0214/2024 - ADOLESCER AJUSTANDO ÀS CIRCUNSTÂNCIAS IMPOSTAS PELA PANDEMIA: TEORIA FUNDAMENTADA NOS DADOS
ADOLESCENCE ADJUSTING THE CIRCUMSTANCES IMPOSED BY THE PANDEMIC: GROUNDED THEORY
Autor:
• Maria Aparecida Bonelli - Bonelli, M. A. - <mmariabonelli@gmail.com>ORCID: https://orcid.org/0000-0003-0542-4411
Coautor(es):
• Aline Oliveira Silveira - Silveira, A. O. - <alinesilveira@unb.br>ORCID: https://orcid.org/0000-0003-4470-7529
• Glauber Weder dos Santos Silva - Silva, G.W.S - <glauberweder@hotmail.com>
ORCID: http://orcid.org/0000-0002-0570-1944
• Diene Monique Carlos - Carlos, DM - <diene.carlos@usp.br>
ORCID: https://orcid.org/0000-0002-4950-7350
• Ligia Bruni Queiroz - Queiroz, L. B. - <ligiabq@usp.br>
• Monika Wernet - Wernet, M. - <monika.wernet@gmail.com>
Resumo:
Objetivo: compreender o adolescer no contexto da pandemia da COVID-19. Método: estudo orientado pela Teoria Fundamentada nos Dados na vertente pós-positivista sob o referencial do Interacionismo Simbólico. A amostragem teórica foi composta por 23 adolescentes que foram entrevistados em profundidade ao longo de 2021. A análise por codificações aberta, axial e seletiva conduziu a uma teorização deste adolescer. Resultados: Intersectados pelo isolamento imposto e pelo significado das interações sociais para o adolescer, os participantes buscaram escolhas relacionais para se ajustarem e perseguir seus projetos. Envolveram-se nos ciberespaços para resgatar interações com pares e, simultaneamente, manejaram relações familiares percebidas enquanto duais, próximas, intensas, mas conflituosas. Destarte, o enfrentamento requereu lidar com sentimentos e abertura ao novo. Avançaram na autonomia, reconhecimento de si e do outro. Conclusão: Sob o entendimento de existirem conexões significativas para a continuidade do seu projeto e processo de desenvolvimento, adolescentes ajustaram-se ao contexto social imposto por meio de escolhas interacionais.Palavras-chave:
Adolescente. Identidade Social. Pandemias. Enfermagem. Teoria Fundamentada.Abstract:
Objective: to understand adolescence in the context of the COVID-19 pandemic. Method: study guided by Grounded Theory in the post-positivist aspect under the framework of Symbolic Interactionism. The theoretical sample consisted of 23 adolescents who were interviewed in depth in 2021. The analysis using open, axial and selective coding led to a theorization of these adolescents. Results: Intersected by the imposed isolation and the meaning of social interactions for adolescence, the participants sought relational choices to adjust and pursue their projects. They got involved in cyberspace to rescue interactions with peers and, simultaneously, managed family relationships perceived as dual, close, intense, but conflicting. Thus, the conflict required dealing with sentiments and being open to new things. They advanced in autonomy, recognition of themselves and others. Conclusion: On the understanding that there are significant connections for the continuity of their project and development process, adolescents adjusted to the social context imposed through interactional choices.Keywords:
Adolescent. Social Identification. Pandemics. Nursing. Grounded Theory.Conteúdo:
Acessar Revista no ScieloOutros idiomas:
ADOLESCENCE ADJUSTING THE CIRCUMSTANCES IMPOSED BY THE PANDEMIC: GROUNDED THEORY
Resumo (abstract):
Objective: to understand adolescence in the context of the COVID-19 pandemic. Method: study guided by Grounded Theory in the post-positivist aspect under the framework of Symbolic Interactionism. The theoretical sample consisted of 23 adolescents who were interviewed in depth in 2021. The analysis using open, axial and selective coding led to a theorization of these adolescents. Results: Intersected by the imposed isolation and the meaning of social interactions for adolescence, the participants sought relational choices to adjust and pursue their projects. They got involved in cyberspace to rescue interactions with peers and, simultaneously, managed family relationships perceived as dual, close, intense, but conflicting. Thus, the conflict required dealing with sentiments and being open to new things. They advanced in autonomy, recognition of themselves and others. Conclusion: On the understanding that there are significant connections for the continuity of their project and development process, adolescents adjusted to the social context imposed through interactional choices.Palavras-chave (keywords):
Adolescent. Social Identification. Pandemics. Nursing. Grounded Theory.Ler versão inglês (english version)
Conteúdo (article):
ADOLESCER AJUSTANDO ÀS CIRCUNSTÂNCIAS IMPOSTAS PELA PANDEMIA: TEORIA FUNDAMENTADA NOS DADOSADOLESCENCE ADJUSTING TO THE CIRCUMSTANCES IMPOSED BY THE PANDEMIC: GROUNDED THEORY
Maria Aparecida Bonelli. Universidade Federal de São Carlos. mmmariabonelli@gmail.com. https://orcid.org/0000-0003-0542-4411.
Aline Oliveira Silveira. Universidade de Brasília. alinesilveira@unb.br. https://orcid.org/0000-0003-4470-7529.
Glauber Weder dos Santos Silva. Secretária de Estado da Saúde Pública do Rio Grande do Norte. glauberweder@hotmail.com. https://orcid.org/0000-0002-0570-1944.
