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EMOTIONS AND COPING STRATEGIES OF MEN TO THE COVID-19 PANDEMIC IN BRAZIL

EMOCIONES Y ESTRATEGIAS DE COPING EN LOS HOMBRES FRENTE A LA PANDEMIA DEL COVID-19 EN BRASIL

ABSTRACT

Objective:

to analyze the emotions and coping strategies of men living in Brazil to the Covid-19 pandemic.

Method:

a qualitative socio-historical study, carried out with 200 men residing in Brazil. A semi-structured form was applied, made available on an online platform between March and May 2020. The data were analyzed by the Collective Subject Discourse method and sustained in the theoretical reference of Coping.

Results:

the strategies most used by the men were the following: compliance with preventive measures, strengthening of family/social ties, promotion of psychological well-being, self-care, emotional suppression, externalization of negative feelings, emotional control, positive reassessment, intellectual investment/professional qualification, maintenance of daily routines, adaptation to home office work, physical activity, control of marital conflicts, acceptance, and strengthening of belief and faith.

Conclusion:

the coping strategies adopted by the men are focused on following a pandemic coping protocol, and on the meaning and channeling of emotion and sense.

DESCRIPTORS:
Pandemics; Coronavirus infections; Men's health; Mental health; Coping strategies

RESUMEN

Objetivo:

analizar las emociones y las estrategias de coping en hombres que viven en Brasil frente a la pandemia del Covid-19.

Método:

estudio socio-histórico y cualitativo, realizado con 200 hombres que viven en Brasil. Se aplicó un formulario semiestructurado, puesto a disposición en una plataforma on-line entre marzo y mayo de 2020. Los datos se analizaron con el método del Discurso del Sujeto Colectivo y se sustentaron en el referencial teórico del Coping.

Resultados:

las estrategias más utilizadas por los hombres fueron las siguientes: cumplimiento de las medidas de prevención, fortalecimiento del vínculo familiar/social, promoción del bienestar psicológico, autocuidado, supresión emocional, externalización de sentimientos negativos, control emocional, reevaluación positiva, inversión intelectual/calificación profesional, mantenimiento de rutinas diarias, adaptación al trabajo en modalidad home office, práctica de actividad física, control de conflictos conyugales, aceptación y fortalecimiento de las creencias y de la fe.

Conclusión:

las estrategias de coping adoptadas por los hombres se enfocan en respetar un protocolo de afrontamiento a la pandemia, en la significación y la canalización de la emoción y del sentido.

DESCRIPTORES:
Pandemias; Infecciones por coronavirus; Salud de los hombres; Salud mental; Estrategias de afrontamiento

RESUMO

Objetivo:

analisar as emoções e as estratégias de coping de homens residentes no Brasil à pandemia da Covid-19.

Método:

estudo sócio-histórico, qualitativo, realizado com 200 homens residentes no Brasil. Realizou-se a aplicação de um formulário semiestruturado, disponibilizado em uma plataforma on-line entre março e maio de 2020. Os dados foram analisados pelo método do Discurso do Sujeito Coletivo e sustentados no referencial teórico de Coping.

Resultados:

as estratégias mais utilizadas pelos homens foram: cumprimento das medidas de prevenção, fortalecimento do vínculo familiar/social, promoção do bem-estar psicológico, autocuidado, supressão emocional, externalização de sentimentos negativos, controle emocional, reavaliação positiva, investimento intelectual/qualificação profissional, manutenção de rotinas diárias, adaptação ao trabalho home office, prática de atividade física, controle de conflitos conjugais, aceitação e fortalecimento da crença e da fé.

Conclusão:

as estratégias de coping adotadas pelos homens estão focadas no seguimento de um protocolo de enfrentamento à pandemia, na significação e canalização da emoção e do sentido.

DESCRITORES:
Pandemias; Infecções por coronavírus; Saúde do homem; Saúde mental; Estratégias de enfrentamento

INTRODUCTION

Today, the world observes, with acute expectation, concern, and fear, the evolution of the pandemic situation of Covid-19, a disease caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2).11. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med [internet]. 2020 [cited 2020 May 27];382:1199-1207. Available from: https://doi.org/10.1056/NEJMoa2001316
https://doi.org/10.1056/NEJMoa2001316...
Specifically, as its evolution demolishes the naturalized social, economic, cultural, and political dynamics of the Nation-States but, mainly and astonishingly, the incontestable and irremediable harms that the data related to the mortality caused by the spread of the virus represent.22. Aggarwal S, Garcia-Telles N, Aggarwal G, Lavie C, Lippi G, Henry BM. Clinical features, laboratory characteristics, and outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19): Early report from the United States. Diagnosis (Berl) [internet]. 2020 [cited 2020 May 27];7(2):91-96. Available from: https://doi.org/10.1515/dx-2020-0046
https://doi.org/10.1515/dx-2020-0046...

