• Christina Keny, Ellis C Dillon, Marcia M Russell, Alexis Colley, Veronica Yank, and Victoria Tang.
• Department of Medicine, Division of Geriatrics, University of California, San Francisco, CA.
• Ann. Surg. 2024 May 1; 279 (5): 736742736-742.

ObjectiveThis qualitative study aimed to explore the challenges faced by older adults regarding the postoperative symptom experience after major elective surgery.BackgroundAlthough extensively studied in oncology settings, the impact of postoperative symptom burden remains largely underexplored in elective major surgery among older adults.MethodsWe employed convenience sampling to recruit adults aged 65 years or above undergoing major elective surgery at the University of California, San Francisco. Semistructured interviews regarding the surgical experience were conducted at 1 and 3 months postoperatively. An inductive qualitative approach was used to identify emerging themes. Symptoms revealed by participants during interviews were also captured.ResultsNineteen participants completed a 1-month postoperative interview, and 17 additionally completed a 3-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 1-month postsurgery compared with pain and depression (both n=6, 35.3%) at 3 months.ConclusionsStudy 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.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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