Diene Monique Carlos. Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo. diene.carlos@usp.br. https://orcid.org/0000-0002-4950-7350.
Lígia Bruni Queiroz. Instituto da Criança e do adolescente do Hospital das Clínicas da FMUSP. ligia.bruni31@gmail.com. https://orcid.org/0000-0002-0326-7072.
Monika Wernet. Universidade Federal de São Carlos. mwernet@ufscar.br. https://orcid.org/0000-0002-1194-3261.
Article taken from the doctoral thesis "Adolescer: interações sociais e construção identitária" (Adolescence: social interactions and identity construction), submitted to the Federal University of São Carlos, São Carlos, SP, Brazil, 2023.
RESUMO
Objetivo: compreender o adolescer no contexto da pandemia da COVID-19. Método: estudo orientado pela Teoria Fundamentada nos Dados na vertente pós-positivista sob o referencial do Interacionismo Simbólico. A amostragem teórica foi composta por 23 adolescentes que foram entrevistados em profundidade ao longo de 2021. A análise por codificações aberta, axial e seletiva conduziu a uma teorização deste adolescer. Resultados: Intersectados pelo isolamento imposto e pelo significado das interações sociais para o adolescer, os participantes buscaram escolhas relacionais para se ajustarem e perseguir seus projetos. Envolveram-se nos ciberespaços para resgatar interações com pares e, simultaneamente, manejaram relações familiares percebidas enquanto duais, próximas, intensas, mas conflituosas. Destarte, o enfrentamento requereu lidar com sentimentos e abertura ao novo. Avançaram na autonomia, reconhecimento de si e do outro. Conclusão: Sob o entendimento de existirem conexões significativas para a continuidade do seu projeto e processo de desenvolvimento, adolescentes ajustaram-se ao contexto social imposto por meio de escolhas interacionais.
Palavras-chave: Adolescente. Identidade Social. Pandemias. Enfermagem. Teoria Fundamentada.
ABSTRACT
Objective: to understand adolescence in the context of the COVID-19 pandemic. Method: study guided by Grounded Theory in the post-positivist aspect under the framework of Symbolic Interactionism. The theoretical sample consisted of 23 adolescents who were interviewed in depth in 2021. The analysis using open, axial and selective coding led to a theorization of these adolescents. Results: Intersected by the imposed isolation and the meaning of social interactions for adolescence, the participants sought relational choices to adjust and pursue their projects. They got involved in cyberspace to rescue interactions with peers and, simultaneously, managed family relationships perceived as dual, close, intense, but conflicting. Thus, the conflict required dealing with sentiments and being open to new things. They advanced in autonomy, recognition of themselves and others. Conclusion: On the understanding that there are significant connections for the continuity of their project and development process, adolescents adjusted to the social context imposed through interactional choices.
Keywords: Adolescent. Social Identification. Pandemics. Nursing. Grounded Theory.
INTRODUCTION
Adolescence is the experience of individuation circumscribed by sociocultural life1, under a complex and dynamic interconnection between past and current experiences, resulting in growing self-recognition1-4. Biopsychic and social relationship transformations5 take place, with a view to life projects, identity structuring and autonomy6-7. Being in social spaces and the relationships established therein influence and shape adolescence and the challenges it brings4,8.
Pandemics intersect social processes and the COVID-19 pandemic involved restrictions on social relations, affecting identity construction, behavior, autonomy and the shaping of adolescents\' future projects9. In this respect, studies have focused on portraying the impact of the pandemic on the behavior and mental health of adolescents10-19. There was a predominance of quantitative methodological approaches11,15-16,18-20, despite the existence of qualitative studies13,17,21, mixed methods10, reflection22-24 and reviews12,14,25-26. No theorizing on adolescence in this context was found.
There is an urgent need to support the process of adolescence with a view to achieving the physical and mental well-being of adulthood, as well as better living conditions27. Despite greater visibility and efforts to include adolescents, there are still shortcomings in health care for this section of the population, especially in undeveloped countries28.
In Brazil, the estimated population is 207 billion inhabitants, and adolescents account for around 15% of this total29 comprising young people aged between ten and 1928, the age group adopted for this purpose by the Brazilian Ministry of Health.
When focusing on health indicators, the World Health Organization (WHO) estimated that in 2019, more than 1.5 million adolescents and young adults between the ages of 10 and 24 died worldwide, and among the main causes were violence, suicides and traffic accidents30. As far as social issues are concerned, in 2021, the percentage of Brazilian children and adolescents living in extreme poverty and poverty reached the highest level compared to previous years: 16.1% and 26.2%, respectively29. This data reveals the demographic and social importance of this group and the need to implement actions under the National Guidelines for Comprehensive Health Care for Adolescents and Young People31 in order to meet the demands of this section of the population.
In line with the above, and with the Accelerated Global Action for Adolescent Health (AA-HA!) and the Global Strategy for Women\'s, Children\'s and Adolescents\' Health (2016-2030)28,32, this study poses the question: \'How have the social interactions and identity processes of adolescents been affected by the COVID-19 pandemic?\'. The aim was to understand adolescence in the context of the COVID-19 pandemic.
METHOD
The Study Design
This is a qualitative, interpretative study, based on the methodological framework of Grounded Theory (GT) in the post-positivist strand33. GT goes beyond description by developing a theoretical model in which the researcher makes an inductive and deductive analysis of the data, alternating between individual and collective experience, in order to validate the phenomena in the process of generating a theory33.
