'It was a great brain, and I miss it': lay perspectives on postoperative cognitive dysfunction

Area of Science:

• Anesthesiology
• Neuroscience
• Geriatric Medicine

Background:

• Postoperative cognitive dysfunction (POCD) is a recognized risk after anesthesia and surgery, yet neurocognitive risks are infrequently discussed preoperatively with older patients.
• Anecdotal accounts of POCD are prevalent in popular media, potentially shaping patient perceptions.
• The alignment between public and scientific understanding of POCD remains unclear.

Purpose of the Study:

• To explore lay perspectives on postoperative cognitive dysfunction (POCD) by analyzing public comments on a news article about surgical risks.
• To identify themes in user comments regarding the causes, impacts, and patient experiences related to POCD.
• To compare lay understandings with professional perspectives on POCD.

Main Methods:

• Inductive qualitative thematic analysis was employed.
• 84 comments from 67 unique users on a UK news article about surgical brain risks were analyzed.
• The analysis focused on identifying recurring themes in user-submitted feedback.

Main Results:

• Key themes included the significant functional impact of POCD (e.g., inability to work or read).
• Users attributed POCD to various causes, notably general anesthesia techniques and a lack of understanding regarding side effects.
• Inadequate patient preparation and insufficient response from healthcare providers were frequently mentioned.

Conclusions:

• A significant misalignment exists between professional and public understanding of POCD, with laypeople emphasizing subjective and functional aspects.
• Patients and caregivers affected by POCD often report feeling unsupported by healthcare providers.
• Recent nomenclature changes for postoperative neurocognitive disorders better incorporate subjective complaints and functional decline, potentially improving concordance with lay perspectives.