Meanings and perspectives of men on what they lived during the Covid-19 pandemic

1 Universidade Federal da Bahia, Escola de Enfermagem, Salvador, BA, Brazil. 2 Universidade Federal do Pará, Faculdade de Enfermagem, Belém, PA, Brazil. 3 Faculdade Estácio de Alagoinhas, Alagoinhas, BA, Brazil. 4 Universidade do Estado da Bahia, Salvador, BA, Brazil. 5 Universidade Federal da Bahia, Salvador, BA, Brazil. 6 Universidade Estadual do Amazonas. Manaus, AM, Brazil. ABSTRACT Objective: To understand the meanings and perspectives attributed by men to the period lived in the Covid-19 pandemic. Method: Qualitative study structured on the concepts of phenomenology, based on Heidegger’s ontic interpretation, carried out with 400 men residing in Brazil. Data was produced through a form made available online. The responses were processed in the NVIVO12 software and analyzed according to the Discourse of the Collective Subject. Results: Two units of analytical meanings revealed in discourse-synthesis emerged. These units were supported by central ideas and ordered in five subunits that represent the collectivity of the investigated phenomenon. The units are: Being and being-in-the-world in the context of the pandemic experiencing its possibilities and The vigor of the past and the present are presented as possibilities for a new future in the face of the pandemic. Conclusion: The meanings and perspectives revealed a being-there in the context of the pandemic based on themselves, with changes in the routine and feelings and willingness to new possibilities and transformations, which generated psychosocial impact and coping and care strategies in the period of the pandemic. As implications, it is necessary to have a new understanding of the man-being, as they demonstrate the need for care, and for a care that goes beyond physical health.


INTRODUCTION
The Covid-19 pandemic has emerged as a complex, real, perceptible, and uncertain phenomenon for all societies on the planet (1) . It has been the greatest health challenge of the century and has caused significant changes in the ways of being and being-there of the populations in their different contexts. There have been several changes in the different dimensions of human life, such as daily relationships, the functioning of cities, as well as habits, behaviors, attitudes, and practices (2) .
From a gender-based perspective, the scientific literature (3)(4)(5) has pointed out that the male population, in general cisgender men -a person who identifies with the gender that they were assigned at birth, in its most different aspects -have been most affected by the Covid-19 pandemic. This population group has high rates of infection, a more severe manifestation of the disease, worse clinical outcomes, and a greater chance of transmitting the disease to close contacts (3) . It has been observed that, in addition to the Covid-19 infection, the pandemic has caused in these people changes in their individual (inter)subjectivities and in their ways of relating to people and the surrounding world. These men have elaborated new meanings and perspectives for themselves, for their family and network of affection, for society, for the world and in their daily life of "being-there" (6) .
Thus, nursing professionals, when well positioned, conscious and trained, are equipped to act in the production of health care for men in pandemic and postpandemic contexts. This work can occur in the context of coping with the conditions imposed by Covid-19 and its effects; in the management of human responses in the different dimensions of life; in comprehensive care for specific male health needs; in the subjects' political and health care empowerment; and in the expansion of health literacy and education.
In this way, concerns resulting from the situation experienced in the pandemic can already be observed in the masculinities of men and in the way they signify their experience in that period. Considering the understanding of being-towards-death, the high mortality of the disease and the news portrayed by the media, the production, creation and transformation in the world -Dasein -of these men gives rise to new ways of being-in-the-world and openness to possibilities of self-care, requiring the development of strategies to assist these people in their needs (6) . This scenario gives rise to new existential and dialogical exchanges, with a necessary dialogue, that, within the scope of health practice, will occur between men and health professionals (7) . Therefore, what are the implications of the "new" scenario for the care process?
Thus, equipped with the understanding of the transformations and the new health care processes of men, manifested in the social territory of the pandemic, and based on the assumptions of existentialism and humanism, essential measures to plan actions and produce care are unveiled, especially in the public health area, with the objective of providing effective, coherent, sensible, and qualified responses to individual and community needs and demands (7) .
Based on the need to delve into this research phenomenon that mobilizes men towards health care, this study intended to answer the question: How do men signify the experience lived in the Covid-19 pandemic? To answer this question, this article aims to: understand the meanings and perspectives attributed by men to the period lived in the Covid-19 pandemic.