In this sense, Symbolic Interactionism (SI) has proved to be an important theoretical reference by emphasizing human behavior as a development of social interactions and the concepts derived therefrom34. From this perspective, adolescence is a singular process, structured and derived from social (including internalized) interactions, with a view to achieving identity.
Location of the study
The study was carried out with adolescents living in a municipality in the interior of São Paulo, whose estimated population in 2022 was 254,822 inhabitants, 13% of them adolescents35. Recognized for its high level of development, the town has a Gross Domestic Product (GDP) per capita of R$47,701.04, a human development index (HDI) of 0.805 and 6.5 points on the Basic Education Development Index (IDEB) 35.
In relation to the São Paulo Social Vulnerability Index (IPVS)36, the population is concentrated in very low vulnerability territory, with 62% stratified as low and very low vulnerability and 17% of the population in high and very high vulnerability territory.
Participants of the study
A total of 26 adolescents were invited, 23 of whom agreed to take part and three of whom did not respond after three attempts to contact them. They were located using the snowball sampling technique, based on key informants identified through an outreach activity developed in a school environment with adolescents in 2019. The snowball sampling technique is indicated for locating populations with specific experience37.
The participants were invited to take part in the study via WhatsApp®, by means of a written presentation by the researcher together with an audio explanation of the study, its objective and data collection strategy. Those who expressed an interest in taking part in the study were asked to provide the contact details of their parent or guardian so that a consent form could be sent to them. The agreement and consent forms were sent via a Google Forms® link. After receipt of consent to participate, the interviews were scheduled.
Gathering of data
The data was collected throughout 2021 and, considering the pandemic situation, it was collected online, through a single open interview, audio recorded on the Google Meet® platform, lasting 20 minutes on average. Initially, sociodemographic information was obtained, and then the guiding questions for the sample groups were presented.
In order to achieve theoretical saturation and category density, that is, the absence of new elements linked to the phenomenon, theoretical sampling33, five sample groups were formed (Table 1).
Table 1
The initial selection criteria for the participants were: (a) to be between 12 and 18 years of age, (b) to be interested in contributing to the study and (c) to have the consent of a parent or guardian.
Analysis of the data
The data collected were transcribed in full and analyzed simultaneously33. The entire process of data collection and analysis was carried out by the first author, a nurse, PhD student in Health Sciences, member of the outreach team at an adolescent health clinic and a school, with previous experience in GT (master\'s research).
Open coding took place through the process of line-by-line analysis to create codes and concepts. The codes were organized by similarity, establishing the initial categories. Axial coding was the process of interpreting the data based on the five components of the Paradigm Model, relating and substantiating the categories. In selective coding, the analytical organization of the data made it possible to identify the paradigmatic model, with the delimitation of the phenomenon and central category of the study. This model was validated with two adolescents, a 17-year-old boy from the private school system and a 15-year-old girl who attended a public school. The validation took place remotely, via Google Meet®, where the diagram representing the Central Category was presented and the narrative of the experience was read out. The adolescents identified with the experience, with emphasis on the sentiments and suffering arising from isolation and separation from their peers. This was the final stage of the GT, important for analyzing its relevance and representativeness33.
All ethical recommendations were respected and the study was approved by the Human Research Ethics Committee, CAAE 39524120.2.0000.5504. Participants were identified by the letter (A), followed by the ordinal number in which the interview was conducted.
RESULTS
The participants were 11 males and 12 females, aged between 12 and 17, the majority were in elementary school (n=17), the others in secondary school (n=6). As for the school system, 11 were from public schools and 12 from private schools. 15 adolescents lived in a nuclear family and six in a single female parent family. In terms of where they lived, according to the IPVS36 (immediate danger to life and health), 4 lived in a region of very low vulnerability, 5 in a region of low vulnerability, 8 in a region of medium vulnerability and 6 in a region of high social vulnerability.
The results show that adolescence in the COVID-19 pandemic is represented by the phenomenon “Maintaining meaningful connections for the continuity and achievement of the life project”, sustained by five conceptual categories, organized from the components of the paradigmatic model: Context (adolescence); Causal conditions (having the project curtailed by the COVID-19 pandemic); Intervening conditions (being suddenly exposed to changes and experiencing the intensification of family relationships); Strategies (intensifying the relationship with oneself, immersing oneself in cyberspace and intensifying the use of Information and Communication Technologies (ICTs) and revisiting projects and expectations); Consequences (suffering emotional distress, recognizing the essential nature of social relationships, expanding autonomy and discovering oneself).
Context
Adolescence is the context of experience, it is shaped by social interactions and encompasses the intertwining of developmental changes (physical, emotional and social demands) under social projections of responsibility and the future, with the current desire and anxiety to live together with peers and the tessitura of their story.
In adolescence you evolve a lot, apart from your physical appearance, your psyche changes, your thoughts, your desire to go out, be with friends, all that sort of thing. And I always wanted to be an adolescent, because I saw my brother going out, my cousins going out, having fun, telling stories, and I thought, I want to go out with my friends, I want to have stories to tell (A14).
Causal Condition
With the project curtailed by the COVID-19 pandemic, the causal condition of this phenomenon is understood, since the prospect of spending adolescence with peers in a freer and more intense manner has been challenged.
