Understanding and decision-making of older people in face of the information about Covid-19: a case study in southern Brazil

Abstract

Information about the Covid-19 pandemic has become the focus of attention in the population's health. In this sense, older people, in addition to being classified as a risk group, are vulnerable to the impacts of the quantity and quality of information received, as they need to go through a digital literacy process. Objective: to understand how active older people use information about Covid-19. Methodologically, a Case Study of a unique type of qualitative methodological theoretical approach was carried out, based on Thomas Wilson's theory of Information Behavior. Semi-structured interviews were carried out, seeking to reach theoretical saturation of the data. Thus, 31 elderly people were interviewed, obtaining an average age of 69 years, mostly with high education. As a result, it was observed that the information was used to assimilate the phenomenon experienced, in the search for understanding how to act and make decisions about health care. It is considered that the case presented elderly people who started to feel more able to select the news during the pandemic period. The findings can contribute to the construction of instructional materials in relation to health information, aiming to make appropriate decisions.

Keywords:
Health of the Elderly; Information literacy; Infodemic

Resumo

As informações sobre a pandemia de Covid-19 passaram a ser foco de atenção na saúde da população. Nesse sentido, pessoas idosas, além de classificadas como grupo de risco, são vulneráveis aos impactos da quantidade e qualidade das informações recebidas, por necessitarem passar por um processo de letramento digital. Objetivo: compreender como pessoas idosas ativas utilizam as informações sobre a Covid-19. Metodologicamente, foi realizado um Estudo de Caso do tipo único de abordagem teórico-metodológica qualitativa, fundamentado na teoria do Comportamento Informacional de Thomas Wilson. Entrevistas semidirigidas foram realizadas, buscando atingir a saturação teórica dos dados. Assim, 31 pessoas idosas foram entrevistadas, obtendo-se média de idade de 69 anos, majoritariamente de alta escolaridade. Como resultados observou-se que as informações foram utilizadas para assimilar o fenômeno vivenciado, na busca por compreender como agir e tomar decisões sobre o cuidado em saúde. Considera-se que o caso apresentou pessoas idosas que passaram a sentir-se mais capacitadas a selecionar as notícias no decorrer do período de pandemia. Os achados podem contribuir na construção de materiais instrutivos em relação às informações sobre saúde, visando a tomadas de decisões adequadas.

Palavras-chave:
Saúde do Idoso; Competência em informação; Infodemia

Resumen

La información sobre la pandemia de Covid-19 se ha convertido en el foco de atención en la salud de la población. En este sentido, las personas mayores, además de ser catalogadas como un grupo de riesgo, son vulnerables a los impactos de la cantidad y calidad de la información recibida, pues necesitan pasar por un proceso de alfabetización digital. Objetivo: comprender cómo las personas mayores activas utilizan la información sobre el Covid-19. Metodológicamente se realizó un Estudio de Caso de un tipo único de enfoque teórico metodológico cualitativo, basado en la teoría del Comportamiento de la Información de Thomas Wilson. Se realizaron entrevistas semiestructuradas, buscando alcanzar la saturación teórica de los datos. Así, fueron entrevistados 31 ancianos, obteniendo una edad promedio de 69 años, en su mayoría con educación superior. Como resultado, se observó que la información fue utilizada para asimilar el fenómeno vivido, en la búsqueda de comprender cómo actuar y tomar decisiones sobre el cuidado de salud. Se considera que el caso presentó personas mayores que pasaron a sentirse más capaces de seleccionar las noticias durante el período de la pandemia. Los hallazgos pueden contribuir para la construcción de materiales didácticos en relación a la información en salud, con el objetivo de tomar decisiones adecuadas.

Palabras clave:
Salud del Anciano; Alfabetización informacional; Infodemia

Introduction

The Covid-19 infodemic has been defined by the WHO as overwhelming abundance of misinformation related to the pandemic, considering this phenomenon as an emerging public health issue^1,2. This situation intensifies mainly due to the false information disseminated through social media, which ultimately impacts the population’s actions regarding Coronavirus precautions^3,4,5. Coronavirus spread was also linked to the proliferation of information about the disease. The term Covid-19 “infodemic” characterizes the excessive amount of easily accessible information about the topic to the population. This phenomenon was oftentimes associated with the dissemination of false or scientifically unverified informational material⁶. During the Covid-19 pandemic, aged individuals were considered a “high-risk group”, receiving stricter recommendations regarding social distancing and protective measures against the disease^7,8,9,10. The risk of aged individuals experiencing severe outcomes related to Covid-19 deserves attention. However, the risk of facing consequences due to the infodemic should also be considered¹¹. The aforementioned considering that this population group is continuously undergoing a digital literacy process, striving to adapt to the new available ways of receiving information^6,11,12.

