INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
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; CI9 5% 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.