Figure 1:

Four interconnected themes were identified by participants. Participants reported several individual-level effects of delaying surgery during the COVID-19 pandemic, including the impact on family and friends, their mental health, their physical health and work. The individual-level subthemes were interrelated (e.g., the impact on family and friends exacerbated the impact on participants’ mental health). Similarly, there were system-level factors, including communication, accountability and responsibility, and health care provider and health care resources that mediated the individual-level impacts. Uncertainty was a cloud that hung over all of the individual-and system-level impacts. Similarly, the COVID-19 pandemic introduced several unique factors that touched many of the themes and subthemes.