This qualitative study examined the experiences of women during lockdown and the prevalence of Covid-19 in 2021. Participants' narratives stem from their perceptions of lockdown during Covid-19 pandemic and the problems they face. The research results were classified into 7 main categories (family-social relations, occupational challenges, financial challenges, leisure time, access to services, psychological reactions, and physical problems) and 21 sub-categories. In the following, each of these categories and sub categories are discussed based on previous studies.
Lockdown limited people's interrelations, and the fact that working parents were tele-working at home created many challenges. Among the most important problems expressed by the participants are the weak relations with relatives and the resulting gloom, tension and quarrel between family members, the annoyance of the elderly with reduced relations, isolation and aggression of children and difficulty caring for children due to the closure of kindergartens.
According to the results, increased women responsibilities and trying to maintain work-family balance made things more difficult for mothers, especially working ones. The new situation requires the reform of gender roles and the greater cooperation of men in managing the household. This was consistent with the findings of other studies [13]. In our study, better relations were observed between parents and children due to lockdown, which was inconsistent with other studies [14, 15]. The results of Spinelli et al. (2020) in Italy showed that the effect of lockdown on the behavioral and emotional problems of children has increased the stress in parents and children and parents have reported more problems [15].
Measures taken by organizations to prevent the spread of Covid-19 in the workplace include limiting unnecessary missions, increasing flexibility in the workplace (telecommuting at home), providing adequate resources (masks, hand sanitizers), education, information about the disease and the monitoring system [16]. The most common problems that participants expressed about the workplace were the fear of being alongside others in the workplace, decline in the number of customers, loss of intimacy of colleagues, increase in workload and telecommuting problems. Our results were consistent with various studies that examined changes in the work environment under Covid-19 [17].
The closure of small businesses is paralyzing for the lower class of the society, increasing unemployment and reducing the income of the poorest groups in society.
In line with our findings, other studies have shown that most businesses, especially those that have been shut down under mandatory lockdowns, have suffered heavy losses, and in small businesses that could not afford long-term lockdowns, closed them to the bankruptcy [18]. Many participants spoke about the impact of this problem on all aspects of family life and outlined the government's financial subsidies. In the absence of effective social security mechanisms and unemployment funds for self-employed individuals, the continuation of the lockdown and suspension of these activities is not possible and may lead to dissatisfaction and union protests.
Many participants also acknowledged the financial problems during the lockdown, which holds for the total living costs as well as medical expenses. With the increase in prices of disinfectants, masks, gloves, and medical expenses, the conditions have become tighter, even for high-income families.
The negative economic effects of lockdown shown in our study were consistent with various studies [5, 6]. Findings from Brooks et al. showed that financial worries and fears are among the negative consequences of lockdowns. Government and policymakers must give the community the necessary mutual trust and offer financial compensation [6]. The consequences of lockdown, including increased household expenditures, economic instability, declining economic prosperity, declining producer incomes, and limited transportation and agricultural services, jeopardize economic growth [5, 18].
Covid-19 caused problems in leisure activities, leisure businesses and the level of participation of people in leisure programs [19]. Participants in the study noted that they spent their leisure time in lockdown engaging in a variety of hobbies, ranging from painting and cooking as traditional hobbies to the use of new technologies that, in addition to entertainment, provide education and information of individuals. Consistent with the results of Basch study, the incredible value of YouTube and its potential collaboration with the entertainment industry to reach out to people in the community for reducing deaths from the Covid-19 pandemic has been shown [20]. The results of the study of Modabber et al. in the city of Jahrom, Iran showed that the highest priorities under home lockdown were: entertainment, daily chores, skill learning, sports and physical activity, spiritual activities, study and scientific activities [21].
