Keywords: quality of life, thyroidectomy, questionnaire QOL-CS Thyroid version, well-being, thyroid cancer

Background:

Health-related quality of life (HRQoL) reflects an individual's perception of their physical, psychological, and social well-being. While thyroid disorders significantly affect HRQoL, more evidence is needed on changes after total thyroidectomy, especially in primary care settings.

Research questions:

How does total thyroidectomy affect the subjective physical, psychological, and social well-being of patients, as measured by the QOL-CS Thyroid Version?

Method:

We conducted a before-and-after interventional study with 62 patients (47 women, 15 men; mean age 51 ± 9.6 years) undergoing total thyroidectomy. Participants completed a validated Bulgarian version of the QOL-CS Thyroid questionnaire before surgery and 6 months afterward. The tool was adapted into two variants—Version 1 (preoperative) and Version 2 (postoperative)—including items on symptoms and treatment. Statistical analysis used paired comparisons with significance at p<0.05. GPs were involved in patient recruitment and follow-up, reflecting the real-life care pathway and enhancing relevance to primary care.

Results:

Neck complaints improved significantly after surgery. The greatest improvement was in physical well-being (p<0.001). Psychological and spiritual domains showed modest, non-significant gains, while the social domain showed significant improvement. Initiating levothyroxine therapy also influenced patients' perceived QoL.

Conclusions:

Total thyroidectomy resulted in improved patient-reported QoL, particularly in physical and social domains. The validated QOL-CS Thyroid Version effectively captured these changes. Continuous monitoring and support from both general practitioners and specialists are essential for reducing complications and enhancing recovery.

Points for discussion:

How can GPs be more actively involved in post-thyroidectomy follow-up?

Could this questionnaire be routinely used in primary care?