Endocrine Abstracts

Objective: To describe the experience of patients with differentiated thyroid carcinoma (DTC) since their diagnosis.

Patients and Methods: Cross-sectional study including 25 patients with DTC who integrated the therapeutic education program (TPE) on DTC at the Nuclear Medicine Center, Sfax, Tunisia. Each participant recounted his or her experience during collective meetings (narrative approach).

Results: Our group was composed of 19 women and 6 men, with an average age of 45.5±15.2 years. The diagnosis was made within the last 3 months in 52%. A thyroid nodule (32%) or adenopathy (32%) were the first warning signs. The diagnosis was announced by the ENT specialist (64%), the treating physician (20%) or the endocrinologist (16%). This experience was satisfactory for 72%. The doctor’s communication about the cancerous nature of the CDT was ‘vague’ for 12%. Also, 16% would have preferred to receive more explicit information. While 68% claimed to have received a clear explanation about the surgical step, 16% would have liked to know more about its objectives. The rest of the treatment protocol (iratherapy, hormone replacement therapy) was fairly well detailed for 80% of the patients. Prior education on the signs of L-thyroxine deficiency/overdose was requested by 40% of participants.

Discussion: The diagnosis of CDT causes an alteration in the patient’s identity, which will henceforth be organised around the tale of the disease and the demands of the medical world. The narrative therapy sessions integrated into the ETP programmes would allow access to the patient’s subjective experience and lead him/her to reappropriate his/her experience in order to better adhere to the planned therapeutic protocol.