Aging of the Brazilian population is gradually increasing; however, it is concurrent with social inequality. In this sense, the development of studies regarding the health-disease relationship among aged individuals contributes to structuring public policies that focus on the current scenario and aim at promoting the feasibility of healthy aging^13,14. There are several health demands that require the attention of the Brazilian health system, and the demographic shift towards an older population adds to this array of needs, considering an increasingly aging population¹⁵.

Technological advancements enable an expansion in access to health information, aiming for awareness raising. However, the ease in sharing informational material also impacts the proliferation of fake news, which was widely observed throughout the Covid-19 pandemic and influenced the behavior of people accessing such materials⁶.

In this regard, it is necessary to develop and enhance studies regarding the process of acquiring and using information concerning its impacts during the Covid-19 pandemic¹⁶, especially in aging populations. Based on this assumption, it is necessary to understand aged individuals’ informational behavior regarding Covid-19 excessive and fake information, as well as its repercussions, when considering health care strategies for this age group and for other generations undergoing the aging process¹⁷. In light of the above, this study aims at understanding how active aged individuals living in a large urban center use the information they have been exposed to amid the Covid-19 infodemic.

Methodology

The current study is part of an international multicenter research project¹⁸, which analyzed the repercussions of the Covid-19 infodemic on aged individuals’ mental health, using a mixed-methods approach with a sequential explanatory strategy¹⁹. This study corresponds to phase two of the project in the city of Porto Alegre, RS, which is one of the municipalities included in the multicenter study. In this context, it is a single-case study of a qualitative theoretical-methodological approach, developed using an inductive method. A single Case Study is proposed, understanding its exploratory nature, where a historical opportunity was found for its development, in the quest to understand aged individuals’ informational behavior during the pandemic, which in contemporary times is inseparable from the Covid-19 infodemic phenomenon. Thus, it is also contextualized as an exploratory Case Study with contemporary characteristics²⁰. The research was theoretically and methodologically grounded on Thomas D. Wilson’s Information Behavior Theory²¹. The research has been approved under opinion 4,134,050 from the National Commission of Ethics in Research (Comissão Nacional de Ética em Pesquisa, CONEP).

The participants were selected based on the assumption that those aged individuals who initially consented to continue participating in the qualitative part of the research would be contacted, as the quantitative phase took place prior to this case study¹⁸. From there, older adults (aged 60 or above) with preserved cognitive function, access to email and/or social media and/or a telephone, living in the city of Porto Alegre/RS and who participated in the first stage of the study were included in this study. The participants should be able to respond autonomously to the questions and interact during data collection. Participants were assured that, if they withdrew from participating in the research, they would simply do not accept verbally or ask to stop at any time. Among the people contacted who agreed to start the interview, only one refused to continue participating.

The data were generated through semi-structured interviews, following a guiding script containing the trigger questions below: “Tell me about a situation (an example) during the Covid-19 pandemic when you needed to seek information”; “Tell me: how do/did you feel when receiving information or news about the disease or the virus?”; “How do you deal with information about Covid-19?”; “Would you like to share anything else about how you react (or have experienced) to this information about COVID-19 in your life?”. Due to the interviews being conducted during the pandemic, they were carried out via phone calls or video call apps and were audio-recorded, aiming to understand the participants’ perspective and experiences regarding the phenomenon under study. The guiding questions were formulated based on Information Behavior to understand information search, analysis, use and sharing²¹. It is worth noting that circular questions were posed throughout the interviews to deepen the data production process.

The initial approach to the participants was made through phone contacts provided by the aged individuals during the web-based survey conducted in Phase 1 of the research. A message via WhatsApp was then sent, providing context about continuation of the research and inviting the aged individuals to participate in the second phase. After the written explanation, if necessary, a phone call was made to address any further questions about the conversation. Once the older adults expressed their interest, a date and time were scheduled for the semi-structured interviews. Contacts via the WhatsApp messaging app and phone calls were made to establish the initial connection with the aged participants for subsequent interviews. Throughout the approach, the researcher did not insist if the aged individuals did not express interest in participating and/or continuing to participate. Although there was already acceptance of phase 1 of the research, willingness to participate in phase 2 was at the discretion of the aged participants, who were reminded of this previous moment, and their eventual consent was recorded again verbally during the audio-recorded interview.

