Needs for preoperative anesthesia communication from the perspectives of older patients and their caregivers: a qualitative study

Preoperative anesthesia communication (PAC) is a crucial component of the anesthesia process. However, the specific PAC needs of older patients remain insufficiently understood, and age-related characteristics and cognitive differences further complicate their comprehension of anesthesia-related information. This study aims to systematically explore the current state of PAC awareness and unmet needs among older patients undergoing elective surgery and their family caregivers, with the goal of informing the optimization of PAC processes and improving communication quality. This study adopted a descriptive qualitative design. Purposeful sampling was used to recruit older patients (aged ≥ 65 years) and their family caregivers scheduled for elective surgery at a tertiary hospital between July and September 2025. Semi-structured interviews were conducted to explore their perceptions of the current PAC process and their unmet needs. Interview data were analyzed using thematic analysis, with coding supported by NVivo 12 version xx. This study recruited 14 older patients and their family caregivers and identified key themes in PAC needs. Through thematic analysis, we identified four themes and nine subthemes, with anesthetic knowledge needs, communication preferences, decision-making needs, and psychosocial support needs as the themes. The subthemes expand upon the main themes. Participants expressed a need for both general information and personalized details tailored to older patients’ health conditions. They also expressed a need for improved clinical decision-making, as well as deeper, more comprehensive needs including psychological support. This study enhances understanding of the experience of older patients and family caregivers in the current PAC process and identifies their needs for personalized content, detailed communication, and adapted formats. It also clarifies the collaborative roles of patients, family caregivers and healthcare professionals in PAC, highlighting the importance of multi-party interaction in supporting information comprehension and decision-making. The findings provide a practical basis for optimizing the PAC process. Future work should develop tailored communication aids, such as question prompt lists for older patients, to improve engagement, reduce barriers, alleviate preoperative anxiety, and promote informed decision-making.