Conference Coverage

Older Adults Differ in Desired Engagement in Postoperative Pain Care

Edited by:
Brian McCurdy

Key Highlights

  • Researchers interviewed 15 adults aged 65 years or older undergoing major noncardiac surgery.
  • Themes described patient and clinician behaviors that helped patients feel engaged in postoperative pain management.
  • Patients’ engagement behaviors did not necessarily align with their satisfaction with their involvement.

According to a qualitative study scheduled for presentation at the ANESTHESIOLOGY Annual Meeting 2026, older adults differed in how much they wanted to participate in postoperative pain management, and their outward engagement did not always reflect how involved they felt. Researchers identified behaviors that patients and clinicians could use to build patients’ sense of participation in their care.

The investigators sought to understand patients’ perceptions of engagement in a general surgical population. They focused on older adults, whom they described as a vulnerable surgical population, to explore how patients perceived their role in the perioperative pain management process.

Researchers conducted semi-structured interviews with patients aged 65 years or older undergoing major noncardiac surgery. Interviews took place before or immediately after hospital discharge. The team used general inductive thematic analysis to identify perceptions of engagement, then organized the themes into a framework describing patients’ experiences.

Study Findings

The researchers interviewed 15 patients before reaching thematic saturation. Participants had a median age of 68 years (range: 65-84); 53.3% were female, and 33.3% were Black. Elective procedures accounted for 40% of surgeries, and participants received care through orthopedic, neurosurgical, and general surgical services. Themes clustered into patient behaviors that fostered engagement and clinician behaviors that helped patients develop that engagement.

Patients used the identified behaviors to varying degrees, but their use did not necessarily correspond with satisfaction with their engagement in pain management. Some patients reported that they had not been invited to participate as much as they wanted. Others appeared externally unengaged yet reported feeling like members of the pain management team.

Clinical Implications

According to the study authors, the findings support first identifying each patient's desired level of engagement, then using those behaviors to support that involvement. They described the results as consistent with broader patient engagement literature emphasizing bidirectional information sharing and decision-making.

The authors identified several areas for future work: gathering clinician perspectives, quantitatively measuring engagement and satisfaction with engagement, and examining relationships between engagement measures and clinician- or patient-centered pain and recovery outcomes.

Expert Commentary

“Interventions designed to improve patient engagement should focus on first identifying the degree to which a patient desires to be engaged and then using the identified behaviors to support that engagement,” the researchers concluded.

Reference

Mara R, Huynh J, Hutcheson K, et al. Am I on the team? A qualitative study of patient engagement in postoperative pain management in older adults. Abstract presented at: ANESTHESIOLOGY 2026; October 16-20, 2026; San Diego, CA. Abstract A1835.