The data collection process for this research with the aged individuals from Porto Alegre took place from July 2021 to April 2022. The interviews for this Case Study were conducted during a period of elderly vaccination with the second dose, social contact insecurity, and a slow decline in the number of deaths and ICU hospitalizations. The final number of interviewees/participants was determined using the Theoretical Data Saturation Technique^22,23. It was considered that it is not possible to rely on a saturation point a priori, respecting the idea that the approach made in the field needs to reflect the researcher’s perception in relation to its objective²⁴. Thus, 31 interviews were conducted. The interview transcriptions were prepared according to how the participants expressed themselves, aiming to maintain the conversational tone. A transcription protocol was followed, which proposes specific writing standards and symbols to identify the way in which the conversation took place²⁵. The data collected and transformed into textual material were systematized using Content Analysis with the aid of the OpenLogus software. Based on relevant convergences in the content discussed, the codings were grouped into thematic categories, guided by interpretations supported by the theoretical framework of Thomas Wilson’s Information Behavior model²¹. It is emphasized that the coding was established through consensus with the team of researchers responsible for developing the Multicenter Project¹⁸, involving collective elaborations and validations during periodic meetings held throughout the research process. The results were interpreted in a way that rendered them meaningful and valid. A second qualitative researcher monitored data analysis for validation¹⁸.

In this methodological context, the case under study proves to be rich in contexts that allowed understanding a unique scenario, associating individuals, informational issues, emergency decrees and availability of vaccines never before administered to the population. This context, experienced from 2020 onwards, also involved the specificities of technological advances, influencing science, health and communication both in positive and in negative ways through easy access to a large amount of information on the topic.

Characteristics of the participants

From the initial stage of the Multicenter study^18,26, which obtained a sample comprised by 381 aged individuals, 128 participants expressed interest in continuing to participate in the next study stage. From the contact with these individuals, 31 aged participants were interviewed, respecting the wishes of each participant who had previously expressed interest and aiming to achieve theoretical data saturation.

The strategy for contacting potential interviewees was established to ensure representativeness of age and gender within the group of older adults (mean age of 69 years old) in the case under study. All the aged participants in the study identified themselves as residents of Porto Alegre/RS, although some had temporarily moved to inland cities during the social isolation period. Other characteristics such as schooling and ethnicity, although not considered in the participant selection process due to lack of considerable variety to articulate with other markers, were described and considered in the characterization of the participants.

The participants in this research were white-skinned, with high schooling levels, characteristics representative of the sample in Porto Alegre/RS from the multicenter study. It is worth noting that they are aged individuals in Porto Alegre with Internet access, contacted via digital media. In addition to experiencing the infodemic via the Internet, they are participants who showed willingness to talk about its use, in line with the topic of this research.

The sociodemographic characteristic of the case study might be associated with the participants’ schooling levels, reasserting the inequality in access to education concerning race/skin color in Brazil. More specifically in Rio Grande do Sul, the illiteracy rate, categorized by race/skin color and age group, reveals that individuals aged 60 or older and identified as black-skinned have an illiteracy rate three times higher than that of white-skinned individuals in the same age group²⁷. Therefore, the fact that the people who make up the case under study have a high level of education also reflects the lack of ethnic representation in access to education in the city of Porto Alegre. People with high schooling, access and understanding of Internet use tend to present a sociodemographic profile indicating a pattern of older adults more familiar with digital media²⁸.

With the insights shared by these aged individuals in their conversations and interviews, coupled with the theoretical framework chosen for analysis and interpretation, it was possible to understand that these people use the overwhelming amount of information that reaches them first to comprehend the pandemic phenomenon and, subsequently, to select methods for dealing with the situation. In this comprehensive process, two thematic categories were structured, which guide the discussion and interpretation of the Case under study.

Results and discussion

The results of the present study are presented in a narrative form, in such a way that some excerpts of speeches that represent Unit of Records are brought into the text. Such Registration Units, within the process of analysis and semiotic interpretation strategy²⁹, allowed the construction of nuclei of meanings that represent the contents transformed into two major themes that represent behaviors of elderly people in the face of information regarding Covid-19. In this way, the excerpts of the speeches do not represent the results in full but illustrate in a semiotic textual narrative important record of the content for the construction of the interpretation according to the theoretical framework used in the research. Two themes emerged as results: “Developing an understanding of the Covid-19 pandemic” and “Decision making: selecting and using methods of protection and health care” which will be described below.

Developing an understanding of the Covid-19 pandemic

The informational behavior of seeking information arises from the need to use this material for a final goal²¹. The research participants had the behavior of obtaining information about the pandemic with the intention of gaining greater understanding of the danger of the situation and, consequently, the necessary preventive measures. There was a skill developed by these older people, after accessing information, to seek what this pandemic was about. The perception of danger exists and presents itself as something beyond control and different from a common flu³⁰. This understanding of the existence of the virus and its consequences, as well as the significance of taking action on the presented problem, was based on the information accessed regarding progression of the disease. These aged individuals seek information to contextualize themselves about the virus, the disease and what to do.

