Abstract
COVID-19 global pandemic has had a profound impact on the quality of life and mental state of the community. The aim of the study was the preliminary assessment of social isolation on individual mental state due to SARS-CoV-2 pandemic. A detailed online questionnaire was conducted in the period from March 2020 to March 2021 among 587 persons from Poland. Most respondents (46.2%) expect a professional psychological support. This is followed by expectations of psychoeducation (37%) and understanding (34.4%). During the pandemic, most people deal with stress by watching TV series It is a form of escape into a different reality. Obtained results demonstrate that place of residence does not corelate with fear of coronavirus. Statistically significant differences occurred when answers regarding aspects of living during pandemic were checked against gender of respondents. Women experience pandemic-related anxiety more severely than men. This research highlights that psychological care should be part of the wider health care system in the time of crisis.
Introduction
In the first quarter of year 2020, WHO declared that the spread of SARS-CoV-2 pathogen should be categorized as pandemic (WHO says, 2020). This outbreak has had a global impact on the contemporary way of life. Each day brings new information regarding Covid-19 pandemic. We receive separate data for death cases where coronavirus was a direct cause as well as for people who died from other illnesses while being infected with SARS-CoV-2.
From psychological context, increase in helplessness, fear, and uncertainty regarding future has significant impact over individuals and social groups. Deterioration of psychological wellbeing is expected to be one of the long-term Covid-19 effects, especially felt by lone and elderly people. It will be exacerbated by limited access to health professionals. According to study by Huang et al. (2020), the progression of illness can vary. Patients can range from asymptomatic, mild symptoms to acute respiratory distress syndrome (“ARDS”). A steep increase of confirmed cases internationally has led to government-imposed restrictions and physical distancing which had social and economic repercussions. Studies emphasize the importance of in-person human interactions in maintaining emotional and psychological equilibrium (Kmietowicz, 2020; Xiao, 2020). Reflecting at the life of an individual—the situation in question has impacted multiple areas of life: personal, professional, and relationships. Our everyday activity has been adversely affected. The way in which we used to be looking after ourselves is no longer available (Ćosić et al., 2020). Emotions that are common during this time such as fatigue, anger, frustration, fear, apathy, discouragement, feeling of guilt and remorse and notion of not being in control of my own life can lead to changes in mental condition (Sønderskov et al., 2020). Quarantine may evoke a state of solitude and anger according to Xiang et al. (2020). Lack of face to face interactions is described as a stress factor in the study made by Zhai et al. (2020). The effect on individual’s physical and mental condition during other historical outbreaks has been confirmed in comparative studies (Lee et al., 2007; Lee et al., 2018). Current research (Qiu et al., 2020; Zandifar, & Badrfam, 2020; Moghanibashi-Mansourieh, 2020) explicitly demonstrates that COVID-19 global pandemic has a profound impact on the quality of life and our mental state.
When we think about mourning, we usually associate it with a physical death of a person close to us. Covid-19 pandemic lets us experience difficult emotions related to the loss of things that we considered certain: safety, freedom, money, etc. A concept of ambiguous loss by Pauline Boss helps us understand this process. It is a situation in which a loss is not entirely clear. There is no conclusion or closure. It may have a physical side (e.g., kidnapping) and psychological side (e.g., when we provide care for a relative suffering from dementia). Ambiguous loss lets us experience emotional split so intense that finding a meaning becomes an enormous challenge. (Boss et al., 2016). Pauline Boss uses her concept to explain emotions experienced during Covid-19 such as uncertainty, desperation, anger, etc. She underlines that our loss is hard to clarify, vague and in the psychological sense can be tracker to lack of trust to the world (as a safe place), to healthcare, children education, and employment. Covid-19 is to affect the process of experiencing ambiguous loss as well as recovery afterward. (https://news.cehd.umn.edu/covid-19-dr-boss-offers-advice-to-ease-anxiety/)
Current pandemic sees the rise of a concept of anticipatory loss. We experience the world changing; however, we are not able to predict how it will end. This uncertainty brings fear of things to come. It is being compared to fear of death. If a person is diagnosed with a serious illness, then our grief is anticipated. (Bouchal, Rallison, Moules, & Sinclair, 2015; Rando, 2000)
Covid-19 changed our perspective in many ways. Personal sense of security has been threatened and many expect more loss in the future.
It is emphasized that psychological care should be part of the wider health care system in the time of crisis (Zhou et al., 2019).
