Analysis of Losses in Physiotherapy Students During the Covid-19 Pandemic: a Phenomenological Approach.

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Marta Terrón Pérez, Sara Cortés Amador, Juan Bautista Portolés Simeó This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4041991/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Background During the COVID 19 Pandemic situation, young people experienced numerous personal losses in many aspects, which impacted their quality of life. Objective: To explore and analyse the losses in physiotherapy students during the first year of the COVID-19 pandemic. Methods: A qualitative phenomenological study was carried out using an open format exercise carried out during the Clinical Specialties class from February-May 2021. Thirty-four (83% female) third-year physical therapy students participated. ATLAS.ti software was used for the analysis and coding of the data by three researchers. Results: After the analysis of the categories, different losses by the participants were found: losses in psychological well-being, losses in physical health, losses in the social sphere (friendships, partners and family relationships, as well as deaths) and spiritual losses (loss of freedom and identity), losses in leisure time (travel, recreational activities and physical exercise) and different losses related to university studies (motivation and enthusiasm and clinical practices). Conclusion: The COVID-19 pandemic has generated losses worldwide in physiotherapy students, with losses in the social sphere being the most expressed. The present study can be used to generate resources that improve the well-being of physiotherapy students, both for optimal academic performance and greater self-care, and reduce psychosocial problems. Grief COVID-19 Students Physical therapy specialty Education Universities Figures Figure 1 1. Introduction The COVID-19 pandemic has caused more than 550 million people to be affected by the disease worldwide and more than 6.3 million deaths (WHOa, 2022). This has caused a great impact in all countries at different levels: social, economic, welfare and quality of life of the population (Onyeaka et al., 2021). Young adults have been one of the population groups studied during the pandemic. Alterations have been found at the psychological level, being one of the groups most affected by stress, anxiety, depression and suicidal thoughts (Arsandaux et al., 2021). At the social level, alterations such as loneliness have been present (Groarke et al., 2020). In addition, an increase in obesity, overweight (Onyeaka et al., 2021) and sedentary lifestyle (Rodríguez-Larrad et al., 2021) has been observed. This situation has triggered numerous personal losses in many aspects. Loss can be defined as any damage to the emotional, material or symbolic resources with which the person has an emotional bond (Harvey & Miller, 1998); it can appear in the face of disability, changes in work or home, in the death of loved ones, etc. (Neimeyer & Ramírez, 2002). The process that triggers the loss is grief (Nicolle et al., 2022); this process does not indicate any pathology, but affective, cognitive, behavioural and physiological alterations can arise, such as sadness, disbelief, crying or insomnia (Worden et al., 2013). It is important that a health professional, knows these processes(Chaurand et al., 2010). Different studies point out the importance of qualitative studies and request research designs that consider subjective narratives that analyse the impact of COVID-19 (Sandín et al., 2020)(Vásquez et al., 2020). Qualitative studies have been found in students of other disciplines (Rood et al., 2022) but not in physiotherapy and much less that analyse losses from a global perspective. Therefore, it was decided to conduct the following study with the objective of analysing and explaining the losses of physiotherapy students during the first year of the COVID-19 pandemic. 2. Methods 2.1 Study design and recruitment A qualitative study of the phenomenological nature was carried out. The field of study focused on students in the third year of physiotherapy at the University of Valencia in the subject of Clinical Specialties II. Data collection was carried out from February-May 2021. The selection of participants was carried out by convenience sampling after finishing the academic year. All students who wanted to participate were included, and no exclusion criteria were proposed. 2.2 Procedure Classroom work was proposed, consisting of answering a question with an open-ended free response. The exercise proposed was the following: “Develop a list of duels or personal losses this year that have impacted you the most”. At the time of the development of the exercise, the students were unaware of their research intention. 2.3 Analysis The analysis of the data was carried out through a process of transcription and pairwise coding. Works were anonymized with a code number. The coding and categorization were performed by two of the researchers, with a third reviewer for the triangulation of the information. The procedure by Colaizzi (Morrow et al., 2015) was followed for the treatment of information. First, in-depth reading of the texts of the participants (A), followed by extraction of identification texts (B), these texts were assigned representative codes (C), and the texts were grouped by meanings into categories (D). Finally, the phenomenon of the study was described by interpretive writing (E). For analysis of the texts, ATLAS.ti 22 software was used. 2.4 Ethics The research project underwent presentation and approval by the Ethics Committee of the University of Valencia (Protocol Number: 1782311), aligning with the principles outlined in the Declaration of Helsinki. Prior to incorporating the student's work into the study, explicit authorization was sought from all participants through the provision of informed consent. Notably, every student included in the study willingly agreed to participate. 3. Results A total of 34 students (83% women) participated, with an average age of 23.3 years. With the 34 subjects, it was enough to reach data saturation. After the analysis of the categories, different losses by the participants were found, Figure 1 shows the themes and subthemes found. [Figure 1. Category tree] 3.1 Theme 1. Losses in the physical health Three different situations were found: on the one hand, subjects who suffered from the disease mildly. “Loss of taste and smell, I was infected with COVID-19, also suffering from constant headaches. The loss of the pleasure of eating was a significant loss for me. To date, I have recovered part of these senses, but not 100%” S7. On the other hand, those who have not been able to receive therapy because they cannot travel to their place of treatment. “This year I have not been able to go to Germany as usual for the past 10 years to be able to treat my disease. Germany is… where I can improve my disease” S13. Or for delaying a pending surgery. “My knee injury (torn meniscus). This event this summer has been for me a real odyssey of feelings and sensations after my surgery was delayed” S11. The third was the losses found due to persistent COVID. “Loss of general well-being: apparently, I am one of the people who has the damn persistent COVID... I continue to suffer continuous headaches and episodes of tachycardia, which also cause me anxiety and low mood” S7. 3.2 Theme 2. Loss of psychological well-being At the psychological level, the loss of mental health caused alterations in students’ anxiety and depression. “As time went by, it continued to have an impact on my mind until in the summer I exploded and I was plunged into terrible anxiety and a little depression…” S21. In addition, negative psychological responses were found, such as insomnia, worry or feeling overwhelmed. “I have spent days crying, having to study, with insomnia, without being able to leave the house to relax, without hope to live, I felt that the house was caving on me” S19. Additionally, losses related to mental stability or loss of enthusiasm for life. “As for my mental health, it has been by far the worst year I have experienced, the most unstable I have felt and the least I have understood myself. I had no illusion about anything, and every day seemed the same” S26. 3.3 Theme 3. Loss of social welfare 3.3.1 Subtheme. Loss of contact a) Loss of family contact due to death In the present study, 14 of the 34 participating students suffered the death of a loved one. “The death of my grandmother. For me, she was one of the most important people in my life with whom I have shared practically my entire life…” S23. Many of the participants did not have the opportunity to say goodbye to their loved ones. “The loss of my uncle who died from causes unrelated to the coronavirus in May 2020 and a mass and “decent” farewell could not be held at the time” S16. Another of the notable losses that have been noted are those of household animals. “The loss of my cat in the middle of confinement, since he was at home and I was in the student apartment, I could not say goodbye to him” S26. b) Loss of family contact due to distance Not being able to be with the family has been one of the most heartfelt losses, both in the day-to-day: “The fact of not being able to go to a family meal with my uncles, grandparents, cousins... It has been one of the most important losses for me” S32. As in important celebrations: “In addition, the loss of family gatherings at Christmas is a very important loss because you do not know if we will all be at the next holidays” S14. Another aspect detected was the loss of time with grandparents. “One of the most important losses has been the time lost with people close to me, especially with my grandmothers who are older people and I feel that the time I have with them is getting shorter” S22. c) Loss of contact with friends due to distance Losses were found regarding social and friendship relationships during the pandemic. “The loss of social relationships, I have not seen my lifelong friends for almost 3 months and I miss our relationship because, no matter what they say, a video call is not the same as going out to eat anywhere” S32. A direct relationship was obtained between the loss of social relationships and the mental health of the students. “I am a very sociable person, and the fact of not being able to meet my friends or not wanting to do it for prevention have caused me moments of loneliness, sadness, anxiety and despair” S11. d) Loss of friendship due to breakup Several situations were found in which a breakup in the friendship relationship occurred. “Losing a relationship with a childhood friend” S18; “I could begin with the loss of a relationship with those I considered lifelong friends” S29. e) Loss of partner contact due to breakup Another aspect to mention was couple breakups. “The most important loss and the one that has changed my life the most, the breakup with my partner. I put it in this position because it is the one that hurts me the most since it is the only loss that I will probably never recover” S17. f) Loss of physical contact The pandemic has allowed investigating an exceptional situation that in normal conditions would not have occurred, the absence of physical contact. “Not being able to have the same physical contact between us to the point of not greeting each other with two kisses or some gesture of affection” S5. The students experienced the lack of contact in a negative way. “Begging for the warmth of the family, more than ever. However, they took it from us again, they took it away again” S9. 3.3.2. Subtheme Loss in leisure time a) Loss of travel In the group studied, the loss of trips was also present. “I had to cancel a trip to Kenya that I had scheduled for half a year” S22. With reference to shorter trips, a relationship was found with an emotional and affective component. “The perimeter closure, which prevents you from not only travelling but visiting your loved ones” S5. a) Loss of leisure activities For the young population, the effect has been very negative, and many comments have been generated about losses in leisure activities. “However, the greatest loss I have had in general has been social life, going out with my friends, spending time away from home, making plans etc.