I already have this, you know: awareness of the danger of all this. And having this awareness, I perhaps have much more awareness than people in general, that is, I already saw that this is what happens, so I won’t do it. I’ve already set it in my mind, I won’t do it, I understand. So I have this, you know, I know that I have to wear a mask to go to the supermarket, that I shouldn’t get close to people, so it’s already something, it’s part of my daily life. I will only stop wearing masks, I will only stop changing my behavior when I’m sure that everything is okay, that it’s cleared, and that we can move freely (Jequitibá, male, 64 years old)

Throughout the pandemic, even amidst the infodemic, it is observed that adopting health precautions becomes part of the participants’ everyday lives. The act of taking care of oneself and protecting themselves against contamination came from the progressively acquired understanding of the topic. Attention to concerns and difficulties practicing safe care during the pandemic becomes extremely necessary, both for users and for health care professionals. Understanding these challenges can exert positive impacts on the safety of practicing health precautions³¹. Information use behaviors correspond to the act of assimilating the material, comparing it to previous knowledge²¹. The aged individuals interviewed are aware of the necessary precautions throughout the pandemic. This understanding has been leveraged to provide relief and guide their ideal actions, also avoiding the potential uncertainty caused by excess of information.

So, this kind of thing, well, it makes you... As time went on, as you kept informing yourself and as time passed, and you exactly understood the issue where you were in the midst of that difficult and different moment in everyone’s life, that gradually gave me... I won’t say security, but certain relief... Being able to deal with it better (Hortênsia, female, 73 years old)

It is possible to understand that these conscious aged individuals seek knowledge about the pandemic and behave in a way that aims at controlling their insecurities and addressing potential uncertainties. There was a shift among older adults to look at themselves as affected by the infodemic, emphasizing the complex nature of this phenomenon. Guidelines specifically aimed at the elderly, labeling them as a “high-risk group” during the pandemic, caused some distress among people belonging to this age group, who perceived this labeling as a confirmation of their vulnerability¹⁰.

Age is weighing on me in a way it didn’t before, you know? Because, uh, we see so much... death, it’s like you can see it... Because you’re old, it’s like... I don’t consider myself old, sixty-three years old... Uh, it’s like you start counting how many years you might have left, you know? When in fact, you should think: ‘no, but there are people who didn’t know there would be a tomorrow’, right? Who died at eighteen, twenty years old due to COVID... Do you understand? But death, it became heavier in my mind, you know? It’s one of those feelings that stayed with me from the pandemic that didn’t exist before (Orquídea, woman, 62 years old)

When thinking about a situation, it is necessary to consider one’s own experiences and implications in facing it, so that both are seen as interrelated³². In this context, informational behavior involves seeking, managing and using information to meet a need²¹. Seeking to understand the informational behavior of the case under study, it becomes necessary to comprehend the experiences underwent during certain Covid-19 pandemic moments, in order to corroborate the understanding of other past crises and, possibly, future ones. Thus, the aim is to empower those who experienced the phenomenon and can, in similar situations, recall what was possible to extract and learn from it³³. Some of the aged individuals interviewed began to interpret relationships differently, understanding the complexity of the situation and, consequently, its various implications.

Yeah, we have to change some paradigms that we see as traditional to more humanitarian ones. And live the essence, love. We have to better understand what love is, tenderness, people’s needs... we have to talk more, stop arguing so much about trivial things (Cipreste, woman, 78 years old)

It is noticed that the news about the Covid-19 pandemic led aged individuals to rethink their practices and relationships, aiming to contribute to caring for their own health and others’. The gradual development of understanding in terms of the information, as well as the pandemic and infodemic scenario, favored the perception of the need for adequate care over time.

Decision making: selecting and using methods of protection and health care

Informational behaviors, ranging from accessing information and understanding the indications provided to reflecting on possible actions to be taken, influences successive decision-making processes²¹. Therefore, individual attitudes also carry significant social responsibility, as they impact various social groups, especially those considered at risk in the fight against the virus³⁴. The study participants reported that the information they sought enabled them to gain discernment, empowering them to act and make more conscious decisions, such as adopting social isolation and disease prevention measures, or preparing themselves for the future.

Which was your purpose in seeking this information, what motivated you to do this search? (Interviewer). To see... trends, right? Even to plan for the future. At the very beginning of the pandemic, it helped me a lot, right? (Carvalho, male, 61 years old)

Despite the learning process identified, aged individuals have low health literacy, requiring support to ensure their autonomy regarding their own well-being³⁵. Therefore, working on health literacy development provides room for considering self-care and seeking safe strategies, not only during the pandemic but also in future health-related situations³⁵.

So I start to see what’s there/I always think: if someone is pointing out that this, this and this shouldn’t be done, I/eh, someone I see on television, through the information you receive [...] Then I see that there are things I shouldn’t do, and I don’t do them. I don’t have this superhero mentality that I can go there and nothing will happen to me. You know? I think: it will happen to me if I, if I slip up, you know? (Jequitibá, male, 64 years old)

It is noted that there was a change trend regarding acceptance of the health recommendations during the pandemic, linked to the support for reopening businesses for those who are not part of high-risk groups. Similarly, part of the population continued to favor universal isolation over time and there were also individuals who, while taking precautions, engaged in activities outside their homes³⁶.