Aim
The aim of the study was to examine people’s reactions to the announcement of a pandemic situation and related restrictions. It was assumed that the perception of the situation will be very individual for each person and the realization of a given situation will stretch in time. The most important was to find out which of the examined factors is declared by the group as differentiating.
Study Group and Methods
The aim of the study was a randomly selected group—it was not assumed that a specific (in some respect) population would be selected. On the other hand, it was noticed that the respondents were mostly women, mostly people related to the profession related to the health service.
Taking into account the size of the group, it was noted that these may be factors that have a significant impact in emergency situations. The first significant factor was the fact that the questionnaire was completed voluntarily.
This speaks for the need for cooperation and the willingness to share your views on the issue under study. The research of the Public Opinion Research Center ISDN 2353-5822 No. 131/2021 shows that the public mood has clearly deteriorated.
There were declines in the assessments of forecasts relating to all dimensions of the situation in the country as well as one’s own situation.
However, these are sociological studies confirming certain trends in the behavior of women (gender) and professions (social sensitivity).
This proves the need for cooperation and the willingness to share your views on the issue under study.
When using the questionnaire, we paid special attention to the clarity of the questions asked, being sure that they were definitively understandable for the respondents. Therefore, in question 27 (What do I expect from a psychologist), he categorized them in terms of expectations: support, understanding, psychoeducation. This forces the respondent to specify what he expects. It helps the psychologist in which direction the help is to be carried out.
Our research (Expectations from physiotherapist and sense of well-being of palliative care patients. Paliatywna w Praktyce 2017; 11,1,8–16, Via Medica, ISSN1898-0678) showed that gender and age have an impact on type of assistance expected.
A detailed online questionnaire was conducted in Poland. The survey was anonymous and voluntary. It was conducted in the period from March 2020 to March 2021. Due to COVID-19 restrictions and social distancing, it was made available online. In total, 587 persons (100%) were questioned and divided into sub-groups of 432 women (73.6%) and 155 men (26.4%) (Figure 1). The group consisted of people from Poland. Participants’ age and place of residence is taken into consideration to demonstrate group’s diversity. The change in behavioral patterns due to quarantine and pandemic is included. A correlation was assumed between emotional response due to pandemic and gender/profession/place of residence. Study group size.
Figure 2 depicts age composition of the study group. Most respondents are between 20 and 30 years of age (46%) and fewest (0.005%) are aged 70 and over. Age composition.
66.3% of respondents reside in cities as shown in Figure 3. Place of residence.
33.7% of respondents work as medical professionals as shown in Figure 4. Medical professionals as part of the study group.
49.7% of respondents have sedentary type of occupation followed by 46% declaring their work as performed “in motion” as shown in Figure 5. Type of work.
47.5% of respondents work remotely followed by 27.3% which still go to the office. 4.4% of the answers point to a forced unemployment as shown in Figure 6. Employment during the pandemic.
Summary of answers.
Figure 7 demonstrates that most participants expect professional support (46.2%) from psychologists followed by psychoeducation (37%) and understanding (34.4%). It was a multiple-choice question, so the total sum of answers is bigger than 100%. Expectations toward psychologists.
While it was possible to choose multiple answers regarding ways of dealing with stress some chose no answer at all (Figure 8). During pandemic, most people watch TV series (35.6%), followed by listening to music (33.4%) and chatting with friends remotely (32.4%). Ways of managing stress during the pandemic.
Statistical Analysis
Tested statistics and relevant p-values.
Chi-Squared Test Results
Bolded cells in Table 2 represent a situation in which an alternative hypothesis was chosen. It is noticeable that gender is statistically significant for seven questions from Table 1. Place of residence (town or city) corelates with emotion of tiredness due to inability to visit cinema, park; and with the fear of infection. Medical or non-medical profession is statistically significant for seven questions from Table 1.
Upset vs gender. Upset vs medical profession.
Sadness vs gender.
Uncertainty vs gender. Uncertainty vs medical profession.
Inability to go outside vs medical profession.
Inability to interact socially vs gender. Inability to interact socially vs medical profession.
Inability to go to the cinema/park vs place of residence.
Adhering to restrictions vs medical profession.
Feeling unsafe vs gender.
Fear of infection vs gender. Fear of infection vs place of residence.
Ability to satisfy the need for medicines, food, etc. vs medical profession.
