Psychosocial health and activities during the COVID-19 pandemic

1Introduction

Currently, the importance of social isolation in preventing the spread of COVID-19 infection is becoming increasingly important. In the measures taken on a daily basis, the closure of sports centers and other mass participation events, as well as changes in business practices, have significantly increased. In addition, many people have started to live by socially isolating themselves at home to prevent getting infected [1–3]. Due to isolation, the life of societies and the world economy have been significantly affected [4–6].

As a result of the sudden decline in business areas, termination of employment contracts or unpaid leave, as well as remote work and a flexible working system have been implemented. Outside of governments and businesses, in the key industries and services (hospitals, essential product supply, pharmacies, food sales, etc.), flexible working from home or remotely has been introduced [3, 7]. Situations such as loss of time management and rearrangement of processes to provide maximum output with a minimum number of personnel, resulted in psychological stress situations [8]. People have experienced traumas, phobic reactions, depression, panic, excessive emotionality, aggression, fear of losing their job, and inability to manage financial processes. As a result of these situations, the pressure situations caused by psychological stress show that the pandemic also created psychosocial problems [4–6, 8–11]. Stress is defined as an internal experience that happens in response to a situation that causes a change in the daily life routine and is difficult to overcome [1, 2, 12, 13]. Since stress is a multifaceted concept, it is often difficult to notice and try to control the emotions that arise when encountering stressful situations. Recognizing stress, learning to manage emotions with an appropriate method, and exhibiting behavior towards it are very important in coping with stress personally [14, 15]. Therefore, individuals need to learn to live with stress and know how to manage it to minimize its negative effects. Effective stress management helps maintain a person’s physical and mental balance while increasing their ability to solve problems and make decisions, as well as increase their efficiency in everyday life [16]. In addition, because stress plays an important role in the occurrence of many diseases, the most important goal of health professionals is to identify stress-causing factors and reduce stress in general society [14]. As a result of the research conducted, it was revealed that uncontrollable stress can result in serious problems for both the person and his/her environment [8, 17, 18]. Self-control and self-management skills to solve the perception of stress are one of people’s most important assets. When emotions are forming, it is important to understand the reasons for this and be able to control that emotion. The perception of control plays an important role in maintaining physical and mental health [8, 14, 19]. The ability to effectively organize, prioritize and manage one’s actions is vital for the workplace and life. However, most people do not have sufficient awareness of the importance of self-management skills. It is important that an individual can adapt their feelings, thoughts, and behavior to changing conditions and be flexible in situations that require struggle and change. Harmonious people can cope with many demands without losing focus or energy and are not distracted by the inevitable uncertainties of public life. To be able to manage emotions is to calm oneself, get rid of intense anxieties, pessimism, and touchiness, get to the source of restlessness and evaluate them, and be able to cope better with negativity. While people whose ability on this is weak are in a constant state of restlessness, people whose ability on this is strong recover more easily as a result of negative experiences [17, 20, 21]. They direct and motivate themselves to do their duties and jobs [22, 23].

Given work-related behaviors, it is known that people perceive that they are in control while doing work and that having the opportunity to self-manage will reduce the perception of stress [17]. With the synergy formed by these components, the individual gains control of their own behavior and management skills. Therefore, self-control and self-management skills are also a matter of will and can be a driving force in reducing the perception of stress, as it is the ability to manage oneself effectively [24]. Measures are being taken to neutralize the harmful effects of stress that begin in the body and continue psychologically by taking measures to neutralize it. Therefore, it can be stated that individuals with high self-management and self-control skills can also strengthen their beliefs about managing stress in the COVID-19 period by recognizing themselves and what they can do and having successful experiences. People clarify their goals through high self-control, organize everyday life [21], and experience well-being and success [2]. Thanks to self-control, individuals are able to cope with procrastination and contribute to their happiness as a result of reducing the stress and pressure caused by the accumulation of work. During COVID-19, employees felt restricted in many ways. The level of stress perception also increases in individuals with increased workload and difficult working conditions [3, 16, 25]. The excess workload and stress negatively affect the employees’ ability to cope with difficulties, but they will be in psychological well-being when it comes to using their self-management skills to deal with negative effects on employees. The fact that an individual performs their job with pleasure, participates in decision-making processes related to their job, is productive, and actively uses their skills and knowledge will increase the self-control of the individual. As a result, the perception of stress will decrease [17, 25].

