Examining the effects of the COVID-19 pandemic on life through interviews conducted by nursing students: a qualitative study

Abstract

This study was aimed to determine the effects of the pandemic on life. This is a qualitative descriptive study and data were collected through semi-structured interviews (n = 200). The data were obtained by retrospectively examining the interviews made by the students between January and May 2021. The researchers prepared ‘Participant Information Form’ and ‘Semi-Structured Interview Form’, which were utilised as data collection tools during the interviews. The qualitative data acquired from the semi-structured interview using descriptive analysis. In the interviews, nursing students are in the role of interviewers. Participants were determined from among the relatives of the students. The research was structured and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research Checklist. The data acquired regarding the effects of the pandemic on life were conceptualised under three themes (nine sub-themes): the meaning of the pandemic(1), the effects of the pandemic on life(2), and coping with the pandemic(3). The study revealed that the pandemic included individual meanings at levels of emotions (fear, hopelessness, loneliness, despair, and uncertainty) and cognition - behaviour (danger, attention-caution, restriction and awareness).Pandemic resulted in changes in the life routines of the participants, changes in mental and social spheres, and various effects as the effect of the disease such as pain.Spiritual approaches (prayer and positive thinking), as well as social support and healthy lifestyle habits, were the methods used to cope with the pandemic. It is recommended that psychiatric nurses plan and implement individual/social interventions based on a psychosocial approach in order to cope with the short and long-term effects of the pandemic.

Supplementary information

The online version contains supplementary material available at 10.1007/s12144-023-04522-3.

The coronavirus, which broke out in Wuhan city, China and showed its effect all over the world, has turned into a pandemic that threatens human health (Catton, 2020). The perceived effect of the pandemic on daily life manifests itself not only as physiological problems and the risk of death, but also socially and psychologically. Additionally, the COVID-19 pandemic, which is perceived as an important threat to issues such as health and economy, has affected the flow of life by causing changes in the daily life behaviours of individuals with the social distancing rules, interruption of education, social isolation, quarantine rules, and working from home (Brooks et al., 2020; Cao et al., 2020; Di Giuseppe et al., 2020; Mukhtar, 2020). The lifestyle (ineffective weight control, insufficient physical activity, etc.) and psychosocial areas (anxiety, decrease in social support, depression, stigma, etc.) changes caused by the pandemic have been deeply felt worldwide (Brooks et al., 2020; Cao et al., 2020; Mukhtar, 2020).

During the pandemic, the change in living conditions has adversely affected the quality of life (Tunç et al., 2020). The World Health Organisation (WHO) defines quality of life as “the standard of life perceived by an individual in line with the values, expectations, culture, and life goal” (WHOQOL Group, 1994). In the literature, it is stated that the pandemic can bring psychologically along negative results such as weight gain, unhealthy nutrition, obesity, health anxiety, poor sleep quality, economic uncertainty, loneliness (Cao et al., 2020; Duran & Erkin, 2021; Nguyen et al., 2020; Pellegrini et al., 2020), depression, anxiety, anger, and attention difficulties as a result of the changing living conditions (Park & ​​Park, 2020). In addition, it has been reported that the majority of the society will possibly experience intense emotional adaptation reactions such as social isolation effects, fear of infection and deaths of relatives in the long term due to the pandemic (Inchausti et al., 2020; Shah et al., 2020). It has been determined that health problems such as hypertension, obesity, diabetes, constipation, cardiovascular diseases, metabolic problems, osteoporosis and balance problems as well as physical inactivity have increased during the pandemic (Ensrud et al., 2014; Fletcher et al., 2018; Jiménez-Pavón et al., 2020; Tural, 2020). In terms of the effect of the pandemic on mental health in young individuals, it is seen that the pandemic has increased the susceptibility to psychological problems and causes post-traumatic stress disorder (Liang et al., 2020). In another study, the most common problems in terms of changes in mood and behaviour during the quarantine were difficulties in concentration (76.6%), distress (52%), irritability (39%), restlessness (38.8%), irritability (38%), feeling of loneliness (31.3%), and anxiety (30.1%) (Orgilés et al., 2020). Moreover, uncertainty, fear and panic about the pandemic lead individuals who have had COVID-19 disease and their families to experience stigma and social exclusion, resulting in conditions such as adjustment disorder and depression (Zhang et al., 2020).