Certainly, Covid-19 showed that the world was not prepared to face (supposed) zoonotic events of pandemic potential. The pattern of transmission and the lethality of the virus are causing instability even in developed countries and/or with strong economies, collapsing their health services and causing them to take extreme measures ranging from border closures to partial or total social isolation with an impact on the work dynamics.11. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med [internet]. 2020 [cited 2020 May 27];382:1199-1207. Available from: https://doi.org/10.1056/NEJMoa2001316
https://doi.org/10.1056/NEJMoa2001316...
-33. Kramer A, Kramer KZ. The potential impact of the Covid-19 pandemic on occupational status, work from home, and occupational mobility. J Vocat Behav [internet]. 2020 [cited 2020 May 27];8;119:103442. Available from: https://doi.org/10.1016/j.jvb.2020.103442
https://doi.org/10.1016/j.jvb.2020.10344...
.

The Covid-19 epidemic hit Latin America late. The first case recorded in Brazil dates from February 25th, 2020, more than 2 months after the first case in China. However, with a continuing political crisis and a questionable coping strategy, Covid-19 infection currently plagues the country with 1,839,850 cases and with 71,469 deaths by July 11th, 2020, and is among the three countries with the largest number of cases in the world, together with the United States of America and India.44. Ministério da Saúde (BR). Boletim epidemiológico especial. Doença pelo Coronavírus COVID-19. Brasília, DF (BR):MS, 2020. Available from: http://saude.gov.br/images/pdf/2020/July/15/Boletim-epidemiologico-COVID-22.pdf
http://saude.gov.br/images/pdf/2020/July...

Since there is no proven cure or treatment, the actions supported by the State have been of social confinement or quarantine, which have beneficial consequences for the control of the pandemic but, in the short- or long-term, tend to produce psychological distress in the populations.55. Cluver L, Lachman JM, Sherr L, Wessels I, Krug E, Rakotomalala S, et al. Parenting in a time of COVID-19. Lancet [internet] 2020 [cited 2020 May 27];395:e64. Available from: https://doi.org/10.1016/S0140-6736(20)30736-4
https://doi.org/10.1016/S0140-6736(20)30...

In this sense, based on the premise that Covid-19 behaves as a democratic agent, which does not discriminate its involvement between different social mediators of difference in terms of ethnicity, social class or gender, the male population can suffer harsh rates of morbidity and mortality, because they tend to adhere less to care measures and to develop particular coping strategies.66. Lazarus RS, Folkman S. Folkman Stress, appraisal, and coping. New York (SU): Springer; 1984.-77. Sousa AR, Queiroz AM, Florentino RMS, Portela PP, Fernandes JD, Pereira A. Homens nos serviços de atenção básica à saúde: repercussões da construção social das masculinidades. Rev. baiana enferm [internet].2016 [cited 2020 May 27];30(3):1-10. Available from: https://doi.org/10.18471/rbe.v30i3.16054
https://doi.org/10.18471/rbe.v30i3.16054...
It is essential to understand how the pandemic is experienced and what coping strategies33. Kramer A, Kramer KZ. The potential impact of the Covid-19 pandemic on occupational status, work from home, and occupational mobility. J Vocat Behav [internet]. 2020 [cited 2020 May 27];8;119:103442. Available from: https://doi.org/10.1016/j.jvb.2020.103442
https://doi.org/10.1016/j.jvb.2020.10344...
are from the perspective of men, as they are generally more negligent with their health.44. Ministério da Saúde (BR). Boletim epidemiológico especial. Doença pelo Coronavírus COVID-19. Brasília, DF (BR):MS, 2020. Available from: http://saude.gov.br/images/pdf/2020/July/15/Boletim-epidemiologico-COVID-22.pdf
http://saude.gov.br/images/pdf/2020/July...
It is already known that, depending on the cultural construction between the genders, human beings perceive the experiences of stress and crisis in different ways. Consequently, the coping strategies adopted in these adverse contexts tend to be different.55. Cluver L, Lachman JM, Sherr L, Wessels I, Krug E, Rakotomalala S, et al. Parenting in a time of COVID-19. Lancet [internet] 2020 [cited 2020 May 27];395:e64. Available from: https://doi.org/10.1016/S0140-6736(20)30736-4
https://doi.org/10.1016/S0140-6736(20)30...

In the theoretical perspective of coping, its authorsargue that stressful events must be understood contextually, considering the dynamic and changing transactions between individuals and the environment. In this sense, coping highlights that the events are characterized as stressors based on the individual assessment of the meaning of the situation as adverse, whose demands exceed their management capacity.66. Lazarus RS, Folkman S. Folkman Stress, appraisal, and coping. New York (SU): Springer; 1984.Contexts such as these can require a set of cognitive and behavioral strategies called coping strategies, for adaptation or control of the adversities.88. Agius R. Covid-19 and Health at Work. Occup Med (Lond) [internet]. 2020 [cited 2020 May 27];70(5):349-351. Available from: https://doi.org/10.1093/occmed/kqaa075
https://doi.org/10.1093/occmed/kqaa075...

In the initial theoretical model of coping,66. Lazarus RS, Folkman S. Folkman Stress, appraisal, and coping. New York (SU): Springer; 1984.there were two major groups of strategies: problem-focused, and emotion-focused. While the first aims at the active management of the stress-generating situation through the use of tactics such as the execution of an action plan, conflict management, the search for social support and the cognitive reassessment, the second consists of escape or avoidance of the problem in order to regulate stress, reducing unpleasant physical states associated with it. Strategies that include the consumption of substances such as alcohol and tobacco, and distancing from the stressful situation, are examples of the latter category.

