Filyasyon Ekibi Çalışanlarının Anlatımıyla COVID-19 Pandemisi
Bu çalışmada COVID-19 pandemisinde sahada görev alan filyasyon ekiplerinin anlatımlarına odaklanılmıştır. Pandemi döneminde insan davranışlarını anlamaya yönelik çok sayıda araştırma gerçekleştirilmiş olsa da filyasyon ekiplerinde görev almış kişilerle yapılmış çalışmalara pek rastlanmamaktadır. Oysa bu kişiler, alınan önlemlere yönelik tepkileri doğrudan gözlemleme olanağına sahip olmuşlardır. Dolayısıyla, filyasyon ekibi çalışanlarının konuyla ilgili deneyimlerini betimlemek, araştırmacıların özellikle pandeminin ilk yılında ulaşamadığı, sahada olgunun nasıl deneyimlendiğini anlamak ve gelecekte alınacak önlemlerin iyileştirilmesi açısından önemlidir. Bu motivasyonla gerçekleştirilen çalışmada, araştırmanın amacı doğrultusunda filyasyon görevinde bulunan hemşire, sağlık memuru ve ebelerden oluşan 12 sağlık personeliyle (Ort yaş= 43,SS= 6.98; 6 kadın) görüşmeler gerçekleştirilmiştir. Görüşmeler 2021 yılı Mayıs-Haziran ayları içinde tamamlanmıştır. Katılımcılara ulaşırken ölçüt örnekleme yöntemi (filyasyon ekibinde yer alma) kullanılmıştır. Görüşmelerde katılımcılardan filyasyon boyunca karşılaştıkları durumları, yaşadıkları zorlukları ve yaptıkları gözlemleri anlatmaları istenmiştir. Görüşmelerin tamamı deşifre edildikten sonra elde edilen metinler, tematik analiz yöntemi ile analiz edilmiştir. Analiz sonucunda elde edilen 140 kod, 22 alt tema altında toplanmıştır. Bu alt temaların yeniden yorumlanması ve sınıflanmasının ardından toplam dokuz üst tema elde edilmiştir. Bunlar bilişsel süreçler (bilgi sahibi olma, bilişsel önyargılar, komplo teorilerine inanç, risk algısı), deneyimler (hastalığı deneyimleme, belirsizliğe alışma, sosyal dışlanmaya maruz kalma, cinsiyet farkları), olumsuz duygular, güven duyma, ahlaki süreçler, alınan tedbirlere uyma (bilinçlilik, ekonomik koşullar), filyasyon görevi (örgütsel güvensizlik, filyasyon görevinin zorluğu), mekânsal etmenler (ev ortamında risk algısı, yaşanılan yerin özelliği) ve kültürel etmenler (kültürel normlar, kültürel ritüeller) temaları olup önlemlere uyma davranışının bireysel, durumsal ve kültürel yönlerine işaret etmektedir. Tümevarımsal bir çıkarım yapıldığında, bu çalışmada elde edilen temaların Kültür x Kişi x Durum yaklaşımıyla örtüştüğü görülmüştür. Söz konusu temalar, alan yazındaki ilgili bulgular çerçevesinde tartışılmıştır.
COVID-19 Pandemic with the Narrative of the Contact Tracing Team Employees
This study focused on, the narratives of the contact tracing team employees who worked in the field during the ongoing COVID-19 pandemic were focused on. Although numerous studies have been conducted to understand human behavior during the pandemic, studies conducted with contact tracing team members are rare. However, these team members have had the opportunity to observe first-hand the reactions of people to the implemented measures. It is therefore crucial to describe the experiences of the contact tracing team employees to understand how the phenomenon was experienced in the field, particularly during the initial year of the pandemic when researchers were unable to access the relevant data. Furthermore, this will inform the development of effective measures to be taken in the future. The objective of this study was to explore this phenomenon. To this end, interviews with 12 medical healthcare personnel comprising nurses, health officers, and midwives (Mage = 43, SS = 6.98; 6 women) who were engaged in contact tracing duties. The interviews were completed in the months of May and June 2021. The criterion sampling method (employed in the contact tracing team) was used when reaching out the participants. During the interviews, the participants were asked to describe the circumstances they encountered during the contact tracing process, the challenges they encountered, and the observations they made. Following the transcription of the interviews, the researchers analyzed the texts by using the thematic analysis method. In total, 140 codes were collected which were then organized into 22 sub-themes. Following the reinterpretation and reclassification of these sub-themes, a total of nine meta-themes were identified. These encompass cognitive processes, experiences, negative emotions, trust, moral processes, adherence with measures, the task of contact tracing, spatial factors, and cultural factors. All these themes highlight the contextual and cultural aspects that underpin individual behavior in complying with caution. In light of the inductive reasoning, it can be argued that the identified themes align with the Culture x Person x Situation approach. These themes were discussed within the context of the pertinent findings from the existing literature.
