Thirst experience and nursing needs in older patients after general anesthesia for gastrointestinal surgery: A qualitative study

Abstract

BACKGROUND

Older patients often experience thirst after general anesthesia for gastrointestinal surgery, particularly during the post-anesthesia care unit (PACU) phase. Thirst not only compromises patient comfort but also induces anxiety, which may hinder recovery. Although previous studies have addressed postoperative thirst, research specifically examining thirst experiences and nursing needs in older patients remains limited.

AIM

To explore thirst experiences and nursing needs of older PACU patients following gastrointestinal surgery, aiming to inform targeted interventions.

METHODS

This study employed a phenomenological approach within a qualitative research framework. A purposeful sampling method was used to select 12 older patients who underwent gastrointestinal surgery under general anesthesia at a tertiary hospital in Shanghai between November and December 2024. Data were collected through semi-structured interviews and analyzed using Colaizzi’s seven-step method. Themes were extracted from the interview data.

RESULTS

Analysis of the interview data identified four main themes and eight subthemes: (1) Intense sensations of thirst post-surgery (subjective experience of thirst and duration of thirst); (2) Emotional experiences of thirst-related discomfort (anxiety, irritability, and helplessness); (3) Practical challenges in relieving thirst (limitations of current interventions and nursing response time); and (4) Patient expectations of nursing care (desire for more timely interventions and expectation for more proactive attention from nursing staff).

CONCLUSION

Older patients frequently experience substantial thirst discomfort after gastrointestinal surgery under general anesthesia. A multidisciplinary perioperative intervention plan is essential to alleviate these symptoms and enhance postoperative comfort.

Key Words: Older people; General anesthesia; Gastrointestinal surgery; Thirst experience; Nursing; Qualitative research

Core Tip: This qualitative study investigated the thirst experience and nursing needs of elderly patients after general anesthesia for gastrointestinal surgery, particularly in the post-anesthesia care unit. The results revealed that such patients frequently suffered from intense, persistent thirst, along with emotional distress such as anxiety and irritability. Although some nursing interventions were implemented, they were insufficient in alleviating the discomfort. The findings emphasize the importance of timely, effective nursing support and suggest a multidisciplinary approach to address thirst-related needs to enhance patient comfort and recovery.

INTRODUCTION

The recovery period after general anesthesia plays a critical role in restoring physical function. Factors such as preoperative fasting, mechanical ventilation during surgery, anesthetic agents, and postoperative care in the post-anesthesia care unit (PACU) often cause discomforts, including dry mouth, thirst, sore throat, pain, anxiety, and fear[1-3]. Among the various symptoms experienced during recovery after extubation under general anesthesia, thirst is often the most intense[4]. Studies have reported an incidence rate of postoperative thirst ranging from 18.5% to 89.6%[5]. This sensation is a multifaceted experience encompassing sensory, physiological, and subjective elements and reflects the body’s need for fluid intake to maintain homeostasis. Common manifestations include dry mouth, a scratchy throat, and an overwhelming urge to drink water[6,7].

The rapid aging of the global population has led to significant demographic shifts, with older individuals constituting the fastest-growing segment. This demographic trend has increased the demand for surgical intervention. Consequently, the proportion of older patients undergoing gastrointestinal surgery has steadily risen[8]. Recent epidemiological studies indicate that patients undergoing general anesthesia for such procedures are particularly susceptible to thirst and dry mouth, especially older patients[9,10]. In these patients, postoperative thirst often persists in the PACU due to the lingering effects of anesthesia and impaired swallowing function, leading to substantial discomfort and anxiety. Postoperative thirst encompasses both physiological and psychological dimensions. It is not only a fundamental physiological need but also a source of psychological distress, manifesting as anxiety, discomfort, and dissatisfaction. This distress may impede recovery and negatively affect the overall patient experience[11,12]. Moreover, postoperative thirst has been identified as a physical stressor associated with higher postoperative morbidity rates and reduced patient satisfaction[13].