More recently, when revisiting his model, one of the authors99. Folkman, S. Stress, coping, and hope. Psycho-Oncology [internet]. 2010 [cited 2020 May 27]; 19(9):901-8. Available from: https://doi.org/10.1002/pon.1836
https://doi.org/10.1002/pon.1836...
proposed a third group of coping strategies, called focused coping. Unlike the two original groups, these strategies aim to regulate positive emotions through the assessment of personal values and beliefs and the pursuit of existential goals. In this sense, it allows the individual to reflect on the gains obtained by facing adverse situations throughout life.

Coping strategies have been used to assess the impact of different stressful events on aspects related to health such as diseases, chronic pain, and medical diagnoses, being associated with psychological constructs such as negative affection, depression, anxiety, and well-being.1010. Kato T. Frequently Used Coping Scales: A Meta-Analysis. Stress Health [internet]. 2015 [cited 2020 May 27];31(4):315-323. Available from: https://doi.org/10.1002/smi.2557
https://doi.org/10.1002/smi.2557...
Different sociodemographic factors such as age, socioeconomic status, and schooling have been associated with the use of certain coping strategies.1010. Kato T. Frequently Used Coping Scales: A Meta-Analysis. Stress Health [internet]. 2015 [cited 2020 May 27];31(4):315-323. Available from: https://doi.org/10.1002/smi.2557
https://doi.org/10.1002/smi.2557...
Regarding the gender variable, a number of studies on gender differences in the use of coping strategies show that men are more likely to use internal coping strategies (for example, the mobilization of personal resources to solve problems) while women are more likely to use external coping strategies (for example, they seek social support).1111. Keser E, Kahya Y, Akın B. Stress generation hypothesis of depressive symptoms in interpersonal stressful life events: The roles of cognitive triad and coping styles via structural equation modeling. Curr Psychol [internet]. 2020 [cited 2020 May 27];39:174-82. Available from: https://doi.org/10.1007/s12144-017-9744-z
https://doi.org/10.1007/s12144-017-9744-...

In this regard, a study1212. Meléndez JC, Mayordomo T, Sancho P, Tomás JM. Coping strategies: gender differences and development throughout life span. Span J Psychol [internet]. 2012 [cited 2020 May 27];15(3):1089-98. Available from: https://doi.org/10.5209/rev_sjop.2012.v15.n3.39399
https://doi.org/10.5209/rev_sjop.2012.v1...
found that, unlike men, women tended to report the more frequent use of coping strategies focused on emotion such as self-blame, open expression of emotions, and the search for social support. Taken together, these findings suggest that both developmental processes associated with socialization and contexts more commonly attended by men and women can be implicated in these differences. For example, while men are encouraged to actively face adverse situations and their social roles are associated with work and finance, women are generally encouraged to adopt a more emotionally focused style and to worry about family and health aspects.1212. Meléndez JC, Mayordomo T, Sancho P, Tomás JM. Coping strategies: gender differences and development throughout life span. Span J Psychol [internet]. 2012 [cited 2020 May 27];15(3):1089-98. Available from: https://doi.org/10.5209/rev_sjop.2012.v15.n3.39399
https://doi.org/10.5209/rev_sjop.2012.v1...

In the current pandemic context for the new coronavirus, studies are beginning to point to the possible negative effects on the mental health of men and women in the short- and long-term.1313. Moreira WC, Sousa AR, Nobrega MPSS. Mental disease in the general population and health professionals during covid-19: a scoping review. Texto Contexto Enferm [Internet]. 2020 [acesso Ago 2020 20];29:e20200215. Disponível em: Disponível em: https://doi.org/10.1590/1980-265X-TCE-2020-0215
https://doi.org/10.1590/1980-265X-TCE-20...
Evidence was found demonstrating similar levels of stress, anxiety, and depression in Spanish women and men in the early stages of contagion in their territory,1414. Ozamiz-Etxebarria N, Dosil-Santamaria M, Picaza-Gorrochategui M, Idoiaga-Mondragon N. Stress, anxiety, and depression levels in the initial stage of the Covid-19 outbreak in a population sample in the northern Spain. Cad Saúde Publica [internet]. 2020 [cited 2020 May 07];36(4):e00054020. Available from: https://doi.org/10.1590/0102-311X00054020
https://doi.org/10.1590/0102-311X0005402...
highlighting the importance of monitoring the raising trend of these levels over time, as well as the need for a contingency plan that would take into account aspects associated with the population's mental illness. In China, in turn, moderate to severe levels of psychological impact related to depression, anxiety, and stress have been recognized, further highlighting gender as a risk factor for higher levels of these symptoms.1515. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health [internet]. 2020 [cited 2020 May 07];17(5):1729. Available from: https://doi.org/10.3390/ijerph17051729
https://doi.org/10.3390/ijerph17051729...

Although these studies have focused on increasing levels of indicators of psychological disorders in the population, highlighting differences in terms of sociodemographic variables, the literature lacks an approach that takes into account the subjectivity that involves facing the challenges imposed in this context, considering sociodemographic and cultural aspects, when possible. In this sense, the present study was guided by the following question: How do men living in Brazil face the Covid-19 pandemic and express their emotions?