Type of sTudy
Qualitative study, based on the concepts of phenomenology, according to Heidegger's interpretation (8) . The emphasis is on the phenomenological revelation of the lived experience, as a potential possibility to reveal the resignification of the way of being of these men during the pandemic.
Studies with phenomenological approach in the health area (9) , such as in Nursing (10) , have been strengthened by the need to understand the specific meanings attributed by each subject inserted in their cultural and historical world.
scenario Data was collected in the five regions of Brazil, in a non-sequential and consecutive collection among the different states.

selecTion criTeria
Adult and older adult men living in Brazil during the collection period were included. Men who were in transit on international trips were not included.
The form was organized in two parts: the first had questions related to the socio-demographic and health characteristics of the participants and the second had open-ended questions related to the investigated phenomenon, aiming to apprehend the meanings and perspectives attributed to the period lived in the pandemic. The open-ended questions were: how have you experienced the Covid-19 pandemic? Did the Covid-19 pandemic bring you any repercussions and/or consequences? If there was any repercussion and/or consequence, can you tell us what you did to overcome it? sample definiTion A total of 400 men participated. Considering the context of the pandemic, which makes it impossible to use conventional methods of data collection, such as phenomenological interviews, the research was conducted in a virtual environment, with a form hosted on Google Forms, validated internally by the researchers and adjusted externally with a group of 20 men.
The selection strategy was based on the consecutive recruitment technique called snowball (11) , with the sharing of the link to access the form on digital social networks, such as Facebook, Instagram and WhatsApp.

daTa collecTion
Data was collected from April to June 2020. The responses sent by the participants were exported and automatically stored by the software Excel. Then, the data was transferred to files in Word format and organized in folders using codes and access passwords, to protect the data and avoid losses. The whole process was conducted by twelve researchers with expertise in the area, in a coordinated manner.

daTa analysis and TreaTmenT
The data were read line by line, organized, systematized, and processed and coded in the NVIVO12 software, to apprehend the figures of the Discourse of the Collective Subject (DCS) (12) . This treatment process considered the real apparent meanings apprehended from the subjects' responses, with the coherences, divergences, and complementary relations of the theoretical elements in the phenomenon (13) . The guidelines of the Consolidated Criteria for Reporting Qualitative Research (COREQ) were adopted to guarantee quality.
DCS is an inductive method that allows access to the construction of collective thinking and unveils the generalities about the investigated phenomenon. Based on the DCS, key expressions and central ideas and/or anchors were located (12) and allowed to reveal the units of meaning in discourse-syntheses, composed of subunits supported by the meanings and perspectives attributed by men to the period lived in the Covid-19 pandemic and the implications for Nursing. This collective representation is revealed in the discourse-syntheses, which were interpreted in the light of Heideggerian phenomenological elements (8) .