Thirst-related discomfort in older patients during the PACU phase is a critical concern that warrants further investigation to enhance postoperative care and improve patient satisfaction. Although previous studies have examined postoperative thirst, the specific experiences and nursing requirements of older patients remain insufficiently explored. In this study, we aimed to assess the challenges encountered by older patients who underwent general anesthesia for gastrointestinal surgery, with a particular focus on their thirst-related discomfort in the PACU. The study evaluated the severity, duration, and emotional impact of thirst while also assessing the effectiveness of current nursing interventions and patient expectations. By improving the understanding of these experiences, the findings aim to guide clinical practice and support the development of more effective patient care strategies. These outcomes are anticipated to contribute to improved postoperative care, reduced discomfort, faster recovery, and enhanced overall treatment outcomes.

MATERIALS AND METHODS

Research participants

Purposive sampling was used to identify older patients undergoing elective gastrointestinal surgery under general anesthesia at a tertiary hospital in Shanghai between November and December 2024. All selected participants were transferred to the PACU and reported experiencing thirst during recovery. The inclusion criteria were as follows: (1) Diagnosed with gastrointestinal diseases and scheduled for elective gastrointestinal surgery under general anesthesia; (2) Aged ≥ 60 years (based on the World Health Organization definition for older adults in developing countries) and transferred to the PACU post-surgery; (3) Fully awake after extubation (evaluated using the Richmond agitation-sedation scale) with a clear complaint of thirst; (4) Able to communicate verbally and engage in normal conversation; and (5) Provided informed consent and agreed to share authentic experiences. The exclusion criteria were as follows: (1) Direct transfer to a general ward or intensive care unit after surgery; (2) History of xerostomia, oral diseases, dialysis, or long-term use of medications that suppress salivation; (3) Comatose or altered mental status, which hindered normal communication; and (4) Declined audio recording of the interview. The sample size was determined by data saturation. No new themes emerged after the 12^th interview, and recruitment ceased as subsequent interviews yielded repeated findings, confirming data saturation.

Development of interview outline

To develop the interview outline, a comprehensive literature review of relevant domestic and international studies was conducted, followed by consultations with PACU nurses and expert opinions. This process led to the creation of an initial interview guide. Preliminary interviews were conducted with two participants who met the inclusion criteria. After discussing the findings with the research team, the outline was revised and finalized. The final interview guide included the following questions: (1) Can you recall your experience of thirst in the PACU during the awakening phase? Could you describe how it felt? How intense was your thirst? (2) How long did the thirst sensation last? Did it gradually subside, or did it persist throughout the recovery phase in the PACU? (3) What kind of discomfort did your thirst cause during recovery? How did you feel when you experienced thirst after surgery? (4) When you experienced thirst, did the nursing staff assist? How effective were the interventions? (5) What measures would you like PACU medical and nursing staff to take to alleviate your thirst and discomfort? And (6) Do you feel that current nursing care adequately addressed your comfort and needs, particularly concerning your thirst?

Data collection and quality control

This study primarily used face-to-face, semi-structured interviews supplemented by participatory observation for data collection. Before the interviews, the researcher provided patients and their families with a detailed explanation of the study’s purpose, significance, methods, and duration. Informed consent was obtained, and consent forms were signed before participation. Given the unique environment of the PACU, interviews were conducted in a relatively quiet, low-traffic area within the general ward of the gastrointestinal surgery department. Interviews took place within six hours post-surgery, specifically between two and six hours after the patient’s transfer to the ward, a period when the patient’s consciousness had sufficiently recovered and their condition was stable. Each interview lasted approximately 20-30 minutes, with data collection continuing until thematic saturation was reached. The researcher, who had received systematic training in qualitative research methods, conducted all interviews. The first interview question was: “Do you recall experiencing thirst during the awakening phase in the PACU?” The interview outline was adjusted as necessary based on specific circumstances. To assess thirst intensity, the visual analog scale for thirst assessment was used, ensuring consistency and comparability of the research results. All interviews were audio-recorded to maintain data accuracy and prevent leading questions. The researcher also followed up with probing questions, repeated or clarified responses when needed, and encouraged participants to describe their experiences of thirst in detail. Additionally, the researcher observed and recorded participants’ emotional responses, vocal tones, and body language throughout the interviews.