By developing small changes in our cognitive and emotional outlook, we can identify strategies to get over or better manage the stress experience. Replacing the reduced activities in daily routines with new areas of activity that give pleasure and satisfaction will give rise to a supportive structure [26]. During the COVID-19 pandemic, positive associations between physical activity and physical health were found, and a negative relationship was found between sedentary behaviors and physical and mental health outcomes in the literature [26]. Physical exercise, activity, healthy eating, relaxation, and regular sleep patterns help reduce mental and physical tensions caused by stress and further facilitate recovery. It has been determined that there are not enough studies in the literature on how to develop self-management skills in order to recognize stress symptoms and manage stress in terms of psychological well-being and stress perception [3, 8] during the COVID-19 period. A study revealing the relationship between these concepts has not been found, which shows that the research is unique. In this way, it is expected that the current study will expand the literature as a result of revealing the relationship between these concepts.

The main aim of the current research is to investigate the relationships between stress perception, self-management, and the change of these variables according to socio-demographic characteristics of people working during the pandemic period. In addition to the physical threat posed by the COVID-19 pandemic to people all over the world, an understanding of its social, psychological, and economic impacts is needed. It is thought that the findings to be obtained as a result of this research will provide additional information about the possible effects of the COVID-19 pandemic and practical data to the literature on employee health and safety.

2Methods

3Results

4Discussion

There was a moderate level of stress perception in almost all individuals and their skills in using self-management strategies were moderate. It was determined that stress perception negatively affects self-management control skills, and there is a relationship between stress perception and self-management control skills. This shows that participants are not very good at using strategies that help them manage their behavior to suddenly reduce discrepancies in externally established standards. In addition, the moderate level of self-management and self-control skills indicates that they do not know themselves and what they can do very well.

One of the study’s findings is that women’s risk perception levels are also higher than men’s. Within the scope of the current research, the perception of stress has been examined in terms of gender, and it has been concluded that the perception of stress was higher in women than in men during the COVID-19 period. This finding is consistent with studies showing that women have higher levels of risk perception [8, 11]. The fact that women’s anxiety rate is higher than men’s supports the conclusion that women feel the negative threat perception of COVID-19 more than men. Although there are studies showing that women have higher levels of risk perception [8, 11], some studies contradict these results [28, 29]. The fact that the women are more anxious than men supports the conclusion that women feel the negative threat perception of COVID-19 more than men. In the current study, we did not find any difference among the participants in terms of self-control and self-management skills. In addition, having high levels of self-management and self-control skills shows that the person has a high level of self-awareness and knows what he/she is capable of. This demonstrates that the person can successfully set a course that provides benefit. Contrary to the findings, in the study by Ercoşkun, according to the gender variable, there was a significant difference in favor of female teacher candidates in the sub-dimensions of self-regulation, self-evaluation, self-reinforcement and total score [22].

When examining according to educational status, it was found that the perception of stress and the perception of control during the COVID-19 pandemic were not affected by the level of education. In contrast to our study, another study conducted by Ekiz et al. found that individuals who graduated from primary education have a high perception of control [19]. The difference in the studies is that the increased level of consciousness along with the level of education has differentiated the perspectives and expectations of individuals about pandemic control practices.

Healthcare is a profession where employees may experience the anxiety of losing both their health and their job at the same time and where the risk of being infected is higher in the workplace [28, 30]. It has been noted that increased anxiety in employees, and in some cases even panic, can spread COVID-19 even faster than the virus. In the study conducted by Zhang et al. it was investigated whether healthcare workers had psychosocial problems during the COVID-19 pandemic and it was observed that anxiety, depression, and obsessive-compulsive symptoms were higher, especially in workers who had one-on-one contact with patients [28]. Similarly, current study found that the professions with high stress levels were health workers. The results of our study are parallel with the knowledge in the literature. In addition, it has been stated that transparent communication will be more important than ever, especially in order to minimize the negative effects of uncertainty on employees, and businesses that act with real consideration of their employees through actions and measures will increase their value even more in this process [31, 32].

Considering the type of sector, there was no difference between the stress level and self-management and self-control skills of individuals working in the private and public sectors. Due to adverse conditions, many sectors are very can take major injuries [32]. When the stress level of the individuals participating in the study was examined, it was seen that more than half of them had a moderate level, close to 6%, and had a serious perception of stress. Similar to the situation in Turkey, studies have shown that individuals have an increased perception of social risk after COVID-19 [3, 11, 34, 35]. It has been stated in the literature that pandemics will have negative effects on working individuals and society [3, 36]. In general, perceptions of inadequacy in self-control and uncertainty were associated with psychological distress during the pandemic [37]. The high stress levels can be attributed to uncertainty about the future, especially job losses and economic anxiety [8]. Due to the COVID-19 pandemic, employees have been dismissed or sent on leave by their employers [38, 40–42]. It has been shown that people who expect to lose their jobs have increased levels of stress [38]. Therefore, the COVID-19 outbreak is worrisome for employees. A recent study has demonstrated that self-control reduces emotional job insecurity in those who were dismissed. Similar to the results of the above-mentioned study, we did not find any difference between the dismissed people and employees in terms of stress perception and self-control and self-management skills. This may be because the dismissed people may have reduced their negative emotions through their self-control skills. The negative consequences of COVID-19 have made businesses vulnerable [44].