eThical aspecTs
The project was approved by the Research Ethics Committee (REC) protocol 4076529/2020, in accordance with Resolution No. 466/2012 of the National Health Council. Participants were provided with the link to the project page on Instagram @cuidadoasaudedehomens, where education and communication on men's health care are offered. The page is a means of disseminating research and can be accessed at any time by the participants and the community to follow information and content on male health.
By providing men with the opportunity to reflect on the period lived in the Covid-19 pandemic, meanings and representations attributed to the "new" context were unveiled, exposing concerns arising from this experience, at a given moment in time, when the present time interferes in a new future, according to the experience lived. The two categories of discourse-syntheses that emerged are supported by their central ideas, which represent the collectivity of the investigated phenomenon.
uniT of meaninG -discourse-synThesis 1: BeinG and BeinG-in-The-world in The conTexT of The pandemic -experiencinG iTs possiBiliTies.
It was understood that these men experienced the context of the pandemic in the dimensions of "being" and "being-there": the emotional and the temporal. In the dimension of being, the discourse of the collective subject revealed that men were anguished by the demands for change in daily life. The discourse showed anxiety, feelings of helplessness and negative emotions due to the worsening of the situation and the fear of being contaminated and contaminating other people. Anguish over the situation, associated with fear of death when realizing its possibility, helped them to create new meanings and perspectives on the pandemic and the necessary measures to launch themselves into other possibilities, in view of the concerns expressed in care.
suBuniT -cenTral idea 1a: The lived and The percepTion of "BeinG-There" in The pandemic [...] first of all, the arrival of the pandemic in my country and in my city was quite a scare for me. It was weird to see all the changes in the routine of my city and to witness, every day, the situation getting worse and the cases advancing. I tried to mentalize that the pandemic was a real problem that was affecting everyone. When it came to contagion and exposure, and I knew that I wouldn't be the only one to be affected, and thinking about it that way, I started to give a new meaning to coronavirus and Covid-19 (DCS of men).
Feelings and emotions were expressed and revealed the fear and concern towards Covid-19 and the acceptance and progressive coping to minimize the harmful effects to the psychosocial well-being caused by the pandemic: [...] I had anxiety, concerns and sadness, especially with the deaths that were reported in the news, which were also related to the fear of having family members with chronic diseases, which put me in a state of permanent tension. I was afraid of the future. After that, I had the acceptance phase, and I began feeling calmer, avoiding greater problems, such as anxiety, which was already something I needed to live with. I had to try to think calmly, to not get desperate, to engage in activities that motivated me and made me happy, replacing work activities and the stir of everyday life, which were interrupted, and also avoid thinking about the bad issues related to the pandemic. I understood that it was a period of risk to everyone's health, and a time when I should protect myself, adopt preventive measures and work for the common good (DCS of men).
The meanings elaborated in the experience of the pandemic mark the male experience in the advent of a new disease, which caused concern and led to social, economic, professional and cultural transformations in human life. It was understood that, with the advance of the pandemic portrayed in the media, men began to attribute new meanings to the moment. The constructed meanings revealed a mobilization and a new way of being aimed at establishing practices of individual self-protection and collective well-being.
suBuniT -cenTral idea 1B: feelinG anGuished and searchinG for ways To feel BeTTer durinG The pandemic Structural and contextual dimensions such as work, being the breadwinner in the family, and leisure and affective activities are part of the daily experience of men in inappropriate, without an anticipated concern with health. This changed in the experience of the pandemic, as shown by the anxieties, interactions, relationships and actions in the "new" present expressed in the discourses. The search for self-care unveils a movement towards the proper way of living the daily life and finding new ways of being, aimed at the "well-being" of men during the Covid-19 pandemic: During the pandemic, men reflected on the meanings given to their ways of being and doing. Thinking about temporality in Heidegger, they reflected on their past to live a new reality, aimed at a more solidary future. In this regard, new meanings of seeing and living the world arose and led to the encounter with oneself, with humanity and with a care not only for oneself but also for others. The knowledge towards being and doing and the encounter with well-being in the pandemic in their experiences were expressed by men:  The anguish generated by the whole situation brought by the pandemic led men to open themselves to reconsider their way of being in the world and their impropriety. Thus, the opening of the being to the outside externalizes the concern with questions of class, politics, citizenship, and the existence of new possibilities of being.

suBuniT -cenTral idea 2a: resiGnifyinG in order
To Be and chanGe in The face of The pandemic In the course of the pandemic, men resignified the way of understanding their being in the world and expressed the development of a concern with questions of class, politics and citizenship: [...] I don't live the same daily reality as before, and I imagine that the other people who live in the favelas or in the ghettos where violence is common, must have felt even more changes with the arrival of the coronavirus, which has become yet another "disgrace" among so many others in our country, where we also live with a State of exception and inequality of privileges (DCS of men).
suBuniT -cenTral idea 2B: developinG new meaninGs and perspecTives To "Become" afTer experiencinG The pandemic The understanding of the lived experience, determined by the discourse, directed the attention of men to face what was avoided or postponed. The new meanings mobilized certainties, attitudes, and convictions, as well as the desire for change, by reconsidering the possibilities of being, creating opportunities, learning and loving to become better through the experience of the pandemic and the disruptions and impacts caused by it:

