One Word to Describe My Experience as a COVID-19 Survivor Six Months after Its Onset: Findings of a Qualitative Study

Abstract

The COVID-19 pandemic emotionally affected the lives of patients cared for in different settings. However, a comprehensive view of the whole experience as lived by survived patients, from the onset of the disease and over time, is substantially unknown to date. A descriptive qualitative design was implemented according to the Standards for Reporting Qualitative Research. Adult patients (=1067) cared for during the first wave (March/April 2020) capable of answering an interview and willing to participate were interviewed (=397) by phone with an interview guide including open- and closed-ended questions. In this context, they were asked to summarise with a metaphor their entire COVID-19 experience at six months. Then, the emotional orientation (positive, neutral, or negative) of the metaphors expressed was identified. The participants were mainly female (206; 51.9%), with an average age of 52.6 years (CI 95% 50.4–53.6), reporting a mild severity of COVID-19 disease at the onset (261; 65.7%) and the perception of being completely healed (294; 70%) at six months. The patients summarised their experiences mainly using negative-oriented (248; 62.5%) metaphors; only 54 (13.6%) reported positive-oriented metaphors and a quarter (95; 23.95) neutral-oriented metaphors. Nearly all positive-oriented metaphors were reported by patients with symptoms at the onset (53; 98.1%), a significantly higher proportion compared to those reporting negative- (219; 88.3%) and neutral–oriented (78; 82.1%) metaphors (p = 0.014). While no other clinical features of the disease were associated, among females, significantly more negative-oriented metaphors emerged. Moreover, neutral-oriented metaphors were reported by younger patients (49.5 years, CI 95% 64.11–52.92) as compared to those negative and positive that were reported by more mature patients (53.9; CI 95% 52.04–55.93 and 54.8; CI 95% 50.53–59.24, respectively) (p = 0.044). Nurses and healthcare services require data to predict the long-term needs of patients. Our findings suggest that, for many patients, the COVID-19 lived experience was negative over time.

The Road Less Traveled: How COVID-19 Patients Use Metaphors to Frame Their Lived Experiences

“…In addition to image metaphors, the present study showed that family metaphors, light metaphors, warmth metaphors, and some war metaphors had a positive effect on patients with COVID-19. This is consistent with the recent literature [ 3 , 28 ] in that COVID-19 infection has provided a special occasion for meaning and for turning the life-threating event into a positive opportunity in fighting the disease and strengthening social relationships. Therefore, these positive metaphorical frameworks can be extensively applied to psychotherapeutic principles used in the treatment of COVID-19.…”

“…Negative image metaphors (e.g., plague, prisoner) were frequently used by COVID-19 patients to describe their concept of selves, suggesting that metaphors play an important role for patients to construct their identities [ 47 , 48 ]. This echoes Palese et al’s findings in that the negative-oriented metaphors used by COVID-19 patients revealed their increased vulnerability due to stigmatization and socioeconomic difficulties and the limited support received [ 28 ]. Healthcare professionals should employ positive image metaphors such as “the fighter” or “winner” in communication with COVID-19 patients in order to help them counter social stigma and to reconstruct their identities [ 16 , 24 ].…”

“…Distance metaphors were employed by patients to express their isolation from normal society and other people. Our findings reveal that quarantine-related social isolation was a major risk factor contributing to psychological problems in COVID-19 patients [ 1 , 2 , 3 , 4 , 28 ]. Furthermore, the fear of infecting others had an adverse impact on the psychological status of patients [ 3 , 29 ].…”

“…Recently, an increasing number of studies have addressed the mental health of COVID-19 patients through their lived experience narratives of COVID-19. Metaphors emerged in patient narratives regarding their unpleasant experiences during COVID-19 [ 1 , 2 , 24 , 28 , 29 ]. COVID-19 survivors summarized their experiences mainly using negative-oriented metaphors [ 28 ].…”

“…Metaphors emerged in patient narratives regarding their unpleasant experiences during COVID-19 [ 1 , 2 , 24 , 28 , 29 ]. COVID-19 survivors summarized their experiences mainly using negative-oriented metaphors [ 28 ]. For example, COVID-19 patients expressed their pain with metaphors such as, “my kidneys were going to jump out of my body” [ 2 ].…”