On 31 December 2019, a disease emerged that led to a global pandemic declaration: COVID-19. The importance of protective behaviors (such as physical distancing, wearing masks, and confirming hygiene rules) has been emphasized. Several studies have been conducted to understand the relevant factors that might promote or hinder people’s adherence to new norms. However, most of these studies have been conducted with people who have lived through the pandemic period. There has been little research focusing on the narratives and observations of contact tracing teams has been realized. In addition, research using qualitative methods has been limited. However, it is worthwhile to understand the pandemic situation from the perspective of contact tracing team members who have gained enormous experience and made first-hand observations of peoples’ actions and reactions. This research therefore explored the experiences of contact tracing team members. To do this, we applied a qualitative research method.
Method
A total of 12 health workers (six women and six men) who had an active role in the contact tracing team of the Kirsehir Provincial Health Directorate participated in the study. The average age of the staff was 43 years (SD = 6.98), and the average length of service was 21 years. The participants have worked in teams throughout the province at the beginning of the contact tracing works. The necessary ethical approvals were obtained before the start of the interviews. The semi-structured interviews consisted of open-ended questions and a demographic information form prepared by the researchers. The interviews were conducted face-to-face and audio recorded with the consent of the participants. Each interview lasted 323 Psikoloji Çalışmaları - Studies in Psychology 10-15 minutes. The data collection phase was terminated upon reaching the point of saturation. The data were analyzed by applying the thematic analysis method (Braun & Clarke, 2006). In contrast to quantitative research, narratives were evaluated using inductive reasoning. This entailed the adoption of a phenomenological approach and the application of a bottom-up process to the data obtained from the health personnel’s accounts. The initial evaluations led to the creation of codes, which in turn yielded sub-themes.
Results
A bottom-up process was employed to identify themes and meta-themes. These meta-themes which consist of several sub-themes, were as follows: Cognitive processes, experiences, negative emotions, trust, moral processes, adherence with measures, the task of contact tracing, spatial factors, and cultural factors. The meta-theme of cognitive processes has is comprised of four sub-themes; knowledge, cognitive bias, risk perception, and belief in conspiracy theories.
Under the meta-theme of experiences, we gathered narratives from participants those related to how people experienced the pandemic. Our participants indicated that the severity of COVID-19 symptoms experienced by individuals during the course of the pandemic is a pivotal factor influencing their adherence to the newly established norms. We identified the sub-themes of experiencing illness, adapting to uncertainty, exposure to social exclusion, and gender differences under this meta-theme. Furthermore, interviewees narrated that some individuals perceived themselves to have been subjected to various forms of social exclusion while infected. It was observed by our participants that individuals were reluctant to acknowledge infection or to disclose their contact with infected individuals. This was driven by a desire to avoid being labelled and socially excluded and to maintain their ability to work and run their business outside the home.
The narratives obtained from experts illustrated that individual and their relatives who had contracted the virus expressed negative emotions including fear, anxiety, worry, anger, and sadness. These emotions were identified as a meta-theme of negative emotions. The narratives that we gathered under the meta-theme of trust covered people’s distrust of medication and politicians. In addition, the role of trust in contact tracing teams in facilitating or impeding the effectiveness of their work was pointed out as a crucial factor.
Some participants indicated that the moral aspect of actions either prevented or motivated people to comply with the measures, which were differentiated as a distinct meta-theme of moral processes. Although moral processes have overlapping aspects with other themes such as experience, we decided to classify this theme separately to emphasize its importance, particularly in the context of interpersonal and intergroup relations which have been studied in social psychology for decades (see Janoff-Bulmann & Carnes, 2013). The participants who had been involved in contact tracing teams told their observations about individuals who had concealed their contact with infected individuals or provided false information about their symptoms and disregarded the newly emerged norm. These observations can be regarded as evidence that individuals’ moral convictions and standards serve to (de)motivate (im)moral behaviors.
The meta-theme of adherence to measures included the codes that indicated the factors that played an important role in the concrete actions taken by people. These factors were grouped under the sub-themes of consciousness and economic conditions.