DISCUSSION
Data was collected in the virtual environment by an online form. The number of participants was relevant for this theme analysis, but this quantitative difference from the phenomenological approach limited the ontology analysis in the hermeneutic circle. Among these situations, the lack of a live interview stands out, as the participants needed to access Information and Communication Technologies (ICT) to answer the form. For these reasons, we chose to conduct a study using some concepts from phenomenology.
The discourses revealed the ways of "being" and "beingthere" of these men in the world, in the context of the Covid-19 pandemic, its historicity, and the possibility of accessing care measures (14) . These men were anguished by the situation, perceiving themselves as being-towardsdeath. For this reason, they searched for paths that would lead them to new ways of being. Thus, they sought to resignify their lives to reach a state of well-being, overcoming problems, getting closer to their family, and expressing solidarity. This search had difficulties related to the concern with the spread of the disease and its mortality, especially in families with members with chronic diseases. Another difficulty was dealing with sexual desire, since libido appeared to increase during this time (2)(3) .
In their collective discourse, men also revealed that these searches for new ways of being were related to their temporality, since they began to rethink their past, through an encounter with themselves in the face of the pandemic situation and the perception of being-towards-death. In view of the mortality presented by the media, they gave new meanings to the current situation, in the search for a new future beyond the pandemic. In this movement, it was understood that they abstained from everyday impropriety, seeking their own ways of being and elaborating new meanings and perspectives in their lives and in the relationships between being-towards-death and the repercussions on men's ways of being, manifested with the advent of the pandemic in their country.
When investigating male experiences in the Covid-19 pandemic, the collective discourse unveiled the experiences and perceptions of men regarding "being-there-in-thepandemic". The "being" and "being-in-the-world" revealed the possibilities experienced by men in this scenario. Men understood "being" in the context of the pandemic based on themselves, their chores, changes in routine, work, feelings, and human relationships, in a scenario of tasks that are part of the life of this being and their own organization of daily life. Since Covid-19 began to spread in the countries, sudden changes have emerged, and the disease has required abrupt adaptation to new habits and behaviors in a large part of the global population. These new configurations emerged because negative repercussions for health and quality of life were pointed out by the literature, calling for new ways of living (14)(15)(16) .
In the scope of men's perceptions on "being-there" in the pandemic, it was understood that feelings and emotions were the phenomenological signs that represented the negative impacts to well-being, mainly the psychosocial well-being. From then on, coping strategies were built and used in their daily lives. As they were surprised by the isolation, the high mortality of the disease, and all the changes imposed on daily life, their way of being was questioned and the uncertainties in their future (15)(16)(17) promoted concerns, sensations and feelings that affected their health. This scenario caused a lot of anguish, leading men to leave their improprieties and find new ways of being for the present and the future, in the face of anguish and their willingness to see new possibilities in life.
In the context of the pandemic, it is possible to infer that men had to deal with the meanings in experiences marked by a context of existential specificity (18) . In several scenarios other than Brazil, such as Japan and Pakistan, behavioral and psychosocial changes were observed in the male population throughout the course of the pandemic, such as changes in sleep patterns, hypervigilance, increased food consumption and access to internet content, increased stress and tension (17) . Other studies have shown positive results, as people have been able to give new meanings and perspectives to their lives (18)(19)(20)(21) .
When living the "new", the discourses showed, based on the experience of "being-there", the meanings elaborated by men in the experience of the Covid-19 pandemic in Brazil. Concerns and changes in daily life marked this experience. The possibilities of being and being-there are understood as "the determining element of Dasein; the relationships that one establishes at each moment with the world in their existential trajectory, which are only completed in death" (8)(9)(10)(11)(12)(13)(14)(15) . In Heideggerian phenomenology, the relationships established, the moment in time, and the world of the pandemic in its existential sense are modified and re-signified by the possibilities of feeling anguished and leaving behind daily inappropriate habits.
In order to protect themselves, men have used individual, intimate and subjective practices, but have also aspired to use practices aimed at the well-being of the community. In this scenario, care emerges as an existential part of life, considering both self-care and "being-with-others", in the ways of dealing with the world through their own ways of being (8)(9)(10)(11)(12)(13)(14)(15)(16)(17) . In this context, their new paths emerge in a previous dimension that allows the appearance, the unveiling (22) , which allows explaining the mobilizations made by men towards a better life in the pandemic, represented by the practices of bio-psycho-social care, of returning to the same things and rethinking the meanings of being and the understanding of oneself in order to strengthen and transform.