Purpose and questions of the research

The aim of the study is to examine the effects of the COVID-19 pandemic on life.

• How is the COVID-19 pandemic process defined?

• How does the COVID-19 pandemic affect life?

• What are the methods of coping with the COVID-19 pandemic?

Methods

Design

This research was carried out as a descriptive qualitative study.

Population and sample of the research

The population of the study consisted of N = 245 interviews. The fourth-year students who took the Mental Health and Psychiatric Nursing course through distance education in the Nursing Department of the Faculty of Health Sciences of the state university are in the role of interviewers in the research. Within the scope of the course, the students were expected to hold an interview about “the effects of the COVID-19 pandemic on life” as a practice skill homework. Each student was expected to conduct a single interview with one participant. The students determined the participant they would interview from their family, close circle or people they were in contact with. The inclusion criteria were that the interviewee and the student gave consent about the use of the interview for research purposes, the interviewee was over the age of 18. The exclusion criteria were that the interviewee had problems in speaking/understanding Turkish, had a history of mental disorder, and had received or was receiving psychological counselling. A total of 245 interview reports including one for each of the students enrolled in the course were submitted. It was determined that 21 of the participants had a diagnosis of mental disorder and 24 of them received psychological counseling or psychotherapy. Therefore, 45 interviews were excluded from the study.Within the scope of the research, n = 200 interviews that met the inclusion criteria were included in the qualitative analysis. The interviews (n = 200) analysed in the study were held face-to-face (n = 155; 77.5%), online (n = 37; 18.5%) or by phone (n = 8; 4.0%). The average interview duration was determined as 41.38 ± 18.25 min.

Descriptive characteristics of the participants

The average age of the participants was 30.54 ± 12.45. Generally, 64.0% of them were female, 66.0% were single, and 38.5% were employed. 73.5% of the participants evaluated their financial situation as moderate. 50.0% were living in the Central Anatolia region, 60.0% were living in the city centre and 77.5% were living with their nuclear family. Also, 18.5% of the participants had a chronic disease and 70.3% of those with chronic diseases were taking drugs (Table 1).

Table 1.

Descriptive characteristics of the participants (n = 200)

Variables	n	%
Age
Mean ± SD = 30.54 ± 12.45 (min.=18.0; max.=76.0)
Gender
Female	128	64.0
Male	72	36.0
Marital Status
Single	132	66.0
Married	68	34.0
Working status
Working	77	38.5
Not working*	51	26.0
Retired	10	5.0
Student	58	29.0
Seasonal worker	3	1.5
Economic situation assessment
Good	45	22.5
Moderate	147	73.5
Poor	8	4.0
Geographical area
The Mediterrenian Region	26	13.0
The Eastern Anatolia Region	16	8.0
The Aegean Region	8	4.0
The Southeastern Anatolia Region	11	5.5
The Central Anatolia Region	100	50.0
The Black Sea Region	22	11.0
The Marmara Region	17	8.5
Characteristics of the place of residence
City center	120	60.0
Country	63	31.5
Rural	17	8.5
People living with
Lonely	16	8.0
Nuclear family (Mother, father, sibling, spouse, children)	155	77.5
Extended family	12	6.0
Other (with friends; at dormitory)	9	4.5
Grandpa and Grandma	8	4
Presence of a chronic disease
Yes	37	18.5
No	163	81.5
Status of using medication for chronic disease**
Yes	26	70.3
No	11	29.7

*Unemployed due to COVID-19 n = 3 (1.5%); **Percentages are calculated over folded n

When the COVID-19-related characteristics of the participants were evaluated, it was determined that 48.5% of them did not experience any symptoms of the disease, and 26.5% completed their treatment with a positive diagnosis of COVID-19. In addition, 67.5% of the participants knew someone diagnosed with COVID-19 but were not in contact. 5.5% of the participants lost someone they knew due to COVID-19, and the deceased (66.6%) was a second-degree relative (grandmother, aunt, aunt-in-law, relative) (Table 2).

Table 2.