Regarding compliance with the isolation recommendations based on scientific studies, it is understood that the participants in this study had the opportunity to choose whether to isolate or not, unlike those from lower economic conditions who did not have the same decision-making opportunity and had to face the streets and the contamination risk. In addition, two groups of participants were identified that could make this choice: the first one agreed with the health recommendations and stayed at home, whereas the other group understood the possibility of easing social isolation measures and resumed activities outside their homes.

Those earning low incomes faced a higher contradiction level between agreeing with the health protection measures but being unable to implement them due to lack of resources. In contrast, the middle-income group (earning between five and twenty minimum wages) showed a stronger connection between agreement and practical adherence to these precautions, as shown in the present study. Finally, individuals with higher incomes showed greater disagreement and lower adherence to the scientific recommendations³⁰. The older people in the present study were aware of the diversity of realities experienced during the pandemic. It is believed that they were able to better deal with possibilities of health problems because they understood how to behave when faced with information. However, they sometimes brought difficulties in perceiving social disparities, which intensified during this period.

Because I used to think: if it’s in the village, the precautions must be lesser, the poor people, because sometimes they don’t even have access to hygiene products, or this access is more difficult. Then, on the other hand... and surprisingly, this virus was very democratic (laughs). Because it really DID NOT choose social classes, because, despite this fear, that we would sometimes hear conversations from the village... People were dying there and people were dying here too, so well, I don’t know where this contagion happens (Rosa, female, 60 years old)

Although intended to protect, the social distancing recommendations brought about confusion regarding the invitation to leave home when Covid-19 vaccination became possible. The call to take to the streets until then was understood as a denial of the existence of dangers arising from the virus, claiming that “Brazil cannot stop”³⁷. This contradiction contributed to certain difficulty in the aged population’s adherence and once again emphasizes the need to understand the informational behavior patterns in this age group to access them effectively³³. Also noteworthy is the work contrary to the vaccination campaign, supported by attempts to discredit the severity of the pandemic and the effectiveness of the vaccine, affecting many people in their understanding of disease prevention³⁸. On the other hand, the aged participants did not show significant reluctance. On the contrary, they were receptive and willing to get vaccinated, deciding to use the immunization.

For example, about good vaccines, ah, it was said a lot that Coronavac was not good, that only Janssen and Pfizer were good. I don’t agree with this. I believe in any vaccine (Ulmeiro, male, 68 years old)

Overall, the participants showed good skills to understand and use information safely. However, it is noticed that the elderly also use scientifically unproven information, which can pose health risks. The same can be observed when analyzing part of the population with high schooling levels, pointing to good information comprehension levels, despite difficulties assessing the truthfulness of some pieces of news³⁹. When studying the Covid-19 infodemic phenomenon in Porto Alegre/RS, it is noticed that, although older adults use true information, sometimes they transform the idea conveyed into something illegitimate. It is perceived that, without critical reflection on the news, its use in everyday life can pose health risks.

I used to see DISCREPANCIES in the media, and then they came up with nonsense it’s all nonsense but to me: ‘oh, but it’s not scientifically proven’. However, each case is unique. I learned that: I am me, you are you, so we have these particularities (Abeto, male, 73 years old)

In light of the above, it is noticed that the difficulty interpreting excessive information can have significant repercussions on people’s health. The infodemic has taken on significant proportions because there is still a large percentage of the population that needs to develop information literacy skills to discern and consequently use information correctly⁴⁰.

Among the consequences of the impact of a large number of news items, including false ones, the increase in laypeople’s difficulty regarding prevention and health treatment issues stands out, leading them to adopt scientifically unproven measures as a way to take care of their health⁴¹. A few participants in this case study opted for preventive measures without scientific basis, using medications and substances with no proven effectiveness against Covid-19.

Except for that preventive medication. We took a preventive medication, which we always took, right? But nothing that would accelerate or rush things. We took the booster, but it was before, well before the vaccine. I couldn’t, in a traditional way, believe in simple things. We took ivermectin, right? (Abeto, male, 73 years old)

The Covid-19 pandemic highlighted the focus on the health of the aged population, stimulating the need for support and monitoring for these individuals. However, it also emphasized ageism, leading to exclusion and underestimation of this age group’s autonomy and ability to think about their own health³³. It is noticed that, despite the challenges related to complexity of the health recommendations, linked to the excess of available information and misinformation, the aged participants in this study showed the ability to understand and use the material beneficially.