…” S31 Generating pain and suffering in affected people. “While I want to recover that social life, that joy, that desire to communicate with people, I cannot do it, it is like a paradox, and I consider it a problem” S19. In many cases, the losses were related to simple activities. “Just going for a drink with my friends or going for a walk at 12” S20. b) Loss of physical activity and physical exercise It is worth noting the losses of physical activity (PA) or physical exercise (PE). “First, the loss of sports, of basketball and that due to the pandemic has not been resumed today. It was a liberation for me, in addition to being a fun way to keep fit and enjoy with my classmates” S17. The loss of PA and PE has had physical, social (loss of team sports) and psychological consequences. “I got frustrated because for me doing sports was an escape, it helped me relax, it reduced my stress, it helped me to forget my routine and even my problems...” S32. 3.4. Theme 4. Losses in the spiritual realm 3.4.1. Subtheme. Loss of identity Another source of discomfort was the anguish in the loss of identity. “I escape from my reality to be able to find the origin of pain, the loss of self, the final climax to a series of minor losses that made my mental structure break like a fragile glass” S3. As a measure of protection against this problem, loneliness and isolation were found. “I am not the person I used to be; I prefer to be in my quiet room watching a series without talking to anyone” S19. 3.4.2 Subtheme. Loss of freedom In this category, the concept of freedom is understood in a practical way, with the choice of being able to occupy spaces freely. “… Loss of freedom, loss of the possibility of going where you want, when you want, with the people you want… One of the most important and one of those that have marked me the most” S10. Generating a loss of control in people's lives. “I had a feeling that I did not manage my life, but that it depended on the measures that were available at all times…” S26. 3.5 Theme 5. Losses in physiotherapy studies 3.5.1. Subtheme. Motivation-illusion A response of demotivation and disappointment in relation to the career was found. “COVID-19 has changed our way of understanding university life; it has stolen part of our academic training and has sown apathy and indifference in the classrooms” S1 3.5.2. Subtheme Loss of clinical practices The experience of the lack of clinical practices also generated negative responses. “…With the new situation, it will not be possible for me to experience hospital practices this year, and clinical practices will not be as I had imagined” S7. 4. Discussion The results found indicate an overall loss of well-being in all aspects. The categories found coincide with the health aspects defined by the WHO (WHOc, 2020). At the same time, it has been observed that these losses have generated numerous processes of mourning with corresponding alterations, such as sadness, loneliness, depression, anxiety, etc. (Worden, et al., 2013). In relation to physical losses, at the beginning of the pandemic, the symptoms of COVID-19 were not exactly known. Currently, there are studies aimed at this topic (Elangovan, 2021). On the other hand, few studies have assessed the impact of COVID-19 on surgical waiting lists in the Spanish state. The study by de Pablos & García-Centeno (2021) indicates a delay of 7.6 to 19.4% in the waiting time for surgery. Mental health is one of the most affected aspects in young adults in relation to the rest of the categories. Stress, depression and anxiety were the alterations that appeared the most. One of the reviews found that anxiety affected 32% of the population and that 28% suffered from depressive disorders (Luo et al., 2020). On the other hand, studies have also found that they speak of compulsive behaviours, avoidance, deterioration of social function and dissatisfaction with life (Li & Xu, 2022). Data referring to negative psychological alterations seem to normalize over time (Robison et al., 2022). More studies are needed to assess and monitor mental health problems adapted to the context and thus be able to facilitate the corresponding health measures. Social losses were the most frequent, generating many categories and subcategories and finding a close relationship with losses in mental health. The high percentages of deaths in the participants are consistent with what happened in Spain during the pandemic (WHOb, 2022). Not being able to perform a community ritual, not being able to be physically present, the loneliness experienced due to lack of support, or not being able to say goodbye to the person (Lacasta-Reverte et al., 2020) has changed the way of coping with losses. These situations may have increased the probability of suffering a complicated grief. It would be necessary to conduct research with standardized instruments to observe whether there has truly been an increase in complicated grief during COVID-19. In relation to the losses due to the deaths of pets, there is currently a period of humanization of companion animals (Pascalev, 2006). The symptoms of grief with pets increase in proportion when they concur with stressful life events (Kimura et al., 2011), which could explain why during the COVID-19 pandemic, they have been identified as more anxiety generators than in a normal situation. Despite the multiple sociological changes, the family continues to be an extremely important factor in Spain (Bote-Díaz & Sánchez-Vera, 2008). Some losses found are related to marked festivities and others to regular contacts. The loss of these ties implies a decrease in social support and an affectation of emotional well-being (Li & Xu, 2022), in addition to an increase in stressors (Mohler-Kuo et al., 2021). On the other hand, the lack of contact with grandparents was noted, and it would be interesting to investigate the consequences for a young adult of losing the relationship or references such as their grandparents. In a university age that is characterized by the achievement of individual autonomy, constant discovery, growth and expansion of relationships, the phenomenon of the pandemic has been negative for its development. Research in university students indicates that a greater number of friendships, quality contact and satisfactory and frequent electronic communication can be strategies that protect against loneliness (Juvonen et al., 2022), in addition to being protective against psychological and mental health problems (Groarke Id et al., 2020). The phenomenon of couples during the pandemic has been investigated in cohabitant couples and marriages (Unther-Bel et al., 2020) but not in university students. Individuals who are threatened by constant stress outside of a relationship are more likely to interact negatively with their partners (Pietromonaco & Overall, 2022), and the COVID-19 pandemic has been a generator of conflicts and stressors (Estlein et al., 2022). Facing conflict requires personal maturity and a quality in the relationship that can be difficult to acquire in young university students. In relation to the loss of physical contact, the studies found indicate the desire and need for contact for many people and the possibility of regulating stress and anxiety through intimate contact (Von Mohr et al., 2017). The slow and affective touch provides benefits such as the mitigation of negative emotions or the bonding between individuals (McParlin et al., 2022). It would be interesting to carry out programs that will enhance physical contact between people and generate some of the aforementioned benefits. During the time of the pandemic and due to restrictions, there has been an enormous amount of free time, with the particularity that the ability to choose activities by the person was lost, since it could not be done outside of a schedule, from the home or in certain inaccessible establishments (Gammon & Ramshaw, 2021). There is a social and psychological need in this time to travel, as well as to enjoy the emotional well-being of knowing other cultures, customs, gastronomy, etc. (Aebli et al., 2021). There is a direct and indirect relationship between travel and life satisfaction, as well as emotional well-being and the feeling of happiness or pleasure (Zins & Ponocny, 2022). In a complementary way, in complicated situations, leisure activities reduce many factors of stress and anxiety (Zhang & Zheng, 2017), in addition to improving well-being in the university population (Doerksen et al., 2014). Therefore, it could be recommended for this population to resume travel and perform activities that reduce academic stress. PA and PE were among the most named losses. It should be noted that Spain had one of the strictest confinements. One explanation for the results is that physiotherapy students perform more hours of PA and PE in their free time than other students (Moreno & Cruz, 2015). Rodríguez-Larrad et al. (2021) found an increase in sedentary lifestyle and a decrease in both moderate and vigorous PA during the pandemic. Given the multiple benefits of PA and PE in the population at all levels (Ekelund et al., 2019) and their direct relationship with health, governments should not allow deprivation of PA and PE in similar situations. From a classical concept, identity would be that which is maintained in each individual and does not vary over time, its essence. This encounters a changing reality, which is constantly evolving and is preyed to uncertainty (Duque et al., 2013, such as the period described in this study in the context of a global pandemic. In relation to the lack of freedom, similar results have been found in other contexts (Procentese et al., 2021). They related the lack of freedom with a need to return to normality or a feeling of urgency to manage time daily at their convenience. In addition, it was found that young people (18 to 29 years) could experience more stress and anxiety than other groups due to mobility limitations before other deficiencies (Gambin et al., 2021). The syndrome of academic burnout consists of a series of negative psychological manifestations, such as anxiety, depression, fatigue, etc., that occur due to excessive pressure or lack of interest that can lead to poor academic performance and health issues (Wang et al., 2021), aspects that have been observed in the present study. Disappointment and loss of motivation have been frequently discussed in different university environments (Jacobo-Galicia et al., 2021). Limitations of the study Within the limitations of the study, it is noted that the data analysed belong to a specific population group (university students) circumscribed to a certain age in a specific context (Valencia), which may not represent other population groups. The sample has not been selected to have greater variability of profiles. 5. Conclusions The present study found losses of physiotherapy students during the COVID-19 pandemic globally and at the biological, psychological, social, spiritual and academic levels. Losses of social habits, loss of freedom or leisure opportunities, affective and emotional problems, absence of physical contact or sports activities, including thoughts about the death of family members or couple breakup, as well as doubts about the professional future influenced by a lack of clinical practice have been found. It is important that universities generate resources that improve the well-being of health care students, both for optimal academic performance and for the improvement of reflective practice that can favour self-care and the reduction of psychosocial problems. Declarations Human Ethics and Consent to Participate: The research project underwent presentation and approval by the Ethics Committee of the University of Valencia (Protocol Number: 1782311). All participants in the study provided their consent by signing an informed consent form. Consent for publication: All authors authorize the publication of the following article Availability of data and materials. The data and materials are available for consultation. Competing interests : The authors have declared that no competing interests exist. Funding: The author(s) received no specific funding for this work. Authors' contributions: Marta Terrón-Pérez. Writing the manuscript. Data analysis and interpretation of manuscript. Critical revision of manuscript. Supervision Juan Bautista Portolés Simeó. Writing the manuscript. Data collection. Data analysis and interpretation of manuscript. Critical revision of manuscript. Sara Cortés-Amador. Data analysis and interpretation of manuscript. Critical revision of manuscript. Administrative and materials support. Acknowledgements: We are grateful to all study participants for explain their experiences during a hard period of their lives. References Aebli, A., Volgger, M., & Taplin, R. (2021). A two-dimensional approach to travel motivation in the context of the COVID-19 pandemic . https://doi.org/10.1080/13683500.2021.1906631 Antonia Lacasta-Reverte, M., Torrijos Zarcero, M., López-Pérez, Y., Carracedo Sanchidrián, D., Pérez Manrique, T., Casado Sanmartín, C., Rocamora González, C., Blanco Rosado, L., Iglesias Gutiérrez, N., Vidal Bermejo, E., Trigo Varela, D., & Martí-Esquitino, J. (2020). Medicina Paliativa Publicación OO cial Sociedad Española de Cuidados Paliativos Medicina Medicina Paliativa Impacto emocional en pacientes y familiares durante la pandemia por COVID-19. Un duelo diferente. Med Paliat , 27 (3), 201–208. https://doi.org/10.20986/medpal.2020.1188/2020 Arsandaux, J., Montagni, I., Macalli, M., Texier, N., Pouriel, M., Germain, R., Mebarki, A., Kinouani, S., Tournier, M., Schuck, S., & Tzourio, C. (2021). Mental health condition of college students compared to non-students during COVID-19 lockdown: The CONFINS study. BMJ Open , 11 (8). https://doi.org/10.1136/BMJOPEN-2021-053231 Chaurand, A., Feixas, G., & Neimeyer, R. A. (2010). El inventario de historia de pérdidas (ihp): presentación y utilidad clínica. Revista de Psicoterapia , 21 (84), 95–101. https://doi.org/10.33898/RDP.V21I84.614 Collazos, J. E. M., & Bermúdez, H. F. C. (2015). Percepción de la actividad física en estudiantes de enfermería frente a fisioterapia. Enfermería Global , 14 (4), 192–200. https://doi.org/10.6018/EGLOBAL.14.4.209811 Constitución . (n.d.). Retrieved July 29, 2022, from https://www.who.int/es/about/governance/constitution De, L., Escobar, P., & García-Centeno, M.