Social representations of Covid-19 among hospitalized adults and older adults

Authors

DOI:

https://doi.org/10.12957/reuerj.2025.87354

Keywords:

Nursing, Psychology, Social, Inpatients, COVID-19, Social Representation

Abstract

Objective: to analyze the social representations of Covid-19 among adults and older adults who had been hospitalized due to the disease. Method: this qualitative, descriptive, and exploratory study applied Social Representations Theory with a procedural approach. Thirty-two individuals previously hospitalized for Covid-19 in a public hospital in Northern Brazil were interviewed via telephone between June and August 2021. The data were analyzed with the aid of the IRAMUTEQ software. The Institutional Review Board approved the study. Results: scientific knowledge influenced participants' practices and daily routines. Six categories emerged: protection, spirituality, adaptation, knowledge, images and attitudes, symptoms, and the health system. Final Considerations: social representations were anchored in the concept of a respiratory, contagious, and severe disease, and were objectified in preventive practices. This study highlights the need for health professionals and managers to consider the psychosocial profile of patients in future crises.

Author Biographies

Claudia Susana Pérez Guerrero, Universidade Federal de São Paulo

Nurse from the University of Concepción, Chile. Master's degree from the Associated Postgraduate Program of the University of Pernambuco and the State University of Paraíba. PhD student at the Federal University of São Paulo. São Paulo, SP, Brazil.

Daniela de Aquino Freire, Universidade de Pernambuco

Nurse. Master's and PhD from the Associated Postgraduate Program of the University of Pernambuco and the State University of Paraíba. Recife, PE, Brazil.

Denize Cristina de Oliveira, Universidade Estadual de Rio de Janeiro

Nurse. PhD. Adjunct Professor at the State University of Rio de Janeiro. Rio de Janeiro, Brazil.

Aurélio Molina da Costa, Universidade de Pernambuco

Doctor from the Federal University of Rio de Janeiro. Master's degree in gynecology and family planning. PhD in Family Planning from the University of Leeds, England. Adjunct Professor at the University of Pernambuco. Recife, PE, Brazil.

Fatima Abrão, Universidade de Pernambuco

Nurse. Master's degree from the Federal University of São Paulo-UNIFESP and PhD from the University of São Paulo (USP). Associate Professor at Universidade de Pernambuco. Recife, PE, Brazil.

References

1. World Health Organization. Covid-19 Epidemiological Update. Genebra: World Health Organization; 2024 [cited 2024 Dec 30]. Available from: https://cdn.who.int/media/docs/default-source/documents/emergencies/20241224_Covid-19_epi_update_special-edition.pdf.

2. Mercer KH, Mollborn S. Distinction through distancing: Norm formation and enforcement during the Covid-19 pandemic. Soc. Sci. Med. 2023 [cited 2024 Dec 15]; 338:116334. DOI: https://doi.org/10.1016/j.socscimed.2023.116334.

3. World Health Organization. From emergency response to long-term Covid-19 disease management: sustaining gains made during the Covid-19 pandemic. Genebra: World Health Organization; 2023 [cited 2024 Dec 15]. Available from: https://www.icao.int/safety/CAPSCA/PublishingImages/Pages/Coronavirus/WHO-WHE-SPP-2023.1-eng.pdf.

4. World Health Organization. WHO Covid-19 dashboard [site de Internet]. Genebra: World Health Organization; 2021 [cited 2025 Jan 01]. Available from: https://data.who.int/dashboards/Covid19/cases.

5. Ko JY, Danielson ML, Town M, Derado G, Greenlund KJ, Kirley PD, et al. Risk factors for Coronavirus Disease 2019 (Covid-19)-associated hospitalization: Covid-19-associated hospitalization surveillance network and behavioral risk factor surveillance system. Clin. Infect. Dis. 2021 [cited 2024 Dec 15]; 72(11):e695-e703. DOI: https://doi.org/10.1093/cid/ciaa1419.