An investigation carried out with 5,545 adult men in Spain identified and recommended similar behaviors to those adopted by men in this study, in an attempt to face the pandemic (23)(24) . In this study, the findings revealed the adoption of strategies based on positive attitudes, with existentialist perspectives based on the concern with oneself, with the meanings of life and with humankind.
Based on this information, nurses and their team can locate the paths that are being used by men to deal with the pandemic, establishing strategies towards a comprehensive and more humane care. Considering that it is difficult for men do deal with self-care and that the pandemic opened their minds to the possibility of taking better care of their own health, nursing professionals can develop strategies to think about men's health care.
Seeking to remain well throughout the course of the pandemic in their country, men exposed their anxieties and attempts to find new paths, which led them to a space of reflection, where they were able to look at themselves and at the conditions of life. The anxiety experienced may have been a source of discomfort and may have caused new perspectives towards things, in the so-called "new normal" (25) . In this period, the discourse revealed a new look to their attitudes and behaviors and changes in habits, which at times seem to be mobilized by the imposition of confinement and at times seem to be an exercise of self-care.
It is worth noting that in Latin American countries, mainly in Brazil, masculinity models are strongly structured in patriarchal hegemony, with a significant influence of machismo. As a consequence, behaviors such as suppressing feelings and showing excessive strength, virility and honor are considered essential to the social construction of masculinities. In this sense, behaviors such as showing sentimentality, talking, and expressing emotions are left out, hidden, which may cause in men the difficulty to express the issues that afflict them.
It is crucial to consider that sensitivity is intrinsic in doing and producing Nursing care, which requires professionals to strengthen sensitive care, welcoming, and qualified listening (26) , in order to apprehend and deal with the demands and needs of men, even those that were not expressed or were hidden.
The comprehension of the discourses allowed recognizing that men were mobilized for "being-and-doing", which, in Heidegger's theory, is based on learning from doing, experimenting, and achieving well-being, with the being as a possibility. The apprehension of the pandemic experience has been significant and has led to changes in the way of being of men, modifying their future (27) . The male discourse reveals the aspirations of the new ways of seeing and living the world, the relationship with oneself, life, and humankind.
Welcoming the transformation while maintaining the identity of being a man is also something in transformation, which may be a phenomenological elaboration on the pandemic context and the ways of living life (28) . It is noticed that people live their daily lives in an improper manner, without valuing things. This can be what is happening with male life, as it has been understood by most men as something that comes easy, which shows in the ways of being during their historicity. The pandemic scenario seems to break with the inappropriate ways of being of men and make them consider new ways of being.
In the phenomenological approach, the reflection made is directed to the different conditions and phenomena of life, with the motivation to help people in whatever way possible. Thus, their assumptions allowed to see the coexistence of male self-care and care for others in the complex context of the Covid-19 pandemic. This scenario has relevant implications for Nursing, as it elucidates male care practices, which are often subtle, hidden, and even invisible in other contexts, allowing nurses and their staff to welcome, value, investigate and intervene in this care.
There are valuable implications of these new meanings for the work process and the production of public health care. Through this evidence, health care workers can more accurately recognize the issues that generate negative repercussions and the positive meanings in the experiences of men, mainly, in times when they are seeking explanations for chaos (29) . In this sense, it is important to recognize that groups of men in contexts of social vulnerabilities, living with barriers of social class, gender minorities, sexuality, and race/color may experience different situations in the Covid-19 pandemic context, which requires specific nursing care and is compatible with the demands emerging from these macro-structural and intersectional contexts.

CONCLUSION
The meanings and perspectives attributed by men to the period lived in the Covid-19 pandemic revealed a being-there in the context of the pandemic based on themselves, with changes in the routine and feelings and willingness to new possibilities and transformations, which generated psychosocial impact and coping and care strategies in the period of the pandemic. Uncertainties led to concerns, and concern led to self-protection through the adoption of individual and collective practices for well-being. In this regard, men are willing to reflect, to look at themselves and at the conditions of life and to seek bio-psycho-social care, which evidences transformations in the identity of being a man and its masculinities.
This understanding has implications for health, especially for nursing. Therefore, it is important that nursing professionals understand the masculinities and male identities and review their care practices, which need to address the health www.scielo.br/reeusp Rev Esc Enferm USP · 2021;55:e03763