Statistical analysis

Within 24 hours of interview completion, two researchers independently transcribed the audio recordings and documented nonverbal information in the corresponding transcript sections. Data analysis followed Colaizzi’s seven-step method[14]: (1) Transcribing the interview data and thoroughly reviewing the content; (2) Identifying and summarizing significant statements; (3) Coding recurring and meaningful statements; (4) Grouping the coded statements into categories; (5) Linking the grouped statements to the research phenomena and developing detailed descriptions; (6) Synthesizing similar statements to form overarching themes; and (7) Conducting member checking by returning the results to participants and refining the analysis based on their feedback.

Ethical considerations

This study was conducted in accordance with established ethical guidelines. All study materials were submitted for review and received approval from the institutional ethics committee before the study commenced. Before participation, patients were thoroughly briefed on the study’s objectives, significance, and procedures. They were assured that their data would be used solely for research purposes. After this explanation, participants signed an informed consent form and formally agreed to participate. They were also informed of their right to withdraw from the study at any time. Throughout the study, participants were not pressured to answer any questions, and their autonomy was fully respected. Any concerns or queries were addressed promptly. To protect privacy, all personal identifiers were replaced with numerical codes.

RESULTS

Twelve older patients (61-81 years) who had undergone general anesthesia for gastrointestinal surgery participated in this study. The male-to-female ratio was balanced, and all participants underwent gastrointestinal surgery. All participants met the inclusion criteria. The demographic characteristics of the interviewees are shown in Table 1. Ethical approval was obtained from the hospital ethics committee, and strict confidentiality was maintained throughout the study. All interview data were processed anonymously, and participants were assigned numerical identifiers. Using Colaizzi’s seven-step analysis method, the interview data were analyzed and categorized into themes. Ultimately, four main themes and eight subthemes were identified, highlighting key aspects of postoperative thirst discomfort and related needs among older patients after general anesthesia for gastrointestinal surgery. The identified themes and subthemes are listed in Table 2.

Table 1 Demographic information of interview participants.

Participant ID	Gender	Age (years)	Education level	Anesthesia duration (minutes)	Recovery duration (minutes)
P1	Male	67	High School	120	65
P2	Male	77	Junior High School	125	60
P3	Female	73	Primary School	50	60
P4	Female	61	High School	80	70
P5	Female	68	Junior High School	130	50
P6	Female	76	High School	80	65
P7	Male	81	No Formal Education	245	70
P8	Female	69	Primary School	125	60
P9	Female	70	College	60	50
P10	Male	71	High School	280	75
P11	Male	71	Secondary Vocational School	195	45
P12	Male	74	Junior High School	80	60

Table 2 Themes and subthemes of the study.

Theme	Subtheme
Intense sensations of thirst post-surgery	Subjective experience of thirst
	Duration of thirst
Emotional experiences of thirst-related discomfort	Anxiety
	Irritability and helplessness
Practical challenges in relieving thirst	Limitations of current interventions
	Nursing response time
Patient expectations of nursing care	Desire for more timely interventions
	Expectation for more proactive attention from nursing staff

Theme 1: Intense sensations of thirst post-surgery

Most patients described postoperative thirst as persistent and overwhelming discomfort, primarily manifesting as a dry mouth and scratchy throat. Some patients even likened the sensation to having a “burning throat” or experiencing “desert-like dryness.” Patients generally reported that thirst began immediately after awakening from anesthesia and persisted throughout the recovery process.