As shown by Table 12, non-medical professionals in general are more affected by loneliness due to home confinement than medical professionals (answers “4” and “5” accounted for 30.8% and 18.7% of cases, respectively).
Home confinement vs medical profession.
Fear of current situation vs gender.
Discussion
SARS-CoV-2 global pandemic forced community to re-evaluate the contemporary way of life. In a very short period of time, society was forced to adapt to a new normal. On the whole, we were deprived of the relative stability and the feeling of control regarding multiple aspects of our life was lost.
Over half of female respondents point to anxiety as related to global pandemic and one third selected “5-YES” when questioned if they experience sadness during this time. Studies among Brazilian community demonstrated that the emotion of sadness was experienced by 40% of adult population which was compounded by emotions of anxiety and upset reported by over half of respondents (Barros et al., 2020). Satici et al. (2020) demonstrated a statistically significant correlation between the fear of COVID-19 and depression, anxiety, and stress.
Almost half of the respondents in this study report fatigue related to lack of face-to-face contacts. Morgul et al. (2020) argue that experiencing fatigue can have adverse effect over psychological wellbeing and prolonged exposure might be associated with mental disorders such as depression.
The study shows that women feel more uncertain than men in the current pandemic situation. The research conducted by Babicki and Mastalerz-Migas(2020) analyzed results obtained from 2457 respondents and concluded that COVID-19 pandemic elevated anxiety, stress, and fear about the future. Babicki emphasizes the need to provide psychological support. Authors identified economic uncertainty and social restrictions as main stress factors.
The current pandemic situation is a new experience and big change for a modern society. This study confirms elevated levels of sadness, anxiety, and uncertainty which may require professional support. Jakovljevic et al. (2020) argue that every such change necessitates gradual adaptation. Next to psychological support, Matias et al. (2020) point to benefits which can be derived from physical activity in improving physical and mental health of a society. Half of the respondents to this study expect professional psychological support followed by one third who would require some kind of psychoeducation. Both forms of assistance play a vital role in potential short and long-term psychological implications. Razai et al. (2020) suggest that detrimental effect of SARS-CoV-2 on individual mental condition can be felt several months after restrictions are removed. The conclusion is based on lessons learnt from SARS (“Severe Acute Respiratory Syndrome”) pandemic from the year 2003. Subjects reported symptoms such as avoiding public and crowded spaces compounded by fear several weeks after the crisis has ended (Reynolds et al., 2008). Yip et al. (2010) observed a 30% increase in suicide attempts among population aged over 65. Half of those who recovered demonstrated symptoms of increased anxiety. That is consistent with studies conducted during 1918–1919 influenza pandemic in the United States (Wasserman, 1992).
SARS-CoV-2 global pandemic has a profound effect on human emotions and behavior. Studies show that unsatisfied needs of people experiencing loss and grief can lead to deterioration of health condition. Scientists suggest that psychological support during Covid-19 should be based on understanding the pandemic from the perspective of loss and grief. This approach should promote better adaptation and mental wellbeing. (Zhai, & Du, 2020)
To stop the spread of the virus, governments around the world have imposed more or less restrictive isolation measures. If confinement and social isolation have been quite effective in terms of physical containment, mental health seems to have been undermined by the emergence of feelings such as uncertainty, fear, and despair. It is likely that in the near future, mental health professionals will be called upon to confront a “parallel pandemic” of acute stress disorder, post-traumatic stress disorder, emotional disorders, sleep disorders, depressive syndromes, and ultimately suicide. (Mucci et al., 2020)
A longitudinal study (Kikuchi et al., 2020) was designed to examine changes in psychological distress of the general public from the early stages to the community transmission phase of the COVID-19 pandemic and to investigate factors associated with these changes.
To examine the relative impact of fear of COVID-19 on nurses’ psychological condition, job satisfaction, and intentions to leave the organization and profession was studied by Labrague and de los Santos (2020). The dimensions of the study showed that increased levels of fear of COVID-19 were associated with decreased job satisfaction, increased psychological distress, and increased intentions for organizational and professional turnover.
Articles on women’s mental health and COVID-19 until May 30, 2020 were searched in the electronic databases of PubMed (Almeida et al., 2020).
The impact of a pandemic on women’s mental health, and strategies to prevent and treat these mental health effects in the female population at certain stages throughout their lives.
Outcomes: Women who experience partner violence are particularly at risk of developing mental health problems during a pandemic. Proactively reaching out to these groups of women can lead to prevention, early detection, and rapid intervention.