Characteristics of the participants regarding COVID-19 (n = 200)

Features	n	%
COVID-19 disease status
Yes, I had a test and the result was positive, my treatment is over.	53	26.5
Yes, I had a test and my result was positive, my treatment continues.	6	3.0
Yes, I doubt it, but it has not been confirmed by a test.	14	7.0
No, I had a test and the result was negative.	30	15.0
No, I did not experience any signs of illness.	97	48.5
The state of knowing someone who has or is suffering from COVID-19 disease
Yes, I know, she/he had a test and it was positive, we live together	38	19.0
Yes, I know, she/he had a test, it was positive, I’m in contact	4	2.0
Yes I know, she/he had a test and it was positive, but I am not in contact.	135	67.5
Yes, I know, she/he died due to COVID-19.	12	6
No, no one around me has had COVID-19.	11	5.5
Closeness of person registered due to COVID-19*
First degree relative (mother, sibling)	2	16.7
Second degree relative (grandmother, aunt, aunt, relative)	8	66.6
Familiar (Co-worker, neighbor, friend’s father)	2	16.7

*Percentages are calculated over folded n

Data collection

The purpose of the interviews conducted in the research is “The effects of the COVID-19 pandemic on life”. In line with the determined purpose, it was planned for the students to conduct semi-structured interviews within the framework of basic questions. Students from seven regions of the country had face-to-face or online interviews with family members or relatives they were in contact with. The interviewee does not have to have or have had COVID-19 or know someone who has COVID-19. However, if the interviewee was followed up with a diagnosis of COVID-19 or was in contact, the student was expected to conduct the interview online. Before the interviews were held, the students were given theoretical lessons on creating a therapeutic environment, interview principles and helping skills used in the interview. Students were informed about how to conduct the interview using the Participant Information Form and the Semi-Structured Interview Form prepared by the researchers, who are instructors. The fact that the students received the same theoretical training before the interview and that they used the semi-structured interview form created by the researchers in the interview ensured that the differences between the interviewers were limited. Written informed consent was obtained from the students for the use of their homework (interview) within the scope of the study, and from the interviewees that the content of the interview would be used within the scope of the study. Students sent their written informed consent forms, Participant Information Form and Interview report to faculty/researchers via e-mail. Of the interview reports sent, all those who were allowed to use the interview in the informed consent form of the student and the interviewee, those who filled out the participant information form completely and those that included the questions in the semi-structured interview form (n = 200) were examined within the scope of the study. The data were obtained by retrospectively examining the interviews made by the students between January and May 2021.

Personal information form

The form prepared by the researchers consists of questions about demographic characteristics (age, gender, marital status, employment status, financial situation, geographical region where they were living, characteristics of the place where they were living, people they were living with, status of having a chronic disease, drug use) and COVID-19-related characteristics of the participants.

Semi-structured interview form

The questions of the interview held by the nursing students concerning “The effects of the COVID-19 pandemic on life” were prepared by the researchers. The semi-structured interview, which will enable to hold in-depth individual interviews, focused on the meaning of the pandemic, its effects on the mental, physical health and social life of the individual, and coping characteristics. Questions of the interview;

1. What does the COVID-19 Pandemic process mean to you?

2. How has the COVID-19 Pandemic affected your life?

   • What were its effects in terms of your daily life, routines, and habits?
   • How did it affect your mental health?
   • How did it affect your physical/general health?
   • How did it affect your social life (such as communication, relationships, spending time with others)?

• 3.How did you cope with the effects of the COVID-19 pandemic? (psychological/mental effects, physical/general health effects, social effects)

Ethical considerations

Before starting the study, written approval was obtained from the Gazi* University Ethics Commission (Research Code No:2020-623*) and written permission from the institution where the study was conducted was obtained. Written informed consent was obtained from the nursing students who conducted the interview and the individuals who participated in the interview via e-mail so that the interview report and its content could be used within the scope of the study. The data collection tools used in the study, the raw data of the research, the coding made during the analysis phase and all other materials would be reserved for confirmability.

Data analysis

In the research, the descriptive information of the interviewed participants was specified using the SPSS Statistics 25 program. The students were expected to report their face-to-face or online interviews in written in the form of a dialogue. The data obtained from the semi-structured interviews were analysed using “Descriptive Analysis”, one of the qualitative data analysis methods. The Consolidated Criteria for Reporting Qualitative research guidelines (COREQ) were used for qualitative data analysis (Tong et al., 2007). Lincoln and Guba trustworthiness criteria (credibility, transferability, dependability and confirmability) which are commonly used to describe rigour in qualitative research were taken into account to ensure validity and reliability throughout the study (Arastaman et al., 2018). The data were converted line-by-line into a data set on a word file. Sub-themes and themes were created by grouping similar codes into categories. For the credibility and dependability of data interpretations, analyses were performed by the researchers independently by four researchers. The analysis of the data was conceptualised by reaching a consensus on the theme-sub-theme-categories made by each researcher. To inform readers judgements about transferability, we have included relevant contextual information about sites and participants in the findings. The data collection tools used in the study, the raw data of the research, the coding made during the analysis phase and all other materials would be reserved for confirmability.

