Exploring the Mental, Social, and Lifestyle Effects of a Positive COVID-19 Infection on Syrian Refugees in Jordan: A Qualitative Study
Abstract
:1. Introduction
2. Methods
2.1. Theoretical Framework
2.2. Sampling
2.3. Recruitment
2.4. Reflexivity
2.5. Data Collection
2.5.1. The Interview Guide
2.5.2. Health Care Professionals’ (HCP) Interviews
2.6. Data Analysis
Derivation of Themes
3. Results
3.1. Major Themes
3.1.1. Node One (Physical Health)-Themes
i. Theme One: Signs and Symptoms
ii. Theme Two: Medical Support
“I had symptoms like my other family members but preferred not to get tested to save money. “I did not need to go to the hospital or receive medical treatment”.
“I was not concerned much because I knew that I would be looked after by the health care team and by my neighbors.”
3.1.2. Node Two (Psychological Health)-Themes
i.a. Theme One: Stigma and Blame
“Here at camp, people are closedminded and consider who got the virus being an unclean person with poor hygiene”.
“I did not want people to know that my daughter and I had COVID. I preferred to keep away from the neighbors so they do not know about our positive infection”.
“I think we got it from our father since he was not compliant with safety precautions”. The participant indicated that the father passed away due to COVID-19 complications.
i.b. Themes Two: Fear of Loss (Loved One or a Job), Fear of Complications
“I am annoyed because I lost my job from the day I got infected. My elder brother is giving me pocket money. I hope to find a new job soon”.
“I was upset and sad because I lost my salary during the isolation period and my wife borrowed money from her cousin to cover some daily needs”.
“At the beginning, I was annoyed because I lost my salary since I need money to help my family in daily life needs and university fees and to save some to get married, but thanks God I returned to my job”
“I was so sad that getting the virus forced me to borrow money from neighbors to buy food”
“I was worried about my father and unfortunately we lost him.”
“I was worried only about my parents. They lost their smell and taste sensations. When I get my salary this month inshallah, I will refer them to the medical advice”.
This is considered to be a major concern for most of the participants the issue of losing loved one, the economic impact.
3.1.3. Node Three (Social health)-Themes
i.a. Theme One-Spouse Support
“My husband was not supportive, and he got mad with me. He had to take care of the home and kids …. He did not really look after them properly…. Actually, I didn’t receive good family support like any other infected persons and that made me sad ….and I was crying all the time”.
i.b. Theme Two. Seeking Support
“I had more time during isolation to talk to my sisters in Syria over phone, this was an advantage of being isolated”.
“In the first 2 days of my isolation, I spent time on Facebook and WhatsApp. Then when my parents and brothers got the infection, I was cooking and cleaning the house”
“The father of my daughter’s friend was calling us all the time and provided all support and advised us to use vitamins C and D”.
“I was busy doing my homework and studying”
“I was talking with my friends and sisters on phone, and spending time on YouTube listening to Quran”.
3.1.4. Node Four-Spirituality Themes
i. Theme One: Closer to God
“We are Muslims and do our prayers all the time, but when I got the result, I prayed to God for protecting my family and me more”.
“I had more time to listen to Quran and thanks to God, I am Muslim and do my prayers on time, and I have a good relationship with God”.
“I spent my isolation reading Quran”
“We are Muslims, and we are close to God, but after getting the virus, I felt that I had to do prayers on time and to get closer to God...”.
“The first few days after my father death, I was sad but it’s a destiny by God and he was not compliant with safety precautions, he was 70 years old and he had hypertension and diabetes mellitus, I spent my isolation time reading Quran”.
“We are Muslims, and we are close to God”.
ii. Theme 2. Acceptance
“I had no feeling of panic or thinking about complications or death, the only thing I was worried about my father, and he developed respiratory problems and passed away; Alhamdullillah (Thank God)”.
“I am Muslim and believe that this virus is from God like any other diseases and Alhamdullillah (Thank God) we recovered and feel good now”.
3.1.5. Node Five: Lifestyle
i. Theme One: Precautions and Protection
“We are reminding each other about following the safety precautions strictly; we are afraid of each other of getting the virus again. May God protect us and all people around the world.”
“We all supported each other and I spent more time with my family since I was on a sick leave, we enjoyed our time together, Alhamdullillah (Thank God)”
“We used to drink herbs like ginger and eat fruits and vegetables like orange”.
“I received just paracetamol for fever and pain and used herbs like ginger and I was drinking orange or lemon as source of vitamin C”.
“We received vitamins C, D, and zinc as my daughter friends used them since her father is a doctor at the ministry of health and prescribed that for her”. He also kept on checking on us …”
“Yes, after getting the virus we changed our diet to be more healthy by increasing vegetables and fruits portions we kept our homemade food as before I got the virus, we don’t do exercises, I have same sleep hours I used to sleep more first few days of getting the virus then my sleep is normal like before getting the virus, about religiosity Alhamdulillah we are Muslims and do our prayers all the time but first two days of the virus I were used to pray to God for protecting me and my family”
“Nobody called us from the Ministry of Health, we didn’t need any medical care support but I was referred to an ENT physician due to losing my sensations, he told me if my sensations don’t return back within one year, I will lose it permanently”.