Subtheme 1 (subjective experience of thirst): Most patients reported considerable discomfort due to thirst after surgery, particularly during the anesthesia recovery phase. Dry mouth and throat discomfort were the most frequently reported symptoms. Patients often described their thirst using vivid and expressive language, emphasizing that it felt markedly different from their usual experience of thirst. P2 recalled: “When I first awoke, my mouth and throat were dry, almost as if they had been scorched by fire-tight and parched-and my throat was slightly sore. This was extremely uncomfortable”. P4 stated: “My throat felt dry, like it was on fire, and swallowing saliva was difficult. Honestly, the thirst I felt at that moment was ten times worse than usual; it was truly unbearable”. P5 said: “My mouth also had a bitter taste, and my lips felt tight. The thirst was so intense that it felt worse than walking a long distance and sweating”. P11 noted: “This was not like normal thirst; not only was my throat dry, but I also felt a burning sensation in my lips, mouth, and even my airways”.

Subtheme 2 (duration of thirst): Most patients indicated that thirst persisted throughout the PACU phase, with little to no substantial relief over time. They commonly described the initial awakening period as particularly intense, with thirst being especially severe and lasting for a prolonged period. Many patients continued to experience discomfort even after leaving the recovery room. P3 explained: “The worst part was when I first awakened. The thirst was particularly intense and lasted approximately 40 minutes. At that time, my thirst felt unbearable, with both my mouth and throat dry. I desperately wanted to drink water but could not”. P7 stated: “From the moment I woke up until I left the recovery room, I felt extremely thirsty and uncomfortable for over an hour. The worst part was at the beginning when the urge to drink water was strongest. It improved slightly later but never fully resolved”. P11 shared: “When I first woke up, the thirst was severe, and my mouth felt like it was cracking. Later, it seemed less dry, but my throat still burned. It felt like I had swallowed a lot of dry air. This was very uncomfortable”.

Theme 2: Emotional experiences of thirst-related discomfort

Postoperative thirst is not only a physical discomfort but also triggers a range of emotional responses, including anxiety, irritability, restlessness, and helplessness. These emotional reactions further intensify patients' overall discomfort.

Subtheme 1 (anxiety): Anxiety is among the most frequently reported emotional responses in patients. Postoperatively, patients often experience heightened anxiety due to uncertainty surrounding their surgery and recovery, particularly in the unfamiliar environment of the PACU. Most patients in this study reported that their anxiety worsened when they were unable to receive fluids promptly. This heightened anxiety not only increased their sensitivity to thirst but also contributed to physical tension, potentially affecting their overall recovery. P8: “I really wanted to drink water, but the staff said I could not. This made me very anxious”. P4: “The dryness in my throat made it hard to breathe, which only intensified my fear and anxiety”. P10: “The thirstier I felt, the more anxious I became, wondering if something was wrong with me”. P12: “I felt as if my body was completely out of control. I could not stop wanting water, but I could do nothing about it, which made me feel very uneasy”.

Subtheme 2 (irritability and helplessness): Thirst also led to irritability in some patients, while others experienced helplessness. Postoperative thirst, particularly after anesthesia, is an unmet need that patients may struggle to express due to lingering anesthesia effects. This often resulted in frustration and irritability as they endured the discomfort of thirst. P8: “It was really frustrating. My hands were strapped, and I could only wait passively for the nurse. The nurses were so busy that they could not attend to me, making me feel helpless”. P12: “I wanted the nurse to help relieve my dry mouth, but I could not speak loudly, and the surrounding machines were so noisy. I could not get a response, which only made me more frustrated”. P3: “I wanted to tell the nurse that I was thirsty and uncomfortable, but my mouth was too dry to speak. The nurse did not come immediately because she was busy with another patient who had just undergone surgery. I felt anxious and as if I had been forgotten”.

Theme 3: Practice challenges in relieving thirst

Subtheme 1 (limitations of current interventions): Patient feedback indicated that existing interventions were insufficient to fully address their needs. Most patients reported that nursing staff responded only when they explicitly communicated their discomfort. However, these interventions were often brief and ineffective, and failed to provide lasting relief from the discomfort caused by thirst. P4: “When I clearly expressed that my mouth was extremely uncomfortable and that I was very thirsty, the nurse came over and told me that it would improve once I returned to the ward. However, there was nothing that could be done at the moment, so I had to endure it”. P7: “The nurse used a cotton swab to moisten my lips. Initially, it seemed to help a little, but within seconds, my lips became dry again, and the discomfort returned”. P9: “The nurse sprayed something into my mouth a few times. It felt moist for a brief time, but it did not help at all. The dryness returned shortly after, and there was no lasting effect”.