The interviewees talked about their perceptions of spatial factors during the pandemic period. They mentioned that individuals exhibited diminished perception of risk when they were at home. However, the households were predominantly large, which made it challenging to implement preventive measures. The theme of the contact tracing task based on the participants narratives regarding the organizational structure and psychological elements of their teamwork.
Finally, the participants described the presence of multitude of cultural elements within their expressions, which were subsequently categorized as cultural norms and rituals. The interviewees posited that cultural norms such as hospitality and proclivity for human relations, as well as cultural rituals such as weddings and funerals, have the effect of violating physical isolation due to the crowded nature of social gatherings.
Discussion
The themes that emerged from the thematic analysis is generally aligned with the findings from the quantitative research conducted during the COVID-19 pandemic. For instance, our meta-theme of cognitive processes has been demonstrated to be a crucial variable in complying with precautions during the pandemic in quantitative research conducted in an international context (e.g., Lin et al., 2020). Among cognitive processes, optimism bias and high-risk perception have been shown to have a negative effect on protective behaviors (Cihan et al., 2020; DiMaria et al., 2020; Fragkaki et al., 2021; Rajaonah & Zio, 2020; Teovanović et al., 2021; Wise et al., 2020).
The findings of our study indicate that moral processes have been associated with protective behaviors (Devereux et al., 2021). In addition, as Diaz and Cova (2021) have suggested, the extent to which individuals adhere to official recommendations during the pandemic is contingent upon their individual moral values.
The phenomenon of social exclusion, as narrated by our participants has been identified as a significant demotivator of compliance in other studies (e.g., He et al., 2020). Consequently, the perception of discriminatory and exclusionary behaviors directed towards infected individuals result in reluctance to adhere to self-quarantine measures (He et al., 2020). Additionally, research suggests that the disease period exerts a significant influence on the post-disease period. For example, individuals who have survived the disease demonstrate a greater propensity to comply with the recommended precautions (Ulu & Aslantürk, 2021). Our findings align with these research findings.
Moreover, our interviewees mentioned that the pandemic elicited negative emotional responses, which also concurs with the existing literature. Individuals reported experiencing and expressing a range of negative emotions including anxiety, anger, and depression, to a notable degree during the pandemic (Kim et al., 2022).
Our participants who worked in contact tracing teams narrated that there is a general lack of compliance with the rules of wearing masks and maintaining physical distance when at home and with relatives. Güzeloğlu (2021) argued that the domestic and collective situations present significant challenges in terms of complying with the precautions, a finding that is also supported by intercultural comparisons (Liu & Mesch, 2020; Ruiz et al., 2021).
Besides, our findings pointed out the importance of individuals’ endorsement of cultural norms and values in terms of (non)adherence with precautionary measures taken during the 325 Psikoloji Çalışmaları - Studies in Psychology pandemic. This finding concurs with the literature as well (e.g., Ünlü & Çiçek, 2021). As evidenced by observations and analyses of other scholars, cultural rituals have undermined the efficacy of protective measures throughout the pandemic (e.g., Primc & Slabe-Erker, 2020).
Conclusion
In accordance with the principles of inductive reasoning, we argue that our results are aligned with the perspective put forth by Cohen and Leung (2011), who suggest the approach of Culture x Person x Situation (CPS) to understand any phenomenon related to human behaviors. This approach posits that, despite the existence of individual differences, people’s behaviors are not independent from the cultural milieu in which they are embedded. Each individual possesses a distinctive personality, yet they are socialized within a specific cultural context. It is not always possible to comprehend behavior that is culturally specific, even when the cultural context is similar. Because there are individual differences in adherence to cultural values and norms. Furthermore, individual and cultural differences may vary depending on the situation or the context. We argue that the holistic approach of CPS provides a comprehensive framework for the re-categorization our findings. Consequently, our themes of cultural norms and rituals can be grouped under the level of culture in the CPS model.
Moreover, our themes of cognitive processes, moral processes, feeling of trust, emotions, experiences, and adherence with measures can be classified at the level of person, while the themes of the contact tracing task and spatial factors can be seen as aspects of the situation. Such a holistic view of a phenomenon is not readily amenable to exploration through the logic of deduction Our work, based on phenomenology thus allows us to make such abstractions. In this sense, our work makes a contribution to existing the literature by demonstrating the process of qualitative induction, whereby certain qualitative features are assembled in a manner that resembles another theoretical framework that is already part of the scientific knowledge base.
In short, this study allowed us to explore the diversity of human (re)actions as described by experts rather than homogenization and generalization of human behaviors in a global crisis characterized by uncertain circumstances.
