Exploring how patients await scheduled surgery: Implications for quality of life

Abstract

In this thesis, I explored the relationship between patient experience of wait time for consultation and scheduled surgery, type of illness (orthopaedic or cardiac), and descriptions of time using qualitative methodology. Thirty two patients awaiting orthopaedic or cardiac surgery were recruited by surgeons in Saskatoon, Saskatchewan during the period of September 2009 to November 2010. Those patients awaiting orthopaedic surgery were interviewed when the decision to treat was made and again at the midpoint of their waiting period. Cardiac surgery patients were interviewed after their angiography and consent to surgery, and again the day prior to surgery. Patients were asked about their perceptions of time while waiting, maximum acceptable wait time for consultation and surgery, and the effects of waiting. Interpretative phenomenology (1) was the method and data were analysed using interpretative phenomenological analysis.Participant suffering, the meaningfulness given to the experience, and the agency participants felt they had over the waiting period determined the lived duration of time experience. Participants considered pain, mobility restriction, disease progression and lethality of condition to be the primary determinants of wait time maximums. Waiting effects included restriction, uncertainty, resignation, coping with waiting, and opportunity. Few subtle differences between groups emerged indicating other variables may be more relevant to the quality of waiting experience. Participant suggestions for improving experience consisted of managing patient conditions and navigating the system. The findings suggest uncertainty in illness impacts the quality of wait time experience. The study denotes the experience of waiting for scheduled surgery is complex and not necessarily a linear relationship between greater symptom severity and less tolerance for wait time.