This study aims to contribute in this direction by proposing, as an objective, to analyze the emotions and the coping strategies of men residing in Brazil in the Covid-19 pandemic. The option to investigate such strategies in a male population is justified by the close relationship with health vulnerabilities, which includes the scenario of people impacted by Covid-19.

METHOD

A socio-historical and qualitative study that proposes to articulate empirical positions, abstractions, subjectivities, and idealisms together with dialectical structures and verbal interaction, seeking to understand the individuals and also the social context.1616. Freitas MTA. A abordagem sócio-histórica como orientadora da pesquisa qualitativa. Cad Pesqui [internet]. 2002 [cited 2020 May 07];116:21-39. Available from: http://doi.org/10.1590/S0100-15742002000200002
http://doi.org/10.1590/S0100-15742002000...
The online survey was conducted with 200 Brazilian men, during the period of isolation and social distance between March and April 2020. For data collection, an online semi-structured form hosted on the Google Forms digital platform was applied.

To guarantee data security, the own criteria established by the platform (confidentiality, reliability, and protection of the generated data) were adopted and made available on social networks linked to the research group and others such as Facebook, Instagram and WhatsApp, from the application of the snowball technique1717. Biernacki, P, Walford, D. Snowball sampling: Problems and techniques of chain referral sampling. Sociol Met Res [internet]. 1981 [cited 2020 May 07];10(2):141-63. Available from: https://doi.org/10.1177/004912418101000205
https://doi.org/10.1177/0049124181010002...
to achieve theoretical sampling in virtual social networks. The Visual Free and Informed Consent Form was made available and the participants gave their electronic consent. The form included questions about sociodemographic aspects, emotions, attitudes, and coping strategies associated with the context of the Covid-19 pandemic in Brazil.

Only men (cisgender, transgender, and non-binary) residing in Brazil were included. Tourists were excluded. To determine the theoretical saturation of the qualitative data, the appearance of repetitive speeches reproduced by other participants was analyzed. During the data collection period, four men who accessed the platform did not accept to participate in the research.

The apprehended data were extracted in full from the platform by trained researchers who organized, systematized, and coded them, using the support of the NVIVO12 Software, meeting the criteria of the Revised Standards for Quality Improvement Reporting Excellence, SQUIRE 2.0.

The structuring of the analysis is anchored in the Collective Subject Discourse (CSD) method, which allows unveiling specific methodological figures, namely: Key Expressions, Central Ideas, and Anchoring, materialized from the analysis of empirical data of a verbal nature, apprehended by the statements of the participants, submitted to systematic and standardized procedures in order to unveil discourses of similar meaning, elaborating the discourses-syntheses, thus expressing the thought of a collective group.1818. Lefevre F, Lefevre AMC. O discurso do sujeito coletivo: um novo enfoque em pesquisa qualitativa. Caxias do Sul, RS(BR): Educs; 2003. The corpus was subjected to analysis based on the theoretical framework of Coping66. Lazarus RS, Folkman S. Folkman Stress, appraisal, and coping. New York (SU): Springer; 1984..

Throughout the process of operationalization of the research, strict quality criteria were met. To this end, the guidelines of the Consolidated Criteria for Reporting Qualitative Research (COREQ) were adopted. The matrix research project was approved by the Research Ethics Committee, complying with all the national and international standards of ethics in research involving human beings.

RESULTS

The participants were mostly cisgender (93.6%), gay (47.7%), aged between 18 and 67 years old, self-reported as of brown race/skin color (39.3%), single (47%) followed by stable union (33%), with complete higher education (66.7%), living in the Northeast region of the country (72.3%), living with non-elderly family members (21.95%), living in houses (67.45%), and with an approximate income above five minimum wages (33.2%).

By analyzing the frequency of emotions self-reported by men, using a list containing positive and negative emotions, the prevalence of the following emotions was identified: anxiety (54.7%), insecurity (42.4%), stress (31.7 %), irritation (27.8%), agony (25.9%), boredom (23.7%), commotion (21.2%), and fear (20%).

Synthesis discourse 01: coping strategies

The collective discourse of men residing in Brazil in the context of the Covid-19 pandemic proved to be consistent with the theoretical model of Coping66. Lazarus RS, Folkman S. Folkman Stress, appraisal, and coping. New York (SU): Springer; 1984., which provides for two broad categories of coping strategies: one focused on the problem and the other on emotion, as presented in the Central Ideas described below.

Central idea 01A: Strategies focused on following a pandemic coping protocol

Mobilized to face the pandemic, the men presented the use of strategies focused on the problem (pandemic), as a way they found to defend themselves from the stressful situation. Thus, the strategies that stood out were the following: compliance with preventive measures, the strengthening of family and social ties, the exercise of care directed to psychological well-being and self-care. In addition to these strategies, the speech showed that men have faced the pandemic in order to promote intellectual investment and professional qualification, maintain daily routines, and adapt to home office work, allocate attention to physical health, control marital conflicts, exercise acceptance, and strengthen belief and faith:

I've tried to meet and respect the recommendations of the Ministry of Health, seeking to wash my hands more frequently and stay at home, complying with the quarantine and social distancing. I try to be close to my family and friends, strengthening relationships, guiding them and exercising care for my mental health, thinking about situations that bring me hope, that help me to face difficult moments like this. Due to this scenario, my self-care only increased, as I have been doing meditation, accessing art, doing more proactive actions with regard to my mental health. I took the opportunity to study, read and take courses to improve my professional preparation and adapt to the new work routine. I've prepared my own meals and practiced physical exercises regularly. By spending more time indoors with my wife, in order to avoid conflicts, I try to minimize the intensity of disagreements by keeping calm and controlling stress. Moreover, I seek to believe in God and trust that He is in control of everything, no matter how desperate it may seem. (CSD of men living in Brazil in Covid-19 pandemic contexts, 2020).

