Quotations representing the theme of individual-level impacts
| Subtheme | Descriptive codes | Exemplar quotations |
|---|---|---|
| Physical health | Pain Discomfort Quality of life Worry | “ … but you can see the pain on her face when she sits at the table, or whatever, and now she spends as much time lying in bed off her legs and her hip.” [Participant 7A] “So, this delay, basically I’m afraid I can have a heart attack or stroke, at any time. So, it’s been very stressful on me and my [spouse] as well.” [Participant 6] “It seems like I’m getting … my breath is getting shorter. I get tired quicker it seems.” [Participant 6] “This wasn’t like you know, a health life-saving surgery so it’s been, it was fine. Like my fibro [fibromyalgia] probably got worse because of stress.” [Participant 3] “… it’s pretty hard for the ones that are waiting like myself included, it, yeah, kind of, it would be nice to get done because everyday pain; I mean a lot of pain.” [Participant 7B] “I’m now on pain medication every day. Yep. At the moment, I don’t do a whole lot because it hurts too much.” [Participant 15] “I mean, the obvious [impact] is the continued pain. So, what I’m sort of dealing with on a sort of weekly basis is, I’m not sure what causes it, but I’ll get a sharp onset of pain in my abdomen just below my ribs … So, it makes it hard and painful to inhale deeply. So, I find myself short of breath even in with simple tasks like climbing a flight of stairs.” [Participant 14] |
| Mental health | Depression Anxiety Worry Frustration Anger Independence Isolation Uncertainty | “It’s been a challenge more from the mental health side of things.” [Participant 1] “It’s been a lot of mental strain, because I know the extra is going to be put on the people at work. And my limited activity at home and just the mental stress of having surgery, period. And then the ups and downs of watching the news to see how bad it’s getting, and if it might get cancelled. And then the relief of having a surgery date, and then the immediate crushing that it was cancelled. So, it’s been an extremely emotional toll on me.” [Participant 9] “I mean, just kind of, like, bummed me out. I’ve got body dysphoria; so having boobs was just lousy.” [Participant 3] “In August I had a panic attack … and talked to the doctor there and anyway, since that time I’ve been extremely; I have been quite calm OK … And then they cancel my surgery so that stress level went up again.” [Participant 6] “… and again, like I know for me, like, it’s not so much of an impact in a physical sense, so, like, in that case, no. But, again, the emotional toll makes me sometimes not want to do anything.” [Participant 9] “And we were able to stop and control the prolapse but every day waiting for that flap surgery, and every day waiting for the reversal. I held my breath that my intestine would not truly fall out of my body.” [Participant 11] “So, there’s kind of the stress over that, the stress over wondering if I do have to delay till April. Obviously, there’s a risk that a gallstone can get stuck and cause a lot worse problems. So, there’s that stress.” [Participant 14] “So this delay, basically I’m afraid I can have a heart attack or stroke, at any time. So, it’s been very stressful on me and my wife as well.” [Participant 6] “I did contact my surgeon’s office to find out how much notice I would get ahead of when the surgery was rebooked, because I have arthritis that’s autoimmune. And so of course, when your stress levels go up, the arthritis tends to flare.” [Participant 14] “You worry all the time. You worry about what could happen, what might happen, why it isn’t happening. So, there’s a lot of depression and anxiety involved.” [Participant 12] “I’m going to be diagnosed with depression and I think it was ultimately a result of the delay because you’re so excited you’re counting down the days and then, like I said, just to be told a week before that after you’ve been waiting for so long that it’s not happening, and you don’t know when it’s happening, like, that loss of control and all of those unknowns … Just, like, on a mental health toll it’s impacted my day to day, and wanting to make plans.” [Participant 10] “I think the biggest reason why I wanted to participate is; just again, it’s that emotional toll that it takes on people on a daily basis and I have to assume that the government thought about that, but perhaps they don’t realize the actual toll that it takes on all of these other people’s lives …” [Participant 9] |
