Perceptions, emotional reactions and needs of adolescent psychiatric inpatients during the COVID-19 pandemic: a qualitative analysis of in-depth interviews

Abstract

Background The new coronavirus pandemic (COVID-19) has been accompanied by severe psychological pressure on the entire population. However, little is known about how this pandemic could affect the more vulnerable population with severe mental illness. Aims To explore adolescent psychiatric inpatients’ perceptions, emotional reactions and needs during the first wave of the COVID-19 pandemic. Methods Individual in-depth interviews were conducted with nine psychiatric inpatients aged 12–17 years. Through open-ended questions, interviewers initiated five themes: (a) knowledge about coronavirus pandemic, (b) changes in everyday routine due to the pandemic, (c) adolescents’ feelings about the pandemic, (d) adolescents’ positive thoughts and behaviors, and (e) how the social environment can help adolescents deal with the pandemic-related situation. A thematic analysis was conducted using line-by-line open coding. Results Regarding their knowledge of the impact of the current pandemic, almost all adolescents focused on information about the nature of coronavirus and on existing crisis management practices. Almost all patients identified predominantly negative changes due to the quarantine state, including restrictions on both social life and personal freedom as well as excessive contact with family members during home isolation. As far as their emotions were concerned, adolescents did acknowledge anxiety about self-harm and harming their loved ones as well as mood swings within the family nucleus; anxiety was also manifested about the unknown and the management of the pandemic in other countries. Avoidance of thought rumination about the coronavirus and its consequences, positive thinking and looking towards the future were reported as constructive strategies for coping with challenging emotions. Additionally, a sense of belongingness seems to have been playing a pivotal role in the adolescents coping strategies. Trust in the authorities and the community was another quite noteworthy point that emerged during the interviews. Lastly, our findings indicated adolescents’ benefit from receiving balanced health messaging coupled with balanced thinking within their social and family environment. Conclusions Enhanced comprehension of possible mediating psychological pathways is needed to help clinicians, researchers, and decision-makers to avert the deterioration of mental disorders and overall functioning, as well as additional stress-related disorders.

Impact of the COVID-19 Pandemic on the Experiences of Hospitalized Patients: A Scoping Review

“…Regarding the identification of feelings experienced during hospitalization , 71.9% (n = 23) of the articles indicated that the patients and family members experienced difficult moments 47 during the hospitalization period, with feelings of loneliness 16 , 17 , 21 , 31 and isolation 16 , 17 , 21 , 29 , 31 , 40 , 41 due to the restrictions regarding visits and companions and a lack of contact between professionals and patients. 20 Feelings such as sadness, 23 , 26 , 46 fear, 17 , 18 , 20 , 22 , 24 – 29 , 32 , 33 , 46 anxiety, 17 , 22 , 28 , 38 , 41 , 46 worry, 17 , 20 – 24 , 32 , 33 , 46 nervousness, 22 guilt, 26 , 46 anger, 23 , 26 tiredness, 24 hopelessness, 46 frustration, 43 discrimination, 18 , 22 vulnerability, 29 , 32 , 46 and uncertainty 22 were also reported, associated with lack of knowledge about the disease and with the situation in which they found themselves. It is noted that the articles described concerns about the personal 21 or family 20 socioeconomic situation as aggravating factors, because of uncertainty of the economic and housing situation.…”

“…Voice and video calls were described as a way of relieving the stress felt by absence of the family, 17 , 33 as well as reducing anxiety and isolation. 23 , 24 However, it was also reported that feelings such as uncertainty and sadness remained, even with the communication strategies. 46 The use of online games, 18 virtual reality, 36 telephone, 24 and television 29 was associated with the feeling of escape from reality, increasing comfort through contact with an environment other than the hospital.…”

“…Regarding the identification of feelings experienced during hospitalization, 71.9% (n = 23) of the articles indicated that the patients and family members experienced difficult moments 47 during the hospitalization period, with feelings of loneliness 16,17,21,31 and isolation 16,17,21,29,31,40,41 due to the restrictions regarding visits and companions and a lack of contact between professionals and patients. 20 Feelings such as sadness, 23,26,46 fear, 17,18,20,22,[24][25][26][27][28][29]32,33,46 anxiety, 17,22,28,38,41,46 worry, 17,[20][21][22][23][24]32,33,46 nervousness, 22 guilt, 26,46 anger, 23,…”

Feelings of Entrapment during the COVID-19 Pandemic Based on ACE Star Model: A Concept Analysis

“…Currently, lockdown restricts individuals to stay at home strictly, and those quarantined report a rise in suicide compared to others [66]. Individuals also feel isolated from the outside world [16], reported feeling trapped in their house, and expressed concerns about the prolonged pandemic [67].…”

A Qualitative Serial Analysis of Drawings by Thirteen-to Fifteen-Year-Old Adolescents in Sweden About the First Wave of the Covid-19 Pandemic

“…While studies relating to psychosocial effects of the pandemic on children and adolescents are prolific and continually increasing (see Chawla et al, 2021 ; Meherali et al, 2021 ), there are still notable knowledge gaps. Many studies are limited to needs of a specific group, often those with particular morbidities or life-situations (see Giannakopoulos et al, 2021 ; Mirlashari et al, 2021 ; Sharma et al, 2020 ; Tse et al, 2021 ). In addition, only a minority of studies are based on data generated directly by children or adolescents, with most instead relying on proxy reports from teachers, parents and other sources ( Berasategi Sancho et al, 2021 ; Evans et al, 2020 ; Ferrari et al, 2021 ; Ferraro et al, 2021 ; Fitzpatrick et al, 2020 ).…”