Central idea 01B: Strategies focused on the meaning and channeling of emotion

The group of strategies focused on emotion refers to the representation of efforts undertaken with the intention of regulating the emotional situation caused by stressful episodes, in this particular case, those presented by the emergence of the pandemic in Brazil, affecting the daily lives of men. The suppression of emotions, externalization of negative feelings, emotional control, and positive re-evaluation are highlighted; these strategies are illustrated in the following speech:

To face this situation I try to feel less negative emotions regarding the new Coronavirus, but President Bolsonaro, who is insane, those that support him and others who disobey the recommendations and orders of the Ministry of Health and the World Health Organization, generate more negative feelings, such as irritation, anger, revolt and concern for people who are a risk group. In this sense, I've been trying to deal with anxiety, anguish, uncertainty, concern and with my internal concerns, which emerge, in this moment of confinement, and are enhanced by the feeling of being alone. For this, I seek to carry out activities that help to dispel the focus of these concerns. Within the scope of the marital relationship, I've been in contact with my wife practically 24 hours a day and, as a result, we've been in conflict at least once a day, a situation that didn't happen normally and I've been looking for strategies such as keeping calm and controlling stress. (CSD of men living in Brazil in Covid-19 pandemic contexts in Brazil, 2020).

Central idea 01C: Strategies focused on the meaning

Focused coping strategies were evidenced in the discourse and express the adoption of a new meaning and re-signification of the pandemic phenomenon experienced by male residents in Brazil:

Although I sometimes get discouraged by the uncertainties, I try to see this pandemic as an atypical, temporary situation and try to give it a new meaning. I started looking for the best way to face the pandemic. I looked to the future and saw a positive way out of this scenario. I tried to reflect on my relationship with others, whether in relation to social, economic, political, but also affective position. It has been a learning experience and in this way I feel more relaxed and also awake to the improvement of this situation. (CSD of men living in Brazil in Covid-19 pandemic contexts in Brazil, 2020).

DISCUSSION

The emotions self-reported by the men reflect what they have felt in recent weeks, in which restrictive and sanitary measures to combat the Covid-19 pandemic were already in place. In this context, it is emphasized that the predominance of negative emotions reported by the men makes sense and is compatible with the current moment, considering the emergence of impact-generating phenomena, which mobilize the development of coping strategies in men.

The men investigated in this study are facing the Covid-19 pandemic from different topographies of coping strategies, which, although different from each other, they are directed towards the same function: to adapt cognitively to problems, with the consequent emergence of new behaviors and attitudes in face of the sudden and unexpected onset of the phenomenon. The grouping of the different coping strategies was interspersed in a complementary way, so that the regulation of anxiety (coping focused on emotion), will allow men to concentrate on making a decision (coping focused on the problem). This cyclical process goes through a review of underlying values and existential objectives (focused coping), giving rise to a forecast and review of life goals, whose objectives are not trivial, but are already at underlying levels from the independence of the individual.66. Lazarus RS, Folkman S. Folkman Stress, appraisal, and coping. New York (SU): Springer; 1984.

Among the actions focused on the problem, it can be noted that the development of strategies to accept responsibility for coping with the pandemic emerged from the collective discourse of men, which can be evidenced through the recognition that men are accepting and fulfilling the recommendations of the health authorities regarding the adoption of preventive measures, hygiene control, isolation and social distancing, and quarantine. When there is the development of strategies for accepting responsibilities to face the problem, the individuals recognize themselves as subjects of action, active political agents in the process in face of the problematic situation.66. Lazarus RS, Folkman S. Folkman Stress, appraisal, and coping. New York (SU): Springer; 1984.In addition, they accept the reality and commit themselves to employing efforts to deal with the stressful situation, changing the reality in which they are inserted.1919. Cupertino APFB, Oliveira BHD, Guedes DV, Coelho ER, Milano RS, Rubac JS, et al. Stress and social support in childhood and adolescence related with depression symptoms in the elderly. Psicol Reflex Crit [internet]. 2006 [cited 2020 May 07];19(3):371-8. Available from: https://doi.org/10.1590/S0102-79722006000300005
https://doi.org/10.1590/S0102-7972200600...