Considering the working sector, during this period, the activities of most enterprises were temporarily stopped, and only enterprises providing basic services were allowed to continue their activities [43]. Similarly, in our study, individuals work in the health, education, and service sectors. There was no difference in the perception of stress and self-management and self-control skills of the employees in this sector. We can attribute this to the fact that COVID-19 affects all sectors.

Another change in working conditions has been flexible working hours. 34.3% of employees have flexible working hours, and 25.4% have remote working hours. In the efforts made within the organization, the process of working from home was experienced. In our study, the employees’ working hours were found to be a maximum of 6 hours. In contrast to our study in the literature, it has also been observed that remote work is mismanaged in some companies and causes more workload for the employee at home [45, 46]. In the study by Ekpanyasku and Padungtod, family and work balance could not be maintained at home due to irregular working hours [3]. According to the report created by Randstad in accordance with the data collected from many countries, 83% of employees have adapted to the new working environment they have due to the COVID-19 pandemic [39]. While 75% of those who can adjust their working hours while maintaining family and work balance at home, almost all working group members have been able to adjust their working hours. In the current study, no differences were found in terms of stress perception and self-management and self-control skills according to the way individuals work. It has been observed that those who can set their working hours at home can complete their work at home in a shorter time and that employees fulfill their individual responsibilities. They have guided and motivated themselves to do their duty and their job.

In the current study, the proportion of those with reduced material income was 35.9%. In the current study, a difference in the perception of stress was found between people with decimated income and people who work. The stress perception of those with reduced income was found to be high [43]. The decrease in income has emerged as the COVID-19 pandemic has caused deterioration in the economic activities of all businesses.

The current study found weak and negative correlations between perceived stress level and management and self-control ability. This situation shows that as the level of stress perceived by the person increases, self-adjustment and self-assessment will decrease, and there will be problems in interpreting the internal balance of the person. As a person strengthens and controls himself, the stress he perceives will decrease. As a result of our research, it has been determined that stress level negatively affects the perception of COVID-19 pandemic control. As individuals’ stress levels increases, their perceptions of controlling the pandemic decreases. Self-assessment decreases and problems may arise in interpreting a person’s internal balance. As a person strengthens and controls themselves, the stress they perceive decreases. Since stress causes high levels of anxiety and fear in individuals, it is likely that protectionist attitudes will develop in individuals. Therefore, our study determined that individuals did not have difficulty complying with the rules related to COVID-19. This shows that these people comply with the rules pertaining to personal protective equipment while working at work and at home. It has been found that people who follow the rules have a high perception of stress and low self-management control skills. Contrary to the current study, in the study conducted by Wang in China, it was observed that taking individual precautions (e.g., following COVID-19 rules such as hand hygiene and wearing a mask) reduced the stress level [11]. A study conducted by Mayer et al. found that there is an association between compliance with the rules for COVID-19 and stress perception [8]. In addition to taking individual measures to control the level of stress perception in society, it is important to implement control measures applied nationwide and individually. It will be easier for individuals who fully understand the importance and content of the measures taken to demonstrate behavior related to compliance with the rules related to COVID-19. Thus, the level of risk perception of individuals will decrease.

The current study reported that 69.1% of individuals had a decrease in sleep quality since the beginning of the COVID-19 pandemic. In the studies conducted, it was reported that there were negative changes in 40.7% and 56% of individuals [3, 47, 48]. These rates are not surprising, given the psychological state created by the COVID-19 pandemic. In the current study, when individuals were examined for decreased sleep quality, there was no difference in stress perception and self-management and self-control skills. During a global pandemic, it is natural for there to be a negative change in sleep quality due to economic distress, changes in exercise behaviors, and concerns about employment and relationships. To improve the quality of sleep during COVID-19, it is recommended to adhere to a number of recommendations, some of which include maintaining a regular sleep routine, limiting listening to news about COVID-19, and regular exercise during daylight hours [3, 47, 48].

