Four categories were identified: 1) factors of mental health, 2) factors of lifestyle behaviours, 3) consequences of the pandemic lockdown, and 4) coping during the pandemic lockdown. The first two categories answered our research question while the other two were additional categories identified. The categories and their subcategories are presented in the Table 2 below and expanded following that with quotes from participants to support result presentation. These quotes have not been modified and reflect the original language used.
Table 2
Research Question and Their Respective Categories, and Subcategories.
Research Question
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Category
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Subcategories
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What are the factors affecting mental health and lifestyle behaviours during the pandemic lockdown?
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1) Factors Affecting Mental Health During the Pandemic Lockdown
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Pandemic Uncertainties
Confinement
Reduction in Social Interactions
Changes and Disruptions to Routines
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2) Factors Affecting Lifestyle Behaviours During the Pandemic Lockdown
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Factors of Eating Habits
Factors of Sleep
Factors of Physical Activity
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(Additional) What are the consequences of the pandemic lockdown?
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3) Consequences of the Pandemic Lockdown on Lifestyle Behaviours and Mental Health
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-
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(Additional) What are the strategies engaged in to cope during the pandemic lockdown?
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4) Coping during the Pandemic Lockdown
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Behavioural Strategies
Cognitive Strategies
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Factors Affecting Mental Health During the Pandemic Lockdown
Participants shared how aspects of the pandemic and lockdown affected mental health by the negative emotions they induced. Uncertainties caused by the pandemic situation in the country induced emotions such as confusion, worry, stress, anxiety, and hopelessness. Concerns about health was common. Participants worried about themselves as well as family and friends contracting the virus. “As for the concerns, majorly, erm, maybe it’s the fear of the spreading of the virus to our family members and some of our parents need to work and something like that…” (Participant 13).
Participants felt concerned over the increasing severity of the pandemic situation (rising cases) during the lockdown. “The MCO, you would see every day for the latest news, patient number...that the COVID patient number is getting higher or lower. When it is getting higher, we would feel more stressed and anxious and, kind of like sad for that.” (Participant 11)
Others also shared concerns about the uncertainty of the country’s economy during this time. This led to worries about their employment security. “…I do know a few people around that lost their job and even my own company we're also cutting down on manpower already. Yeah so, it is, it is quite worrying lah (slang, pragmatic particle)…” (Participant 6)
The lack of clear lockdown instructions and COVID-19 related information during the early period were another one of the uncertainties faced. Participants shared how they were simultaneously confused and overwhelmed by the information available. Some felt the lack of clarity led to unpreparedness in terms of work.“…my mental health was, uh, not great at the beginning of the semester or I, at least uh, one or two weeks before the semester because, as soon as MCO was announced, even though we kind of expected that it would happen at some point, it was still like, okay, it's... real, now what, what do I use? Zoom? BB collab? Teams? Uh, how? Coursework assignments, umm all the assignments had to be made online friendly in a very short time, so it was a lot of adrenaline rush.” (Participant 7)
Participants also felt lost and demotivated not knowing how long the pandemic and lockdown situation would last and how their future would be affected. They lamented about wanting things to go back to normal. “I can't think of anything else except that I’m just hoping we can all go back to our normal way of living. Basically, pre-covid times.” (Participant 3)
Second, the state of confinement also negatively affected participants, leading to feelings of loss of freedom. Some described feeling emotionally drained but also restless from the lack of movement. The free time some participants reported having also led to stressful ruminating behaviour while others felt pressured to be productive during this time. “There's nothing to do in this cage [sic] (house). Ah, even if there is, it'll only take up like, few hours of your time, then... what about the rest of the time. It's like, you know so.... you- you feel like, a bit like, useless doing nothing.” (Participant 4)
Third, reduction in physical social interactions during the lockdown led to loneliness. “…After 2 weeks also, it got really bad. Like, really bad in a sense where like, there is no social connection like... I regularly catch up with people so suddenly it went to zero and that was very excruciating.” (Participant 8).
Fourth, participants revealed changes and disruptions to routines (i.e., work, future plans) caused frustration and disappointment. They were also overwhelmed and burnout from the increased workload or the blurring of work-life boundaries. “And there was no divide between like home and work. So, I was like, there was definitely a time when I was like, working more than the required hours. Then, you feel very like, a bit burned out by that...” (Participant 5).
Factors Affecting Lifestyle Behaviours During the Pandemic Lockdown
Participants also revealed specific aspects of their situation during the lockdown that influenced their lifestyle behaviours, most notably eating habits, sleep, and physical activity.
For eating habits, convenience prompted snacking behaviour as participants described having snacked due to snacks being conveniently available in their living space. “When I walk past the dining table, I see the cookie jar and I just take some.” (Participant 3). Convenience was also crucial when their living space did not allow for cooking and meals end up being takeaways. Snacking behaviours had also been in response to negative emotions like stress and boredom. “Actually, not hungry also. It’s just like, like, my mouth needs something to chew on... There's like, there’s no feeling of hungriness at all and being (inaudible) it's like, something to, to... get rid of the bored feel I guess.” (Participant 12).
Family influenced eating habits during the lockdown. Some participants described meals being prepared by family and that snacking was encouraged as a family activity. Distrust of takeaway and delivery services also prevented some from relying on said services during lockdown. Limited participants cited exercising self-control during the lockdown to manage their eating habits.