-C. (2021). IMPACTO DE LA COVID-19 SOBRE LAS LISTAS DE ESPERA QUIRÚRGICAS. Rev Esp Salud Pública , 95 , 3–4. www.mscbs.es/resp Ekelund, U., Tarp, J., Steene-Johannessen, J., Hansen, B. H., Jefferis, B., Fagerland, M. W., Whincup, P., Diaz, K. M., Hooker, S. P., Chernofsky, A., Larson, M. G., Spartano, N., Vasan, R. S., Dohrn, I.-M., Hagströmer, M., Edwardson, C., Yates, T., Shiroma, E., Anderssen, S. A., & Lee, I.-M. (n.d.). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis . https://doi.org/10.1136/bmj.l4570 Elangovan, S. (2021). Acute Loss of Smell or Taste Without Nasal Blockage Should Raise Suspicion for COVID-19 Infection. In Journal of Evidence-Based Dental Practice (Vol. 21, Issue 1). https://doi.org/10.1016/j.jebdp.2020.101525 Entre la progresión y la regresión: la configuración identitaria en los procesos de pérdida . (n.d.). Retrieved July 25, 2022, from https://www.redalyc.org/articulo.oa?id=423539422013 Estlein, R., Ateret Gewirtz-Meydan, |, & Opuda, E. (2022). O R I G I N A L A R T I C L E Love in the time of COVID-19: A systematic mapping review of empirical research on romantic relationships one year into the COVID-19 pandemic . https://doi.org/10.1111/famp.12775 Gambin, M., Sękowski, M., Woźniak-Prus, M., Wnuk, A., Oleksy, T., Cudo, A., Hansen, K., Huflejt-Łukasik, M., Kubicka, K., Łyś, A. E., Gorgol, J., Holas, P., Kmita, G., Łojek, E., & Maison, D. (2021). Generalized anxiety and depressive symptoms in various age groups during the COVID-19 lockdown in Poland. Specific predictors and differences in symptoms severity. Comprehensive Psychiatry , 105 . https://doi.org/10.1016/J.COMPPSYCH.2020.152222 Gammon, S., & Ramshaw, G. (n.d.). Leisure Sciences Distancing from the Present: Nostalgia and Leisure in Lockdown . https://doi.org/10.1080/01490400.2020.1773993 Groarke Id, J. M., Berry, E., Graham-Wisener, L., Mckenna-Plumley, P. E., Mcglinchey, E., & Armour, C. (2020). Loneliness in the UK during the COVID-19 pandemic: Cross-sectional results from the COVID-19 Psychological Wellbeing Study . https://doi.org/10.1371/journal.pone.0239698 Harvey, J. H., & Miller, E. D. (1998). TOWARD A PSYCHOLOGY OF LOSS . Jacobo-Galicia, G., Máynez Guaderrama, A. I., & Cavazos-Arroyo, J. (2021). Miedo al Covid, agotamiento y cinismo: su efecto en la intención de abandono universitario. European Journal of Education and Psychology , 14 (1), 1–18. https://doi.org/10.32457/EJEP.V14I1.1432 Journal, A. I., Doerksen, S. E., Elavsky, S., Rebar, A. L., & Conroy, D. E. (2014). Leisure Sciences Weekly Fluctuations in College Student Leisure Activities and Well-Being . https://doi.org/10.1080/01490400.2014.860778 Juvonen, J., Lessard, L. M., Kline, N. G., & Graham, S. (2022). Young Adult Adaptability to the Social Challenges of the COVID-19 Pandemic: The Protective Role of Friendships. Journal of Youth and Adolescence , 51 , 585–597. https://doi.org/10.1007/s10964-022-01573-w Kimura, Y., Kawabata, H., & Maezawa, M. (2011). Psychiatric Investigation of 18 Bereaved Pet Owners. Journal of Veterinary Medical Science , 73 (8), 1083–1087. https://doi.org/10.1292/JVMS.10-0317 Li, S., & Xu, Q. (2022). Family support as a protective factor for attitudes toward social distancing and in preserving positive mental health during the COVID-19 pandemic. Journal of Health Psychology , 27 (4), 858–867. https://doi.org/10.1177/1359105320971697 Luo, M., Guo, L., Yu, M., & Wang, H. (2020). The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public – A systematic review and meta-analysis. Psychiatry Research , 291 . https://doi.org/10.1016/J.PSYCHRES.2020.113190 Mohler-Kuo, M., Dzemaili, S., Foster, S., Werlen, L., & Walitza, S. (2021). Stress and Mental Health among Children/Adolescents, Their Parents, and Young Adults during the First COVID-19 Lockdown in Switzerland. Int. J. Environ. Res. Public Health , 18 , 4668. https://doi.org/10.3390/ijerph18094668 Neimeyer, R., & Ramírez, Y. (2002). Aprender de la pérdida: una guía para afrontar el duelo . http://www.recuperacionemocionalecuador.com/images/cere/Aprender-de-la-perdida-Neimeyer.pdf Nicolle, S., Arcos, A., Nathali, D., & Mori, P. (2022). Duelo y el duelo complicado: Una revisión de la literatura científica en el tiempo. Journal of Neuroscience and Public Health , 2 (1), 197–204. https://doi.org/10.46363/JNPH.V2I1.4 Onyeaka, H., Anumudu, C. K., Al-Sharify, Z. T., Egele-Godswill, E., & Mbaegbu, P. (2021). COVID-19 pandemic: A review of the global lockdown and its far-reaching effects. SCIENCE PROGRESS , 104 (2), 1–18. https://doi.org/10.1177/00368504211019854 Pascalev, A. K. (2006). We and they: Animal welfare in the era of advanced agricultural biotechnology. Livestock Science , 103 (3), 208–220. https://doi.org/10.1016/J.LIVSCI.2006.05.007 Pietromonaco, P. R., & Overall, N. C. (2022). Implications of social isolation, separation, and loss during the COVID-19 pandemic for couples’ relationships. Current Opinion in Psychology , 43 , 189–194. https://doi.org/10.1016/J.COPSYC.2021.07.014 Procentese, F., Esposito, C., Gonzalez Leone, F., Agueli, B., Arcidiacono, C., Freda, M. F., & di Napoli, I. (2021). Psychological Lockdown Experiences: Downtime or an Unexpected Time for Being? Frontiers in Psychology , 12 , 1159. https://doi.org/10.3389/FPSYG.2021.577089/BIBTEX REDES SOCIALES Y FAMILIA EN ESPAÑA. CONSISTENCIA Y DEBILIDADES . (n.d.). Retrieved July 29, 2022, from https://www.redalyc.org/articulo.oa?id=161017350012 Rodríguez-Larrad, A., Mañas, A., Labayen, I., González-Gross, M., Espin, A., Aznar, S., Serrano-Sánchez, A., Vera-Garcia, F. J., González-Lamuño, D., Ara, I., Carrasco-Páez, L., Castro-Piñero, J., Carmen Gómez-Cabrera, M., Márquez, S., Tur, J. A., Gusi, N., Benito, P. J., Moliner-Urdiales, D., Ruiz, J. R., … Irazusta, J. (2021). Impact of COVID-19 Confinement on Physical Activity and Sedentary Behaviour in Spanish University Students: Role of Gender. Int. J. Environ. Res. Public Health , 18 , 369. https://doi.org/10.3390/ijerph18020369 Rood, L., Tanzillo, T., & Madsen, N. (2022). Student nurses’ educational experiences during COVID-19: A qualitative study . https://doi.org/10.1016/j.nedt.2022.105562 Sandín, B., Valiente, R. M., García-Escalera, J., & Chorot, P. (2020). Impacto psicológico de la pandemia de COVID-19: Efectos negativos y positivos en población española asociados al periodo de confinamiento nacional. Revista de Psicopatología y Psicología Clínica , 25 (1), 1–22. https://doi.org/10.5944/RPPC.27569 Shamay-Tsoory, S. G., & Eisenberger, N. I. (2021). Getting in touch: A neural model of comforting touch. Neuroscience and Biobehavioral Reviews , 130 , 263–273. https://doi.org/10.1016/J.NEUBIOREV.2021.08.030 Spain: WHO Coronavirus Disease (COVID-19) Dashboard With Vaccination Data | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data . (n.d.). Retrieved July 25, 2022, from https://covid19.who.int/region/euro/country/es Trani, M. di, Tanzilli, A., Candidi, M., Esteves, J. E., Mcparlin, Z., Cerritelli, F., & Friston, K. J. (2022). Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony. HYPOTHESIS AND THEORY , 17. https://doi.org/10.3389/fpsyg.2022.783694 Unther-Bel, C. G., Vilaregut, A., Carratala, E., Torras-Garat, S., & Erez-Testor, C. P. (2020). A Mixed-method Study of Individual, Couple, and Parental Functioning During the State-regulated COVID-19 Lockdown in Spain. Family Process , 59 (3). https://doi.org/10.1111/famp.12585 Vásquez, G., Urtecho-Osorto, Ó. R., Agüero-Flores, M., Díaz-Martínez, M. J., Paguada, R. M., Varela, M. A., Landa-Blanco, M., & Echenique, Y. (2020). Mental health, confinement, and coronavirus concerns: a qualitative study. Revista Interamericana de Psicología/Interamerican Journal of Psychology , 54 (2), e1333–e1333. https://doi.org/10.30849/RIPIJP.V54I2.1333 Von Mohr, M., Kirsch, L. P., & Fotopoulou, A. (n.d.). The soothing function of touch: affective touch reduces feelings of social exclusion . https://doi.org/10.1038/s41598-017-13355-7 Wang, J., Bu, L., Li, Y., Song, J., & Li, N. (2021). The mediating effect of academic engagement between psychological capital and academic burnout among nursing students during the COVID-19 pandemic: A cross-sectional study. Nurse Education Today , 102 , 104938. https://doi.org/10.1016/J.NEDT.2021.104938 WHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data . (n.d.). Retrieved July 29, 2022, from https://covid19.who.int/ Worden, J. W. (n.d.). EL TRATAMIENTO DEL DUELO: Asesoramiento psicológico y terapia . € Unther-Bel, C. G., Vilaregut, A., Carratala, E., Torras-Garat, S., & Erez-Testor, C. P. (2020). A Mixed-method Study of Individual, Couple, and Parental Functioning During the State-regulated COVID-19 Lockdown in Spain. Family Process , 59 (3). https://doi.org/10.1111/famp.12585 Aebli, A., Volgger, M., & Taplin, R. (2021). A two-dimensional approach to travel motivation in the context of the COVID-19 pandemic . https://doi.org/10.1080/13683500.2021.1906631 Antonia Lacasta-Reverte, M., Torrijos Zarcero, M., López-Pérez, Y., Carracedo Sanchidrián, D., Pérez Manrique, T., Casado Sanmartín, C., Rocamora González, C., Blanco Rosado, L., Iglesias Gutiérrez, N., Vidal Bermejo, E., Trigo Varela, D., & Martí-Esquitino, J. (2020). Medicina Paliativa Publicación OO cial Sociedad Española de Cuidados Paliativos Medicina Medicina Paliativa Impacto emocional en pacientes y familiares durante la pandemia por COVID-19. Un duelo diferente. Med Paliat , 27 (3), 201–208. https://doi.org/10.20986/medpal.2020.1188/2020 Arsandaux, J., Montagni, I., Macalli, M., Texier, N., Pouriel, M., Germain, R., Mebarki, A., Kinouani, S., Tournier, M., Schuck, S., & Tzourio, C. (2021). Mental health condition of college students compared to non-students during COVID-19 lockdown: The CONFINS study. BMJ Open , 11 (8). https://doi.org/10.1136/BMJOPEN-2021-053231 Chaurand, A., Feixas, G., & Neimeyer, R. A. (2010). El inventario de historia de pérdidas (ihp): presentación y utilidad clínica. Revista de Psicoterapia , 21 (84), 95–101. https://doi.org/10.33898/RDP.V21I84.614 Collazos, J. E. M., & Bermúdez, H. F. C. (2015). Percepción de la actividad física en estudiantes de enfermería frente a fisioterapia. Enfermería Global , 14 (4), 192–200. https://doi.org/10.6018/EGLOBAL.14.4.209811 Constitución . (n.d.). Retrieved July 29, 2022, from https://www.who.int/es/about/governance/constitution De, L., Escobar, P., & García-Centeno, M.-C. (2021). IMPACTO DE LA COVID-19 SOBRE LAS LISTAS DE ESPERA QUIRÚRGICAS. Rev Esp Salud Pública , 95 , 3–4. www.mscbs.es/resp Ekelund, U., Tarp, J., Steene-Johannessen, J., Hansen, B. H., Jefferis, B., Fagerland, M. W., Whincup, P., Diaz, K. M., Hooker, S. P., Chernofsky, A., Larson, M. G., Spartano, N., Vasan, R. S., Dohrn, I.-M., Hagströmer, M., Edwardson, C., Yates, T., Shiroma, E., Anderssen, S. A., & Lee, I.-M. (n.d.). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis . https://doi.org/10.1136/bmj.l4570 Elangovan, S. (2021). Acute Loss of Smell or Taste Without Nasal Blockage Should Raise Suspicion for COVID-19 Infection. In Journal of Evidence-Based Dental Practice (Vol. 21, Issue 1). https://doi.org/10.1016/j.jebdp.2020.101525 Entre la progresión y la regresión: la configuración identitaria en los procesos de pérdida . (n.d.). Retrieved July 25, 2022, from https://www.redalyc.org/articulo.oa?id=423539422013 Estlein, R., Ateret Gewirtz-Meydan, |, & Opuda, E. (2022). O R I G I N A L A R T I C L E Love in the time of COVID-19: A systematic mapping review of empirical research on romantic relationships one year into the COVID-19 pandemic . https://doi.org/10.1111/famp.12775 Gambin, M., Sękowski, M., Woźniak-Prus, M., Wnuk, A., Oleksy, T., Cudo, A., Hansen, K., Huflejt-Łukasik, M., Kubicka, K., Łyś, A. E., Gorgol, J., Holas, P., Kmita, G., Łojek, E., & Maison, D. (2021). Generalized anxiety and depressive symptoms in various age groups during the COVID-19 lockdown in Poland. Specific predictors and differences in symptoms severity. Comprehensive Psychiatry , 105 . https://doi.org/10.1016/J.COMPPSYCH.2020.152222 Gammon, S., & Ramshaw, G. (n.d.). Leisure Sciences Distancing from the Present: Nostalgia and Leisure in Lockdown . https://doi.org/10.1080/01490400.2020.1773993 Groarke Id, J. M., Berry, E., Graham-Wisener, L., Mckenna-Plumley, P. E., Mcglinchey, E., & Armour, C. (2020). Loneliness in the UK during the COVID-19 pandemic: Cross-sectional results from the COVID-19 Psychological Wellbeing Study . https://doi.org/10.1371/journal.pone.0239698 Harvey, J. H., & Miller, E. D. (1998). TOWARD A PSYCHOLOGY OF LOSS . Jacobo-Galicia, G., Máynez Guaderrama, A. I., & Cavazos-Arroyo, J. (2021). Miedo al Covid, agotamiento y cinismo: su efecto en la intención de abandono universitario. European Journal of Education and Psychology , 14 (1), 1–18. https://doi.org/10.32457/EJEP.V14I1.1432 Journal, A. I., Doerksen, S. E., Elavsky, S., Rebar, A. L., & Conroy, D. E. (2014). Leisure Sciences Weekly Fluctuations in College Student Leisure Activities and Well-Being . https://doi.org/10.1080/01490400.2014.860778 Juvonen, J., Lessard, L. M., Kline, N. G., & Graham, S. (2022). Young Adult Adaptability to the Social Challenges of the COVID-19 Pandemic: The Protective Role of Friendships. Journal of Youth and Adolescence , 51 , 585–597. https://doi.org/10.1007/s10964-022-01573-w Kimura, Y., Kawabata, H., & Maezawa, M. (2011). Psychiatric Investigation of 18 Bereaved Pet Owners. Journal of Veterinary Medical Science , 73 (8), 1083–1087. https://doi.org/10.1292/JVMS.10-0317 Li, S., & Xu, Q. (2022). Family support as a protective factor for attitudes toward social distancing and in preserving positive mental health during the COVID-19 pandemic. Journal of Health Psychology , 27 (4), 858–867. https://doi.org/10.1177/1359105320971697 Luo, M., Guo, L., Yu, M., & Wang, H. (2020). The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public – A systematic review and meta-analysis. Psychiatry Research , 291 . https://doi.org/10.1016/J.PSYCHRES.2020.113190 Mohler-Kuo, M., Dzemaili, S., Foster, S., Werlen, L., & Walitza, S. (2021). Stress and Mental Health among Children/Adolescents, Their Parents, and Young Adults during the First COVID-19 Lockdown in Switzerland. Int. J. Environ. Res. Public Health , 18 , 4668. https://doi.org/10.3390/ijerph18094668 Neimeyer, R., & Ramírez, Y. (2002). Aprender de la pérdida: una guía para afrontar el duelo . http://www.recuperacionemocionalecuador.com/images/cere/Aprender-de-la-perdida-Neimeyer.pdf Nicolle, S., Arcos, A., Nathali, D., & Mori, P. (2022). Duelo y el duelo complicado: Una revisión de la literatura científica en el tiempo. Journal of Neuroscience and Public Health , 2 (1), 197–204. https://doi.org/10.46363/JNPH.V2I1.4 Onyeaka, H., Anumudu, C. K., Al-Sharify, Z. T., Egele-Godswill, E., & Mbaegbu, P. (2021). COVID-19 pandemic: A review of the global lockdown and its far-reaching effects. SCIENCE PROGRESS , 104 (2), 1–18. https://doi.org/10.1177/00368504211019854 Pascalev, A. K. (2006). We and they: Animal welfare in the era of advanced agricultural biotechnology. Livestock Science , 103 (3), 208–220. https://doi.org/10.1016/J.LIVSCI.2006.05.007 Pietromonaco, P. R., & Overall, N. C. (2022). Implications of social isolation, separation, and loss during the COVID-19 pandemic for couples’ relationships. Current Opinion in Psychology , 43 , 189–194. https://doi.org/10.1016/J.COPSYC.2021.07.014 Procentese, F., Esposito, C., Gonzalez Leone, F., Agueli, B., Arcidiacono, C., Freda, M. F., & di Napoli, I. (2021). Psychological Lockdown Experiences: Downtime or an Unexpected Time for Being? Frontiers in Psychology , 12 , 1159. https://doi.org/10.3389/FPSYG.2021.577089/BIBTEX REDES SOCIALES Y FAMILIA EN ESPAÑA. CONSISTENCIA Y DEBILIDADES . (n.d.). Retrieved July 29, 2022, from https://www.redalyc.org/articulo.oa?id=161017350012 Rodríguez-Larrad, A., Mañas, A., Labayen, I., González-Gross, M., Espin, A., Aznar, S., Serrano-Sánchez, A., Vera-Garcia, F. J., González-Lamuño, D., Ara, I., Carrasco-Páez, L., Castro-Piñero, J., Carmen Gómez-Cabrera, M., Márquez, S., Tur, J. A., Gusi, N., Benito, P. J., Moliner-Urdiales, D., Ruiz, J. R., … Irazusta, J. (2021). Impact of COVID-19 Confinement on Physical Activity and Sedentary Behaviour in Spanish University Students: Role of Gender. Int. J. Environ. Res. Public Health , 18 , 369. https://doi.org/10.3390/ijerph18020369 Rood, L., Tanzillo, T., & Madsen, N. (2022). Student nurses’ educational experiences during COVID-19: A qualitative study . https://doi.org/10.1016/j.nedt.2022.105562 Sandín, B., Valiente, R. M., García-Escalera, J., & Chorot, P. (2020). Impacto psicológico de la pandemia de COVID-19: Efectos negativos y positivos en población española asociados al periodo de confinamiento nacional. Revista de Psicopatología y Psicología Clínica , 25 (1), 1–22. https://doi.org/10.5944/RPPC.27569 Shamay-Tsoory, S. G., & Eisenberger, N. I. (2021). Getting in touch: A neural model of comforting touch. Neuroscience and Biobehavioral Reviews , 130 , 263–273. https://doi.org/10.1016/J.NEUBIOREV.2021.08.030 Spain: WHO Coronavirus Disease (COVID-19) Dashboard With Vaccination Data | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data . (n.d.). Retrieved July 25, 2022, from https://covid19.who.int/region/euro/country/es Trani, M. di, Tanzilli, A., Candidi, M., Esteves, J. E., Mcparlin, Z., Cerritelli, F., & Friston, K. J. (2022). Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony. HYPOTHESIS AND THEORY , 17. https://doi.org/10.3389/fpsyg.2022.783694 Vásquez, G., Urtecho-Osorto, Ó. R., Agüero-Flores, M., Díaz-Martínez, M. J., Paguada, R. M., Varela, M. A., Landa-Blanco, M., & Echenique, Y. (2020). Mental health, confinement, and coronavirus concerns: a qualitative study. Revista Interamericana de Psicología/Interamerican Journal of Psychology , 54 (2), e1333–e1333. https://doi.org/10.30849/RIPIJP.V54I2.1333 von Mohr, M., Kirsch, L. P., & Fotopoulou, A. (n.d.). The soothing function of touch: affective touch reduces feelings of social exclusion . https://doi.org/10.1038/s41598-017-13355-7 Wang, J., Bu, L., Li, Y., Song, J., & Li, N. (2021). The mediating effect of academic engagement between psychological capital and academic burnout among nursing students during the COVID-19 pandemic: A cross-sectional study. Nurse Education Today , 102 , 104938. https://doi.org/10.1016/J.NEDT.2021.104938 WHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data . (n.d.). Retrieved July 29, 2022, from https://covid19.who.int/ Worden, J. W. (n.d.). EL TRATAMIENTO DEL DUELO: Asesoramiento psicológico y terapia . Zhang, J., & Zheng, Y. (2017). How do academic stress and leisure activities influence college students’ emotional well-being? A daily diary investigation . https://doi.org/10.1016/j.adolescence.2017.08.003 Zins, A. H., & Ponocny, I. (2022). On the importance of leisure travel for psychosocial wellbeing. Annals of Tourism Research , 93 . https://doi.org/10.1016/J.ANNALS.2022.103378 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 23 Apr, 2024 Editor assigned by journal 23 Apr, 2024 Submission checks completed at journal 22 Apr, 2024 First submitted to journal 08 Mar, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4041991","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":294493168,"identity":"edcdd1b7-543b-42f8-a6a2-c6c4ce4b8be0","order_by":0,"name":"Marta Terrón Pérez","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyUlEQVRIiWNgGAWjYNCDD0SqY2xgYDCAsGaQrIWZhxj1uu1nnz/4wfBHznz24WOPbdsOM/DzH8CvxexMumFjD4OBscy5tHTjXKAWyRkJBLQcSGNs4GEwSJzBw2MmnduWxmBwg4DDzM4/Y2z8w2BQD9ZiCdRif56Qw26kMTYDbUmQAGlhbLMBhgQhh914xjhbxsDYcAYPW5pkzzkbHokbhLScT2P4+KZCTl6Ch/mYxI8yCTn+fgIOgwADBJOoqBkFo2AUjIJRQAAAABXgN51AMPWOAAAAAElFTkSuQmCC","orcid":"","institution":"University of Valencia","correspondingAuthor":true,"prefix":"","firstName":"Marta","middleName":"Terrón","lastName":"Pérez","suffix":""},{"id":294493169,"identity":"45710886-6a9c-419d-b58c-0b0e91a5c17b","order_by":1,"name":"Sara Cortés Amador","email":"","orcid":"","institution":"University of Valencia","correspondingAuthor":false,"prefix":"","firstName":"Sara","middleName":"Cortés","lastName":"Amador","suffix":""},{"id":294493170,"identity":"7038c1a5-39a2-46ee-9c56-7d8274dd140c","order_by":2,"name":"Juan Bautista Portolés Simeó","email":"","orcid":"","institution":"University of Valencia","correspondingAuthor":false,"prefix":"","firstName":"Juan","middleName":"Bautista Portolés","lastName":"Simeó","suffix":""}],"badges":[],"createdAt":"2024-03-08 11:07:38","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4041991/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4041991/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":55527566,"identity":"4bc639c2-b43f-4b1a-8760-54a2b2ef2e1e","added_by":"auto","created_at":"2024-04-29 15:06:01","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":99504,"visible":true,"origin":"","legend":"\u003cp\u003eCategory tree\u003c/p\u003e","description":"","filename":"Figure1Categorytree.png","url":"https://assets-eu.researchsquare.com/files/rs-4041991/v1/82749f09390628f69fb2ba8d.png"},{"id":55528507,"identity":"6e3dedfe-f961-4a38-937e-a834ab5dedbf","added_by":"auto","created_at":"2024-04-29 15:14:00","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":359334,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4041991/v1/e53a9749-fab2-4f41-8e5a-fa0f6031e87e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eAnalysis of Losses in Physiotherapy Students During the Covid-19 Pandemic: a Phenomenological Approach.\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eThe COVID-19 pandemic has caused more than 550 million people to be affected by the disease worldwide and more than 6.3 million deaths (WHOa, 2022). This has caused a great impact in all countries at different levels: social, economic, welfare and quality of life of the population (Onyeaka et al., 2021).\u003c/p\u003e\n\u003cp\u003eYoung adults have been one of the population groups studied during the pandemic. Alterations have been found at the psychological level,\u0026nbsp;being one of\u0026nbsp;the groups most affected by stress, anxiety, depression and suicidal thoughts (Arsandaux et al., 2021). At the social level, alterations such as loneliness have been present (Groarke et al., 2020). In addition, an increase in obesity, overweight (Onyeaka et al., 2021) and sedentary lifestyle (Rodr\u0026iacute;guez-Larrad et al., 2021) has been observed. This situation has triggered numerous personal losses in many aspects.\u003c/p\u003e\n\u003cp\u003eLoss can be defined as any damage to the emotional, material or symbolic resources with which the person has an emotional bond (Harvey \u0026amp; Miller, 1998); it can appear in the face of disability, changes in work or home, in the death of loved ones, etc. (Neimeyer \u0026amp; Ram\u0026iacute;rez, 2002). The process that triggers the loss is grief (Nicolle et al., 2022); this process does not indicate any pathology, but affective, cognitive, behavioural and physiological alterations can arise, such as sadness, disbelief, crying or insomnia (Worden et al., 2013). It is important that a health professional, knows these processes(Chaurand et al., 2010).\u003c/p\u003e\n\u003cp\u003eDifferent studies point out the importance of qualitative studies and request research designs that consider subjective narratives that analyse the impact of COVID-19 (Sand\u0026iacute;n et al., 2020)(V\u0026aacute;squez et al., 2020). Qualitative studies have been found in students of other disciplines (Rood et al., 2022) but not in physiotherapy and much less that analyse losses from a global perspective. Therefore, it was decided to conduct the following study with the objective of analysing and explaining the losses of physiotherapy students during the first year of the COVID-19 pandemic.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cp\u003e\u003cem\u003e2.1 Study design and recruitment\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA qualitative study of the phenomenological nature was carried out. The field of study focused on students in the third year of physiotherapy at the University of Valencia in the subject of Clinical Specialties II. Data collection was carried out from February-May 2021.