New possible determinants of the quality of life of patients with treated thyroid cancer: a qualitative study/Possiveis novos determinantes da qualidade de vida de pacientes com cancer de tireoide tratado: um estudo qualitativo

The aim of this study was to develop a qualitative approach of determinant factors of the quality of life of treated patients with papillary thyroid carcinoma. Sixteen in-depth interviews were conducted with individuals 18 to 45 years old regarding their disease representations and experiences, followed by statements content analysis. The results show issues already provided in structured questionnaires about quality of life, although others were only partially assumed in these surveys (management of the concept of disease etiology; the "forced" patient introduction into the medical conceptual universe; the fear of the prognosis and positive changes in lifestyle). The results interpretation were benefited from recently developed theoretical elaborations: the anxieties related to illness experience seem to be configured as a "modern risk", in the context of a "risk society". The development of structured questionnaires on quality of life requires frequent qualitative studies to capture changes in subjective aspects of the construct, given the dynamic changes of historical, cultural and psychological meanings of the health disease process, constantly influenced by technological innovations and continuing epidemiological interpretations. Key words Qualitative research, quality of life, papillary thyroid carcinoma, adults. Objetivou-se uma abordagem qualitativa de fatores que determinariam a qualidade de vida de pacientes com carcinoma papilifero de tireoide tratados. Foram feitas 16 entrevistas em profundidade com individuos de 18 a 45 anos sobre suas representacoes e experiencias com esta enfermidade, seguidas por analise de conteudo de enunciados. Os resultados contem aspectos ja previstos em questionarios estruturados sobre qualidade de vida, mas outros estao parcialmente presumidos nesses questionarios (manejo do conceito de etiologia da doenca, a insercao "forcada" dos pacientes no universo conceitual medico, o medo do prognostico e as mudancas "positivas" no estilo de vida). A interpretacao desses resultados beneficiou-se de elaboracoes teoricas de desenvolvimento recente: as angustias sobre a experiencia da doenca parecem configurar-se, para os participantes, como um "risco moderno", no contexto de uma "sociedade de riscos". O desenvolvimento de questionarios estruturados de qualidade de vida requer constantes estudos qualitativos que captem mudancas nos aspectos subjetivos do construto, dada a dinamicidade dos significados historicoculturais e psicolo