371463.1573.191563.9483.621662.0680.851762.8577.741861.9681.731963.3177.422058.9975.512164.6982.902258.3076.922360.8176.482465.1981.442560.0474.252661.6776.642763.0279.932866.1773.972965.7980.103063.6977.713165.0173.963265.3673.193361.1380.283460.7180.163561.3183.733661.2578.643765.8075.103861.7174.863962.5577.844063.7475.814159.0578.374263.9480.814366.8482.224463.1977.134564.8077.904661.0477.034758.5979.724865.1573.634966.2478.075063.1582.66Table 3
Evaluation data of social relations.
No.Control groupTest group162.4780.19262.6584.11362.1284.48466.4979.33565.1980.67658.0885.95767.4183.55865.3877.64965.2781.351066.2279.871166.1679.181259.4378.951361.1885.511460.2786.851560.8082.841662.9685.331763.1781.561861.5186.911962.1777.252058.3182.692165.4684.212260.1885.952363.7786.142465.7881.172560.1281.692666.8182.582763.7680.222864.2979.792958.6079.093064.3283.943164.2176.213267.3376.183365.2785.083467.1082.233559.5179.553666.2380.843767.1879.553860.2281.273967.5786.144065.0978.354163.9582.294267.3886.394364.5679.314466.7085.424562.5479.284664.3176.194765.9883.104867.8780.434964.9580.595058.2386.88Table 4
Evaluation data of the environmental field.
No.Control groupTest group160.1780.46266.8480.25358.6777.46461.8882.72565.1079.78656.0777.20756.6083.47865.4981.92959.7880.701064.6276.221155.4373.221259.9280.721361.6075.851460.7974.751565.5682.131657.9779.141766.6776.811854.2982.451959.3574.302061.0880.842158.3780.152264.4380.312362.4575.132466.5974.592562.7177.522665.4675.962758.3573.832857.8782.272966.3080.693055.7673.443156.3078.063256.4183.473359.4075.893463.7679.013562.3577.403660.0682.623762.4176.823866.7278.953959.6279.474060.1078.604158.4978.364260.8682.784363.6182.694457.6180.874564.8575.034658.8574.454757.3680.524857.2775.754962.3477.485064.4378.35Figure 1
Comparison diagram of data between the test group and the control group in the field of physiology.Figure 2
Comparison diagram of data between the test group and the control group in the psychological field.Figure 3
Comparison diagram of data between the experimental group and the control group in social relations.Figure 4
Comparison diagram of data between the experimental group and the control group in the environmental field.