\u003c/p\u003e\n\u003cp\u003eThe selection of participants was carried out by convenience sampling after finishing the academic year. All students who wanted to participate were included, and no exclusion criteria were proposed.\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e2.2 Procedure\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eClassroom work was proposed, consisting of answering a question with an open-ended free response. The exercise proposed was the following: \u0026ldquo;Develop a list of duels or personal losses this year that have impacted you the most\u0026rdquo;. At the time of the development of the exercise, the students were unaware of their research intention. \u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e2.3 Analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe analysis of the data was carried out through a process of transcription and pairwise coding. Works were anonymized with a code number. The coding and categorization were performed by two of the researchers, with a third reviewer for the triangulation of the information. The procedure by Colaizzi (Morrow et al., 2015) was followed for the treatment of information. First, in-depth reading of the texts of the participants (A), followed by extraction of identification texts (B), these texts were assigned representative codes (C), and the texts were grouped by meanings into categories (D). Finally, the phenomenon of the study was described by interpretive writing (E). For analysis of the texts, ATLAS.ti 22 software was used.\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e2.4 Ethics\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe research project underwent presentation and approval by the Ethics Committee of the University of Valencia (Protocol Number: 1782311), aligning with the principles outlined in the Declaration of Helsinki. Prior to incorporating the student\u0026apos;s work into the study, explicit authorization was sought from all participants through the provision of informed consent. Notably, every student included in the study willingly agreed to participate.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003eA total of 34 students (83% women) participated, with an average age of 23.3 years. With the 34 subjects, it was enough to reach data saturation. After the analysis of the categories, different losses by the participants were found, Figure 1 shows the themes and subthemes found.\u003c/p\u003e\n\u003cp\u003e[Figure 1. Category tree]\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.1 Theme 1. Losses in the physical health\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThree different situations were found: on the one hand, subjects who suffered from the disease mildly.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;Loss of taste and smell, I was infected with COVID-19, also suffering from constant headaches. The loss of the pleasure of eating was a significant loss for me. To date, I have recovered part of these senses, but not 100%\u0026rdquo; S7.\u003c/p\u003e\n\u003cp\u003eOn the other hand, those who have not been able to receive therapy because they cannot travel to their place of treatment.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;This year I have not been able to go to Germany as usual for the past 10 years to be able to treat my disease. Germany is\u0026hellip; where I can improve my disease\u0026rdquo; S13.\u003c/p\u003e\n\u003cp\u003eOr for delaying a pending surgery.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;My knee injury (torn meniscus). This event this summer has been for me a real odyssey of feelings and sensations after my surgery was delayed\u0026rdquo; S11.\u003c/p\u003e\n\u003cp\u003eThe third was the losses found due to persistent COVID.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;Loss of general well-being: apparently, I am one of the people who has the damn persistent COVID... I continue to suffer continuous headaches and episodes of tachycardia, which also cause me anxiety and low mood\u0026rdquo; S7.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.2 Theme 2. Loss of psychological well-being\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAt the psychological level, the loss of mental health caused alterations in students\u0026rsquo; anxiety and depression.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;As time went by, it continued to have an impact on my mind until in the summer I exploded and I was plunged into terrible anxiety and a little depression\u0026hellip;\u0026rdquo; S21.\u003c/p\u003e\n\u003cp\u003eIn addition, negative psychological responses were found, such as insomnia, worry or feeling overwhelmed.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;I have spent days crying, having to study, with insomnia, without being able to leave the house to relax, without hope to live, I felt that the house was caving on me\u0026rdquo; S19.\u003c/p\u003e\n\u003cp\u003eAdditionally, losses related to mental stability or loss of enthusiasm for life.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;As for my mental health, it has been by far the worst year I have experienced, the most unstable I have felt and the least I have understood myself. I had no illusion about anything, and every day seemed the same\u0026rdquo; S26.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.3 Theme 3. Loss of social welfare\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.3.1 Subtheme. Loss of contact\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ea) Loss of family contact due to death\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn the present study, 14 of the 34 participating students suffered the death of a loved one.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;The death of my grandmother. For me, she was one of the most important people in my life with whom I have shared practically my entire life\u0026hellip;\u0026rdquo; S23.\u003c/p\u003e\n\u003cp\u003eMany of the participants did not have the opportunity to say goodbye to their loved ones.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;The loss of my uncle who died from causes unrelated to the coronavirus in May 2020 and a mass and \u0026ldquo;decent\u0026rdquo; farewell could not be held at the time\u0026rdquo; S16.\u003c/p\u003e\n\u003cp\u003eAnother of the notable losses that have been noted are those of household animals.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;The loss of my cat in the middle of confinement, since he was at home and I was in the student apartment, I could not say goodbye to him\u0026rdquo; S26.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eb) Loss of family contact due to distance\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNot being able to be with the family has been one of the most heartfelt losses, both in the day-to-day:\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;The fact of not being able to go to a family meal with my uncles, grandparents, cousins... It has been one of the most important losses for me\u0026rdquo; S32.\u003c/p\u003e\n\u003cp\u003eAs in important celebrations:\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;In addition, the loss of family gatherings at Christmas is a very important loss because you do not know if we will all be at the next holidays\u0026rdquo; S14.\u003c/p\u003e\n\u003cp\u003eAnother aspect detected was the loss of time with grandparents.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;One of the most important losses has been the time lost with people close to me, especially with my grandmothers who are older people and I feel that the time I have with them is getting shorter\u0026rdquo; S22.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ec) Loss of contact with friends due to distance\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eLosses were found regarding social and friendship relationships during the pandemic.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;The loss of social relationships, I have not seen my lifelong friends for almost 3 months and I miss our relationship because, no matter what they say, a video call is not the same as going out to eat anywhere\u0026rdquo; S32.\u003c/p\u003e\n\u003cp\u003eA direct relationship was obtained between the loss of social relationships and the mental health of the students.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;I am a very sociable person, and the fact of not being able to meet my friends or not wanting to do it for prevention have caused me moments of loneliness, sadness, anxiety and despair\u0026rdquo; S11.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ed) Loss of friendship due to breakup\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSeveral situations were found in which a breakup in the friendship relationship occurred.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;Losing a relationship with a childhood friend\u0026rdquo; S18; \u0026ldquo;I could begin with the loss of a relationship with those I considered lifelong friends\u0026rdquo; S29.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ee) Loss of partner contact due to breakup\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAnother aspect to mention was couple breakups.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;The most important loss and the one that has changed my life the most, the breakup with my partner. I put it in this position because it is the one that hurts me the most since it is the only loss that I will probably never recover\u0026rdquo; S17.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ef) Loss of physical contact\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe pandemic has allowed investigating an exceptional situation that in normal conditions would not have occurred, the absence of physical contact.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;Not being able to have the same physical contact between us to the point of not greeting each other with two kisses or some gesture of affection\u0026rdquo; S5.\u003c/p\u003e\n\u003cp\u003eThe students experienced the lack of contact in a negative way.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;Begging for the warmth of the family, more than ever. However, they took it from us again, they took it away again\u0026rdquo; S9.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.3.2. Subtheme Loss in leisure time\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ea) Loss of travel\u003c/p\u003e\n\u003cp\u003eIn the group studied, the loss of trips was also present.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;I had to cancel a trip to Kenya that I had scheduled for half a year\u0026rdquo; S22.\u003c/p\u003e\n\u003cp\u003eWith reference to shorter trips, a relationship was found with an emotional and affective component.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;The perimeter closure, which prevents you from not only travelling but visiting your loved ones\u0026rdquo; S5.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ea)\u0026nbsp;\u003c/em\u003e\u003cem\u003eLoss of leisure activities\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFor the young population, the effect has been very negative, and many comments have been generated about losses in leisure activities.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;However, the greatest loss I have had in general has been social life, going out with my friends, spending time away from home, making plans etc.\u0026hellip;\u0026rdquo; S31\u003c/p\u003e\n\u003cp\u003eGenerating pain and suffering in affected people.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;While I want to recover that social life, that joy, that desire to communicate with people, I cannot do it, it is like a paradox, and I consider it a problem\u0026rdquo; S19.\u003c/p\u003e\n\u003cp\u003eIn many cases, the losses were related to simple activities.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;Just going for a drink with my friends or going for a walk at 12\u0026rdquo; S20.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eb)\u0026nbsp;\u003c/em\u003e\u003cem\u003eLoss of physical activity and physical exercise\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIt is worth noting the losses of physical activity (PA) or physical exercise (PE).\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;First, the loss of sports, of basketball and that due to the pandemic has not been resumed today. It was a liberation for me, in addition to being a fun way to keep fit and enjoy with my classmates\u0026rdquo; S17.\u003c/p\u003e\n\u003cp\u003eThe loss of PA and PE has had physical, social (loss of team sports) and psychological consequences.