When considering that, in times of pandemic caused by viral outbreaks, population anxiety is widespread, the use of coping strategies structured on cognitive-behavioral characteristics has played a satisfactory role in overcoming events that trigger adverse behaviors. Such resources promote good results in maintaining anxiety control in times of Covid-19, given the presence of cyberchondria associated with the excessive search for online information that impacts on emotional regulation, which constitutes an expressive risk factor for health.2020. Jungmann SM, Witthöft M. Health anxiety, cyberchondria, and coping in the current Covid-19 pandemic: Which factors are related to coronavirus anxiety? J Anxiety Disord [internet]. 2020 [cited 2020 May 07];102239. Available from:Available from:https://doi.org/10.1016/j.janxdis.2020.102239
https://doi.org/10.1016/j.janxdis.2020.1...
In relation specifically to the context of the pandemic in which the number of people with Covid-19 is spreading, there is a lack of research studies in the field of coping strategies such as, for example, emotional regulation, which draws the attention given the problematic context caused by anxiety to the population health on the planet.1313. Moreira WC, Sousa AR, Nobrega MPSS. Mental disease in the general population and health professionals during covid-19: a scoping review. Texto Contexto Enferm [Internet]. 2020 [acesso Ago 2020 20];29:e20200215. Disponível em: Disponível em: https://doi.org/10.1590/1980-265X-TCE-2020-0215
https://doi.org/10.1590/1980-265X-TCE-20...
,2121. AC Oliveira, Lucas TC, Robert AI. What has the covid-19 pandemic taught us about adopting preventive measures?. Texto Contexto Enferm [Internet]. 2020 [cited 2020 May 07];29:e20200106. Available from: https://doi.org/10.1590/1980-265x-tce-2020-0106
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-2323. Rajkumar RP. Covid-19 and mental health: A review of the existing literature. Asian J Psychiatr [internet]. 2020 [cited 2020 May 07];52:102066. Available from: https://doi.org/10.1016/j.ajp.2020.102066
https://doi.org/10.1016/j.ajp.2020.10206...

When the apparent acceptance, in a responsible manner, was unveiled, the determinations of the health authorities of the country and the world denoted the search for the strengthening and maintenance of the measure of social support as a means of actively facing the resolution of the problem. In theorizing the coping strategies, social support is configured in the strategy in which the individuals add efforts in the search for support in their emotional/affective, professional, and social network.66. Lazarus RS, Folkman S. Folkman Stress, appraisal, and coping. New York (SU): Springer; 1984.This search allows men to deal with the consequences generated by the stressful situation, and to achieve positive responses to the situation experienced.1919. Cupertino APFB, Oliveira BHD, Guedes DV, Coelho ER, Milano RS, Rubac JS, et al. Stress and social support in childhood and adolescence related with depression symptoms in the elderly. Psicol Reflex Crit [internet]. 2006 [cited 2020 May 07];19(3):371-8. Available from: https://doi.org/10.1590/S0102-79722006000300005
https://doi.org/10.1590/S0102-7972200600...

In an experience of coping with other circumstances involving the population, a study showed an association between social support and strategies for coping with problems, demonstrating that this relationship can mediate or moderate the impact of experiences on health.2424. Greenglass E, Fiksenbaum L, Eaton J. The relationship between coping, social support, functional disability and depression in the elderly. Anxiety, Stress, and Coping [internet]. 2006 [cited 2020 May 07];19(1):31. Available from: https://doi.org/10.1080/14659890500436430
https://doi.org/10.1080/1465989050043643...
-2525. Mosher CE, Prelow HM, Chen WW, Yackel ME. Coping and social support as mediators of the relation of optimism to depressive symptoms among black college students. Journal Black Psychology [internet]. 2006 [cited 2020 May 07];32(4):507-11. Available from: https://doi.org/10.1177/0095798405282110
https://doi.org/10.1177/0095798405282110...
A number of studies that analyzed the effects of social support on mental health outcomes in the Chinese population in the context of the new coronavirus revealed that the social support received by the population and medical team were significantly associated with self-efficacy and quality of sleep, and negatively associated with the degree of anxiety and mental stress of the individual in the short term.2626. Xiao H, Zhang Y, Kong D, Li S, Yang N. The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (Covid-19) in january and february 2020 in China. Med Sci Monit [internet]. 2020 [cited 2020 May 07];26:e923549. Available from: https://doi.org/10.12659/MSM.923549
https://doi.org/10.12659/MSM.923549...
-2727. Xiao H, Zhang Y, Kong D, Li S, Yang N. Social capital and sleep quality in individuals who self-isolated for 14 days during the coronavirus disease 2019 (Covid-19) outbreak in january 2020 in China. Med Sci Monit [internet]. 2020 [cited 2020 May 07];26:e923921. Available from: https://doi.org/10.12659/msm.923921
https://doi.org/10.12659/msm.923921...

The speech revealed that men demonstrated concerns about the individual mental health situation, using strategies to promote psychological well-being emphasized by the practice of positive attitudes, distraction, promotion of leisure and entertainment, and raising the feeling of hope. Such evidence indicates the determination of the importance of mental health on the part of men, which can signal a paradigmatic change in the social construction of masculinities, based on a model against hegemony.

In China, during the initial period of the epidemic, concerns about health and anxiety were evidenced, with a direct association with the pandemic. Thus, a significant psychological impact on the population was identified, with great emphasis on stress, intrusive and negative thoughts, as well as preventive behaviors, but which, from a scientific point of view, was not considered as satisfactory or advantageous for people.1313. Moreira WC, Sousa AR, Nobrega MPSS. Mental disease in the general population and health professionals during covid-19: a scoping review. Texto Contexto Enferm [Internet]. 2020 [acesso Ago 2020 20];29:e20200215. Disponível em: Disponível em: https://doi.org/10.1590/1980-265X-TCE-2020-0215
https://doi.org/10.1590/1980-265X-TCE-20...
Such implications can lead to persistent pessimism, compromising psychological well-being and the worldview perception.