I had a lot of expectations as a teenager, of going out, going to lots of parties, having fun with my friends, but then the pandemic came and ended all the expectations I had (A15).
Intervening conditions
They found themselves being suddenly exposed to changes and experiencing the intensification of family relationships, a condition that intervened in the expectations projected for adolescence. The change in the course of the process of adolescence requires social interaction in a context symbolically immersed in fear and restriction, confronting expectations of the past and the future.
The changes were felt most intensely when the schools closed and they realized that they were confined to their homes. They are suddenly prevented from frequenting social spaces where they can interact with their peers, especially in schools.
Before the pandemic, I used to arrive despondent and leave school happy, with my stomach aching from laughing so much, it was really cool, [...] from one day to the next, man, there was nothing, it was over, everyone had to stay at home, just on the cell phone screen, so it was a shock, like, you know, out of nowhere the disease appeared and it was over (A17).
Being isolated was a symbol that was difficult to work out, as was wearing a mask that made it impossible to see and feel the other person, which interfered with interactions.
It\'s hard, I only see my friends at school, and they have to wear masks, I can\'t remember almost anyone\'s face, and when they take their mask off, I think “Oh my God!” (A10).
Online teaching was complex, they described difficulties with the platforms used by the schools, limits to concentration and the lack of an educator/adolescent bond. The speed with which everything happened required an abrupt adaptation.
It was a bit strange, all of a sudden you couldn\'t look at anyone, you could only hear their voice, or see them through the screen of your cell phone. It was difficult, we\'d get bored and just leave the class and leave the teacher talking and go and do something else, you know, so it was really hard to learn anything, it was really hard to concentrate (A10).
The change was sudden, symbolized tension and required an intense process of the Mind with directives for (re)significations and actions. The inversion of interactional spaces was imposed along with the intensification of family relationships. In this sense, the way in which the family positioned itself in support had a major impact on the experience.
Family relationships, sometimes considered to be strengthened by the imposition of coexistence, were also immersed in conflicts arising from sharing spaces, tasks, dealing with different personalities, as well as the continuous supervision of parents/family members.
[...] I started to get really sad, like, I bite my nails, and then I started biting my nails a lot, and then my mom called some friends to help me do homework, to stay here at home, to help each other, you know, to see if we could cheer up a bit, that\'s what helped me (A9).
Being with the family was nice, but I think because we spent a lot of time together and there was no space, there were fights, we answered each other back, me and my brother, in fact my whole family fought (laughs) [...] my mother controlled everything, all the time. But we also started doing more things together, like watching movies, TV shows, sitting on the balcony, having lunch or sunbathing (A3).
Overall, family interactions were perceived as making little contribution to achieving the individuality of BEING in adolescence and its particularities.
Strategies
Faced with the challenges of social isolation, teenagers had to use strategies to keep going with their lives and their projects. They intensified their relationship with themselves, immersing themselves in cyberspace and intensifying their use of Information and Communication Technologies (ICTs) and revisiting projects and expectations.
Being forced into this new context of interaction caused them to regard adolescence during the pandemic as difficult and complicated, because they considered that they were being deprived of the best phase of their lives, restricted to their homes, unable to go out, travel and, above all, be with their friends.
In adolescence, the development of the Self occurs in the midst of interactions, including with oneself, when they perceive themselves as being in oscillation, with different \'vibes\' in a single moment.
Adolescence also has its downsides, because it\'s when you discover yourself and go through different emotions and sometimes they\'re emotions that affect you and that tell you more about your personality, and so it\'s something very strange, kind of bipolar, because one moment you\'re one way and another moment you\'re another, every moment you\'re in a different \'vibe\', different choices, I think that\'s it (A13).
The process of understanding oneself structured adolescence, they reflected on what and how things and people are seen and felt, with greater sensitivity to the symbols emitted around them. The pandemic imposed a lonely and painful process of relating to oneself.
I had to learn to live in my own company and that\'s difficult [...] I think about a lot of things on my own and end up getting paranoid, and my friends helped me forget a bit, [...] This time alone was good for me to get to know myself better, to mature, [...], being alone changed me a lot, I became very critical of myself, I\'m learning to live with it, and I changed a lot due to the sadness of being alone, I became a bit fearful, very sentimental and emotional (A18).
Immersing themselves in cyberspace and intensifying the use of ICTs was a move made by teenagers in their search for social interaction and the support it offered. They considered cyberspace to be conducive to freedom of choice, of whom to talk to, what to access and how to relate.
When I\'m on my cell phone, I leave the world of the pandemic for a while, and go to a world with more people, you know, that\'s it, connecting with more people (A4).
The social isolation imposed by the COVID-19 pandemic restricted interactional experiences and impacted personal and social identity.
School was the symbol of freedom, as they felt freer there, making choices without so many family projections and impositions. Thus, the impossibility of being there, of interacting with peers by going to school, was seen as the main loss and launched teenagers into cyberspace, eager for new ways of relating freely and alleviating suffering.
We were stuck at home, I had very bad days, I was alone all day, in the dark room, doing absolutely nothing and I ended up calling some of my friends so we could make video calls, almost daily to talk, because it\'s very difficult not to talk, not to talk at all, it\'s difficult to do everything by message, so psychologically the pandemic affected me enormously, it affected me too much to be without my friends (A19).
