Patient Experiences With Thyroid Nodules: A Qualitative Interview Survey
Abstract Objective To qualitatively explore the broad set of preferences and attitudes patients have about thyroid nodules, which influence the decision‐making process. Study Design A descriptive survey design was administered as interviews. Setting Outpatient thyroid surgery clinic. Methods Semistr...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | OTO Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/oto2.39 |
| _version_ | 1797537465684197376 |
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| author | Matthew R. Naunheim Manuela vonSneidern Molly N. Huston Okenwa C. Okose Amr H. Abdelhamid Ahmed Gregory W. Randolph Mark G. Shrime |
| author_facet | Matthew R. Naunheim Manuela vonSneidern Molly N. Huston Okenwa C. Okose Amr H. Abdelhamid Ahmed Gregory W. Randolph Mark G. Shrime |
| author_sort | Matthew R. Naunheim |
| collection | DOAJ |
| description | Abstract Objective To qualitatively explore the broad set of preferences and attitudes patients have about thyroid nodules, which influence the decision‐making process. Study Design A descriptive survey design was administered as interviews. Setting Outpatient thyroid surgery clinic. Methods Semistructured interviews were conducted with 20 patients presenting for initial evaluation of thyroid nodules at a surgeon's office. Probative, open‐ended questions were posed regarding diagnosis, treatment, risk attitudes, and the decision‐making process. Thematic analysis was used to develop code‐transcribed interviews, and an iterative refinement resulted in underlying themes. Results During the diagnostic process, patients integrated emotional responses (fear, anxiety, and shock) with rationale concerns (likelihood of cancer, risk assessment), and ultimately relied heavily on expert opinion and recommendation. Contextualization with other personal or familial health problems served as helpful touchstones for decision‐making. Overtreatment and overdiagnosis were not commonly discussed. When thinking about potential therapies, there was a strong bias to action rather than surveillance among patients. Surgical risk and the possibility of lifelong medication, however, were strong motivators for a subset of patients to seek nonsurgical alternatives. Conclusion Patients describe a decision‐making process that incorporates emotional response and rational consideration of risks, contextualized within the personal experience and physician expertise. The bias for action and intervention is strong, and most patients strongly weighted physicians' recommendations. Themes from this qualitative analysis may serve as the backbone for future stated preference research pertaining to thyroid disease. |
| first_indexed | 2024-03-10T12:16:33Z |
| format | Article |
| id | doaj.art-833adf2696b949869b22c815a5ddbfb9 |
| institution | Directory Open Access Journal |
| issn | 2473-974X |
| language | English |
| last_indexed | 2024-03-10T12:16:33Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | OTO Open |
| spelling | doaj.art-833adf2696b949869b22c815a5ddbfb92023-11-21T15:50:29ZengWileyOTO Open2473-974X2023-01-0171n/an/a10.1002/oto2.39Patient Experiences With Thyroid Nodules: A Qualitative Interview SurveyMatthew R. Naunheim0Manuela vonSneidern1Molly N. Huston2Okenwa C. Okose3Amr H. Abdelhamid Ahmed4Gregory W. Randolph5Mark G. Shrime6Department of Otolaryngology–Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USADepartment of Otolaryngology–Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USADepartment of Otolaryngology–Head and Neck Surgery Washington University in St Louis St Louis Missouri USADivision of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School Boston Massachusetts USADivision of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School Boston Massachusetts USADivision of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School Boston Massachusetts USADepartment of Global Health and Social Medicine Harvard Medical School Boston Massachusetts USAAbstract Objective To qualitatively explore the broad set of preferences and attitudes patients have about thyroid nodules, which influence the decision‐making process. Study Design A descriptive survey design was administered as interviews. Setting Outpatient thyroid surgery clinic. Methods Semistructured interviews were conducted with 20 patients presenting for initial evaluation of thyroid nodules at a surgeon's office. Probative, open‐ended questions were posed regarding diagnosis, treatment, risk attitudes, and the decision‐making process. Thematic analysis was used to develop code‐transcribed interviews, and an iterative refinement resulted in underlying themes. Results During the diagnostic process, patients integrated emotional responses (fear, anxiety, and shock) with rationale concerns (likelihood of cancer, risk assessment), and ultimately relied heavily on expert opinion and recommendation. Contextualization with other personal or familial health problems served as helpful touchstones for decision‐making. Overtreatment and overdiagnosis were not commonly discussed. When thinking about potential therapies, there was a strong bias to action rather than surveillance among patients. Surgical risk and the possibility of lifelong medication, however, were strong motivators for a subset of patients to seek nonsurgical alternatives. Conclusion Patients describe a decision‐making process that incorporates emotional response and rational consideration of risks, contextualized within the personal experience and physician expertise. The bias for action and intervention is strong, and most patients strongly weighted physicians' recommendations. Themes from this qualitative analysis may serve as the backbone for future stated preference research pertaining to thyroid disease.https://doi.org/10.1002/oto2.39decision‐makingpatient preferencespreferencesthematic analysisthyroid |
| spellingShingle | Matthew R. Naunheim Manuela vonSneidern Molly N. Huston Okenwa C. Okose Amr H. Abdelhamid Ahmed Gregory W. Randolph Mark G. Shrime Patient Experiences With Thyroid Nodules: A Qualitative Interview Survey OTO Open decision‐making patient preferences preferences thematic analysis thyroid |
| title | Patient Experiences With Thyroid Nodules: A Qualitative Interview Survey |
| title_full | Patient Experiences With Thyroid Nodules: A Qualitative Interview Survey |
| title_fullStr | Patient Experiences With Thyroid Nodules: A Qualitative Interview Survey |
| title_full_unstemmed | Patient Experiences With Thyroid Nodules: A Qualitative Interview Survey |
| title_short | Patient Experiences With Thyroid Nodules: A Qualitative Interview Survey |
| title_sort | patient experiences with thyroid nodules a qualitative interview survey |
| topic | decision‐making patient preferences preferences thematic analysis thyroid |
| url | https://doi.org/10.1002/oto2.39 |
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