Table 5.
Meta-matrices of frequency and percentage of quantitative data and narrations of qualitative data.
| Items | COVID-19 Patients (N = 103) (%) | Narratives (n = 5) | ||||
|---|---|---|---|---|---|---|
| 0 | 1 | 2 | 3 | 4 | ||
| PSS-10, item 1*Upset because of something that happened unexpectedly | 23(22.3) | 27(26.2) | 45(43.7) | 7(6.8) | 1(1.0) | Patient A: “Then the ones who came here later than me were discharged, the ones who were older than me were discharged… Everyone said that I was in good condition, really good, but I was not discharged.” |
| Patient B: “At that moment, I didn't believe that I might get this disease, because I really paid attention to prevention. The other reason is, we left (Henan province) on January 23. We were afraid that the highway would be closed, so we left after eating dinner. We left during the night. We started quarantine once we arrived (Shanghai), we didn’t get out of the house… so I didn't believe that I will have this disease.” “I said that my protection was good, how could I have the disease? Because I have calculated the proportion of the disease, the proportion of individuals who were ill. (The rate) was just like winning 5 million (in the lottery) …Just very few people. Because at that time I also paid attention to the news. Because there were almost 10 million people in Wuhan, probably only ten thousand people (get the disease). I said this is about one-in-ten thousand, basically. Isn't it? So, I didn't believe it. When the test results came out and he said it was positive, I was, like, worried.” | ||||||
| Patient E: “My family members were quarantined, and some friends were quarantined, which kind of affected me. And I thought it was a viral flu before (the results came out). Although I wore a mask, I treated more than 200 patients during that time. Those patients were isolated, and I felt under pressure from this aspect. ” | ||||||
| PSS-10, item 2 Felt that you were unable to control the important things in your life | 26(25.2) | 31(30.1) | 34(33.0) | 10(9.7) | 2(1.9) | Patient A: “There are some uncertainties about the unknown.” “… Everything is unknown. You know? … So, as the extension of time, the longer the time, the more anxious (I feel). I don’t know how the progression (of disease) happened on me.” “So, the information we got wasn't enough to support my confidence, and it makes me doubt what's going on. I need to analyze it from something I have no idea with. I try to find something. The more I found, the weirder I feel. Anyway, the feeling is vague. I’m at a loss.” Patient D: ”There's a lot of uncertainty going on here. I packed up my things. I was ready to be transferred, and then there was no news. They asked me to transfer and I packed up my things, and then there was no news. It happened several times, during these days. So, the anxiety caused from this aspect is comparably obvious.““But it's a new disease. Nobody knows much about it. And nobody's ever seen what in my case, right?”Patient E: “So, would it influence, and how much influence would it make later? What kind of damage would it cause, to myself and the people around me? We're uncertain about that.”“When encountering this kind of problem, SARS and COVID-19, from the government to the hospital, and to the individual levels, I feel no one could have that defensive state once in a sudden. Of course, we have drills during peacetime, but the practice is not enough to cope with such a problem. Not enough to cope with this problem. After the whole order were all messed up at once, I felt very puzzled. At that time there was a kind of vacant feeling.” |
| PSS-10, item 6** Found that you could not cope with all the things you had to do | 21(20.4) | 32(31.1) | 39(37.9) | 11(10.7) | 0(0.0) | Patient A: [the Patient was worried about her privacy. She hid her illness from her neighbour, and she worried that the neighbour will find out the truth and their relationship will break down.] I was thinking what if one day, if I don't come home all the time, or if my condition gets worse, what could I tell them? (We have) so many years of friendship. Then they will say, you swore that you were at home, and I brought you food to your house every day. You have taken them in, and you also told me how they tasted? “Patient C: ”After being discharged, I need to find another place. To have be quarantined for a few more days. I'm afraid I won't be able to find a place to stay.“Patient D: ”I don't know if there's going to be any changes in the future, or some sort of consequence.“ ”I don't know much about the mental health problems either. How do you feel about my current mental state? Is there any mental issue or situation that might follow?“Patient E: ”One (of my worries) is fear of causing panic, the other is fear of further disclosure of privacy… There are a lot of doctors living in my residential area. If there is a panic, it's not just me (that would be influenced). Maybe the community will stop me from going back to the residential area, and the other doctors would also be expelled. So, there’s high pressure from public opinion. |