Fear of Covid-19 and problems of lockdown in many cases prevented participants from seeking treatment for their various illnesses until the disease came to advanced stages. On the other hand, the congestion of health centers caused fatigue among health staff and can had a negative impact on service provision to the patient. According to the participants, one of the solutions to reduce the mentioned problems is the prosperity of online medical consultations. Consistent with our results, a study in India found that pursuing remote counseling and accessing patient information from e-medical records enables timely response during prolonged lockdown for COVID-19, and this experience provides valuable insight on the possibility of managing visits and remote patient follow-up in the future [22].
One of the most important challenges expressed by the participants was educational services. It can be said that the most important impact of this crisis in the realm of educational services is the recognition of distance education, and therefore, it can be an opportunity to develop and strengthen the systems of online learning, international education and online research [23]. According to the results of the study, online education is associated with advantages and disadvantages, including the reduction of traffic, ease of access to various resources, possibility of recording courses, up-to-datedness of e-learning information due to using the Internet context and the availability of education 24/7. Limitations include unfamiliarity with new technology, high costs of using computer equipment, high costs of Internet, non-availability of computers to everyone, possibility of heating and reduced student motivation.
Social media can help spread knowledge quickly during the pandemic [24].
Aside from the correct information, incorrect information about the current pandemic is frequently observed, and this can have serious consequences [25]. According to the participants, sometimes this influx of right and wrong information has resulted in nothing but fear and stress, and there is a strong need to increase health literacy, especially media health literacy, as well as proper management of information by governments and international organizations.
Consistent with the results of a study in Palestine, students used social media to continue learning about the Covid-19 pandemic during school lockdown, it caused a rapid spread of panic about the pandemic among this age group [26].
Almost all participants experienced a variety of mental disorders under lockdown conditions, including sleep disorders, headaches, tension, feelings of helplessness, stress and anxiety, as well as obsessive-compulsive disorder. In many participants, hope for the future diminished due to the prolongation of the lockdown.
Although managerial and lockdown measures were able to contain the epidemic, the prolongation of home lockdown and lockdowns and the departure from the normal life that led a large number of people to stay at home had inevitable psychological consequences for the general public [27]. Failure to treat these conditions can lead to chronic anxiety and depression or other mental disorders [28]. Numerous studies have examined the psychological consequences of these conditions, the results of which were consistent with our study [11, 29]. A study in India found that since COVID-19 was declared a pandemic, most Indians have developed mental health disorders, including feelings of insecurity, anxiety, depression, sleep disorders, panic attacks and loneliness [28].
The results of a study by Emami et al. showed that high blood pressure, cardiovascular disease, diabetes, kidney disease, smoking and COPDs were among the most common underlying diseases in hospitalized patients due to Covid-19 [30]. Participants who had such problems were more likely to be worried about this.
Participants who were exposed to second-hand smoke were very concerned about the relationship between cigarettes and Covid-19. In this regard, the findings of epidemiological meta-analysis in the Kashyap study showed that although active smoking is associated with a higher risk of Covid-19, mechanically, exposure to cigarettes, even as a passive smoker, can increase the risk of disease and death [31].
In addition, with the onset of lockdown and home-staying, people's lifestyles and diets have changed, with participants saying they were overeating and overweight.
Limited physical activity during lockdown can have adverse metabolic consequences and dramatically increase the risk of severe and debilitating disorders such as diabetes, cancer, osteoporosis, and cardiovascular disease. Decreased physical activity can also affect people's mental health and can be experienced in the form of emotions such as sadness, anger, frustration or irritation [32].
Contrary to our study, in which, with the exception of one participant, others reported experiencing poor physical conditions during lockdown because they were unable to walk enough, the results of Cheval et al. on 377 participants from France and Switzerland showed that compared to pre-pandemic period, lockdown resulted in dedicating more time to walking and moderate physical activity (10 minutes per day) and in sedentary lifestyle (75 minutes per day) [33]. In Coyle’s study, women reported that COVID-19 led to a healthier lifestyle, spending more time on exercising, and enhancing mental and physical health [34].
Using a qualitative approach to determine meaningful categories and sampling with maximum variation are the strengths of this study. limitation of the current study is performing some of the interviews remotely due to the prevalence of Covid-19.