It was possible to perceive that ICTs, enabled and facilitated by the pandemic, alleviated the lack of interactions with peers and provided opportunities to meet people, moments of distraction and leisure. Despite this, they reinforced the loss and distancing of friendships.
What changed most with the pandemic, I think, was physical contact with friends, now we only talk by video call or voice call, and online games, and I ended up losing some friends, the relationship with my friends became quite distant (A1).
The need to see and feel the other person in the interaction process was noted with regret. Shyness was recognized as an additional obstacle in this context; they missed laughing and talking to friends. Being face-to-face with others provides different sensations and exchanges when compared to the virtual world.
Despite the difficulties they experienced, they remained hopeful for the return to everyday life and continued to invest in their projects, looking beyond the pandemic, despite the losses - friends, meetings, graduations, parties, trips and even loved ones. Astuteness and the desire for new challenges stood out in the hope of resuming their projects.
My expectation with the end of the pandemic is to go out, talk to friends, which is what I missed the most, [...] In the future, I intend to go to college, study, have a job, and later maybe buy my own car, have my own source of income (A14).
Consequences
All this rearrangement of life and interactions for adolescents during the pandemic caused them to suffer emotional stress, recognizing the essentiality of social relations, expanding autonomy and self-discovery.
Restrictions on movement in social spaces for interactions with peers was a loss felt by adolescents, especially at school.
What I wanted was to have been able to continue with my friends, to continue laughing, to have them close to me (A20).
I missed my classroom, school was a place where I felt good, where sometimes I\'d arrive sad and leave laughing, and with online school nobody even talks, they don\'t say anything, it\'s really bad (A15).
The strategies they adopted were insufficient in terms of emotional support. They felt sad, anxious, alone, bored, angry and afraid. Many showed emotional distress and some developed psychological problems. Their feelings were described as complex and not wholly understood.
Before, I used to talk to my mother more, but now, during the pandemic, I don\'t know how to explain the reasons for the feelings I have, like sadness at missing my family, my friends, or some annoyance I feel. I think that before I knew more about what I was feeling, and now because so many things are happening, I don\'t know what\'s going on with my feelings, it\'s a bit harder to talk about, and I feel more sadness, it\'s hard to live with the pandemic (A2).
[...] the psychological issue was very difficult during the pandemic, because I developed anxiety, there were some months that were difficult, I even had some problems with depression, I lost a lot of friends, a lot, because face-to-face conversations are one thing and remote conversations are something else, so it\'s very difficult psychologically, both psychologically and physically, because physical contact, the warmth of having people close to you is very good, and is missed (A7).
I developed an eating disorder because of all this, because of staying at home, because of the pandemic itself (A21).
This greater immersion in their feelings, sadness and anxieties allowed them to mature, fostered solidarity and empathy, enabling them to highlight the evolution of their interaction processes with themselves and their sensitivity.
The pandemic made me think that there\'s not just me in the world, and I need to help others, like not going out, wearing a mask, using hand sanitizer, like not transmitting this disease to my family (A6).
I really missed meeting people, because I was no longer able to socialize, not even at home, I didn\'t know how to respond to people anymore, I couldn\'t pay attention anymore, have physical contact, anything that touched me, I couldn\'t identify what it was, what the meaning was (A12).
They reinforced the importance of social relations for adolescents, especially friendships. Although cyberspace provided a virtual meeting place for teenagers, it was perceived as \'distant\' and impersonal.
With the freedom offered by belonging to and managing cyber-spaces, teenagers were challenged in their autonomy when it came to making decisions about studying and meeting deadlines when handing in assignments and exams. They experienced difficulties in self-organization.
Because I had to create a routine, a routine of waking up, getting up, doing homework, talking to people, even online. Now we talk a lot, do a lot in class, and I learn a lot too, but I\'ve had to organize my studies, hand in activities, pay attention to deadlines, take care of everything at school (A5).
This autonomy transcended into family life, because, with the obligation to stay at home, new roles were assigned to adolescents, and they began to take care of the house and younger siblings, especially when their parents maintained their work routine.
In a move simultaneously to overcome the frustration of not living up to their adolescent expectations and to allow themselves to try out new roles and situations, they made discoveries in different areas, such as reading, writing, sports activities, cooking, make-up, body arts, and social interaction through games and online communication platforms.
During the pandemic, we spent a lot of time on our cell phones, so we learned a lot of things on our phones. For example, I learned how to cook better, do makeup and I also started reading on my cell phone, it was really cool (A13).
Thus, the theoretical model \'Adjusting to the circumstances imposed by the pandemic\', represented by figure 1, emerges in the adolescent\'s movement and strategies for adjusting to the circumstances imposed by the pandemic, in an attempt to maintain meaningful connections and the continuity, integrity and normality of their life process. This projection for living through adolescence, observed in the phenomenon under study, can be seen in the preponderance of the categories \'Intervening conditions\', \'Strategies\' and \'Consequences\'.
Figure 1
DISCUSSION
Adolescence is socially associated with the construction of identity and a life project, processes based on and through social relationships. Anchored in the IS, identities require and transcend recognition of the Self, the I in relationships, with reflections on individual actions and those of others, cultural inferences, under a comparative process and with comprehensive efforts on interactions, values, behavior and conduct38.
In adolescence there is a greater force behind the formation of identities, given the rise of autonomy, behavioral and personality recognition, all of which are influenced by social relations. Socio-economic status, family configuration and interaction processes between parents and children, as well as the influence of affection and openness to dialogue, reflect on adolescents\' social behavior7.
