Association Between Post-Traumatic Growth and Stigma Among Post-Thyroidectomy Patients: An Explanatory Sequential Mixed-Methods Study

Objective To explore the current status and associated factors of stigma among postoperative thyroid cancer patients, and the association and potential pathways of post-traumatic growth (PTG) on stigma.Methods We adopted a mixed-methods design based on an explanatory sequential approach, encompassing both quantitative and qualitative methods. Quantitative analysis was performed utilizing the convenience sampling method, involving 184 post-operative patients with thyroid cancer from a tertiary hospital in Hunan Province for a cross-sectional survey. Data were collected via demographic questionnaires, the Social Impact Scale, and the Post-Traumatic Growth Inventory. Qualitative analysis was conducted through purposive sampling, and semi-structured in-depth interviews were conducted with 12 of the patients.Results The recruited patients had mean stigma and PTG scores of 61.62±13.33 and 60.54±14.78, respectively. We also found that PTG correlated significantly negatively with stigma (p<0.05). Hierarchical regression analysis further revealed that PTG accounted for 21.7% of the variance in stigma scores (p<0.05). Additionally, the qualitative analysis yielded three major themes and six subthemes: 1) reconstructing a positive mindset amid psychological struggles; 2) reconstructing illness cognition through social support; and 3) behavioral adaptation and self-identity reconstruction.Conclusion Thyroid cancer patients may experience some level of stigmatization post-surgery, which may be inversely correlated with their PTG levels. Therefore, researchers should develop clinical interventions to improve PTG via emotional regulation, cognitive restructuring, social support, and health behavior promotion.