Subtheme 2 (nursing response time): Patients expressed varying opinions on the responsiveness of nursing staff. Some felt that nurses responded promptly and provided appropriate care, whereas others expressed dissatisfaction with delays, believing that a slow response worsened their discomfort. P8: “When I felt uncomfortable, the nurse came quickly, asked me what was bothering me, wiped my mouth, and even asked if I felt better. This made me feel that they truly cared about my well-being”. P11: “When I told the nurse that my mouth was uncomfortable and that I was very thirsty, she simply told me to wait until I returned to the ward. I understand that nurses are busy, but at that moment, I felt ignored. My mouth was extremely dry, but I had to wait”. P9: “The nurse did not address my discomfort and thirst in a timely manner. If they had responded more quickly, I would have felt more comfortable physically and less distressed emotionally”.

Theme 4: Patient expectations of nursing care

Patients had high expectations for nursing care, hoping that healthcare providers would offer more thorough and thoughtful care to alleviate postoperative thirst and address their emotional needs. Their expectations primarily focused on diversifying nursing interventions, improving communication and empathy, and ensuring more timely responses from nursing staff.

Subtheme 1 (desire for more timely interventions): Patients expressed a desire for more direct and effective interventions to alleviate the intense discomfort of thirst immediately after awakening from anesthesia. Several participants emphasized the need for additional measures to relieve discomfort during recovery. Innovative approaches were proposed for managing oral dryness and thirst (e.g., P6: “Using devices to moisten the mouth”; P9: “Providing more accessible options such as oral sprays or lozenges”; P4: “Offering various relief options tailored to specific patient needs”; P11: “If we had been informed of methods to relieve thirst before or after surgery, we would have felt more mentally prepared and less anxious”).

Subtheme 2 (expectation for more proactive attention from nursing staff): Most patients expressed a preference for nurses to be more proactive in addressing their needs in the postoperative recovery room. They expected nurses to offer assistance without waiting for patients to request help and to provide emotional support during recovery. P12: “Upon awakening from surgery, I found myself in an unfamiliar environment, surrounded by the constant noise of machines. Sometimes, I felt so uncomfortable that I could not express myself, but I really hoped the nurses would check on me”. P9: “I was very weak after surgery and hoped that nurses would proactively ask where I was feeling discomfort and help me in a timely manner. Although the nurses were busy, it would have been reassuring if they had simply asked if I was thirsty”.

DISCUSSION

In this study, we aimed to investigate thirst experiences and the associated nursing needs of older patients undergoing gastrointestinal surgery under general anesthesia. It was designed to provide a deeper understanding of how older patients in the PACU perceive and experience thirst, as well as their expectations regarding nursing care. The results indicate that most patients report experiencing intense and persistent thirst. However, in many cases, this discomfort is not immediately or effectively alleviated. Beyond physical discomfort, thirst frequently leads to anxiety, which further hinders postoperative recovery. Although current nursing practices provide some relief, the absence of comprehensive and individualized care strategies means that patients' thirst is not fully addressed. Based on these findings, we propose potential improvements in nursing interventions to enhance the postoperative thirst experience of older patients.

Timely assessment of thirst symptoms and addressing patients’ thirst needs

This study found that many older patients experienced intense thirst during PACU recovery, with some reporting prolonged discomfort. Unfortunately, this symptom is often not promptly addressed. This delay appears to stem from inadequate thirst assessment by nursing staff and the absence of a structured approach to managing thirst. This aligns with the findings of Oztas and Oztas[9], who reported that postoperative patients frequently experience intense thirst and dry mouth; however, these symptoms are often neglected and not regularly evaluated. Similarly, Motta et al[11] found that 75.4% of patients experienced thirst within 30 minutes postoperatively, emphasizing the need for timely nursing interventions. For surgical patients, promptly recognizing and addressing thirst is essential to ensure comfort and minimize distress[15].