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;I got frustrated because for me doing sports was an escape, it helped me relax, it reduced my stress, it helped me to forget my routine and even my problems...\u0026rdquo; S32.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.4. Theme 4. Losses in the spiritual realm\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.4.1. Subtheme. Loss of identity\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAnother source of discomfort was the anguish in the loss of identity.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;I escape from my reality to be able to find the origin of pain, the loss of self, the final climax to a series of minor losses that made my mental structure break like a fragile glass\u0026rdquo; S3.\u003c/p\u003e\n\u003cp\u003eAs a measure of protection against this problem, loneliness and isolation were found.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;I am not the person I used to be; I prefer to be in my quiet room watching a series without talking to anyone\u0026rdquo; S19.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.4.2 Subtheme. Loss of freedom\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn this category, the concept of freedom is understood in a practical way, with the choice of being able to occupy spaces freely.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u0026hellip; Loss of freedom, loss of the possibility of going where you want, when you want, with the people you want\u0026hellip; One of the most important and one of those that have marked me the most\u0026rdquo; S10.\u003c/p\u003e\n\u003cp\u003eGenerating a loss of control in people\u0026apos;s lives.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;I had a feeling that I did not manage my life, but that it depended on the measures that were available at all times\u0026hellip;\u0026rdquo; S26.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.5 Theme 5. Losses in physiotherapy studies\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.5.1. Subtheme. Motivation-illusion\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA response of demotivation and disappointment in relation to the career was found.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;COVID-19 has changed our way of understanding university life; it has stolen part of our academic training and has sown apathy and indifference in the classrooms\u0026rdquo; S1\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.5.2. Subtheme Loss of clinical practices\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe experience of the lack of clinical practices also generated negative responses.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u0026hellip;With the new situation, it will not be possible for me to experience hospital practices this year, and clinical practices will not be as I had imagined\u0026rdquo; S7.\u003c/p\u003e"},{"header":"4.\tDiscussion","content":"\u003cp\u003eThe results found indicate an overall loss of well-being in all aspects. The categories found coincide with the health aspects defined by the WHO (WHOc, 2020). At the same time, it has been observed that these losses have generated numerous processes of mourning with corresponding alterations, such as sadness, loneliness, depression, anxiety, etc. (Worden, et al., 2013).\u003c/p\u003e\n\u003cp\u003eIn relation to physical losses, at the beginning of the pandemic, the symptoms of COVID-19 were not exactly known. Currently, there are studies aimed at this topic (Elangovan, 2021). On the other hand, few studies have assessed the impact of COVID-19 on surgical waiting lists in the Spanish state. The study by de Pablos \u0026amp; Garc\u0026iacute;a-Centeno (2021) indicates a delay of 7.6 to 19.4% in the waiting time for surgery.\u003c/p\u003e\n\u003cp\u003eMental health is one of the most affected aspects in young adults in relation to the rest of the categories. Stress, depression and anxiety were the alterations that appeared the most. One of the reviews found that anxiety affected 32% of the population and that 28% suffered from depressive disorders (Luo et al., 2020). On the other hand, studies have also found that they speak of compulsive behaviours, avoidance, deterioration of social function and dissatisfaction with life (Li \u0026amp; Xu, 2022). Data referring to negative psychological alterations seem to normalize over time (Robison et al., 2022). More studies are needed to assess and monitor mental health problems adapted to the context and thus be able to facilitate the corresponding health measures.\u003c/p\u003e\n\u003cp\u003eSocial losses were the most frequent, generating many categories and subcategories and finding a close relationship with losses in mental health.\u003c/p\u003e\n\u003cp\u003eThe high percentages of deaths in the participants are consistent with what happened in Spain during the pandemic (WHOb, 2022). Not being able to perform a community ritual, not being able to be physically present, the loneliness experienced due to lack of support, or not being able to say goodbye to the person (Lacasta-Reverte et al., 2020) has changed the way of coping with losses. These situations may have increased the probability of suffering a complicated grief. It would be necessary to conduct research with standardized instruments to observe whether there has truly been an increase in complicated grief during COVID-19.\u003c/p\u003e\n\u003cp\u003eIn relation to the losses due to the deaths of pets, there is currently a period of humanization of companion animals (Pascalev, 2006). The symptoms of grief with pets increase in proportion when they concur with stressful life events (Kimura et al., 2011), which could explain why during the COVID-19 pandemic, they have been identified as more anxiety generators than in a normal situation.\u003c/p\u003e\n\u003cp\u003eDespite the multiple sociological changes, the family continues to be an extremely important factor in Spain\u0026nbsp;(Bote-D\u0026iacute;az \u0026amp; S\u0026aacute;nchez-Vera, 2008).\u0026nbsp;Some losses found are related to marked festivities and others to regular contacts. The loss of these ties implies a decrease in social support and an affectation of emotional well-being\u0026nbsp;(Li \u0026amp; Xu, 2022),\u0026nbsp;in addition to an increase in stressors\u0026nbsp;(Mohler-Kuo et al., 2021). On the other hand, the lack of contact with grandparents was noted, and it would be interesting to investigate the consequences for a young adult of losing the relationship or references such as their grandparents.\u003c/p\u003e\n\u003cp\u003eIn a university age that is characterized by the achievement of individual autonomy, constant discovery, growth and expansion of relationships, the phenomenon of the pandemic has been negative for its development. Research in university students indicates that a greater number of friendships, quality contact and satisfactory and frequent electronic communication can be strategies that protect against loneliness (Juvonen et al., 2022), in addition to being protective against psychological and mental health problems (Groarke Id et al., 2020).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe phenomenon of couples during the pandemic has been investigated in cohabitant couples and marriages (Unther-Bel et al., 2020) but not in university students.\u0026nbsp;Individuals who are threatened by constant stress outside of a relationship are more likely to interact negatively with their partners\u0026nbsp;(Pietromonaco \u0026amp; Overall, 2022), and the COVID-19 pandemic has been a generator of conflicts and stressors (Estlein et al., 2022). Facing conflict requires personal maturity and a quality in the relationship that can be difficult to acquire in young university students.\u003c/p\u003e\n\u003cp\u003eIn relation to the loss of physical contact, the studies found indicate the desire and need for contact for many people and the possibility of regulating stress and anxiety through intimate contact (Von Mohr et al., 2017).\u0026nbsp;The slow and affective touch provides benefits such as the mitigation of negative emotions or the bonding between individuals\u0026nbsp;(McParlin et al., 2022). It would be interesting to carry out\u0026nbsp;programs\u0026nbsp;that will enhance physical contact between people and generate some of the aforementioned benefits.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDuring the time of the pandemic and due to restrictions, there has been an enormous amount of free time, with the particularity that the ability to choose activities by the person was lost, since it could not be done outside of a schedule, from the home or in certain inaccessible establishments (Gammon \u0026amp; Ramshaw, 2021).\u003c/p\u003e\n\u003cp\u003eThere is a social and psychological need in this time to travel, as well as to enjoy the emotional well-being of knowing other cultures, customs, gastronomy, etc. (Aebli et al., 2021). There is a direct and indirect relationship between travel and life satisfaction, as well as emotional well-being and the feeling of happiness or pleasure (Zins \u0026amp; Ponocny, 2022).\u0026nbsp;In a complementary way,\u0026nbsp;in complicated situations, leisure activities reduce many factors of stress and anxiety (Zhang \u0026amp; Zheng, 2017), in addition to improving well-being in the university population (Doerksen et al., 2014).\u0026nbsp;Therefore, it could be recommended for this population to resume travel and perform activities that reduce academic stress.\u003c/p\u003e\n\u003cp\u003ePA and PE were among the most named losses. It should be noted that Spain had one of the strictest confinements. One explanation for the results is that physiotherapy students perform more hours of PA and PE in their free time than other students (Moreno \u0026amp; Cruz, 2015). Rodr\u0026iacute;guez-Larrad et al. (2021) found an increase in sedentary lifestyle and a decrease in both moderate and vigorous PA during the pandemic. Given the multiple benefits of PA and PE in the population at all levels (Ekelund et al., 2019) and their direct relationship with health, governments should not allow deprivation of PA and PE in similar situations.\u003c/p\u003e\n\u003cp\u003eFrom a classical concept, identity would be that which is maintained in each individual and does not vary over time, its essence. This encounters a changing reality, which is constantly evolving and is preyed to uncertainty (Duque et al., 2013, such as the period described in this study in the context of a global pandemic.\u003c/p\u003e\n\u003cp\u003eIn relation to the lack of freedom, similar results have been found in other contexts (Procentese et al., 2021). They related the lack of freedom with a need to return to normality or a feeling of urgency to manage time daily at their convenience. In addition, it was found that young people (18 to 29 years) could experience more stress and anxiety than other groups due to mobility limitations before other deficiencies (Gambin et al., 2021).\u003c/p\u003e\n\u003cp\u003eThe syndrome of academic burnout consists of a series of negative psychological manifestations, such as anxiety, depression, fatigue, etc., that occur due to excessive pressure or lack of interest that can lead to poor academic performance and health issues (Wang et al., 2021), aspects that have been observed in the present study. Disappointment and loss of motivation have been frequently discussed in different university environments (Jacobo-Galicia et al., 2021).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations of the study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWithin the limitations of the study, it is noted that the data analysed belong to a specific population group (university students) circumscribed to a certain age in a specific context (Valencia), which may not represent other population groups. The sample has not been selected to have greater variability of profiles.\u003c/p\u003e"},{"header":"5.\tConclusions","content":"\u003cp\u003eThe present study found losses of physiotherapy students during the COVID-19 pandemic globally and at the biological, psychological, social, spiritual and academic levels. Losses of social habits, loss of freedom or leisure opportunities, affective and emotional problems, absence of physical contact or sports activities, including thoughts about the death of family members or couple breakup, as well as doubts about the professional future influenced by a lack of clinical practice have been found.\u003c/p\u003e\n\u003cp\u003eIt is important that universities generate resources that improve the well-being of health care students, both for optimal academic performance and for the improvement of reflective practice that can favour self-care and the reduction of psychosocial problems.