6. Bonanad C, García-Blas S, Tarazona-Santabalbina F, Sanchis J, Bertomeu-González V, Fácila L, et al. The effect of age on mortality in patients with Covid-19: a meta-analysis with 611,583 subjects. J. Am. Med. Dir. Assoc. 2020 [cited 2024 Dec 15]; 21(7):915-8. DOI: https://doi.org/10.1016/j.jamda.2020.05.045.

7. Ministério da Saúde (Br). Secretaria de Vigilância em Saúde. Boletim epidemiológico especial 92. Doença pelo Novo Coronavírus – Covid-19. Brasília: Mininstério da As´de; 2021 [cited 2023 Sep 01]. Available from: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos/Covid-19/2021/boletim_epidemiologico_Covid_92_10dez21.pdf.

8. Theano P, Periklis P, Vasilis P, Elli K, Dimitrios P. SARSCOV-2 psychosomatic effects and fear of stigma on the discharge day of infected individuals: SAPFO study. Psychiatr. Danub. 2020 [cited 2024 Apr 07]; 32(3-4):577-80. DOI: https://doi.org/10.24869/psyd.2020.577.

9. Halama P, Tencerová J, Uhrecký B. “The doctors and nurses looked like aliens': a qualitative study on the subjective hospitalization experiences of severe Covid-19 patients in Slovakia”. Int. J. Qual. Stud. Health Well-Being. 2025 [cited 2024 Dec 30]; 20(1):2438831. DOI: https://doi.org/10.1080/17482631.2024.2438831.

10. Jodelet D. Representaciones sociales: contribución a un saber sociocultural sin fronteras. In: Jodelet D, Tapia A, coordenadores. Develando la cultura. Estudios en representaciones sociales. Mexico DF: Universidad Nacional Autónoma de México; 2000. p. 7-30.

11. Jodelet D. A separate epidemic. Pap. Soc. Represent. 2020 [cited 2023 Dec 01]; 29(2):x1-11. Available from: https://psr.iscte-iul.pt/index.php/PSR/article/view/579.

12. Apostolidis T, Santos F, Kalampalikis N. Society Against Covid-19: Challenges for the Socio-genetic Point of View of Social Representations. Pap. Soc. Represent. 2020 [cited 2024 Apr 03]; 29(2):3.1-14. Available from: https://hal.univ-lyon2.fr/hal-03252766.

13. Pizarro JJ, Cakal H, Méndez L, Costa C, Zumeta LN, Gracia-Leiva M, et al. Tell me what you are like and I will tell you what you believe in: Social representations of Covid-19 in the Americas, Europe and Asia. Pap. Soc. Represent. 2020 [cited 2021 Nov 06]; 29(2):23.1-38. Available from: https://psr.iscte-iul.pt/index.php/PSR/article/view/558/468.

14. Bú EA, Alexandre MES, Bezerra VAS, Sá-Serafin RCN, Coutinho MPL. Representations and social anchorages of the new coronavirus and the Covid-19 treatment by Brazilians. Estud. psicol. 2020 [cited 2020 Oct 21]; 37:e200073. DOI: https://doi.org/10.1590/1982-0275202037e200073.

15. Páez D, Pérez JA. Social representations of Covid-19. Int. J. Soc. Psychol. 2020 [cited 2021 Jul 06]; 35(3):600-10. DOI: https://doi.org/10.1080/02134748.2020.1783852.

16. Jaspal R. Social representation and identity processes in relation to Covid-19 reactions: an introduction. J. Br. Acad. 2023 [cited 2024 Apr 03]; 11(s5):1-6. DOI: https://doi.org/10.5871/jba/011s5.001.

17. Almeida RMF, Queiroz ABA, Ferreira MA, Silva RC. Covid-19: psychosociological phenomenon and implications for nursing. Rev. Esc. Enferm. USP. 2021 [cited 2024 Apr 03]; 55:e20210123. DOI: https://doi.org/10.1590/1980-220X-REEUSP-2021-0123.