“This virus was made at the laboratory to get rid of elderly people in the world, and don’t ask me why because this is my inner feeling.”
“It’s real and transmitted all over the world”.
“After getting the virus and till this moment we are taking care of each other and reminding each other by safety precautions all the time”.
“We usually follow a healthy lifestyle even before COVID-19; nothing changed.”
“… my husband got mad because he lost his salary during the isolation period he needs his salary to buy cigarettes for smoking but thanks God after finishing the isolation he got relieved”……She continued “…I tried to calm him down but he was so mad because he was not able to buy cigarettes but Alhamdullillah after discharge he returned back to his work, but that didn’t affect me at all I was happy deep inside because he stopped smoking in isolation period”.
“Yes, I am concerned and if it continues, I will save money to visit a private doctor because I don’t have medical insurance”.
ii. Vaccine Hesitancy
“…No, I think they are new and needs more studies to confirm their safety and efficacy”
“No, I am still not convinced by the safety and efficacy of those vaccines maybe after years when they are safe and effective 100% and are free.”
“I will take the vaccine however, they said it will take months until we receive it”.
3.2. Emerging Themes
“I received free treatment and received free coupons with 20 Jordanian Dinars for each one of us from UNCHR in the camp.”
“Here at camp, the environment is not healthy and closed-minded also, and they are not educated; they considered who got the virus to be a dirty person or with scabies.”
“I am not upset due to not getting paid; as I told you, we are receiving help from UNCHR and live for free at camp, and our water and electricity are free.”
“I lost my job from the date I got infected by the virus, my big brother is giving me pocket money, I want to search for a new job” …I wish I can find a job soon”
“I preferred to isolate myself at home using home remedies to save costs for buying bread or chicken for her daughters”.
“I was upset and sad because I lost my salary during the isolation period and my wife borrowed money from her cousin to cover some daily needs, but Alhamdulillah (Thank God) I recovered and returned back to my job”
3.3. Health Care Providers Interview Findings
4. Discussion
5. Limitation and Strengths
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
NPI | Non-Pharmaceutical Intervention |
UNHCR | United Nations High Commissioner for Refugees |
HCP | Health care providers |
PCR | Polymerase chain reaction |
WHO | World Health Organization |
Ministry of Health | MOH |
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Number | Major Themes | Sub-Themes |
---|---|---|
Theme one | Physical effect |
|
Theme Two | Mental and psychological impact |
|
Theme Three | Social impact |
|
Theme Four | Spiritual impact |
|
Theme five | lifestyle and behavior |
|
Setting | |
---|---|
Camp | Host Community |
Poor household support | Economical and financial impact |
Social Exclusion | Fear of loss of financial support |
Stigma | Limited access to medical care |
Loss of Job | Closer and tightened social relationship within the same household |
Poor social support |
Theme | Subtheme | Setting | |
Camp (N = 10) | Host Community (N = 10) | ||
Physical effect | Signs and Symptoms | 8 | 8 |
Good medical support | 10 | 3 | |
Mental and psychological impact | Stigma and Blame | 5 | 4 |
Fear of loss | 4 | 6 | |
Social impact | Bad spouse support | 3 | 0 |
Seeking support | 5 | 6 | |
Spiritual impact | Closer to God | 10 | 10 |
Acceptance | 10 | 10 | |
lifestyle and behavior | Precautions and extra protection | 9 | 8 |
Vaccine hesitancy | 8 | 5 |
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Share and Cite
Kheirallah, K.A.; Ababneh, B.F.; Bendak, H.; Alsuwaidi, A.R.; Elbarazi, I. Exploring the Mental, Social, and Lifestyle Effects of a Positive COVID-19 Infection on Syrian Refugees in Jordan: A Qualitative Study. Int. J. Environ. Res. Public Health 2022, 19, 12588. https://doi.org/10.3390/ijerph191912588
Kheirallah KA, Ababneh BF, Bendak H, Alsuwaidi AR, Elbarazi I. Exploring the Mental, Social, and Lifestyle Effects of a Positive COVID-19 Infection on Syrian Refugees in Jordan: A Qualitative Study. International Journal of Environmental Research and Public Health. 2022; 19(19):12588. https://doi.org/10.3390/ijerph191912588
Chicago/Turabian StyleKheirallah, Khalid A., Bayan F. Ababneh, Heba Bendak, Ahmed R. Alsuwaidi, and Iffat Elbarazi. 2022. "Exploring the Mental, Social, and Lifestyle Effects of a Positive COVID-19 Infection on Syrian Refugees in Jordan: A Qualitative Study" International Journal of Environmental Research and Public Health 19, no. 19: 12588. https://doi.org/10.3390/ijerph191912588