Autonomy refers to the ability to make decisions according to one’s own beliefs and preferences. In order to preserve autonomy in the decision-making process, it is fundamental to ensure access to good quality information and educational opportunities for adequate instruction during active aging⁴². Based on the interviewees’ accounts, it is evident that their understanding of the situation and the action possibilities empowered aged individuals to feel confident in making decisions about their own care. Therefore, the autonomy of these seniors is reflected in the decision-making processes identified.

Understanding of knowledge develops through analysis and comparison with an existing informational background. Therefore, the process of adopting new information is based on the actions and processes required to incorporate this knowledge into a person’s existing understanding²¹. Consequently, development of the ability to understand information allowed the aged participants to agree or disagree with the accessed content based on their life experiences. This enabled them to choose whether or not to apply it in their everyday lives.

It’s true that all this can make us feel a bit depressed, but we also need to know because if you don’t know about it, you don’t worry about it, you don’t take care of yourself. It’s much easier, for example, to say something to someone and have a debate about it, both of you discussing, ‘it’s right, it’s wrong’, ‘it’s like this, it’s not like this’, than to see in a newspaper someone saying ‘blah blah blah’ and then changing the subject. So, if you know that thing, bring it out, discuss it, and when you leave there, you’ve understood everything better (Gerbera, woman, 77 years old)

Information seeking comes to an end when the user’s information needs are satisfied. When individuals feel adequately informed and their questions are answered, they tend to finish this behavior²¹. This can be understood from the participants’ statements indicating their contentment with the information they found. In addition, as they understand how to access information, they standardize their behavior for future situations.

In the Covid-19 infodemic context herein presented, it emphasizes the importance of investing in strategies aimed at its control, considering aged individuals’ informational behaviors. In it essential to include actions to educate these people, considering their diverse contexts. Therefore, it becomes indispensable to rely on the components of support networks for the aged population⁴³.

The informational behaviors showed by the aged participants in this research reached their end when they began to use the information obtained. This took place through their in-depth understanding of the Covid-19 situation, helping them contextualize themselves regarding the phenomenon presented, as well as based on the practical application of the content incorporated from the news related to the topic.

Final considerations

The infodemic phenomenon intensified during the Covid-19 pandemic brought about the possibility of health hazards, especially for those individuals with difficulties selecting and understanding the available material. It can be observed that the aged individuals who participated in this study, experiencing this event, used all the information about the Coronavirus to understand what was happening during the pandemic and to seek ways to take care of their own health through the available protection and prevention methods. Severity of the pandemic became evident for the interviewees due to the excess of information on the topic; however, this same excess brought about the need to evaluate the methods used to obtain accurate and safe information about health.

This study has some limitations. As it is a single case study, replicability of this study is not possible. The data collection period was 9 months, providing insights from different moments of the pandemic. The interviews were conducted only once with each participant, not providing a longitudinal view of the case. Despite these limitations, it is believed that the results of this study confirm the need to continue giving a voice to older adults, to expand studies and explore various contexts related to the health of the aged population.

Understanding how older adults used information during the pandemic, not only to confront the disease but also the news infodemic, can contribute to the development of future informational materials tailored to this population. The experiences shared in this study emphasize the need for planning and providing support networks that understand older adults as proactive agents in the pursuit of knowledge.

