Structural equation modeling on health-related quality of life among patients with thyroid cancer

Purpose: The aim of the study was to create a structural model based on Wilson and Cleary's Conceptual Model of Patient Outcomes. Secondly, the intention was to identify variables influencing the health-related quality of life (HRQoL) as reported by patients with thyroid cancer. Methods: A total of 201 patients with thyroid cancer were recruited from an outpatient clinic. Data were collected from June to November, 2015, using a structured questionnaire. The questionnaire included the Quality of Life-Thyroid Scale, Thyroid Stimulating Hormone (TSH), Medical Outcome Study Social Support Survey, MD Anderson Symptom Inventory-Thyroid, the Brief Illness Perception Questionnaire, and general characteristics of patients. The data were analyzed using the SPSS/WIN 21.0, AMOS 21.0, and SmartPLS 3.2.3 programs. Results: The fitness of the hypothetical model with the Wilson and Cleary model was satisfactory, showing that the coefficients of determination (R²) were between .101 and .692 and the predictive relevance (Q²) were between .124 and .320. The model explained 69.2% of the HRQoL. Symptom experience, functional status, disease perception, and social support directly and indirectly affected HRQoL. Age and TSH had an indirect influence on the HRQoL with the mediation effect of reported symptom experience. Conclusion: To improve the quality of life for patients with thyroid cancer, comprehensive nursing interventions need to be developed and applied. Decreasing the reported symptoms, changing the perception of the disease, improving functional status, and increasing social support may contribute to a higher quality of life among patients with thyroid cancer.