When the size of the activities done at home during the COVID-19 pandemic is examined, it was determined that the most common activities were working at work, daily living activities, self-care activities, cleaning, cooking, watching television, reading books and listening to music, watching home cinema, religious activity, playing online computer games, respectively. Since the beginning of COVID-19, various events had to be held at home due to the closure of exercise and sports facilities and the inability to participate in cultural events. The current study’s overall decrease in physical activity is probably due to social distancing, travel restrictions, and the closure of regular exercise venues. In the study by Ekpanyasku and Padungtod, it was determined that physical activity decreased due to COVID-19 disruption of work-life balance [3]. The study findings support each other. Considering the psychological benefits of physical activity on mental health [49–51], additional strategies are needed to increase physical activity. It has been emphasized that increasing physical activity is a valuable strategy for improving mental health and preventing the risk of developing stress [14]. In the current study, no difference was found when the individuals’ physical activity was examined in terms of stress perception, self-management and self-control skills of the individuals whose physical activity decreased. This may be due to the cultural characteristics of the group that made up the sample.

As a result of the one-variable analysis for PSS scores, the variables that were found to be significant were included in the multivariate linear regression analysis. Dependent variable PSS total score: In the regression model, in which the independent variables are gender, occupation, a decrease in income and compliance with the rules and total self-management scores was seen. Determining factors for PSS total scores: Gender, decrease in income, obeying the rules, and self-management total scores were determined (R² = 0.248, F = 11.452, p = 0.000). Since R² was 0.248, we determined that the tools mentioned above explain the perception of stress by 24.8%. A recent study determined that COVID-19 stress has a significant effect on adjustment to business life (p < 0.001). In this case, one-unit change in the stress variable causes an increase of 1.14 units in adjustment to business-life. Since R² was reported as 0.38, it has been determined that the stress can explain business-life adjustment by 38% [52]. In this aspect, the studies are similar to each other.

5Conclusion

Our data showed that the participants had a moderate level of stress. Using moderate self-control strategy was one of the factors affecting perceived stress. We demonstrated that the participants were under stress during this difficult period and could not cope with the process in a controlled manner. The current study found negative correlations between perceived stress level and self-management and self-control ability. This shows that, as the level of stress perceived by the person increases, self-adjustment and self-assessment will decrease, and there will be problems in interpreting the internal balance of the person. As a person strengthens and controls himself, the stress he perceives will decrease. As a result of our research, it has been determined that stress level negatively affects the perception of COVID-19 pandemic control. During this period, while preparing programs for coping with stress, it may be beneficial to include social support and help the development of self-control and self-management skills. Based on the results, it can be said that organizational support practices for employees during COVID-19 should be developed. It has been determined that organizational support has important effects on increasing the employee’s self-management and self-control and decreasing stress. For this reason, it has been determined that the level of organizational support, which seems to have a significant impact on their psychological status, can be increased by increasing support for employees and reducing work stress perception during COVID-19. Reducing job demands and workload, increasing job control and rewarding can help keep employees motivated and protected. Concrete reward systems to be implemented within the scope of perceived organizational support will help to meet the expectations of employees who have difficulties in meeting their socio-emotional needs. At this point, keeping employees happy, giving importance to their happiness, supporting self-control and self-management rights have a key role that can produce positive results for both the organization and employees. Because the support from leaders or organizational practices can be a source of inspiration for employees to use their own knowledge for different problems or purposes.

In line with the data obtained from the study, we would like to make some suggestions. First, considering that women have a higher perception of stress than men, it is necessary to support women in terms of improving self-management and self-control skills against stress. Second, since the levels of stress perception of healthcare professionals are higher than the levels of non-healthcare professionals, the number of protective and preventive measures should be increased in the working areas. Third, it is important to emphasize the necessity of education and trainings that inform the society and employees about the importance of complying with the rules related to pandemic in home and working life. By taking into account that income status and compliance with the rules are effective in managing the perception of stress, we suggest that the governments should take measures against these stress-inducing factors by providing the necessary economic support to the unemployed or low-income employees. Fourth, since the beginning of pandemic, various activities had to be conducted at home due to the closure of exercise and sports facilities and the inability to participate in cultural events, which decreased physical activity. Because of the positive impact of physical activity on mental health, activities and programs that promote physical activity can be planned. Lastly, it is recommended to investigate whether the perceived stress in the normalization process in the post-pandemic period has permanent effects on the psychosocial state of employees.

This study is not without limitations. The fact that the research is conducted in a certain period creates a common constraint for such studies with different features. The perception and psychosocial situations of individuals change over time with the changing situation, precautions, and practical applications throughout the country.

Ethical approval

The study was approved by the Scientific Research Ethics Committee of Ankara University (decision no. İ4-233-20, date 29.04.2020).

Informed consent

Informed consent form was obtained from all participants prior to the study.

Conflict of interest

The authors declare that there is no conflict of interest associated with this work.