| Family and friends | Isolation Independence Burden | “But it tells you, it shows you the stress. That my constant surgeries and the postponement because of COVID. That my child could see how crucial this was. A teenager. Interviewer: Yeah, it impacts the entire family? Oh, to just an extreme.” [Participant 11] “So he [participant’s father] ended up just, like, rejigging his schedule; looks like he’ll take a different day of work, whenever this actually happens. So, it was just, like, very stressful for a lot of people who had kind of, like, tried to reorganize their life around me.” [Participant 3] “At this point, my son, this is what I really want to stress, this wasn’t just me. I have a 16 [year-old son]. He’s a competitive athlete … and he made the choice to pull out of his training, even COVID-safe because at this point, we’re 2 weeks before my surgery and if anyone’s exposed to COVID I’m not going. So, my whole house shut down. We isolated and shut down completely. So, when you talk about socialization it wasn’t just mine, I had a teenager and a home that it affected.” [Participant 11] “Socialization and relationships that didn’t really … well … apart from in my marriage, I guess. I don’t know if fibroids, if they were affecting my hormone levels. But I did decrease my libido so probably had an impact on my marriage as I was waiting. Not, I don’t know how you think it’s not something you could quantify but that’s just a sense that I got a change that I sensed in myself.” [Participant 4] “Like I’m fortunate, I have a really good husband at home, but I’ve definitely had to rely on him more like even some days it’s hard to want to make dinner, for example, just because it’s so emotionally tolling. So yeah, he’s definitely had to step up, and I’ve definitely relied on friends and family, a lot more, and just talking about everything and more detail, sometimes I feel like a broken record.” [Participant 9] |
| Work | Income Responsibility Identity Burden Insecurity | “I also have to worry about where is my income coming in, I have to make sure that my mortgage is paid, my bills are paid and I can’t be irresponsible because I don’t want to suffer. I don’t want to suffer due to the fact that COVID and the lack of surgeries and what’s happening is going to affect me in the future, because it will.” [Participant 10] “I have to miss more work because I’m now going to massage therapy once a week and for deep tissue and then physiotherapy. I’m still on modified work duty for my last failed surgery of this. So that continues my work doesn’t know exactly when I’m going to be gone now.” [Participant 15] “My job is quite physical, lifting relatively heavy things. So I’ve had to ask for others’ help with those types of tasks, which is another mental health thing because I don’t like imposing on other people, and I don’t like feeling incompetent.” [Participant 14] “For me, how it affected me was I couldn’t go back to work. I was waiting, like, because of the surgeries I wasn’t well enough. I was constantly waiting. Like for all care, even just support when you have a new appliance, COVID, it affects all of that. When you can’t go into proper clinics, when you know there’s just, it just affected every element. And at this point now, I find myself not employed, because at some point your employers have to move on.” [Participant 11] “Fortunately, I’m able to work from home most days and so when I’m not feeling well, I can kind of step away for my, for my work and just, kind of, focus on me for a bit.” [Participant 9] “I haven’t been able to work as well, which is another factor … I’m going to lose business because of this.” [Participant 9] |
| Quality of life | Physical health Mental health | “For that, so, from a health perspective it’s been pretty extreme, the delays. Right and you remember within those time periods. When you’re having surgeries that rely upon one successful completion to move to that next stage, to try and move you through … those periods, it affects your nutrition, it affects your sleep, it affects every aspect of your life.” [Participant 11] “I think there’s a line, of course, between life and death. And then there’s a line between a quality of life, where a person is still affected daily. And I think that is just as important as the life and death.” [Participant 12] “But I did decrease my libido so probably had an impact on my marriage as I was waiting. Not, I don’t know how you think it’s not something you could quantify but that’s just a sense that I got a change that I sensed in myself. So that was difficult.” [Participant 4] “I mean I’m functioning, but I spend a lot of time on the couch, right.” [Participant 6] “I have been, I’m not myself by no means. I used to be very active. I’m not as reliable as I once was; I’m cancelling on things constantly because either a) I’ve lost my voice, b) I’m in so much pain I can’t lift anything.” [Participant 10] “Yeah. It’s not urgent, it’s not life threatening. It’s just, it’s quality of life. It really just impacts me at the moment.” [Participant 15] |