Lastly, inactivity and financial capability were also noted to influence eating habits during the pandemic. Some participants reduced their food intake as they experienced lesser hunger due to inactivity while others only afforded food based on their financial capability.
For sleep, digital device usage before bedtime or preoccupation with work distracted some participants from going to bedtime. Participants also shared sleeps schedules changed due to the lack of daytime commitments (i.e., having to wake up early to travel to work). They admitted to sleeping late because they lost track of bedtime due to the abundance of free time, or for some, they did not feel tired enough to fall asleep from not doing anything in the day. “Because I just feel like, very energetic, I don't feel tired at all. I also don't feel sleepy and then when I just start scrolling social media then it just... sometimes it just went too long.” (Participant 9).
For physical activity, exercise was a coping method during the lockdown for some, but most did not exercise due to negative attitudes such as laziness and inconsistent motivation. Lack of space at home also hindered participants from exercising during the lockdown while some described the lack of social support from helping them maintain their engagement in exercise. “When I do (exercise) alone, like I will take a very long break in between, no one is like, ‘Hey, you need to start your workout... you need to continue your training. If not, you cool down your body and you need to take a long time…’ Having friends there to have conversation in between the set of the workout itself.” (Participant 11).
Consequences of the Pandemic Lockdown on Lifestyle Behaviours and Mental Health
Participants described the changes in lifestyle behaviours and mental health they noticed during the lockdown. Overall, these changes were negative. They noted experiencing more deterioration in lifestyle behaviours like poorer sleep quality, reduced physical activity, and increased screen time.
Almost all participants reported sleep schedules to be disrupted with commonalities in going to bed much later at night and waking up later than usual. “I would say the most severely... impacted is my sleep because I tend to uh.... sleep later than, than usual. It's like, sometimes I would just straight away sleep at 6 am, like going through the whole night.” (Participant 12)
In terms of physical activity, six participants maintained some form of exercise during the lockdown. However, mostly admitted having not engaged in any exercise or were less active during the lockdown compared to before. “Physical activity definitely went down during the MCO.” (Participant 10)
Participants also noted that an increase in their electronic devices’ usage compared to before the lockdown as they would spend much of their free time watching videos or scrolling through social media. “I tend to use more handphone during the lockdown.” (Participant 13)
Unlike sleep and physical activity, responses for eating habits were mixed. About a third of participants perceived themselves to be eating healthier because meals were prepared at home. About half of the participants also revealed an increase in snacking behaviour during the lockdown, “Snacking, I would say at home, I would snack more. It’s like, sometimes I do work, I would take some keropok (crunchy fried snacks) to eat rather than, in hostel I would just, I would just really control myself like last time…” (Participant 12)
In terms of mental health, five participants noted having experienced issues with motivation with work and exercise during the lockdown. Participants described having struggled to carry out these tasks consistently across the period of the lockdown. “But I can’t stay motivated for that...for long. Like throughout the MCO, maybe just the first 2 months I was very excited to do it (exercise). But towards the third month, I feel like I lost motivation.” (Participant 11)
Coping during the Pandemic Lockdown
In response to the challenges during lockdown, participants engaged in various coping methods that can be divided into 1) behavioural coping to 2) cognitive coping. Behavioural coping is when participants either adapted an existing behaviour or engaged in new behaviours to cope whereas cognitive coping refers to when participants managed their emotions and thoughts towards the stressor.
Behaviour Coping
Participants shared distracting themselves by keeping busy with activities during the lockdown (i.e., watching TV or videos, cooking). They also avoided things that were causing them stress, for example, watching less news updating the daily COVID cases. “...since it is MCO, yeah, I also like, watch... I, I, I did watch movies... TV shows ah... uh... I've also took up some online courses to distract, distract myself from, from the issues, and also, I worked out every day in my room.” (Participant 9).
Due to the movement restriction measures, participants kept contact with friends and family via online means. Interacting with family and housemates they were living with during the lockdown also gave some physical and emotional support. “I had my sister with me, uh staying with me so in a way there was like two of us to…uh, it wasn't so lonely and then we both can share the responsibilities of like, you know, doing groceries and cooking.” (Participant 5).
Participants also shared keeping a routine to help with issues relating with work and productivity. “When it started to prolong (the lockdown), that's when I knew like, okay, I need to have a schedule. Yeah, to organize my time because if I don't uh, I wouldn't, I wouldn't be able to work like, productively.” (Participant 5).
Cognitive Coping
Some participants coped by adjusting their perspective during the lockdown, such as thinking of their time in lockdown as a “break”. That said, some also expressed focusing on and expressing appreciation for the positive aspects of their circumstance. “...even though, I felt a loss of personal freedom, when I went out shopping, uh, I, changed my point of view. I, I appreciated that the roads were so empty. I could drive easily, you know… I appreciate what I have lah, rather than to think that I don't have that freedom...” (Participant 2).
Several participants also identified themselves as being an “introvert” and thus enjoying their alone time during the lockdown. “I think my mental health was okay lah because I think I'm much of a… quite a solitary person. So, I, I do enjoy having to stay at home and not meeting so many people actually.” (Participant 6).