Results

The data obtained from the interviews examined in the study were conceptualised under three themes (nine sub-themes): The meaning of the pandemic (1), The effects of the pandemic on life (2), and Coping with the pandemic (3) (Table 3).

Table 3.

Theme, sub-theme and codes

Theme	Sub-theme	Codes
1. The meaning of the pandemic	1a. Pandemic at the level of emotions	-Feear -Hopelessness -Loneliness -Despair -Uncertainty
	1.b. Pandemic at the level of cognition and behaviour	-Danger -Attention and caution -Restiction -Awareness
2. The effects of the pandemic on life	2.a. Changes in routines	-Sleep -Nutrition -Physical activity -Education
	2.b.Mental change	-Being unable to enjoy life -Depressive symptoms -Fear of death
	2.c. Effect of disease-Pain	-
	2.d.Social change	- Impairments in social interaction -Awareness
3. Coping with the pandemic	3.a.Sprituality	-Positive thinking -Prayer
	3.b.Social support	-
	3.c. Healthy lifestyle habits	-Heath nutrition -Sports -Enjoyable activity -Attention to hygiene

Theme 1. The meaning of the pandemic

What the participants mentioned about the Pandemic was grouped under two sub-themes: level of emotions and cognition and behaviour level.

1.a. Pandemic at the level of emotions

While the participants expressed the meaning of the pandemic for them, they mostly talked about negative emotional burdens. The fact that life is restructured in line with the current conditions and it is beyond the control of individuals brought feelings of fear, hopelessness, loneliness, despair, and uncertainty to the fore. In particular, it was observed that restrictions trigger individuals to have negative emotions.

• Fear, stress, death, not going out, confusion, loneliness. Being separated from loved ones and missing them very much.(P61) [Fear].

• It was a very bad process. Being unable to get out of the house, fatigue, uncertainty about how long this pandemic had pushed me into despair. (P1) [Hopelessness].

• Loneliness and longing for our freedoms. (P92) [Loneliness].

• The pandemic expresses to me that it is a never-ending process, but also expresses despair, pain, grief, and death. (P177) [Despair].

• I felt as if I had fallen into a great uncertainty during this whole process. This uncertainty also brought fear. During this process, I worried more about my family than I did myself. (P59) [Uncertainty].

1.b. Pandemic at the level of cognition and behaviour

The participants also described the pandemic process at the level of cognition and behaviour. They expressed the process as “danger” and also concretised it with “attention and caution” and “restriction” behaviour.

• Whenever I hear the word pandemic, I think of a serious, dangerous and deadly period. (P28) [Danger].

• I can express this process with words such as illness, precaution, attention, hygiene, mask, prohibitions…(P113) [Attention and caution].

• The world has been swallowed hole by something invisible. We’ve all retracted into our shells. Our lives are restricted in every way. (P3) [Restriction].

The participants mentioned mostly negative experiences regarding the meaning of the pandemic. However, some participants, who described this period as “awareness”, expressed that it has made them more aware of how precious values like health, social interaction and freedom are.

• I can say that it is a period that has changed our lives instantly, has showed us the value of health and social communication but has been also tiring for us and has tested people’s patience. (P8) [Awareness].

• It has made me realise the importance of health, the indispensability of freedom, the indispensability of relatives and friends, and the value of many other things. (P65) [Awareness].

Theme 2. The effects of the pandemic on life

During the pandemic, extreme actions to prevent the spreading of the virus have brought about the necessity to change their lifestyles. It was stated that the pandemic affected the lives of the participants in terms of changes in daily life routines, mental or social changes, and the effect of the disease-pain.

2.a. Changes in routines

The inevitable changes brought about by the pandemic process have affected life in all dimensions, as stated by one participant. “…it has had a negative impact on my life. Everything I’m used to doing came to a sudden stop. It’s as though I started a new life order (P118). The participants expressed the changes especially in nutrition, physical activity and sleep routines from daily life skills, as well as the effects associated with changes in the education system.

