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"It's Incapacitated me in so Many Ways": Older Adults' Lived Experience with Postoperative Symptoms at Home Following Major Elective Surgery.

Keny C, Dillon EC, Russell MM, Colley A, Yank V, Tang V. "It's Incapacitated me in so Many Ways": Older Adults' Lived Experience with Postoperative Symptoms at Home Following Major Elective Surgery. Annals of surgery. 2023 Dec 5.

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Abstract:

OBJECTIVE: This qualitative study aimed to explore the challenges faced by older adults regarding the postoperative symptom experience following major elective surgery. BACKGROUND: Although extensively studied in oncology settings, the impact of postoperative symptom burden remains largely underexplored in elective major surgery among older adults. METHODS: We employed convenience sampling to recruit adults aged = 65 years undergoing major elective surgery at the University of California, San Francisco. Semi-structured interviews regarding the surgical experience were conducted at one and three months postoperatively. An inductive qualitative approach was used to identify emerging themes. Symptoms revealed by participants during interviews were also captured. RESULTS: Nineteen participants completed a one-month postoperative interview, and seventeen additionally completed a three-month interview. Three themes emerged: 1) postoperative symptoms significantly impacted valued life activities and psychosocial well-being, 2) participants felt "caught off guard" by the intensity and duration of postoperative symptoms, and 3) participants expressed the need for additional support, resources, and education on symptom management. The most frequently mentioned symptoms were postoperative pain (n = 12, 63.1%), gastrointestinal discomfort (n = 8, 42.1%), and anxiety/stress (n = 8, 42.1%) at one-month post-surgery, compared to pain and depression (both n = 6, 35.3%) at three months. CONCLUSIONS: Study participants were surprised by the negative impact of postoperative symptoms on their psychosocial well-being and ability to engage in valued life activities. Symptom burden is an important patient-reported outcome that should be assessed postoperatively. Interventions to minimize postoperative symptom burden in older adults could optimize quality of life and participation in meaningful activities during surgical recovery.




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