18. Félix LB, Andrade DA, Ribeiro FS, Correia CCG, Santos MFS. The concept of Social Representation Systems in national and international production: a literature search. Psicol. Saber Soc. 2016 [cited 2024 Dec 15]; 5(2):198-217. DOI: https://doi.org/10.12957/psi.saber.soc.2016.20417.

19. Gomes AMT, Silva EMP, Oliveira DC. Social representations of AIDS and their quotidian interfaces for people living with HIV. Rev. Latino-Am. Enfermagem. 2011 [cited 2020 Dec 03]; 19(3):485-92. DOI: https://doi.org/10.1590/S0104-11692011000300006.

20. Camargo BV, Justo AM. Tutorial para uso do software IRAMUTEQ. UFSC; 2021. Available from: http://iramuteq.org/documentation/fichiers/Tutorial%20IRaMuTeQ%20em%20portugues_22.11.2021.pdf.

21. Ministério da Saúde (Br). Estatuto do Idoso. 2ª ed. rev. Brasília: Ministério da Saúde; 2013. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/estatuto_idoso_3edicao.pdf.

22. Moscovici S. Representações sociais: Investigações em psicologia social. 11ª ed. Tradução de Pedrinho A. Guarechi. Petrópolis, RJ: Vozes; 2015.

23. Moscovici S. A psicanálise, sua imagem e seu público. Tradução de Sonia Fuhrmann. Petrópolis, RJ: Vozes; 2012.

24. Chen M, Wang X, Yun Q, Lin Y, Wu Q, Yang Q, et al. Would older adults perform preventive practices in the Post-Covid-19 Era? A community-based cross-sectional survey in China. Int. J. Environ. Res. Public Health. 2021 [cited 2024 Apr 06]; 18(19):10169. DOI: https://doi.org/10.3390/ijerph181910169.

25. Rosa A, Mannarini T. The “Invisible Other”: Social Representations of Covid-19 Pandemic in Media and Institutional Discourse. Pap. Soc. Represent. 2020 [cited 2024 Apr 06]; 29(2):5.1-5.35. Available from: https://psr.iscte-iul.pt/index.php/PSR/article/view/548.

26. Jamili S, Ebrahimipour H, Adel A, Badiee S, Hoseini SJ, Vejdani M, et al. Experience of patients hospitalized with Covid-19: a qualitative study of a pandemic disease in Iran. Health Expect. 2021 [cited 2024 Apr 06]; 25:513-21. DOI: https://doi.org/10.1111/hex.13280.

27. Sahoo S, Mehra A, Dua D, Suri V, Malhotra P, Yaddanapudi LN, et al. Psychological experience of patients admitted with SARS-CoV-2 infection. Asian J. Psychiatr. 2020 [cited 2024 Apr 06]; 54:102355. DOI: https://doi.org/10.1016/j.ajp.2020.102355.

28. Gomes AMT, Marques SC, Apostolidis T, Nogueira VPF, Souza KPDS, França LCM. Social representations about spirituality of people who lives with aids: un study according to structural approach. Psicol. Saber Soc. 2016 [cited 2024 Apr 06]; 5(2):187-97. DOI: https://doi.org/10.12957/psi.saber.soc.2016.27037.

29. Zhu S, Gao Q, Yang L, Yang Y, Xia W, Cai X, et al. Prevalence and risk factors of disability and anxiety in a retrospective cohort of 432 survivors of Coronavirus Disease-2019 (Covid-19) from China. PLoS ONE. 2020 [cited 2024 Apr 07]; 15(12):e0243883. DOI: https://doi.org/10.1371/journal.pone.0243883.