• Before everything happened, I maintained a relatively normal sleep pattern. I was happy the moment my head hit the pillow. That’s all changed. I go into lazy mode (feel extremely lazy) whenever I can’t find something to occupy my time during the day. I don’t feel that so much when I go to sleep (P10) [Sleep].

• The increase in the length of stay at home during the pandemic has negatively influenced my eating habits. I’m no longer as physically active as I used to be. Add to that, I’m always eating fast food. Both have caused to gain weight rapidly. (P27) [Nutrition and Physical activity].

• …I was preparing for the university exam. While I was going to the cram school every day, our classrooms were shut down due to the pandemic and I had to continue my education at home. Since I encountered such a thing for the first time, I had a hard time adapting to distance education and had difficulty in understanding what were taught. This situation overstrained me too much. I had both exam anxiety and worries about how COVID-19 would continue. My life has been turned upside down (P118) [Education].

2.b. Mental change

The pandemic’s most important effect that cannot be ignored was on individuals’ mental health. The participants stated their negative psychological experiences as “being unable to enjoy life”, “depressive symptoms”, and “fear of death”.

• It is a process where I am psychologically worn out and exhausted. Sometimes I feel like I am not enjoying life. (P2) [Being unable to enjoy life].

• This process is a period of time for me to experience many emotions together. I feel very unstable emotionally. One day doesn’t quite fit the other. Being at home, being careful all the time, living with time constraints, wearing a mask all the time, and almost ending social life make me really sad. (P81) [Being unable to enjoy life].

• I became more depressed. Obviously, I want to go back to my old life as soon as possible. (P22) [Depressive symptoms].

• I have depressive thoughts and this causes negative emotions. Over time, it made me introverted. (P46) [Depressive symptoms].

• I have fear of death and fear of losing my loved ones. This makes me depressed from time to time. (P27) [Fear of death].

• I had the fear of death, I was afraid of not being able to see my family. (P117) [Fear of death].

2.c. Effect of disease-Pain

It was stated that lives of the participants who had COVID-19 during the pandemic were significantly restricted especially due to the pain they experienced.

• I was very tired, extremely felt weak. I had difficulty in moving because of the pain in my body. I had a lot of problems due to the chest pain. I had respiratory distress even while speaking. The breath I took was not enough for me in any way. I coughed while speaking. I couldn’t sleep well because of the pain. (P1) [Pain].

• Since I am always at home, I usually stay physically inactive. I have to use the computer for hours because of time-consuming homework resulting in pain in my eyes and back. I also suffered from headaches that lasted for days, accompanied by fatigue, joint pains, nausea, and nasal congestion while I was showing symptoms of the disease. (P33) [Pain].

• When I was a COVID-19 patient, I had constantly pain, weakness and fatigue. (P91) [Pain].

2.d. Social change

While the pandemic negatively affected the interpersonal relations of the participants in their social lives, it also enabled individuals to acquire awareness in understanding the importance of their values. While the participants described the negative effect of the pandemic in terms of social change as impairments in social interaction, they stated its positive effect as experiencing awareness.

• I have no social life, I lead a monotonous life- home to work; work to home. When I was a very active person, I started living a passive life and became unable to leave the house out of work. (P70) [Impairments in social interaction].

• My social life has been negatively affected. Lack of communication with my circle made me feel lonely at some moments. (P104) [Impairments in social interaction].

• I understood the value of my loved ones very well, every moment is important, corona taught me these. (P1) [Awareness].

• I didn’t really like the fact that I couldn’t spend time with my friends and family during the pandemic. During this period, I learned how difficult it is to spend a long time alone in a limited space, and how important things like communicating with people and socialising are in my life. (P27) [Awareness].

Theme 3. Coping with the pandemic

In coping with the changes brought by the pandemic and its effects on the individual and life, the participants focused on “Spiritualism”, “Social support” and “Healthy lifestyle habits”.

3.a. Spirituality

The participants, who accept the new lifestyle and uncertainty brought by the pandemic, endeavoured to focus on the temporary nature of the process with spiritual approaches, and consider positive factors such as vaccination and spending time with the family in reducing the psychological effects of the situation. Most participants regarded spiritual methods such as “prayer” as effective coping factors. They benefited from the relaxing effect of spiritual approaches to cope with the pandemic.