PACU nursing staff should routinely assess patients for signs of thirst, particularly among older patients. This assessment should consider the intensity and duration of thirst, along with any associated symptoms. A comprehensive evaluation should incorporate both subjective patient reports and objective clinical indicators, recognizing the physiological and psychological impact of thirst. By implementing regular and systematic monitoring of thirst symptoms, nursing staff can more effectively identify patient needs and provide timely interventions, thereby reducing emotional distress and supporting optimal postoperative recovery.

Enhancing training and awareness of thirst care

This study found that although healthcare staff were aware of patients’ thirst-related discomfort, many patients reported that nursing staff did not promptly address or effectively manage their thirst symptoms. This highlights a gap in the identification and management of postoperative thirst. Compared to other postoperative complications, such as bleeding and pain, healthcare providers generally paid less attention to the severity of thirst in patients after surgery, particularly in the PACU[16,17].

Several factors may contribute to this issue. In clinical nursing practice, postoperative thirst is often regarded as a transient discomfort that does not pose a serious threat to life, leading to its neglect as a significant symptom. However, thirst symptoms are typically subtle and difficult to quantify, making it challenging for older patients to effectively communicate their needs. As a result, nursing staff may not always recognize thirst symptoms in older patients promptly or provide the necessary interventions to alleviate their discomfort. Previous studies have also shown that thirst is a common postoperative discomfort in the PACU[18] and is recognized as a major stressor immediately after surgery[19]. However, current perioperative nursing practices rarely involve actively inquiring about patients’ thirst symptoms, suggesting that thirst is not given sufficient attention as a postoperative concern[20].

The role of the nursing team in the care of surgical patients is crucial. It is important to enhance the training of nurses in managing thirst, particularly in recognizing and addressing postoperative thirst in older patients. In addition to improving nursing skills, managing postoperative thirst should involve a team-based approach that includes input from physicians, pharmacists, and psychologists. Physicians can adjust medication regimens according to patients’ specific conditions to minimize side effects that may contribute to thirst. Pharmacists can provide recommendations on medications to better manage thirst, while psychologists can assist patients in coping with postoperative anxiety. Through such interdisciplinary collaboration, postoperative thirst management can be addressed more comprehensively.

Developing effective intervention programs to alleviate thirst discomfort

This study also found that older patients had higher expectations for postoperative thirst management, despite some understanding the demanding workload of healthcare providers. Although existing nursing measures can alleviate dry mouth to some extent, their effectiveness in addressing intense thirst is limited, particularly in patients with swallowing difficulties or those in whom the effects of anesthesia have not yet fully worn off. A systematic review by Çelik et al[21] highlighted the use of ice chips and cold liquids as oral interventions to relieve postoperative thirst. A randomized controlled trial by Yang et al[1] recommended transcutaneous electrical nerve stimulation during recovery from anesthesia to reduce thirst-related discomfort. Additional evidence supports various interventions for managing postoperative thirst, including water, ice, menthol, carbohydrate- and protein-rich liquids, oral moisturizers, mouth rinses, cold gargles, wet gauze, 0.75% citric acid spray, and cold water[22]. Currently, interventions for postoperative thirst in the PACU focus mainly on reducing the intensity or discomfort of thirst. However, most methods are relatively simple and do not adequately address the frequency and duration of thirst. Furthermore, existing interventions lack a systematic and comprehensive approach and do not establish a structured nursing protocol. Therefore, integrating effective intervention strategies into a structured program is essential to improve postoperative thirst management in older patients undergoing general anesthesia for gastrointestinal surgery.

Addressing patients’ emotional needs and providing psychological support

In addition to physiological interventions, it is crucial to address patients’ emotional needs. Preoperative nursing education plays a vital role in supporting postoperative recovery. Following the principles of Enhanced Recovery After Surgery, preoperative education[23] helps patients mentally prepare for potential postoperative challenges, such as thirst. When patients are informed about the likelihood of experiencing thirst after surgery, their anxiety is reduced, and they are better equipped to manage the recovery process. This proactive approach not only alleviates anxiety but also facilitates timely nursing interventions, supports psychological adjustment, and enhances patient cooperation during recovery.