| PCL-5, item 6 Avoiding memories, thoughts, or feelings related to the stressful experience | 63(61.2) | 34(33.0) | 5(4.9) | 1(1.0) | 0(0.0) | Patient B: “Don't even think about it. The more you think about it, the worse the emotion would be.”“There’s a word called heartless. Think less about things, which might be better.”Patient C: “When you're sick, you won't get better even if you worry yourself to death. So, take it as it comes, take it as it comes!” |
| PCL-5, item 7 Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations | 62(60.2) | 32(31.1) | 9(8.7) | 0(0.0) | 0(0.0) | Patient B: “You see, I don't read much of the negative information on the phone… I just read the positive ones. Some (information) are about the ones who get sick and some of family members have died. So cruel. I just, I just try not to read them.”Patient C: “(I) try to fill my day a little bit, which can really help me to distract myself a little bit.” |
| PCL-5, item 10** Blaming yourself or someone else for the stressful experience or what happened after it | 52(50.5) | 39(37.9) | 7(6.8) | 5(4.9) | 0(0.0) | Patient A: “The other thing is, the doctor didn't go and ask you… He didn't have more communication with you… I really want to tell the doctor (my ideas). Things turned to be that I have said a lot, I have spoken thousands of words, and just (get) one response: “What to do? Wait for the result.” “You're not respected in this environment, you know?”Patient B: “Some of the homeowners of the community said online that, he said (he) watched me go out, and go out to buy food, and talk with others in the corridor. I said he made it up, and it’s a defamation action. My son and daughter-in-law, they have dialed 110 to call the police. ” “We can still sue him if he doesn't apologize and make this clear in the (online) group.“Patient C: ”The biggest problem is that, what is terrible is not the disease, but the human hearts.“”Then because the people around you, people all treat you, how to say,as you are the plague, you got the plague, and they give you a label. “Patient E: ”Sometimes, it's true that natural and man-made disaster, I think, they’re always combined together. Natural disaster is a man-made disaster.“ |
| PCL-5, item 11** Having strong negative feelings such as fear, horror, anger, guilt, or shame | 45(43.7) | 50(48.5) | 4(3.9) | 4(3.9) | 0(0.0) | (Fear, Horror): Patient A: “I also felt like if I follow this thought, I felt very scared.”“This horror is originated from the unknown.” “It comes from unknown. The horror is all about the unknown. Information asymmetry, yes. We can't solve it.”Patient C: “At least there's a window (in that room before confirmed infection) where we can see cars coming and going and so on. But not here, there’s nothing could be seen here… (I have the feeling of) airtight, airtight phobia. ”Patient E: “(About) pulmonary fibrosis or something like that, it's more or less about understanding whether or not it’s going to affect my life or so in the future. After all, we are people in the first place, and people could be afraid. Isn't it?” (Guilt): Patient A: “My pressure is from my neighbors and relatives, such as my sister and my parents in Wuhan, where’s my hometown. They would like to (have) video call with me these 10 s、20 s days. They want to video chat with me, a person quarantined at home [The patient lied to them. The fact is, she was hospitalized]. I can't video chat with them. Every time I need to find some reasons to reject them. I felt sad about it. The more day (passed), the more stressed I feel. And I couldn’t let them know. You have to lie to the people who care and love you.” “That kind of guilty feeling… Suddenly, I had to lie, and then I had to cover up the lie with a bunch of lies. It was really stressful.” (Helpless): Patient A: “Actually, I felt like we were abandoned. I had this kind of feeling at that moment… Really, at that time, I thought about the stories we read many years ago, about the leprosy hospital. (I) really thought pessimistic. During that time, you had no one to take care of you, and you need to survive on your own.” “The feedback from the doctors really made me feel helpless. It made me feel very helpless.” |
Key: PSS-10, Perceived Stress Scale-10; PCL-5, PTSD Checklist for DSM-5.
Note: Patient A, female, aged between 50 and 55 years old kept her infection as a secret. She did not reveal her diagnosis to her neighbors and other family members, except her husband. Patient B, male, aged between 60 and 65 years old. Patient C, male, aged between 35 and 40 years old. Patient D, male, aged between 30 and 35 years old. His family members were also infected with the virus. Patient E, female, aged between 35 and 40 years old. She was hospitalized again because of the repeat positive virus test result.
*
P < 0.05, **P < 0.01