• I tried to think positively. I told myself that things would end soon. (P6) [Positive thinking].

• I didn’t make it clear to people that I was mentally distraught. I tried to look at the bright side… I got to spend more time with my family. We got to know one another better. Everyone is going through the same thing. that’s what I believed. (P38) [Positive thinking].

• Bad situation, boring. I think that even if it ends as soon as possible, it will be out of our lives. Besides, I think that the disease will end and they will find a solution to it. (P125) [Positive thinking].

• I gave myself more to my prayers. I pray constantly. (P82) [Prayer].

• … I try to console myself. I try to calm down by praying. (P167) [Prayer].

3.b. Social support

Social support from family and friends was stated as a force in coping with negative emotions experienced during the pandemic.

• My family was of great support in this regard. They always spoke to me with understanding and listened. I always felt that they were with me. These supports relieved me a little, reduced my anxiety and increased my concentration at work. I made frequent phone calls and video calls with my family. Being in contact with them gave me strength. (P2) [Social support].

• I have received main support from my family in this regard. I tried to relax myself psychologically by spending time with my family. Sometimes I helped my partner, we talked as a family, sometimes I played games with my children. That’s how we coped. Family support really solves all psychological problems (P150) [Social support].

• I talked to family and friends over the internet whenever I felt lonely. (K27) [Social support].

3.c. Healthy lifestyle habits

In coping with the physical, social and spiritual effects of the pandemic, the participants used different individual methods to take precautions both specific to the situation they live in and for the future effects of the process. Healthy nutrition and immune-enhancing supplements were among the methods they used in order not to have COVID-19 disease or to increase body resistance after getting over the disease.

• After the family got over the virus, we started using vitamins regularly to avoid getting sick again and to get rid of the permanent effects of the disease. (P37) [Healthy nutrition].

• Since the disease broke out, I have tried to pay more attention to my health. I started to eat foods that can strengthen my immunity. I try to eat healthy food and not skip meals… (P110) [Healthy nutrition].

In order to eliminate the effects of the decrease in daily living activities brought about by the restrictions, creating a sports routine at home and starting to do different motivating activities at home were expressed as effective coping methods.

• Under lockdown I’d put exercising on hold at first. Then I gained weight - that pushed me to exercise at home again. The pandemic is going to come to an end sooner or later. However, I don’t want to wind up out of shape physically by the time it’s actually over. (P84) [Sports].

• At the moment, I bought a few products to do sports at home and started to do sports to move at home, albeit a little. (P158) [Sports].

• I have always preferred to do activities that I can enjoy to provide morale and motivation. (P65) [Enjoyable activity].

• I did sports myself at home, I tried yoga, I tried watercolor works, I keep myself busy by trying things like recipes. (P114) [Enjoyable activity].

• …. I wanted to improve my language and found some things for it. I wanted to attend online seminars, so I had the opportunity to attend them about my profession and my field. (K180) [Enjoyable activity].

Measures within the scope of mask, social distancing and hygiene rules recommended by experts were also seen as coping methods.

• We have followed the mask, social distancing and hygiene rules stated by the experts. When we came from outside, we ventilated our clothes and paid great attention to hand hygiene. (P62) [Attention to hygiene].

• In order to protect myself from the virus, I constantly paid attention to my hygiene and cleanliness. (K136) [Attention to hygiene].

Discussion

This study aimed to examine the effects of the COVID-19 pandemic on life through the interviews made by the nursing students within the scope of the mental health and psychiatric nursing course. The findings obtained through qualitative data analysis in the study were discussed under three headings in the context of themes.

The meaning of the pandemic

The meanings attributed to the pandemic process in the present study were mostly negative experiences. Interviewees expressed the pandemic as fear, hopelessness, loneliness, despair, and uncertainty, especially at the level of emotions, which is compatible with the study by de Freitas Melo et al. (2021). In the study, conducted with a large sample group, it was determined that the associations related to coronavirus were fear, uncertainty, hopelessness, death, isolation and disease (de Freitas Melo et al., 2021). Especially the conceptualisation of the pandemic as danger, attention-caution, restriction and awareness in the present study may be due to the rapid spreading of COVID-19, the risk of infection, and resulting in death.