## 5. Analysis and Discussion

This article takes thyroid cancer as the research object to judge the effect of home care in the care of thyroid diseases. Thyroid cancer includes four types of undifferentiated thyroid cancer, medullary thyroid carcinoma, follicular thyroid carcinoma, and thyroid microcarcinoma. Thyroid cancer is a big concept, which includes many diseases. Before the operation, it is vital to educate the patient and family members about thyroid cancer, explain the operation’s safety and importance, and provide enough comfort and explanation. Thyroid cancer patients have a poor quality of life, according to studies, despite the fact that their survival rate is rather good. Furthermore, their physical, psychological, social, and mental states are often better than those of survivors of colon cancer, breast cancer, and other malignant tumors, who need more intense treatment and have a poorer prognosis. Due to the stress of the procedure, thyroid cancer patients may develop hoarseness, coughing after eating, hypocalcemia, numbness of the limbs and face, and even convulsions. Excessive stress or sleeplessness may occur in certain thyroxine users, which may have a negative impact on everyday living, social activities, and self-confidence. Individual patients may also feel self-enclosure and lethargy, as well as negative attitudes such as a dislike for cleanliness, sleeping with their heads covered, and neglecting to take medication and meals on time. This study showed that the quality of life scores of the two groups before intervention are low, and the difference is not statistically significant (P>0.05).The family is the strong backing for the patient’s disease recovery process and the most important social support system. Inviting family members to participate and provide social support is conducive to the patient’s maintenance of healthy behavior and effective self-care. Quality of life is a new type of health index that conforms to the transformation of the biomedical model to the biopsychosocial medicine model. This study focuses on nursing care that improves family functioning. Nursing care is shifted from “curative” to “caring” according to the “family-centered care model” (FCC) suggested by the worldwide medical and nursing community, which evaluates the patient’s family function and extends the hospital’s nursing intervention plan to the patient’s family with the help of nurses, family members’ supervision, and societal support. Model behavior acts as a role model for family and community and provide emotional support to sufferers. This research is aimed at improving the life attitude and mental condition of patients by improving family function and emotional will, so that physical functions can be effectively adjusted, consciously cooperate with surgical treatment and life-long drug treatment, actively cope with disease, improve self-care ability, and improve survival quality and carry out targeted interventions in problem solving, communication, role function, emotional response, emotional intervention, behavior control, etc., to provide strong support for patients’ healthy behaviors and improve patients’ sense of responsibility for health. Medication, re-examination, family life, and other issues have all been actively addressed, and the quality has increased. After intervention, the four categories of quality of life ratings in the observation group were considerably higher than those in the control group, with a statistically significant difference (P=0.05). It demonstrates that nurse intervention to promote family function and social support for patients with thyroid cancer may improve their quality of life. Many people with thyroid cancer have no symptoms in the early stages of the illness, and unfavorable responses only develop when the lesion mass compresses the nerves. The ideal moment for the sickness has passed us by at this point. As a result, there are still a lot of unknowns when it comes to thyroid cancer surgery, factors that are bothering the patient’s mental health. Malignant tumors are stressful life occurrences, and when combined with the stress reaction generated by the surgery in the patient’s psyche, it is easy to fall into a bad mood. Work and school environments have also been proven to have an impact on the psychological discomfort of thyroid cancer patients in studies.This study showed that the SAS and SDS scores of the two groups before the intervention were both higher than 50 points, and they belonged to a state of mild anxiety and depression. Through nursing interventions to improve the patient’s family function and social support, in psychological communication, it is understood that patients are worried about not being able to work normally after illness, afraid of losing financial resources, lack of family support, and failing to provide material and living conditions for disease treatment. Therefore, the patient adopts a negative attitude in the face of family and social pressure. The research team members contact their families more to allow patients to communicate more with each other and create a relaxed and cheerful atmosphere for patients through interactive communication. Furthermore, we remove patient sadness and enhance life care so that patients may directly experience the care of their families, get effective emotional support, understand social support, and meet the challenge of cancer with tenacious resolve to keep a positive attitude. Simultaneously, we provide extensive advice on patients’ lifestyles, such as nutrition and exercise, and we increase patient awareness and health, reducing anxiety and despair. After intervention, the SAS and SDS scores of the observation group are considerably lower than those of the control group, with a statistically significant difference (P=0.05). It demonstrates that nurse intervention to promote family function and social support for patients with thyroid cancer may improve their psychological quality of life. To sum up, the nursing intervention to improve the family function and social support of patients is to use nurses to carry out planned and purposeful psychological and behavioral interventions to optimize the patient’s mood, thereby improving the unhealthy mental state, enhancing confidence in disease recovery, and improving the quality of life.


## 6. Conclusion

Due to too much work and life pressure, patients with thyroid disease have no time to take care of their bodies after illness, which causes most patients to treat the disease in a nonstandard state and greatly affects the treatment effect. Home nursing is a new adjuvant treatment method that has emerged in recent years. It has a very obvious effect on mobilizing patients’ initiative in treatment and can promote patients’ speedy recovery. In home nursing, nurses provide patients with health services; guide and educate patients on how to maintain healthy behaviors in lifestyle, diet, nutrition, exercise, etc.; and participate with family members to increase the enthusiasm of patients to participate in beneficial physical and mental activities. Home care also enables patients to have a clear understanding of the cause and medication methods. During the patient’s hospitalization, the nurse and the patient are in point-to-film contact, and the patient mechanically obeys the examination and treatment, and there is little information about the cause of the disease. With the transformation of the medical model, nurses have moved to the community and the family and carried out home care, which makes nurses become health educators, consultants, and managers of patients and families. The nurse analyzes the cause of the patient to make the patient understand the disease and to take the correct medication and actively treat it. In short, home care improves the cure rate, reduces the recurrence rate, reduces the occurrence of complications, and plays a role that cannot be achieved in hospital treatment. Therefore, it is very worthy of popularization and application.



---

*Source: 1766544-2022-02-21.xml*