In this study, patients frequently reported that thirst not only affected their physical comfort but also exacerbated their anxiety and distress, particularly among those experiencing heightened psychological stress due to uncertainties in their recovery. Previous research has demonstrated an association between the duration of thirst and overall comfort and recovery outcomes[24]. Timely assessment and management of thirst are essential for minimizing patient discomfort. A randomized controlled trial by Conchon and Fonseca[25] found that perioperative patients often perceive thirst as a more intense form of distress than hunger and, in some cases, even more distressing than physical discomfort. Similarly, Lin et al[26] reported that unaddressed thirst can lead to negative emotional states, including anxiety, stress, and irritability. Psychological well-being is critical to postoperative recovery[27]. Emotional support and psychological interventions, particularly in the presence of postoperative discomfort, can significantly alleviate anxiety and distress, ultimately improving recovery outcomes[28].

Therefore, in addition to providing physiological care, healthcare providers must address patients’ emotional needs. When patients experience discomfort, nurses should take the initiative to offer support and reassurance to help reduce anxiety. Additionally, effective communication enables patients to gain a clearer understanding of their physical condition and recovery progress, which, in turn, fosters confidence and mitigates the negative emotions associated with thirst.

Strengths and limitations

This study employed a phenomenological design to investigate the multidimensional thirst experience and unmet needs of older patients undergoing gastrointestinal surgery under general anesthesia, particularly during their PACU stay. Semi-structured interviews were conducted within 2-6 hours of the postoperative period following patients’ return to the ward, capturing rich qualitative data on both biopsychosocial manifestations and emotional responses. These interviews provided valuable insights into the physical and psychological dimensions of recovery and patients’ specific needs. The findings highlight that postoperative thirst discomfort in older patients is a complex issue with multiple contributing factors. Future postoperative care should prioritize prompt thirst relief and improved communication between healthcare providers and patients. Enhancing patient education on recovery expectations may help alleviate anxiety and facilitate a smoother healing process.

This study has several limitations. First, the sample was drawn from a single tertiary hospital and included only 12 participants, limiting the generalizability of the findings. The small sample size may have restricted the representation of different subgroups. Future research should consider expanding the sample by incorporating data from multiple centers to improve representativeness and explore factors influencing the severity of thirst and postoperative complications. Second, interviews were conducted 2-6 hours after the patients’ return to the ward, potentially introducing recall bias regarding PACU experiences. Patients’ emotional states and memory distortions may have affected the accuracy of symptom recollection. Future studies should integrate quantitative methods to provide a more comprehensive evaluation of the physiological and emotional effects of postoperative thirst discomfort. Additionally, this study primarily focused on the early postoperative phase without assessing changes in thirst perception over a longer recovery period or the long-term effects of nursing interventions. Given that older patients often experience slower recovery with considerable variability in recovery timelines, future research should incorporate longitudinal studies to track the evolution of thirst experiences at different postoperative stages. This would provide a more comprehensive understanding of how thirst progresses throughout recovery.

CONCLUSION

This study employed a qualitative approach to explore the experiences and needs of older patients following gastrointestinal surgery under general anesthesia, with a focus on postoperative thirst discomfort in the PACU. The findings indicate that patients generally experience intense thirst, which is often not promptly alleviated and is accompanied by heightened anxiety and distress. Although patients acknowledge the efforts of healthcare providers, current nursing interventions do not fully address thirst, particularly in terms of emotional support and personalized care, where significant gaps remain. Future research should explore the clinical effects of combining traditional Chinese and Western medicine interventions and establish a comprehensive postoperative management pathway based on a multidisciplinary approach. Through standardized assessments, graded interventions, and dynamic adjustments, this approach aims to systematically enhance the postoperative experience of older patients.