The effects of the pandemic on life

The pandemic, along with its many negative effects, has inevitably changed the lifestyle of the society. People have led a more sedentary lifestyle by attending online activities or meetings or watching movies. In the present study, it was observed that daily life skills such as sleep, nutrition and physical activity were mentioned as affected routines. When examined within the scope of the literature, it was found that similar effects were observed in different societies, similar to the present study. A study reported that home restriction had a negative effect on sleep quality (Altena et al., 2020). The prevalence of sleep problems is high during the COVID-19 pandemic and it has been identified to affect approximately 40% of people applying to general health services (Jahrami et al., 2021). The studies conducted in different societies have reported that sleep problems are experienced along with psychological symptoms such as anxiety, stress and depression (Cellini et al., 2020; Voitsidis et al., 2020).

Staying at home and interruption of work-related routines can also lead to irregular eating habits and frequently snacking (Scully et al., 2009). As a matter of fact, negative experiences in nutrition and physical activity from the prominent effects in the present study, cannot be ignored. Optimal intake of nutrients is crucial, given the significant effects of COVID-19 disease on the immune system. Similar to the results of the present study, in which experiences on reduction in physical activity were shared extensively, a study reported that 41% of adult participants stated that they did not do physical activity or exercise during lockdown (Haddad et al., 2020). As the obligations brought by the pandemic, it can cause more common sedentary behaviours such as staying at home for a long time, prolonged sitting, and increased time on screen (video games, watching TV, use of mobile devices) (Chen et al., 2020a). Additionally, decreased levels of physical activity can lead to weight gain due to decreased energy expenditure, risk of obesity and impairment of chronic health conditions (Owen et al., 2010). For this reason, simple and easily applicable exercises such as being active at home, standing and maintaining a healthy level of physical activity will be effective.

The lockdown or home restriction associated with the pandemic has made it compulsory for most people to work or study at home. The pandemic has affected the education system as well as the daily life skills of the participants. The effect of the COVID-19 pandemic caused the educational activities in the classrooms to be temporarily interrupted. In a study examining student views on online education during the pandemic, it was stated that online education was stressful and affected their health condition and social lives (Chakraborty et al., 2021). Online learning can be perceived as lack of interaction compared to classroom learning (Bali & Liu,, 2018). Online education has several disadvantages such as browsing problems, computer compatibility or technical problems (Arkorful & Abaidoo, 2015; Healy et al., 2014).

In addition to the changes in daily life, the pandemic also has effects on mental health. Psychological reactions given during the pandemic include anxiety, fear, disappointment, loneliness, anger, boredom, depression, stress, maladaptive behaviours such as avoidance behaviours, emotional distress, and defensive reactions (Taylor, 2019). In the present study, the participants stated that the pandemic caused them not to enjoy life in a spiritual sense and resulted in depressive symptoms and fear of death. In this sense, long-term lockdown has a negative effect on mental health and psychological behaviours, and as a result, depression is likely to develop and worsen (Fiorenzato et al., 2021; Xiao, 2020). The studies in different populations have indicated that mild/moderate/severe depression levels increase compared to pre-pandemic period (Ahmed et al., 2020; Mazza et al., 2020). Another finding of the present study was that the participants felt fear of death due to the unknown nature of the pandemic, its rapid development, and the high number of deaths. This finding of the present study is compatible with results of the study by Newton-John et al. (2020) investigating fear of death within the scope of pandemic. The study findings revealed that death anxiety had a significant positive correlation with anxious beliefs and behaviours related to COVID-19 (Newton-John et al., 2020).

In the present study, the participants stated that the COVID-19 pandemic negatively affected physical health as well as mental health. Symptoms such as headache, joint pain, chest pain, and shortness of breath are observed in individuals who had or have had COVID-19 disease (Carfi et al., 2020). In the present study, the participants stated that they suffered from especially shortness of breath, joint pain, weakness and fatigue, and this brought a significant restriction in their lives. In their study, Chen et al. (2020b) stated that in a one-month follow-up, health-related quality of life got impaired among COVID-19 patients, and patients suffered from significant physical and mental disorders.

It was stated that the pandemic negatively affected social life as well as mental and physical changes. People were prevented from making social contacts except with those in their immediate circle due to the measures taken to keep the spread of the COVID-19 under control. In this sense, it was thought that increasing loneliness led a decrease in social interaction. In the present study, one of the participants said, “My social life has been affected very negatively. Lack of communication with my circle made me feel lonely at some moments”; this statement supports this result. In addition to the negative effects of the pandemic, its positive effect was also stated by the participants. In the present study, some of the participants stated that as a positive feature of the pandemic, it offered an opportunity to improve lifestyle and raised awareness. In their study, Asıcı & Günlü (2020) reported that university students gained awareness about their loved ones, life and self, which is compatible with the finding of the present study.

