Fatigue after Thyroidectomy: A Qualitative Exploration of Patients' Lived Experiences.

Abstract

Introduction: Fatigue is a common, yet understudied, patient-reported symptom after thyroidectomy. This study sought to explore patients' lived experience of fatigue post-thyroidectomy.

Methods: Semi-structured interviews were conducted with adult patients who underwent thyroidectomy for benign and malignant thyroid disease between January 2021 and January 2024. Data were analyzed by qualitative content analysis.

Results: Participants (n = 20) were a median of 44 years (range 21-73). The majority were female (90%), White (75%), diagnosed with thyroid cancer (45%), and had undergone a total thyroidectomy (50%). Most participants (75%) spontaneously discussed experiencing fatigue post-thyroidectomy, describing their physical symptoms related to fatigue as "tiredness", "exhaustion", or "decreased energy". Qualitative results could be organized into three domains describing participant experience with fatigue: (i) the impact of fatigue on their life (including impacts on work, day-to-day life, and social interactions), (ii) beliefs about the source of fatigue (such as medication), and (iii) expectations about fatigue as an outcome. Participants also discussed fatigue in relation to other life stresses and non-thyroid comorbidities. Most patients were underprepared for the possibility and severity of fatigue post-thyroidectomy. Participants suggested that surgeons "bringing [fatigue] up" as a possible outcome could improve patient expectations.

Conclusions: Fatigue is a significant outcome after thyroidectomy, affecting every aspect of patients' lives. As the first in-depth qualitative study to describe patients' experience with fatigue, this study highlights the need for further research to improve patient expectations and elucidate underlying mechanisms leading to post-thyroidectomy fatigue.