Social support is a key protective factor. It can be improved through online contact—for example, Safe Messaging with clinicians, telemedicine visits, online support groups, on-line doula support. Gender gaps may worsen as women are overburdened with most household tasks, including caring for children and the elderly.
Another study found (Lum & Simpson, 2021) that women’s physical activity can improve the quality of life of British women aged 45–55 during the developing Covid pandemic. Participants who encountered PAG experienced fewer depressive symptoms and perceived stress, and had better physical and mental health and quality of life than women who did not participate in the study. The physical and mental health benefits and the support of friends were factors that motivated women to exercise during Covid blockade.
The purpose of the study (Li et al., 2021) was to assess pandemic outbreak-related psychological stress and symptoms of acute stress reaction (ASR) in health care students and to characterize them regarding: whether they potentially require intervention. Participants were assessed for reported childhood difficulties, stressful life events, Internet addiction, and family functioning. Good family functioning was associated with reduced risk of distress (OR 0.43, 95% CI 0.33–0.55) and likely ASR (OR 0.48, 95% CI 0.33–0.69). All associations were independent of baseline psychological stress. Results from this study showed that COVID-19-related psychological stress and high ASR symptom burden are common among health students. In these unprecedented times, consider extended family and professional support for those in distress.
The study by Giorgi et al. (2020) included the analysis of 35 articles. Mental problems associated with health emergencies, such as anxiety, depression, post-traumatic stress disorder (PTSD), and sleep disorders, are more likely to affect health care workers, especially those on the front line and those in contact with the community . Job insecurity, long periods of isolation, and uncertainty about the future worsen mental health, especially in younger and more educated people. Much can be helped by improving workplace infrastructure, adopting appropriate and common measures to prevent contagion, including regular provision of personal protective equipment (PPE) and implementing resilience training programmes. This review provides a basis for better understanding workers’ psychological conditions during a pandemic, integrating individual and societal perspectives, and providing insight into possible individual, societal, and occupational approaches to this “psychological pandemic.”
A meta-analysis of data on the consequences of illness was conducted by Lopez-Leon et al. (2021). In addition to purely somatic symptoms, they reported: memory problems, sleep disturbances, and psychiatric disorders: depression, mood disorders, constant worry, insomnia, chronic headaches, chronic fatigue syndrome, post-traumatic stress disorder (PTSD).
Cross-cultural studies were also analyzed and included in the work of Obschonka et al. (2021) paying attention to regional, cultural, economic, and ecological contexts. In the conditions of the country in which the research was carried out, the domestic situation and the lack of opportunities for freedom played a huge role, and therefore the restrictions on contacts with people were perceived as the most threatening.
Conclusions
From psychological standpoint, increase in helplessness, fear, and uncertainty regarding the future have a profound impact over individuals and social groups. Most respondents to this survey (46.2%) expect a professional psychological support. This is followed by expectations of psychoeducation (37%) and understanding (34.4%). It is worth noting that the study was conducted during global pandemic. Taking into consideration that almost half of the respondents selected the need of psychological care, it is logical to speculate that this percentage will increase in the future. It is accompanied by the observation that females in general experience fear of pandemic to a higher degree than males (answer “5” was selected by 19% and 5% of respondents, respectively). All of this validates the necessity to pay particular interest to psychological well-being in longer term. During the pandemic, most people deal with stress by watching TV series (35, 6%), followed by listening to music (33.4%) and chatting with friends remotely (32.4%). Statistically significant differences occurred when answers regarding aspects of living during pandemic were checked against the profession of respondents. Non-medical professionals in general experienced uncertainty to a greater degree than medical professionals (answers “4” and “5” were chosen by 63.2% and 51% of respondents, respectively). As much as 18.3% of women chose “5-Yes” to the question whether they experience sadness during pandemic, the same answer was chosen only by 9.7% of men. This study recognizes the need of psychological support for the individual and the group. Its availability will have a direct effect in lowering levels of sadness, uncertainty and will result in improved psychological wellbeing. It is worth considering future research regarding evaluation of psychological support and its effectiveness during and after global pandemic. Our research shows that in a randomly selected group, the majority were women at large percentage health care workers.
It is influenced by socio-economic conditions, which, despite the severe pandemic situation, motivate to action and increase the level of subjective perception of threat. Women are more focused on providing help and dominate the population of medical personnel.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