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate: \u0026nbsp;\u003c/strong\u003eThe research project underwent presentation and approval by the Ethics Committee of the University of Valencia (Protocol Number: 1782311). All participants in the study provided their consent by signing an informed consent form.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eAll authors authorize the publication of the following article\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials.\u0026nbsp;\u003c/strong\u003eThe data and materials are available for consultation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e: The authors have declared that no competing interests exist.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e The author(s) received no specific funding for this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u0026nbsp;\u003c/strong\u003eMarta Terr\u0026oacute;n-P\u0026eacute;rez. Writing the manuscript. Data analysis and interpretation of manuscript. Critical revision of manuscript. Supervision\u003c/p\u003e\n\u003cp\u003eJuan Bautista Portol\u0026eacute;s Sime\u0026oacute;. Writing the manuscript. Data collection. Data analysis and interpretation of manuscript. Critical revision of manuscript.\u003c/p\u003e\n\u003cp\u003eSara Cort\u0026eacute;s-Amador. Data analysis and interpretation of manuscript. Critical revision of manuscript. Administrative and materials support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e We are grateful to all study participants for explain their experiences during a hard period of their lives.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAebli, A., Volgger, M., \u0026amp; Taplin, R. (2021). \u003cem\u003eA two-dimensional approach to travel motivation in the context of the COVID-19 pandemic\u003c/em\u003e. https://doi.org/10.1080/13683500.2021.1906631\u003c/li\u003e\n \u003cli\u003eAntonia Lacasta-Reverte, M., Torrijos Zarcero, M., L\u0026oacute;pez-P\u0026eacute;rez, Y., Carracedo Sanchidri\u0026aacute;n, D., P\u0026eacute;rez Manrique, T., Casado Sanmart\u0026iacute;n, C., Rocamora Gonz\u0026aacute;lez, C., Blanco Rosado, L., Iglesias Guti\u0026eacute;rrez, N., Vidal Bermejo, E., Trigo Varela, D., \u0026amp; Mart\u0026iacute;-Esquitino, J. (2020). Medicina Paliativa Publicaci\u0026oacute;n OO cial Sociedad Espa\u0026ntilde;ola de Cuidados Paliativos Medicina Medicina Paliativa Impacto emocional en pacientes y familiares durante la pandemia por COVID-19. Un duelo diferente. \u003cem\u003eMed Paliat\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(3), 201\u0026ndash;208. https://doi.org/10.20986/medpal.2020.1188/2020\u003c/li\u003e\n \u003cli\u003eArsandaux, J., Montagni, I., Macalli, M., Texier, N., Pouriel, M., Germain, R., Mebarki, A., Kinouani, S., Tournier, M., Schuck, S., \u0026amp; Tzourio, C. (2021).\u0026nbsp;Mental health condition of college students compared to non-students during COVID-19 lockdown: The CONFINS study. \u003cem\u003eBMJ Open\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e(8). https://doi.org/10.1136/BMJOPEN-2021-053231\u003c/li\u003e\n \u003cli\u003eChaurand, A., Feixas, G., \u0026amp; Neimeyer, R. A. (2010).\u0026nbsp;El inventario de historia de p\u0026eacute;rdidas (ihp): presentaci\u0026oacute;n y utilidad cl\u0026iacute;nica. \u003cem\u003eRevista de Psicoterapia\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(84), 95\u0026ndash;101. https://doi.org/10.33898/RDP.V21I84.614\u003c/li\u003e\n \u003cli\u003eCollazos, J. E. M., \u0026amp; Berm\u0026uacute;dez, H. F. C. (2015). Percepci\u0026oacute;n de la actividad f\u0026iacute;sica en estudiantes de enfermer\u0026iacute;a frente a fisioterapia.\u0026nbsp;\u003cem\u003eEnfermer\u0026iacute;a Global\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(4), 192\u0026ndash;200. https://doi.org/10.6018/EGLOBAL.14.4.209811\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eConstituci\u0026oacute;n\u003c/em\u003e. (n.d.). Retrieved July 29, 2022, from https://www.who.int/es/about/governance/constitution\u003c/li\u003e\n \u003cli\u003eDe, L., Escobar, P., \u0026amp; Garc\u0026iacute;a-Centeno, M.-C. (2021). IMPACTO DE LA COVID-19 SOBRE LAS LISTAS DE ESPERA QUIR\u0026Uacute;RGICAS. \u003cem\u003eRev Esp Salud P\u0026uacute;blica\u003c/em\u003e, \u003cem\u003e95\u003c/em\u003e, 3\u0026ndash;4. www.mscbs.es/resp\u003c/li\u003e\n \u003cli\u003eEkelund, U., Tarp, J., Steene-Johannessen, J., Hansen, B. H., Jefferis, B., Fagerland, M. W., Whincup, P., Diaz, K. M., Hooker, S. P., Chernofsky, A., Larson, M. G., Spartano, N., Vasan, R. S., Dohrn, I.-M., Hagstr\u0026ouml;mer, M., Edwardson, C., Yates, T., Shiroma, E., Anderssen, S. A., \u0026amp; Lee, I.-M. (n.d.).\u0026nbsp;\u003cem\u003eDose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis\u003c/em\u003e. https://doi.org/10.1136/bmj.l4570\u003c/li\u003e\n \u003cli\u003eElangovan, S. (2021). Acute Loss of Smell or Taste Without Nasal Blockage Should Raise Suspicion for COVID-19 Infection. In \u003cem\u003eJournal of Evidence-Based Dental Practice\u003c/em\u003e (Vol. 21, Issue 1). https://doi.org/10.1016/j.jebdp.2020.101525\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eEntre la progresi\u0026oacute;n y la regresi\u0026oacute;n: la configuraci\u0026oacute;n identitaria en los procesos de p\u0026eacute;rdida\u003c/em\u003e.\u0026nbsp;(n.d.). Retrieved July 25, 2022, from https://www.redalyc.org/articulo.oa?id=423539422013\u003c/li\u003e\n \u003cli\u003eEstlein, R., Ateret Gewirtz-Meydan, |, \u0026amp; Opuda, E. (2022). \u003cem\u003eO R I G I N A L A R T I C L E Love in the time of COVID-19: A systematic mapping review of empirical research on romantic relationships one year into the COVID-19 pandemic\u003c/em\u003e. https://doi.org/10.1111/famp.12775\u003c/li\u003e\n \u003cli\u003eGambin, M., Sękowski, M., Woźniak-Prus, M., Wnuk, A., Oleksy, T., Cudo, A., Hansen, K., Huflejt-Łukasik, M., Kubicka, K., Łyś, A. E., Gorgol, J., Holas, P., Kmita, G., Łojek, E., \u0026amp; Maison, D. (2021). Generalized anxiety and depressive symptoms in various age groups during the COVID-19 lockdown in Poland. Specific predictors and differences in symptoms severity. \u003cem\u003eComprehensive Psychiatry\u003c/em\u003e, \u003cem\u003e105\u003c/em\u003e. https://doi.org/10.1016/J.COMPPSYCH.2020.152222\u003c/li\u003e\n \u003cli\u003eGammon, S., \u0026amp; Ramshaw, G. (n.d.). \u003cem\u003eLeisure Sciences Distancing from the Present: Nostalgia and Leisure in Lockdown\u003c/em\u003e. https://doi.org/10.1080/01490400.2020.1773993\u003c/li\u003e\n \u003cli\u003eGroarke Id, J. M., Berry, E., Graham-Wisener, L., Mckenna-Plumley, P. E., Mcglinchey, E., \u0026amp; Armour, C. (2020). \u003cem\u003eLoneliness in the UK during the COVID-19 pandemic: Cross-sectional results from the COVID-19 Psychological Wellbeing Study\u003c/em\u003e. https://doi.org/10.1371/journal.pone.0239698\u003c/li\u003e\n \u003cli\u003eHarvey, J. H., \u0026amp; Miller, E. D. (1998). \u003cem\u003eTOWARD A PSYCHOLOGY OF LOSS\u003c/em\u003e.\u003c/li\u003e\n \u003cli\u003eJacobo-Galicia, G., M\u0026aacute;ynez Guaderrama, A. I., \u0026amp; Cavazos-Arroyo, J. (2021). Miedo al Covid, agotamiento y cinismo: su efecto en la intenci\u0026oacute;n de abandono universitario.\u0026nbsp;\u003cem\u003eEuropean Journal of Education and Psychology\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(1), 1\u0026ndash;18. https://doi.org/10.32457/EJEP.V14I1.1432\u003c/li\u003e\n \u003cli\u003eJournal, A. I., Doerksen, S. E., Elavsky, S., Rebar, A. L., \u0026amp; Conroy, D. E. (2014). \u003cem\u003eLeisure Sciences Weekly Fluctuations in College Student Leisure Activities and Well-Being\u003c/em\u003e. https://doi.org/10.1080/01490400.2014.860778\u003c/li\u003e\n \u003cli\u003eJuvonen, J., Lessard, L. M., Kline, N. G., \u0026amp; Graham, S. (2022). Young Adult Adaptability to the Social Challenges of the COVID-19 Pandemic: The Protective Role of Friendships. \u003cem\u003eJournal of Youth and Adolescence\u003c/em\u003e, \u003cem\u003e51\u003c/em\u003e, 585\u0026ndash;597. https://doi.org/10.1007/s10964-022-01573-w\u003c/li\u003e\n \u003cli\u003eKimura, Y., Kawabata, H., \u0026amp; Maezawa, M. (2011). Psychiatric Investigation of 18 Bereaved Pet Owners. \u003cem\u003eJournal of Veterinary Medical Science\u003c/em\u003e, \u003cem\u003e73\u003c/em\u003e(8), 1083\u0026ndash;1087. https://doi.org/10.1292/JVMS.10-0317\u003c/li\u003e\n \u003cli\u003eLi, S., \u0026amp; Xu, Q. (2022). Family support as a protective factor for attitudes toward social distancing and in preserving positive mental health during the COVID-19 pandemic. \u003cem\u003eJournal of Health Psychology\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(4), 858\u0026ndash;867. https://doi.org/10.1177/1359105320971697\u003c/li\u003e\n \u003cli\u003eLuo, M., Guo, L., Yu, M., \u0026amp; Wang, H. (2020). The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public \u0026ndash; A systematic review and meta-analysis. \u003cem\u003ePsychiatry Research\u003c/em\u003e, \u003cem\u003e291\u003c/em\u003e. https://doi.org/10.1016/J.PSYCHRES.2020.113190\u003c/li\u003e\n \u003cli\u003eMohler-Kuo, M., Dzemaili, S., Foster, S., Werlen, L., \u0026amp; Walitza, S. (2021). Stress and Mental Health among Children/Adolescents, Their Parents, and Young Adults during the First COVID-19 Lockdown in Switzerland. \u003cem\u003eInt. J. Environ. Res. Public Health\u003c/em\u003e, \u003cem\u003e18\u003c/em\u003e, 4668. https://doi.org/10.3390/ijerph18094668\u003c/li\u003e\n \u003cli\u003eNeimeyer, R., \u0026amp; Ram\u0026iacute;rez, Y. (2002).\u0026nbsp;\u003cem\u003eAprender de la p\u0026eacute;rdida: una gu\u0026iacute;a para afrontar el duelo\u003c/em\u003e. http://www.recuperacionemocionalecuador.com/images/cere/Aprender-de-la-perdida-Neimeyer.pdf\u003c/li\u003e\n \u003cli\u003eNicolle, S., Arcos, A., Nathali, D., \u0026amp; Mori, P. (2022). Duelo y el duelo complicado: Una revisi\u0026oacute;n de la literatura cient\u0026iacute;fica en el tiempo.\u0026nbsp;\u003cem\u003eJournal of Neuroscience and Public Health\u003c/em\u003e, \u003cem\u003e2\u003c/em\u003e(1), 197\u0026ndash;204. https://doi.org/10.46363/JNPH.V2I1.4\u003c/li\u003e\n \u003cli\u003eOnyeaka, H., Anumudu, C. K., Al-Sharify, Z. T., Egele-Godswill, E., \u0026amp; Mbaegbu, P. (2021). COVID-19 pandemic: A review of the global lockdown and its far-reaching effects. \u003cem\u003eSCIENCE PROGRESS\u003c/em\u003e, \u003cem\u003e104\u003c/em\u003e(2), 1\u0026ndash;18. https://doi.org/10.1177/00368504211019854\u003c/li\u003e\n \u003cli\u003ePascalev, A. K. (2006). We and they: Animal welfare in the era of advanced agricultural biotechnology. \u003cem\u003eLivestock Science\u003c/em\u003e, \u003cem\u003e103\u003c/em\u003e(3), 208\u0026ndash;220. https://doi.org/10.1016/J.LIVSCI.2006.05.007\u003c/li\u003e\n \u003cli\u003ePietromonaco, P. R., \u0026amp; Overall, N. C. (2022). Implications of social isolation, separation, and loss during the COVID-19 pandemic for couples\u0026rsquo; relationships.\u0026nbsp;\u003cem\u003eCurrent Opinion in Psychology\u003c/em\u003e, \u003cem\u003e43\u003c/em\u003e, 189\u0026ndash;194. https://doi.org/10.1016/J.COPSYC.2021.07.014\u003c/li\u003e\n \u003cli\u003eProcentese, F., Esposito, C., Gonzalez Leone, F., Agueli, B., Arcidiacono, C., Freda, M. F., \u0026amp; di Napoli, I. (2021).\u0026nbsp;Psychological Lockdown Experiences: Downtime or an Unexpected Time for Being?