Compared to children, adolescents spend more time with their peers than with their families and thus form more complex relationships with them9. This reorientation towards their peers stimulates their development and gives them a sense of social self-identity9. The adolescents in this study pointed out the importance of relationships with friends for developing identity, and the interruption in socializing caused by the pandemic was seen as an obstacle, threatening development, thwarting expectations, generating ruptures, uncertainties and suffering.
It follows then that widespread changes in the social environment, such as forced physical distancing and reduced face-to-face social contact with peers, can have a substantial effect on adolescence9.
The pandemic brought about the loss of friends and made it impossible to celebrate previously planned social events with the character of "rites of passage". However, it brought benefits, especially the recognition and appreciation of friendship and relationships28.
The social isolation of the pandemic situation was seen as restricting the realization of projects and the building of meaningful relationships. To counteract this, there was an intensification of communication through ICTs, including as a resource for agreeable experiences39, an aspect that leads to the discussion of the purpose of ICTs during adolescence.
When considering the anxiety surrounding adolescence, it is worth drawing a parallel between the social restriction experienced by adolescents during the pandemic and controlling family relationships. The uncontrolled or unsupervised socialization of young people is identified as a precursor to deviant behavior40, but adolescence requires freedom. It is in unsupervised environments that adolescents exercise their decision-making power7, build relationships and develop autonomy. Freedom of choice is socially expected during adolescence, from the choice as to with whom, how and where to relate, to decisions about the future. Adolescents project the acquirement of this freedom, which in the context under study was disrupted, but it was sought nevertheless, demonstrating that it is a structural element of adolescence, with indications that it is based on support for families with adolescents.
Social interactions with peers allow adolescents to recognize themselves in relationships, to reflect on their behavior and the behavior of others, and provide a space for speaking and listening. They thus contribute to the adolescent\'s well-being and projects9. Strengthening friendships is essential, for which reason the search for peers is intense4. Friendships are powerful for dealing with problems, including bad experiences, and form an important support network4,41. This study has confirmed the distinctive meaning of friendships in adolescence.
In addition, the COVID-19 pandemic brought to the surface reflections on mental health and psychological suffering in the face of restrictions on social relations42, an aspect reinforced here. A study found that 51% of adolescents reported having experienced a worsening in their level of irritability, 48% in their anxiety level and 47% in their general mood during the COVID-19 pandemic. Of these, 39% reported increased depression19.
As regards family relationships, the pandemic had a double effect, as a promoter of affection, protection and care, but also of negative sentiments such as loneliness, sadness and disdain, largely due to family dysfunctions, arguments and disagreements42. Understanding family relationships is a guide for interventions to support adolescents and families during and after the pandemic43.
Expanded social relations have proved to be a special place for adolescence, with indications of protecting their occurrence. They can exercise their choices, especially those of interaction and with peers who support the process of \'experimentation\' that is typical and necessary for adolescence. On the other hand, the social construction that links adolescence to situations of risk and vulnerability leads some families to adopt a behavior of vigilance and control. Health and education professionals can provide an opportunity to talk about this, in order to support families and adolescents in achieving open communication and decision-making that respond to and sustain this need of the adolescent.
In this respect, the school is a propitious and important social space in the results of this study. It happens that actions in this context tend to be imbued with capacitism, under the guise of protection and the notion that adolescents are \'minors, almost non-subjects\'44. Protection is important, but it needs to be sustained by processes that promote the self based on the relationship with oneself and with other social beings33, otherwise it will fail to emancipate people.
Every situation that leads to a restriction or curtailment of social relations puts the adolescent\'s development and project at risk. It is therefore imperative to resume social relationships that are essential to identity processes when thinking about the social context, and intersubjectivities are on the list of actions to support adolescence.
It is a challenge for public policies to go beyond the simple numerical expansion of spaces for socialization in order to improve the dialogs and intersubjectivities in these spaces. It is what is experienced in these social interactions that influences adolescents and their critical autonomy.
The findings of this study make it possible to illustrate the essential need for a view that places social (peer, family and extended) relations at the center, as opposed to one that insists on giving priority to issues of biology and risk. These will only make sense if they are thematized based on the foundations of the social interactions that project and sustain adolescence. Therefore, the focus must be on building relational environments that promote emancipation, which have their own features and depend on the individuality of each adolescent and their social insertion.
FINAL CONSIDERATIONS
The theoretical model \'Adjusting to the circumstances imposed by the pandemic\' discusses the movement of adolescents to face the consequences of isolation and to live adolescence despite the restrictions imposed, while keeping their project on the horizon. It portrays the importance attributed to adolescence in terms of freedom to be and relate in social spaces.
The theory developed here represents a framework for understanding adolescents\' relational choices when facing crises and adversity with social restrictions. It allows health professionals, educators and the family to provide support for adolescents and their relational choices, with guidelines for an open dialog that values such choices and the project envisaged by the adolescent.
As for the limitations, it is important to note that the study was only carried out in one municipality and did not cover all social classes, which points to the need to explore new facets of the phenomenon of adolescence. It should be emphasized that the experiences portrayed do not apply across the board to all adolescents, as something new can always arise, and can be further explored for later inclusion in the theoretical model, which is characteristic of the method used.
FUNDING
This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001.