In our study, the male population recognizes the pandemic as an element that triggers potentialities for self-care, mobilizing men to pay more attention to and, consequently, exercise self-care practices, based on the use of body care expressed in the practice of physical activity. In this respect, it is believed that the fact that epidemic diseases accompany the changes and social behaviors at each time, in which measures have been established, such as the institution of vaccines, health control at airports and other contexts associated with the maintenance of a common good, can influence the interest and consequent inclination of people to make decisions regarding the adoption of self-protection and care strategies, even in irritating circumstances, such as having to deal with a viral threat.2828. Jamison DT, Gelband H, Horton S, Jha P, Laxminarayan R, Mock CN, et al. Disease control priorities: improving health and reducing poverty. 3rd edition. Washington, DC(US): The International Bank for Reconstruction and Development/The World Bank; 2017 [cited 2020 May 07]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525302/
https://www.ncbi.nlm.nih.gov/books/NBK52...

It is also important to infer that there are positive elements with the emergence of pandemics. In pandemic contexts, people are given the opportunity to prepare for the advent of new threats, influenced, for example, by technology, communication, surveillance, and last-generation IT, which consequently shapes the pandemic and awakens people to create coping strategies with the purpose of mitigating risks and harms so that there is direct containment.2828. Jamison DT, Gelband H, Horton S, Jha P, Laxminarayan R, Mock CN, et al. Disease control priorities: improving health and reducing poverty. 3rd edition. Washington, DC(US): The International Bank for Reconstruction and Development/The World Bank; 2017 [cited 2020 May 07]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525302/
https://www.ncbi.nlm.nih.gov/books/NBK52...

Due to the influence of the isolation and social distancing measures adopted with the arrival of the Covid-19 pandemic in Brazil, men are experiencing new stressors, such as losses in academic and professional training, at work, in income, and in the marital relationship, through the emergence of conflicts and dilemmas to be faced in the new daily routine. However, even with the appearance of these stressors, men have demonstrated promoting the management of the problem that causes suffering, bringing them closer to them, in order to face them, develop new creations and alternatives to deal with them, establishing, therefore, resolution and adaptation.

Confronting the pandemic context by establishing strategies centered on the problem enables men to create plans, establish a change in the situation in an attempt to minimize the problem, reducing the capacity and intensity of the stressor source, engaging to change the problematic situation, minimizing stress as well as the appearance of threats and/or possible harms without losing control of the situation. From this perspective, it is possible to identify in the discourse how men try to deal with problems related to marital coexistence, such as uncertainty, loneliness, dissatisfaction with the political scenario, and the impacts on individual and collective life.

The discourse also revealed the presence of belief and faith in God as a strategy used by men to deal with the transformations and repercussions caused by the pandemic. Linked to this dimension, the attribution was observed of new meanings to the pandemic context by the men under study, which, in some way, reveal the emergence of learning about the context experienced, in which positivity and hope is envisioned. Thus, it is analyzed that the development of a focused coping emerges, which presents itself in a different way in qualitative character from the other coping styles, since the emergence of values and beliefs, added to the review of existential objectives, the gains with the experiences, and the reordering of priorities, are on the rise.1919. Cupertino APFB, Oliveira BHD, Guedes DV, Coelho ER, Milano RS, Rubac JS, et al. Stress and social support in childhood and adolescence related with depression symptoms in the elderly. Psicol Reflex Crit [internet]. 2006 [cited 2020 May 07];19(3):371-8. Available from: https://doi.org/10.1590/S0102-79722006000300005
https://doi.org/10.1590/S0102-7972200600...

Under this dimension, centered on the logic of re-signification and the attribution of positive meanings to the pandemic, the presence of an appropriate ethical and social dimension has been observed, permeated by optimistic purposes, which contributes to the minimization of possible impacts generated on psychosocial well-being and on quality of life, thus allowing the emergence of new horizons.2929. Lemon SM. Ethical and Legal Considerations in mitigating pandemic disease: workshop summary. Institute of Medicine; Board on Global Health; Forum on Microbial Threats. 2007. Available from: https://www.ncbi.nlm.nih.gov/books/NBK54171/
https://www.ncbi.nlm.nih.gov/books/NBK54...

When analyzing the development of emotion-centered coping strategies, it can be seen that, by coming into contact with the stressful situation, in this particular case, the pandemic, men developed distancing strategies through the suppression of negative emotions, in a process away from the emotional problem, in order to avoid it, in an elusive escape66. Lazarus RS, Folkman S. Folkman Stress, appraisal, and coping. New York (SU): Springer; 1984., in which there is an effort to escape from the problem, conducting palliative strategies and not changing the situation that generated the stress. From this perspective, they recognize the need to pay attention to the social and relational aspects of gender in a given social transformation, such as the onset of an epidemic disease that generates a pandemic of this magnitude.

