Deng Carolyn, Jowsey Tanisha, Becker Ines, Campbell Doug, Hill Jack, Bhagvandas Jignal, Fuchs Ralph, Lightfoot Nicholas J, Djamali Kaveh, Weller Jennifer
Department of Anaesthesia and Perioperative Medicine, Te Toka Tumai Auckland, Auckland, New Zealand; Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.
Br J Anaesth. 2025 Apr;134(4):1068-1076. doi: 10.1016/j.bja.2024.12.026. Epub 2025 Feb 1.
We explored how adult surgical patients perceived their risk of major postoperative complications, including neurological complications, and how much information they wanted to receive about such risks.
We undertook a mixed-methods study including a 13-item survey and thematic analysis of semi-structured interviews with patients undergoing noncardiac, non-neurologic surgery.
Of 557 distributed surveys, 547 were returned completed. Of these, 88% of respondents had previously undergone surgery. Respondents were most likely to indicate an extreme level of concern for major stroke (64%), followed by heart attack (56%), minor stroke (46%), and cognitive decline (43%). Women were more likely to indicate a higher level of concern for cognitive decline than men (odds ratio 1.6, 95% confidence interval 1.1-2.4, P=0.015). Seventeen people participated in interviews. Six themes were identified: (1) trust in healthcare professionals; (2) surgery to achieve hopes and ambitions; (3) previous experiences govern expectations and perception of risk; (4) positive outlook and spirituality as protective factors; (5) support matters; and (6) a personalised approach to risk discussion.
Many participants did not know the risks of major perioperative complications but based their risk perception on previous experiences and trust in health professionals. Participants focused on hope more than their concerns. Information provision should be personalised as patients expressed differences in the desired amount of information on risks.
我们探讨了成年外科手术患者如何看待其术后发生重大并发症（包括神经系统并发症）的风险，以及他们希望获得多少有关此类风险的信息。
我们开展了一项混合方法研究，包括一项包含13个条目的调查，以及对接受非心脏、非神经外科手术患者进行的半结构化访谈的主题分析。
在分发的557份调查问卷中，共收回547份完整问卷。其中，88%的受访者此前接受过手术。受访者最有可能表示对重大中风极为担忧（64%），其次是心脏病发作（56%）、轻微中风（46%）和认知能力下降（43%）。女性比男性更有可能表示对认知能力下降更为担忧（优势比1.6，95%置信区间1.1 - 2.4，P = 0.015）。17人参与了访谈。确定了六个主题：（1）对医疗保健专业人员的信任；（2）通过手术实现希望和抱负；（3）既往经历影响期望和风险认知；（4）积极的人生观和精神信仰作为保护因素；（5）支持很重要；（6）针对风险讨论采取个性化方法。
许多参与者不知道围手术期重大并发症的风险，但他们的风险认知基于既往经历和对医疗保健专业人员的信任。参与者更关注希望而非担忧。由于患者在所需风险信息数量方面存在差异，因此应提供个性化的信息。