30. Barros-Leite B, Lima MRO, Caminha M, Santos K, Cunha CBC, Andrade LB. Short-term functional changes after hospital discharge by Covid-19 through teleconsultation at a reference service in Northeast Brazil: a cross-sectional study. J. Med. Virol. 2021 [cited 2024 Apr 06]; 94(3):994-1000. DOI: https://doi.org/10.1002/jmv.27410.

31. Sun N, Wei L, Wang H, Wang X, Gao M, Hu X, et al. Qualitative study of the psychological experience of Covid-19 patients during hospitalization. J. Affect. Disord. 2021 [cited 2024 Dec 16]; 278:15-22. DOI: https://doi.org/10.1016/j.jad.2020.08.040.

32. Costa SS. The pandemic and the labor market in Brazil. Rev. Adm. Pública. 2020 [cited 2024 Apr 01]; 54(4):969-78. DOI: https://doi.org/10.1590/0034-761220200170.

33. Neves JA, Machado ML, Oliveira LDA, Moreno YMF, Medeiros MAT, Vasconcelos FAG. Unemployment, poverty, and hunger in Brazil in Covid-19 pandemic times. Rev. Nutr. 2021 [cited 2024 Apr 01]; 34:e200170. DOI: https://doi.org/10.1590/1678-9865202134e200170.

34. Park S, Massey PM, Stimpson JP. Primary source of information about Covid-19 as a determinant of perception of Covid-19 severity and vaccine uptake source of information and Covid-19. J. Gen. Intern. Med. 2021 [cited 2024 Apr 08]; 36(10):3088-95. DOI: https://doi.org/10.1007/s11606-021-07080-1.

35. Santos KCO, Junqueira-Marinho MF, Reis AT, Camacho KG, Nehab MF, Abramov DM, et al. Social Representations of Hesitant Brazilians about Vaccination against Covid-19. Int. J. Environ. Res. Public Health. 2023 [cited 2024 Apr 08]; 20(13):6204. DOI: https://doi.org/10.3390/ijerph20136204.

36. Joia LA, Michelotto F. Universalists or Utilitarianists? The Social Representation of Covid-19 Pandemic in Brazil. Sustainability (Basel). 2020 [cited 2024 Apr 07]; 12(24):10434. DOI: https://doi.org/10.3390/su122410434.

37. Joia LA, Michelotto F, Lorenzo M. Sustainability and the social representation of the Covid-19 pandemic: a missing link. Sustainability (Basel). 2022 [cited 2024 Apr 07]; 14(17):10527. DOI: https://doi.org/10.3390/su141710527.

38. Oliveira DC, Silva KP, Machado YY, Stefaisk RLM, Domingues JP, Pontes APM, et al. Social representation of Covid-19 for the population of a small-sized city. Rev. Enferm. UERJ. 2024 [cited 2024 Aug 19]; 32:e76360. DOI: https://doi.org/10.12957/reuerj.2024.76360.

39. Mondragon NI, Sancho NB, Ozamiz-Etxebarria N, Saez IA. Coping with Covid-19: social representations underlying blaming processes and fear. Psychol. Health. 2021 [cited 2024 May 20]; 37(7):828-46. DOI: https://doi.org/10.1080/08870446.2021.1896717.

40. Rateau P, Tavani JL, Delouvée S. Social representations of the coronavirus and causal perception of its origin: the role of reasons for fear. Health (London). 2023 [cited 2024 Apr 08]; 27(1):94-113. DOI: https://doi.org/10.1177/13634593211005172.

41. Ferreira AVC, Araújo LF, Neto RNSB. Social representations of Covid-19 among brazilian elderly women: a structural approach. LRPP. 2022 [cited 2024 Sep 01]; 28(2):e617. DOI: https://doi.org/10.24265/liberabit.2022.v28n2.617.

42. Torres-López TM, Reyes-Velázque KG, Lozano-Valenzuela CA, Sandoval-Díaz M. Social representations of Covid-19 of Mexican older people: at the beginning and two years after the pandemic. Actual. Psicol. 2024 [cited 2024 Sep 14]; 38(136):125-39. DOI: https://doi.org/10.15517/ap.v38i136.53862.