The avoidance strategy can lead to non-resolution of the problem, which can lead to increased stress, further potentiate the problems arising from troubled relationships, and generate a momentary sense of well-being. But, at the same time, men also exercise self-control, trying to remain calm. In this sense, self-control refers to the attitudes used to manage feelings, actions, and reactions in face of a stressful situation. For this to occur effectively, men need to understand their feelings, being able to maintain control of the situation through emotional and behavioral balance.

As a way of seeking to understand the impacts of the pandemic that causes Covid-19 on the development of the person, a study recommends reflecting on the perspective of cultural psychology, as a way to understand the career development and the possible coping strategies built and performed.3030. Guan Y, Deng H, Zhou X. Understanding the impact of the Covid-19 pandemic on career development: Insights from cultural psychology. J Vocat Behav [internet]. 2020 [cited 2020 May 07];103438. Available from: https://doi.org/10.1016/j.jvb.2020.103438
https://doi.org/10.1016/j.jvb.2020.10343...
In this sense, attention is paid to the observation of how the cultural guidelines internalized by the individuals, such as values, beliefs, lifestyle, and regulatory standards, are capable of shaping certain individual responses and coping strategies in face of the pandemic. In addition to awaken to the reflection of “How does the national culture promote influence over collective actions and rules in a given pandemic context as a way to effect a rapid change?” In this sense, the need to look at the phenomenon from the understanding of coping in the light of its theory is grounded.66. Lazarus RS, Folkman S. Folkman Stress, appraisal, and coping. New York (SU): Springer; 1984.

Through the appearance of other stressful elements during the pandemic period, which are not concentrated in the health field, although they have intersections with it, men report negative emotions manifested through feelings such as irritation, anger, revolt, and worry. Confrontation, a strategy focused on emotion, is configured in the form of aggressive coping that a person adopts to change a situation experienced, expressing, for example, feelings of anger and inflexibility. Such strategies do not always lead to positive results, which can be harmful, toxic, and destructive for the Brazilian men who live with this problem.1919. Cupertino APFB, Oliveira BHD, Guedes DV, Coelho ER, Milano RS, Rubac JS, et al. Stress and social support in childhood and adolescence related with depression symptoms in the elderly. Psicol Reflex Crit [internet]. 2006 [cited 2020 May 07];19(3):371-8. Available from: https://doi.org/10.1590/S0102-79722006000300005
https://doi.org/10.1590/S0102-7972200600...

When observing the way men face the pandemic, from the focus on emotions, an effort is perceived to create and reframe the scenario, in order to establish positive attitudes and responses to the problem to be faced, as a means of providing psychological well-being, resulting in a positive reassessment. As a strategy of positive reassessment of the stress-generating factor, the individuals develop and/or seek to control emotions related to apprehension, insecurity, uncertainty, fear, and sadness. While this strategy is employed by the person, the desire to reframe, learn, and change from a conflicting situation emerges, which is structured in emotional cognitive control.66. Lazarus RS, Folkman S. Folkman Stress, appraisal, and coping. New York (SU): Springer; 1984.In this light, it is recommended to strengthen strategies to protect mental health, both during the course of the pandemic and in the post-pandemic period.1313. Moreira WC, Sousa AR, Nobrega MPSS. Mental disease in the general population and health professionals during covid-19: a scoping review. Texto Contexto Enferm [Internet]. 2020 [acesso Ago 2020 20];29:e20200215. Disponível em: Disponível em: https://doi.org/10.1590/1980-265X-TCE-2020-0215
https://doi.org/10.1590/1980-265X-TCE-20...

The study is limited by the use of the data collection strategy via the web, considering the impossibility of access to men with lower schooling level, qualification for the use of information and communication technologies, and who have cognitive, visual and other limitations that make it impossible for them to answer the survey. In addition, although the study was carried out in all the Brazilian regions, most of the participants were concentrated in the Northeast Region, which makes it impossible to make generalizations about the phenomenon. However, the apprehended data evidence a significant scenario of analysis about the phenomenon, being an important methodological device for the formulation of programmatic and strategic actions to face the Covid-19 pandemic context in the Brazilian male population.

CONCLUSION

The study revealed that the coping strategies most used by men were the following: compliance with preventive measures, strengthening the family/social bond, promotion of psychological well-being, self-care, emotional suppression, externalization of negative feelings, emotional control, positive reassessment, intellectual investment/professional qualification, maintenance of daily routines, adaptation to home office work, physical activity, control of marital conflicts, acceptance, and strengthening of belief and faith. These coping strategies adopted by men are focused on following a pandemic coping protocol, and on the meaning and channeling of emotion and sense.

By recognizing the coping strategies employed by men, it is possible to know the resources that are used and validated by the male population with a focus on mitigating the problem faced, whether they are in the search for dealing directly with the problem, moving away from it through the focus on emotion or establishing a new meaning from the reframing.

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NOTES

  • APPROVAL OF ETHICS COMMITTEE IN RESEARCH

    Approved by the Research Ethics Committee of the Nursing School of the Universidade Federal da Bahia, opinion No. 3,960,330; CAAE No. 11851619.2.0000.5531

Publication Dates

  • Publication in this collection
    30 Nov 2020
  • Date of issue
    2020

History

  • Received
    06 June 2020
  • Accepted
    13 Aug 2020
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