title: Waiting for thyroid surgery: a study of psychological morbidity and determinants of health associated with long wait times for thyroid surgery.
abstract: OBJECTIVE
  Patients with thyroid pathology tend have longer surgical wait times. Uncertainty during this wait can have negative psychologically impact. This study aims to determine the degree of psychological morbidity in patients waiting for thyroid surgery.
  
  
  METHODS
  Prospectively assessing patients pre- and postoperative psychological morbidity (level 2c).
  
  
  METHODS
  Patients waiting for thyroidectomy were mailed a sociodemographic and four psychological morbidity questionnaires: Impact of Events Scale-Revised (IES-R), Illness Intrusiveness Ratings Scale (IIRS), Perceived Stress Scale (PSS) and Hospital Anxiety and Depression Scale (HADS). We assessed whether anxiety was related to length of wait and a number of clinical/sociodemographic factors.
  
  
  RESULTS
  We achieved a 53% response rate over a 3-year period, with 176 patients providing complete preoperative data; and 74 (42%) completed postoperative data. The average age was 53 (± 12) years; 82% were female. Respondents with a suspicious or known malignancy waited an average of 107 days while those with benign neoplastic biopsies waited an average of 218 days for thyroidectomy. Respondents reported substantial psychological morbidity with high IES-R, IIRS, PSS, and HADS scores. There was no significant association between psychological morbidity and wait times, clinical or sociodemographic factors. Postoperative anxiety decreased significantly in all psychological morbidity measures except for the IIRS.
  
  
  CONCLUSIONS
  Patients waiting for thyroid surgery have mild to moderate psychological morbidity and long wait times for surgery. These appear not to be related. Psychological morbidity decreases after surgery. Reducing wait time can potentially reduce the time that patients have to live with unnecessary stress and anxiety.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada. antoine.eskander@mail.utoronto.ca
authors.forename: Antoine
authors.initials: A
authors.lastname: Eskander
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Devins
authors.forename: Jeremy
authors.initials: J
authors.lastname: Freeman
authors.forename: Alice C
authors.initials: AC
authors.lastname: Wei
authors.forename: Lorne
authors.initials: L
authors.lastname: Rotstein
authors.forename: Nitin
authors.initials: N
authors.lastname: Chauhan
authors.forename: Anna M
authors.initials: AM
authors.lastname: Sawka
authors.forename: Dale
authors.initials: D
authors.lastname: Brown
authors.forename: Jonathan
authors.initials: J
authors.lastname: Irish
authors.forename: Ralph
authors.initials: R
authors.lastname: Gilbert
authors.forename: Patrick
authors.initials: P
authors.lastname: Gullane
authors.forename: Kevin
authors.initials: K
authors.lastname: Higgins
authors.forename: Danny
authors.initials: D
authors.lastname: Enepekides
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000523:psychology*; D014850:Waiting Lists