43. Eiguren A, Idoiaga N, Berasategi N, Picaza M. Exploring the social and emotional representations used by the elderly to deal with the Covid-19 pandemic. Front. Psychol. 2021 [cited 2024 Sep 14]; 11:586560. DOI: https://doi.org/10.3389/fpsyg.2020.586560.

44. Novikova IA, Berezina EB, Sachkova ME, Dvoryanchikov NV, Novikov AL, Bovina IB. To be scared or not to be scared: social representations of Covid-19 in young people (a cross-cultural study). Soc. Sci. 2024 [cited 2024 Sep 15]; 13(1):62. DOI: https://doi.org/10.3390/socsci13010062.

45. Pathak V, Kharshiing KD, Shahnawaz MG. Covid-19 and emerging adults in India: A social representation approach. Cult. Psychol. 2024 [cited 2024 Sep 15]; 1-29. DOI: https://doi.org/10.1177/1354067X241242410.

46. Mustafa M, Abbas K, Ahmad R, Ahmad W, Tantry IQ, Islam S, et al. Unmasking vulnerabilities in the age of Covid 19 (Review). World Acad. Sci. J. 2025 [cited 2024 Dec 30]; 7(2):290. Available from: https://www.spandidos-publications.com/10.3892/wasj.2024.290.

47. Bajwah S, Wilcock A, Towers R, Costantini M, Bausewein C, Simon ST, et al. Managing the supportive care needs of those affected by Covid-19. Eur. Respir. J. 2020 [cited 2024 Dec 30]; 55(4):2000815. DOI: https://doi.org/10.1183/13993003.00815-2020.

48. Boschiero MN, Palamim CVC, Ortega MM, Mauch RM, Marson FAL. One year of Coronavirus Disease 2019 (Covid-19) in Brazil: a political and social overview. Ann. Glob. Health. 2021 [cited 2024 Apr 01]; 87(1):44. DOI: https://doi.org/10.5334/aogh.3182.

49. Coelho MMF, Cavalcante VMV, Cabral RL, Oliveira RM, Araújo MAM, Gomes AMT. Structural analysis of the social representations on Covid-19 among assistance nurses. Texto Contexto Enferm. 2021 [cited 2024 Apr 08]; 30:e20200358. DOI: https://doi.org/10.1590/1980-265X-TCE-2020-0358.

50. Cercilier PMC, Oliveira DC, Stefaisk RLM, Domingues JP, Machado YY. Social representations of professional and personal self-protection for nurses in the Covid-19 context. Rev. Enferm. UERJ. 2024 [cited 2024 Jun 15]; 32:e74342. DOI: https://doi.org/10.12957/reuerj.2024.74342.

51. Nóbrega MPSS, Marcheti PM, Nasi C, Oliveira E, Moreira WC, Mendes DT, et al. Fear-Generating Circumstances in Brazilian Nursing Professionals in the Context of the Covid-19 Pandemic. NTQR. 2022 [cited 2024 Jun 04]; 13:e667. DOI: https://doi.org/10.36367/ntqr.13.2022.e667.

52. Soleimani F, Aligholipour M, Aghal M, Mamaghani EA. Covid 19 related perceived discrimination in medical settings, March and April 2020. Inquiry. 2021 [cited 2024 Apr 01]; 58:1-5. DOI: https://doi.org/10.1177/00469580211020884.

Published

2025-04-14

How to Cite

1.
Guerrero CSP, Freire D de A, Oliveira DC de, Costa AM da, Abrão F. Social representations of Covid-19 among hospitalized adults and older adults. Rev. enferm. UERJ [Internet]. 2025 Apr. 14 [cited 2025 May 1];33(1):e87354. Available from: https://www.e-publicacoes.uerj.br/enfermagemuerj/article/view/87354

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