Effect of Preoperative Psychological Support on Self-Efficacy and Anxiety Levels in Patients After Total Thyroidectomy

Abstract

Background: This study aimed to examine the association between preoperative psychological support and postoperative outcomes in patients undergoing total thyroidectomy.

Methods: A retrospective study was conducted on 120 patients who underwent total thyroidectomy at the First Affiliated Hospital of Xinjiang Medical University between January 2023 and December 2025. According to their actual preoperative nursing plan documented in the medical records, patients were divided into two groups. The conventional treatment group received standard clinical treatment, while the psychological support group received additional unstructured preoperative psychological counselling in addition to routine treatment. Outcomes included self-efficacy (Strategies Used by People to Promote Health scale), psychological resilience (Chinese version of the Connor-Davidson Resilience Scale [CD-RISC]), anxiety level (Self-Rating Anxiety Scale), postoperative pain (Numerical Rating Scale), and health literacy (Chinese version of the All Aspects of Health Literacy Scale).

Results: On the fifth postoperative day, the self-efficacy scores (positive attitude, self-decision-making and self-stress reduction) and psychological resilience (optimism, perseverance and self-improvement) were all higher in the psychological support group than in the conventional treatment group (p < 0.05). There were no significant differences in anxiety or pain scores between the two groups at baseline (p > 0.05). On the fifth postoperative day, anxiety and pain levels had decreased, with the psychological support group experiencing lower levels (46.91 ± 3.46 and 1.28 ± 0.33, respectively) than in the conventional treatment group (49.41 ± 5.08 and 1.92 ± 0.51, respectively) (p < 0.05). The complication rate in the psychological support group was 6.67%, which was lower than in the conventional treatment group (p < 0.05). However, this difference should be interpreted with caution, because multiple surgical factors may influence postoperative complications. There were no significant differences in health literacy or total scores between the two groups at baseline (p > 0.05). On the fifth postoperative day, the health literacy score in the psychological support group was higher than in the conventional treatment group (p < 0.05). 

Conclusions: This retrospective study suggests that preoperative psychological support was associated with more favourable postoperative outcomes in patients undergoing total thyroidectomy. However, given the nonrandomised, retrospective design of this study, these findings should be interpreted as exploratory and require confirmation through prospective randomised controlled trials.