REFERENCES
1. Janssen LHC, Verkuil B, Van Houtum LAEM, Wever MCM, Elzinga BM. Perceptions of parenting in daily life: adolescent-parent differences and associations with adolescent affect. J Youth Adolesc. 2021;50(12):2427-2443.
2. Andrews JL, Foulkes L, Blakemore SJ. Peer influence in adolescence: public-health implications for COVID-19. Trends Cogn Sci. 2020;24(8):585-7.
3. Hellfeldt K, López-Romero L, Andershed H. Cyberbullying and psychological well-being in young adolescence: the potential protective mediation effects of social support from family, friends, and teachers. Int J Environmental Research and Public Health. 2020;17(1):45.
4. Laursen B, Dickson DJ, Boivin M, Bowker JC, Brendgen M, Rubin KH. Revisiting the hypothesis that friends buffer against diminished self-esteem arising from poor quality parent–adolescent relationships: a replication study. Developmental Psychology. 2021;57(12):2067–81.
5. Oliveira PC, Reis ML, Vandenberghe L, Souza MM, Medeiros. Sobrevivendo: vulnerabilidade social vivenciada por adolescentes em uma periferia urbana. Interface - Comunicação, Saúde, Educação. 2020;24:e190813.
6. Quiroga F, Capella C, Sepulveda G, Conca G, Miranda J. Identidad personal en niños y adolescentes: estudio cualitativo. Rev Latino Am Cienc Soc Niñez Juv. 2021;19(2):1-25.
7. Hoffmann JP. Self-control, peers, and adolescent substance use: an international analysis. Journal of Substance Use. 2022(1):1-6.
8. Viduani A, Benetti S, Martini T, Buchweitz C, Ottman K, Wahid SS, et al. Social isolation as a core feature of adolescent depression: a qualitative study in Porto Alegre, Brazil. Int J Qual Stud Health Well-being. 2021;16(1):1978374.
9. Orben A, Tomova L, Blakemore S. The effects of social deprivation on adolescent development and mental health. The Lancet Child and Adolescent Health. 2020;4(20):634–40.
10. Peterle CF, Fonseca CL, Freitas BHBM de, Gaíva MAM, Diogo PMJ, Bortolini J. Emotional and behavioral problems in adolescents in the context of COVID-19: a mixed method study . Rev Latino-Am Enfermagem. 2022;30(spe):e3744.
11. Malta DC, Gomes CS, Vasconcelos NM de, Barros MB de A, Lima MG, Souza Júnior PRB de, et al. Alcohol consumption among adolescents during the COVID-19 pandemic, convid adolescentes: behavior research. Rev Bras Epidemiol. 2023;26:e230007.
12. Palacio-Ortiz JD, Londoño-Herrera JPA, Nanclares-Márquez A, Robledo-Rengifo P, Quintero-Cadavid CP. Psychiatric disorders in children and adolescents during the COVID-19 pandemic. Rev Colombiana de Psiquiatria. 2020;49(4):279-88.
13. Gadagnoto TC, Mendes LMC, Monteiro JC dos S, Gomes-Sponholz FA, Barbosa NG. Emotional consequences of the COVID-19 pandemic in adolescents: challenges to public health. Rev Esc Enferm USP. 2022;56:e20210424.
14. Marques ES, Moraes CL, Hasselmann MH, Deslandes SF, Reichenheim ME. A violência contra mulheres, crianças e adolescentes em tempos de pandemia pela COVID-19: panorama, motivações e formas de enfrentamento. Cad Saúde Pública. 2020;36(4):e00074420.
15. Pizarro-Ruiz JP, Ordóñez-Camblor N. Effects of Covid-19 confinement on the mental health of children and adolescents in Spain. Scientific reports. 2021;11.(1):11713.
16. Zhang C, Ye M, Fu Y, Yang M, Luo F, Yuan J, Tao Q. The psychological impact of the COVID-19 pandemic on teenagers in China. J Adolesc Health. 2020; 67(6):747-755.
17. Barth AM, Meinert AC, Zopatti KL, Mathai D, Leong A W, Dickinson EM et al. A qualitative inquiry of parents’ observations of their children’s mental health needs during the COVID-19 pandemic. Children\'s Health Care. 2022; 51(2):213-24.
18. Mallik CI, Radwan RB. Impact of lockdown due to COVID-19 pandemic in changes of prevalence of predictive psychiatric disorders among children and adolescents in Bangladesh. Asian J Psychiatr. 2021;56:102554.
19. Maristany M, Preve P, Cros B, Revilla R. Efectos del confinamiento en adolescentes en pandemia por covid-19 en ciudad de Buenos Aires, Argentina. Psico. 2021; 52(3):e41309-e41309.
20. Givigi RCN, Silva RS, Menezes EC, Santana JRS, Teixeira CMP. Efeitos do isolamento na pandemia por COVID-19 no comportamento de crianças e adolescentes com autismo. Rev Latinoam de Psicopatologia Fundamental. 2021; 24(3), 618–40.
21. Santos KAM, Miura PO, Barboza AMM, Araújo CGSLA. Quais os significados sobre família em situação de pandemia para os adolescentes?. Ciência & Saúde Coletiva. 2022; 27(1):193-203.
22. Costa LCR, Gonçalves M, Sabino FHO, Oliveira WA de, Carlos DM. Adolescer em meio à pandemia de Covid-19: um olhar da teoria do amadurecimento de Winnicott. Interface (Botucatu). 2021;25:e200801.