Coping with the pandemic

Social traumas such as epidemics and natural disasters, which have a strong impact, cause changes in individuals’ perspectives on life (Duman, 2019). In the present study, it was determined that there was a change in the life philosophy of the participants and their relations with their close circle and they developed coping methods that can be considered as spiritual strengthening and growth. Praying, focusing on positive thoughts, starting to do spiritual practices where they feel well, and spending more time with their families were expressed by the participants as frequently preferred methods in coping with the challenging circumstances encountered during the pandemic. One of the methods of coping with stress applied by individuals getting over COVID-19 is the spiritual approach. According to the literature, religious coping approach is important in protecting mental health in the social problems (Pargament & Raiya, 2007). In a similar study, it was determined that individuals prayed more and felt better during the COVID-19 pandemic (Iddi et al., 2021).

The importance of social support in reducing distress and mental health difficulties in stressful situations cannot be ignored (Naushad et al., 2019). Although one of the main goals of isolation during the pandemic is to reduce infection rates by reducing social contact, social support also plays a protective role for mental health. During the restrictions, the individual may feel lonely and isolated from others. As a matter of fact, in line with the findings of the present study, loneliness was stated as an important result during the pandemic. In coping with this situation, regular contact with one’s friends and close circles in video or phone calls can increase the level of social support (Bavel et al., 2020). Staying in touch with others virtually and face-to-face, has been stated as one of the most commonly used coping strategies (Finlay et al., 2021).

In line with the findings of the present study, it can be asserted that the pandemic motivated some participants to adopt healthier lifestyle behaviours (immune-enhancing supplements, home exercises, hygiene rules, enjoyable activities). In the literature, it has been stated that especially exercises such as going for a walk and doing yoga are coping strategies frequently defined to promote physical and mental health (Finlay et al., 2021) and exercise and meditation are effective on reducing stress (Van Der Zwan et al., 2015). In addition, in the present study, concerning coping with the pandemic period, the participants stated that there was an increase in their behaviours including protective measures such as masks, social distancing, gloves, and hygiene rules in order to prevent exposure to the COVID-19 pandemic, to protect the individual, family members and society, and to reduce health-related anxieties.

Limitations

Within the scope of the study, the face-to-face, phone, video or online interviews were held. The diversity in the interview methods can be regarded as one of the study’s limitations. However, it is thought that the use of the same semi-structured interview form in all interviews within the scope of the study minimised the effects of this limitation. For confirmability, after the data were analysed in the study, the lack of participant confirmation about the findings is considered as a limitation.

Conclusion

This study offers new data about the pandemic experiences of the general population. As a result of the study, it was determined that the COVID-19 pandemic brought negative associations for the person, affected the individual spiritually, socially and physically, but caused some individuals to raise awareness about finding meaning in life. Moreover, the participants coped with this process by exhibiting spiritual approach, social support and healthy lifestyle behaviours. In line with these results, it may be recommended to plan descriptive studies with a larger sample in order to figure out the long-term mental, social and physical effects of the pandemic. In addition, psychosocial interventions to reduce the short and long-term effects of the pandemic on life should be made available. In this context, it is recommended that psychiatry professionals plan and implement psychosocial approach-based individual/social interventions. It is necessary to develop the effective strategies in order to cope positively with the effects of the pandemic, which is a part of life.

Supplementary information

Below is the link to the electronic supplementary material.

Author contributions

All authors have agreed on the final version and meet at least one of the following criteria: Substantial contributions to conception and design, acquisition of data or analysis and interpretation of data; Drafting the article or revising it critically for important intellectual content.

Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Declarations

Ethical considerations

Before starting the study, written approval (Research Code No Decision No: 24.11.2020-E121625, Research Code No:2020 − 623) was obtained from the Ethics Commission of the institution the researchers were affiliated with and written permission from the institution where the study was conducted was obtained. Written informed consent was obtained from the nursing students who conducted the interview and the individuals who participated in the interview via e-mail so that the interview report and its content could be used within the scope of the study. 

Conflict of interest

No conflict of interest has been declared by the author.