References

• ¹ Organização Pan-Americana da Saúde. Entenda a infodemia e a desinformação na luta contra a COVID-19 [internet]. 2020 [acessado 2023 Abr 10]. Disponível em: https://iris.paho.org/handle/10665.2/52054?locale-attribute=pt
  » https://iris.paho.org/handle/10665.2/52054?locale-attribute=pt
• ² Li W, Yang Y, Liu ZH, Zhao YJ, Zhang Q, Zhang L, Cheung T, Xiang YT. Progression of Mental Health Services during the COVID-19 Outbreak in China. Int J Biol Sci 2020; 16(10):1732-1738.
• ³ Hua J, Shaw R. Coronavirus (COVID-19) "Infodemic" and Emerging Issues through a Data Lens: The Case of China. Int J Environ Res Public Health 2020; 17(7):1-12.
• ⁴ Mian A, Shujhat K. Coronavirus: the spread of misinformation. BMC Med 2020; 18(1):1-2.
• ⁵ Kayes ASM, Islam MS, Watters PA, Ng A, Kayesh H. Automated Measurement of Attitudes Towards Social Distancing Using Social Media: A COVID-19 Case Study. First Monday 2020; 25(11). Doi:10.20944/preprints202004.0057.v1
  » https://doi.org/10.20944/preprints202004.0057.v1
• ⁶ Allanverdipour H. Global challenge of health communication: infodemia in the coronavirus disease (COVID-19) pandemic. J. Educ. Community Health 2020; 7(2):65-67.
• ⁷ Armitage R, Nellums LB. COVID-19 and the consequences of isolating the elderly. Lancet Public Health 2020; 5:e256.
• ⁸ Morrow-howell N, Galucia N, Swinford E. Recovering from the COVID-19 Pandemic: A Focus on Older Adults. J Aging Soc Policy 2020; 32:526-535.
• ⁹ Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun 2020; 109:102433.
• ¹⁰ Dourado SPC. A pandemia de COVID-19 e a conversão de idosos em "grupo de risco". Cadernos de Campo 2020; 29:153-162.
• ¹¹ Castro A, Camargo BV. Representaciones sociales de la vejez y el envejecimiento en la era digital: literatura. Psicologia em Revista 2017; 23(3):882-900.
• ¹² Garcia KR, Rodrigues L, Pereira L, Busse G, Irbe M, Almada M, Christensen C, Midão L, Dias I, Heery D, Hardy R, Quarta B, Poulain MM, Bertram M, Karnikowski M, Costa E. Improving the digital skills of older adults in a COVID-19 pandemic environment. Educ Gerontol 2021; 47(4):196-206.
• ¹³ Lima-Costa MF, Barreto SM. Tipos de estudos epidemiológicos: conceitos básicos e aplicações na área do envelhecimento. Epidemiol Serv Saude 2003; 12(4):189-201.
• ¹⁴ Falcão DVS, Carvalho IS. Idosos, gênero e saúde mental. In: Falcão DVS, Araújo LF, organizadores. Idosos e saúde mental. Campinas: Papirus; 2010.
• ¹⁵ Minayo MCS, Coimbra Júnior CEA, organizadores. Antropologia, saúde e envelhecimento. Rio de Janeiro: Fiocruz; 2011.
• ¹⁶ Zhang Y, Ma ZF. Impact of the COVID-19 Pandemic on Mental Health and Quality of Life Among Local Residents in Liaoning Province, China: A Cross-Sectional Study. Int J Environ Res Public Health 2020; 17(7):1-12.
• ¹⁷ Meng F, Guo X, Zhang X, Peng Z, Lai KH. Examining the Role of Technology Anxiety and Health Anxiety on Elderly Users: Continuance Intention for Mobile Health Services Use. In: Anais do 53rd Hawaii International Conference on System Sciences; 2020; Havaí. p. 3297-3306.
• ¹⁸ Cavalcante RB. COVID-19 infodemic and its repercussions on the mental health of the elderly: a multicenter study Brazil/Portugal/Chile/Mexico/Peru/Colombia [internet]. 2021 Jul [citado em 10 abr. 2023]. Disponível em: https://doi.org/10.17605/OSF.IO/YZUPJ
  » https://doi.org/10.17605/OSF.IO/YZUPJ
• ¹⁹ Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches. 4. ed. Thousand Oaks: Sage Publications; 2014. 20. Yin R. Estudo de caso: planejamento e métodos. 5a ed.Porto Alegre: Bookman; 2015.
• ²⁰ Wilson TD. Human Information Behavior. Inf Sci 2000; 1(3):1-7.
• ²¹ Fontanella B, Ricas J, Turato E. Amostragem por saturação em pesquisas qualitativas em saúde: contribuições teóricas. Cad Saude Publ 2008; 24(1):17-27.
• ²² Fontanella B, Luchesi B, Saidel M, Ricas J, Turato E, Melo D. Amostragem em pesquisas qualitativas: proposta de procedimentos para constatar saturação teórica. Cad Saude Publ 2011; 27(2):388-394.
• ²³ Minayo MCS. Amostragem e saturação em pesquisa qualitativa: consensos e controvérsias. Rev Pesq Qualit 2017; 7(5):1-12.
• ²⁴ Kock IV. A interação pela linguagem. São Paulo: Contexto; 1997.
• ²⁵ Santos CMD, Frichembruder K, Severo MB, Gehrke GH, Cavalcante RB, Bulgarelli AF. Cefaleia em idosos brasileiros no contexto de infodemia de covid-19. Rev Bras Geriat Geront 2022; 25(6):1-12.