23. Dos Santos C. COVID-19 e saúde mental dos adolescentes: vulnerabilidades associadas ao uso de internet e mídias sociais. Holos. 2021; 3(1):1-14.
24. Fernandes ADSA, Speranza M, Mazak MSR, Gasparini DA, Cid MFB. Desafios cotidianos e possibilidades de cuidado com crianças e adolescentes com Transtorno do Espectro Autista (TEA) frente à COVID-19. Cad Bras Ter Ocup. 2021; 29(1):e2121.
25. Oliveira WA de, Silva JL da, Andrade ALM, Micheli DD, Carlos DM, Silva MAI. A saúde do adolescente em tempos da COVID-19: scoping review. Cad Saúde Pública. 2020;36(8):e00150020.
26. Windarwati HD, Lestari R, Supianto AA, Wicaksono SA, Ati NAL, Kusumawati MW et al. A narrative review into the impact of COVID‐19 pandemic on senior high school adolescent mental health. J of Child and Adolescent Psychiatric Nursing. 2022; 35(3):206-17.
27. Fauzi FA, Zulkefli NAM, Baharom A. Aggressive behavior in adolescent: The importance of biopsychosocial predictors among secondary school students. Front Public Health.2023; 14(11):992159.
28. Organização Pan-Americana de Saúde. Estratégia e plano de ação para a saúde do adolescente e do jovem: relatório final [Internet]. Washington, DC: OPAS; 2019 [citado 2023 abr 29]. Disponível em: https://www.paho.org/pt/documentos/cd57inf8-estrategia-e-plano-acao-para-saude-do-adolescente-e-do-jovem-relatorio-final.
29. Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional por Amostra de Domicílios Contínua: Características gerais dos domicílios e dos moradores 2022. Brasília: IBGE. [citado 2023 Set 28]. Disponível em: https://biblioteca.ibge.gov.br/visualizacao/livros/liv102004_informativo.pdf.
30. World Health Organization. Adolescent health epidemiology. Geneva: WHO, 2021 [citado 2023 Set 28]. Disponível em: https://www.who.int/maternal_child_adolescent/epidemiology/adolescence/en/.
31. Brasil. Ministério da Saúde. Secretaria de Atenção em Saúde. Departamento de Ações Programáticas Estratégicas. Diretrizes nacionais para a atenção integral à saúde de adolescentes e jovens na promoção, proteção e recuperação da saúde. Brasília: Ministério da Saúde, 2010. 132 p.
32. World Health Organization. Global strategy for women’s, children’s and adolescents’ health 2016–2030. Geneva: WHO, 2015. [citado 2023 abr 29]. Disponível em: https://www.paho.org/pt/documentos/global-strategy-womens-childrens-and-adolescents-health-2016-2030-disponivel-somente-em.
33. Strauss A, Corbin J. Pesquisa Qualitativa: Técnica e procedimentos para o desenvolvimento da teoria fundamentada. 2 ed. Porto Alegre: Artmed; 2008.
34. Charon J.M. Symbolic interactionism: an introduction, an interpretation, an integration. 10 ed. Boston: Prentice Hall, 2010.
35. Instituto Brasileiro de Geografia e Estatística. Panorama cidade de São Carlos. 2022. Brasília: IBGE. Disponível em: < https://cidades.ibge.gov.br/brasil/sp/sao-carlos/panorama>. Acesso em: 20 ago. 2023.
36. São Paulo. Índice Paulista de Vulnerabilidade Social. 2010: São Paulo, 2010 - https://ipvs.seade.gov.br/view/pdf/ipvs/mun3548906.pdf.
37. Parker C, Scott S, Geddes A. Snowball Sampling. SAGE Research Methods Foundations, 2019.
38. Martines EAL de M, Azevedo SR de S, Leme MI da S. A arte na (re)construção da identidade de adolescentes em uma escola do campo. Psicol Esc Educ. 2022;26:e225431.
39. Branquinho C, Santos AC, Matos MG. A COVID-19 e a voz dos adolescentes e jovens em confinamento social. Psicol. Saúde & Doenças. 2020;21(3):62432.
40. Hoeben EM, Rulison KL, Ragan DT, Feinberg ME. Moderators of friend selection and influence in relation to adolescent alcohol use. Prevention Science. 2021; 22(5):567-78.
41. Dryburgh NS, Ponath E, Bukowski WM, Dirks MA. Associations between interpersonal behavior and friendship quality in childhood and adolescence: a meta‐analysis. Child Development. 2022; 93(3):e332-e347.
42. Santos KAM, Miura PO, Barboza AMM, Araújo CGSLA. Quais os significados sobre família em situação de pandemia para os adolescentes?. Ciência & Saúde Coletiva. 2022; 27(1):193-203.
43. Ferrara P, Franceschini G, Corsello G, Mestrovic J, Giardino I, Vural M, Pettoello-Mantovani M. Effects of coronavirus disease 2019 (COVID-19) on family functioning. The J of Pediatrics. 2021;237(1):322-323.e2.
44. Moreira MCN, Dias FDS, Mello AGD, York SW. Gramáticas do capacitismo: diálogos nas dobras entre deficiência, gênero, infância e adolescência. Cienc Saude Coletiva. 2022;27(10):3949-58.