• ²⁶ Instituto Brasileiro de Geografia e Estatística. (IBGE). Pesquisa Nacional por Amostra de Domicílios Contínua Anual: tabela 7139 - taxa de escolarização, por cor ou raça e grupo de idade [internet]. 2021 [acessado 2023 Abr 15]. Disponível em: https://sidra.ibge.gov.br/tabela/7139
  » https://sidra.ibge.gov.br/tabela/7139
• ²⁷ Kitamura ES, Cavalcante RB, Castro EAB, Leite ICG. Infodemia de covid-19 em idosos com acesso a mídias digitais: fatores associados a alterações psicopatológicas. Rev Bras Geriat Geront 2022; 25(6):1-14.
• ²⁸ Feldman MS. Strategies for interpreting qualitative data. London: Sage Publications 1994.
• ²⁹ Massarani L, Mendes IM, Fagundes V, Polino C, Castelfranchi Y, Maakaroun B. Confiança, atitudes, informação: um estudo sobre a percepção da pandemia de covid-19 em 12 cidades brasileiras. Cien Saude Colet 2021; 26(8):3265-3276.
• ³⁰ Fundação Oswaldo Cruz (Fiocruz). Saúde Mental e Atenção Psicossocial na Pandemia Covid-19 - A quarentena na Covid-19 - orientações e estratégias de cuidado [internet]. 2020 [acessado 2023 Abr 15]. Disponível em: https://www.fiocruzbrasilia.fiocruz.br/a-quarentena-na-covid-19-orientacoes-e-estrategias-de-cuidado
  » https://www.fiocruzbrasilia.fiocruz.br/a-quarentena-na-covid-19-orientacoes-e-estrategias-de-cuidado
• ³¹ Morin E. Introdução ao pensamento complexo. 4. ed. Porto Alegre: Sulina; 2011.
• ³² Hammerschmidt KSA, Santana RF. Saúde do idoso em tempos de pandemia Covid-19. Cogitare enfermagem 2020; 25:e72849.
• ³³ Paakkari L, Okan O. COVID-19: health literacy is na underestimated problem. Lancet Public Health 2020; 5(5):249-250.
• ³⁴ Cardoso RSS, Pereira JM, Santana AB, Sá SPC, Lindolpho MC, Chrizostimo MM, Santana RF. Letratento em saúde na pessoa idosa em tempos de pandemia e infodemia do covid-19: um desafio mundial. In: Santana RF, organizador. Enfermagem gerontológica no cuidado do idoso em tempos da COVID 19. Brasília, ABen; 2021. p. 145-150.
• ³⁵ Isolamento social. Medo de ser contaminado. Datafolha; 2020 Ago. [internet]. [acessado 2023 Abr 10]. Disponível em: http://media.folha.uol.com.br/datafolha/2020/08/19/34c9d0ae243b593db19bc9652df8d054reab.pdf
  » http://media.folha.uol.com.br/datafolha/2020/08/19/34c9d0ae243b593db19bc9652df8d054reab.pdf
• ³⁶ Marques RS, Santos LCS. #OBrasilNãoPodeParar e o discurso político no vídeo propaganda do Governo Federal. Tríade 2021; 9(20):218-239.
• ³⁷ Barcellos C, Xavier DR. As diferentes fases, os seus impactos e os desafios da pandemia de covid-19 no Brasil. Reciis 2022; 16(2):221-226.
• ³⁸ Souza VQC, Morbeck CAE, Faria TS, Lima BGC, Cavalcante LN. A infodemia dentro da pandemia: conhecimento sobre a covid-19 na região metropolitana de salvador/ba. Rev. Interdisciplinar de Ciência Aplicada 2022; 6(11):40-45.
• ³⁹ Mata ML, Grigoleto MC, Lousada M. Dimensões da competência em informação: reflexões frente aos movimentos de infodemia e desinformação na pandemia da covid-19. Liinc em Revista 2020; 16(2):e5340.
• ⁴⁰ Barreto MS, Caram CS, Santos JLG, Souza RR, Goes HLF, Marcon SS. Fake news about the COVID-19 pandemic: perception of health professionals and their families. Rev Esc Enferm USP 2021; 55:e20210007.
• ⁴¹ Organização Mundial da Saúde (OMS). Envelhecimento ativo: uma política de saúde [internet]. Brasília: OMS; 2005 [acessado 2023 Abr 9]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/envelhecimento_ativo.pdf.
• ⁴² Cavalcante RB, Carbogim FC, Bulgarelli AF, Santos CMD, Ribeiro AQ, Pinto IC, Zacharias FCM, Fabriz LA, Oliveira DM, Mendonça ET, Moreira TR, Machado RM, Bitencourt GR, Souza PA, Santana RF, Cruz GECP, Freitas ER, Silva HS, Cruz FV, Fhon JRS, Kitamura ES, Leite ICG, Braz PR, Santos RCD, Rocha FP, Silva EA, Tavares TB, Martins JGD, Püschel VAA. Repercussões da infodemia associada ao covid-19 na saúde mental do idoso no Brasil. Rev.Cubana de Información en Ciencias de la Salud 2022; 33:1-26.

• Chief Editors:
  Maria Cecília de Souza Minayo, Romeu Gomes, Antônio Augusto Moura da Silva

Publication Dates

• Publication in this collection
  02 June 2025
• Date of issue
  2025

History

• Received
  21 Aug 2023
• Accepted
  29 Jan 2024
• Published
  31 Jan 2024