\u0026nbsp;\u003cem\u003eFrontiers in Psychology\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e, 1159. https://doi.org/10.3389/FPSYG.2021.577089/BIBTEX\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eREDES SOCIALES Y FAMILIA EN ESPA\u0026Ntilde;A. CONSISTENCIA Y DEBILIDADES\u003c/em\u003e. (n.d.). Retrieved July 29, 2022, from https://www.redalyc.org/articulo.oa?id=161017350012\u003c/li\u003e\n \u003cli\u003eRodr\u0026iacute;guez-Larrad, A., Ma\u0026ntilde;as, A., Labayen, I., Gonz\u0026aacute;lez-Gross, M., Espin, A., Aznar, S., Serrano-S\u0026aacute;nchez, A., Vera-Garcia, F. J., Gonz\u0026aacute;lez-Lamu\u0026ntilde;o, D., Ara, I., Carrasco-P\u0026aacute;ez, L., Castro-Pi\u0026ntilde;ero, J., Carmen G\u0026oacute;mez-Cabrera, M., M\u0026aacute;rquez, S., Tur, J. A., Gusi, N., Benito, P. J., Moliner-Urdiales, D., Ruiz, J. R., \u0026hellip;\u0026nbsp;Irazusta, J. (2021). Impact of COVID-19 Confinement on Physical Activity and Sedentary Behaviour in Spanish University Students: Role of Gender. \u003cem\u003eInt. J. Environ. Res. Public Health\u003c/em\u003e, \u003cem\u003e18\u003c/em\u003e, 369. https://doi.org/10.3390/ijerph18020369\u003c/li\u003e\n \u003cli\u003eRood, L., Tanzillo, T., \u0026amp; Madsen, N. (2022). \u003cem\u003eStudent nurses\u0026rsquo; educational experiences during COVID-19: A qualitative study\u003c/em\u003e. https://doi.org/10.1016/j.nedt.2022.105562\u003c/li\u003e\n \u003cli\u003eSand\u0026iacute;n, B., Valiente, R. M., Garc\u0026iacute;a-Escalera, J., \u0026amp; Chorot, P. (2020). Impacto psicol\u0026oacute;gico de la pandemia de COVID-19: Efectos negativos y positivos en poblaci\u0026oacute;n espa\u0026ntilde;ola asociados al periodo de confinamiento nacional. \u003cem\u003eRevista de Psicopatolog\u0026iacute;a y Psicolog\u0026iacute;a Cl\u0026iacute;nica\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(1), 1\u0026ndash;22. https://doi.org/10.5944/RPPC.27569\u003c/li\u003e\n \u003cli\u003eShamay-Tsoory, S. G., \u0026amp; Eisenberger, N. I. (2021). Getting in touch: A neural model of comforting touch. \u003cem\u003eNeuroscience and Biobehavioral Reviews\u003c/em\u003e, \u003cem\u003e130\u003c/em\u003e, 263\u0026ndash;273. https://doi.org/10.1016/J.NEUBIOREV.2021.08.030\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eSpain: WHO Coronavirus Disease (COVID-19) Dashboard With Vaccination Data | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data\u003c/em\u003e. (n.d.). Retrieved July 25, 2022, from https://covid19.who.int/region/euro/country/es\u003c/li\u003e\n \u003cli\u003eTrani, M. di, Tanzilli, A., Candidi, M., Esteves, J. E., Mcparlin, Z., Cerritelli, F., \u0026amp; Friston, K. J. (2022). Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony. \u003cem\u003eHYPOTHESIS AND THEORY\u003c/em\u003e, 17.\u0026nbsp;\u003ca href=\"https://doi.org/10.3389/fpsyg.2022.783694\"\u003ehttps://doi.org/10.3389/fpsyg.2022.783694\u003c/a\u003e\u003c/li\u003e\n \u003cli\u003eUnther-Bel, C. G., Vilaregut, A., Carratala, E., Torras-Garat, S., \u0026amp; Erez-Testor, C. P. (2020). A Mixed-method Study of Individual, Couple, and Parental Functioning During the State-regulated COVID-19 Lockdown in Spain.\u0026nbsp;\u003cem\u003eFamily Process\u003c/em\u003e, \u003cem\u003e59\u003c/em\u003e(3). https://doi.org/10.1111/famp.12585\u003c/li\u003e\n \u003cli\u003eV\u0026aacute;squez, G., Urtecho-Osorto, \u0026Oacute;. R., Ag\u0026uuml;ero-Flores, M., D\u0026iacute;az-Mart\u0026iacute;nez, M. J., Paguada, R. M., Varela, M. A., Landa-Blanco, M., \u0026amp; Echenique, Y. (2020). Mental health, confinement, and coronavirus concerns: a qualitative study. \u003cem\u003eRevista Interamericana de Psicolog\u0026iacute;a/Interamerican Journal of Psychology\u003c/em\u003e, \u003cem\u003e54\u003c/em\u003e(2), e1333\u0026ndash;e1333. https://doi.org/10.30849/RIPIJP.V54I2.1333\u003c/li\u003e\n \u003cli\u003eVon Mohr, M., Kirsch, L. P., \u0026amp; Fotopoulou, A. (n.d.). \u003cem\u003eThe soothing function of touch: affective touch reduces feelings of social exclusion\u003c/em\u003e. https://doi.org/10.1038/s41598-017-13355-7\u003c/li\u003e\n \u003cli\u003eWang, J., Bu, L., Li, Y., Song, J., \u0026amp; Li, N. (2021). The mediating effect of academic engagement between psychological capital and academic burnout among nursing students during the COVID-19 pandemic: A cross-sectional study. \u003cem\u003eNurse Education Today\u003c/em\u003e, \u003cem\u003e102\u003c/em\u003e, 104938. https://doi.org/10.1016/J.NEDT.2021.104938\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eWHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data\u003c/em\u003e. (n.d.). Retrieved July 29, 2022, from https://covid19.who.int/\u003c/li\u003e\n \u003cli\u003eWorden, J. W. (n.d.).\u0026nbsp;\u003cem\u003eEL TRATAMIENTO DEL DUELO: Asesoramiento psicol\u0026oacute;gico y terapia\u003c/em\u003e.\u003c/li\u003e\n \u003cli\u003e\u0026euro; Unther-Bel, C. G., Vilaregut, A., Carratala, E., Torras-Garat, S., \u0026amp; Erez-Testor, C. P. (2020).\u0026nbsp;A Mixed-method Study of Individual, Couple, and Parental Functioning During the State-regulated COVID-19 Lockdown in Spain. \u003cem\u003eFamily Process\u003c/em\u003e, \u003cem\u003e59\u003c/em\u003e(3). https://doi.org/10.1111/famp.12585\u003c/li\u003e\n \u003cli\u003eAebli, A., Volgger, M., \u0026amp; Taplin, R. (2021). \u003cem\u003eA two-dimensional approach to travel motivation in the context of the COVID-19 pandemic\u003c/em\u003e. https://doi.org/10.1080/13683500.2021.1906631\u003c/li\u003e\n \u003cli\u003eAntonia Lacasta-Reverte, M., Torrijos Zarcero, M., L\u0026oacute;pez-P\u0026eacute;rez, Y., Carracedo Sanchidri\u0026aacute;n, D., P\u0026eacute;rez Manrique, T., Casado Sanmart\u0026iacute;n, C., Rocamora Gonz\u0026aacute;lez, C., Blanco Rosado, L., Iglesias Guti\u0026eacute;rrez, N., Vidal Bermejo, E., Trigo Varela, D., \u0026amp; Mart\u0026iacute;-Esquitino, J. (2020). Medicina Paliativa Publicaci\u0026oacute;n OO cial Sociedad Espa\u0026ntilde;ola de Cuidados Paliativos Medicina Medicina Paliativa Impacto emocional en pacientes y familiares durante la pandemia por COVID-19. Un duelo diferente. \u003cem\u003eMed Paliat\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(3), 201\u0026ndash;208. https://doi.org/10.20986/medpal.2020.1188/2020\u003c/li\u003e\n \u003cli\u003eArsandaux, J., Montagni, I., Macalli, M., Texier, N., Pouriel, M., Germain, R., Mebarki, A., Kinouani, S., Tournier, M., Schuck, S., \u0026amp; Tzourio, C. (2021).\u0026nbsp;Mental health condition of college students compared to non-students during COVID-19 lockdown: The CONFINS study. \u003cem\u003eBMJ Open\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e(8). https://doi.org/10.1136/BMJOPEN-2021-053231\u003c/li\u003e\n \u003cli\u003eChaurand, A., Feixas, G., \u0026amp; Neimeyer, R. A. (2010).\u0026nbsp;El inventario de historia de p\u0026eacute;rdidas (ihp): presentaci\u0026oacute;n y utilidad cl\u0026iacute;nica. \u003cem\u003eRevista de Psicoterapia\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(84), 95\u0026ndash;101. https://doi.org/10.33898/RDP.V21I84.614\u003c/li\u003e\n \u003cli\u003eCollazos, J. E. M., \u0026amp; Berm\u0026uacute;dez, H. F. C. (2015). Percepci\u0026oacute;n de la actividad f\u0026iacute;sica en estudiantes de enfermer\u0026iacute;a frente a fisioterapia.\u0026nbsp;\u003cem\u003eEnfermer\u0026iacute;a Global\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(4), 192\u0026ndash;200. https://doi.org/10.6018/EGLOBAL.14.4.209811\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eConstituci\u0026oacute;n\u003c/em\u003e. (n.d.). Retrieved July 29, 2022, from https://www.who.int/es/about/governance/constitution\u003c/li\u003e\n \u003cli\u003eDe, L., Escobar, P., \u0026amp; Garc\u0026iacute;a-Centeno, M.-C. (2021). IMPACTO DE LA COVID-19 SOBRE LAS LISTAS DE ESPERA QUIR\u0026Uacute;RGICAS. \u003cem\u003eRev Esp Salud P\u0026uacute;blica\u003c/em\u003e, \u003cem\u003e95\u003c/em\u003e, 3\u0026ndash;4. www.mscbs.es/resp\u003c/li\u003e\n \u003cli\u003eEkelund, U., Tarp, J., Steene-Johannessen, J., Hansen, B. H., Jefferis, B., Fagerland, M. W., Whincup, P., Diaz, K. M., Hooker, S. P., Chernofsky, A., Larson, M. G., Spartano, N., Vasan, R. S., Dohrn, I.-M., Hagstr\u0026ouml;mer, M., Edwardson, C., Yates, T., Shiroma, E., Anderssen, S. A., \u0026amp; Lee, I.-M. (n.d.).\u0026nbsp;\u003cem\u003eDose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis\u003c/em\u003e. https://doi.org/10.1136/bmj.l4570\u003c/li\u003e\n \u003cli\u003eElangovan, S. (2021). Acute Loss of Smell or Taste Without Nasal Blockage Should Raise Suspicion for COVID-19 Infection. In \u003cem\u003eJournal of Evidence-Based Dental Practice\u003c/em\u003e (Vol. 21, Issue 1). https://doi.org/10.1016/j.jebdp.2020.101525\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eEntre la progresi\u0026oacute;n y la regresi\u0026oacute;n: la configuraci\u0026oacute;n identitaria en los procesos de p\u0026eacute;rdida\u003c/em\u003e.\u0026nbsp;(n.d.). Retrieved July 25, 2022, from https://www.redalyc.org/articulo.oa?id=423539422013\u003c/li\u003e\n \u003cli\u003eEstlein, R., Ateret Gewirtz-Meydan, |, \u0026amp; Opuda, E. (2022). \u003cem\u003eO R I G I N A L A R T I C L E Love in the time of COVID-19: A systematic mapping review of empirical research on romantic relationships one year into the COVID-19 pandemic\u003c/em\u003e. https://doi.org/10.1111/famp.12775\u003c/li\u003e\n \u003cli\u003eGambin, M., Sękowski, M., Woźniak-Prus, M., Wnuk, A., Oleksy, T., Cudo, A., Hansen, K., Huflejt-Łukasik, M., Kubicka, K., Łyś, A. E., Gorgol, J., Holas, P., Kmita, G., Łojek, E., \u0026amp; Maison, D. (2021). Generalized anxiety and depressive symptoms in various age groups during the COVID-19 lockdown in Poland. Specific predictors and differences in symptoms severity. \u003cem\u003eComprehensive Psychiatry\u003c/em\u003e, \u003cem\u003e105\u003c/em\u003e. https://doi.org/10.1016/J.COMPPSYCH.2020.152222\u003c/li\u003e\n \u003cli\u003eGammon, S., \u0026amp; Ramshaw, G. (n.d.). \u003cem\u003eLeisure Sciences Distancing from the Present: Nostalgia and Leisure in Lockdown\u003c/em\u003e. https://doi.org/10.1080/01490400.2020.1773993\u003c/li\u003e\n \u003cli\u003eGroarke Id, J. M., Berry, E., Graham-Wisener, L., Mckenna-Plumley, P. E., Mcglinchey, E., \u0026amp; Armour, C. (2020). \u003cem\u003eLoneliness in the UK during the COVID-19 pandemic: Cross-sectional results from the COVID-19 Psychological Wellbeing Study\u003c/em\u003e. https://doi.org/10.1371/journal.pone.0239698\u003c/li\u003e\n \u003cli\u003eHarvey, J. H., \u0026amp; Miller, E. D. (1998). \u003cem\u003eTOWARD A PSYCHOLOGY OF LOSS\u003c/em\u003e.\u003c/li\u003e\n \u003cli\u003eJacobo-Galicia, G., M\u0026aacute;ynez Guaderrama, A. I., \u0026amp; Cavazos-Arroyo, J. (2021). Miedo al Covid, agotamiento y cinismo: su efecto en la intenci\u0026oacute;n de abandono universitario.\u0026nbsp;\u003cem\u003eEuropean Journal of Education and Psychology\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(1), 1\u0026ndash;18. https://doi.org/10.32457/EJEP.V14I1.1432\u003c/li\u003e\n \u003cli\u003eJournal, A. I., Doerksen, S. E., Elavsky, S., Rebar, A. L., \u0026amp; Conroy, D. E. (2014). \u003cem\u003eLeisure Sciences Weekly Fluctuations in College Student Leisure Activities and Well-Being\u003c/em\u003e. https://doi.org/10.1080/01490400.2014.860778\u003c/li\u003e\n \u003cli\u003eJuvonen, J., Lessard, L. M., Kline, N. G., \u0026amp; Graham, S. (2022). Young Adult Adaptability to the Social Challenges of the COVID-19 Pandemic: The Protective Role of Friendships. \u003cem\u003eJournal of Youth and Adolescence\u003c/em\u003e, \u003cem\u003e51\u003c/em\u003e, 585\u0026ndash;597. https://doi.org/10.1007/s10964-022-01573-w\u003c/li\u003e\n \u003cli\u003eKimura, Y., Kawabata, H., \u0026amp; Maezawa, M. (2011). Psychiatric Investigation of 18 Bereaved Pet Owners. \u003cem\u003eJournal of Veterinary Medical Science\u003c/em\u003e, \u003cem\u003e73\u003c/em\u003e(8), 1083\u0026ndash;1087. https://doi.org/10.1292/JVMS.10-0317\u003c/li\u003e\n \u003cli\u003eLi, S., \u0026amp; Xu, Q. (2022). Family support as a protective factor for attitudes toward social distancing and in preserving positive mental health during the COVID-19 pandemic. \u003cem\u003eJournal of Health Psychology\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(4), 858\u0026ndash;867. https://doi.org/10.1177/1359105320971697\u003c/li\u003e\n \u003cli\u003eLuo, M., Guo, L., Yu, M., \u0026amp; Wang, H. (2020). The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public \u0026ndash; A systematic review and meta-analysis. \u003cem\u003ePsychiatry Research\u003c/em\u003e, \u003cem\u003e291\u003c/em\u003e. https://doi.org/10.1016/J.PSYCHRES.2020.113190\u003c/li\u003e\n \u003cli\u003eMohler-Kuo, M., Dzemaili, S., Foster, S., Werlen, L., \u0026amp; Walitza, S. (2021). Stress and Mental Health among Children/Adolescents, Their Parents, and Young Adults during the First COVID-19 Lockdown in Switzerland. \u003cem\u003eInt. J. Environ. Res. Public Health\u003c/em\u003e, \u003cem\u003e18\u003c/em\u003e, 4668. https://doi.org/10.3390/ijerph18094668\u003c/li\u003e\n \u003cli\u003eNeimeyer, R., \u0026amp; Ram\u0026iacute;rez, Y. (2002).\u0026nbsp;\u003cem\u003eAprender de la p\u0026eacute;rdida: una gu\u0026iacute;a para afrontar el duelo\u003c/em\u003e. http://www.recuperacionemocionalecuador.com/images/cere/Aprender-de-la-perdida-Neimeyer.pdf\u003c/li\u003e\n \u003cli\u003eNicolle, S., Arcos, A., Nathali, D., \u0026amp; Mori, P. (2022). Duelo y el duelo complicado: Una revisi\u0026oacute;n de la literatura cient\u0026iacute;fica en el tiempo.\u0026nbsp;\u003cem\u003eJournal of Neuroscience and Public Health\u003c/em\u003e, \u003cem\u003e2\u003c/em\u003e(1), 197\u0026ndash;204. https://doi.org/10.46363/JNPH.V2I1.4\u003c/li\u003e\n \u003cli\u003eOnyeaka, H., Anumudu, C. K., Al-Sharify, Z. T., Egele-Godswill, E., \u0026amp; Mbaegbu, P. (2021). COVID-19 pandemic: A review of the global lockdown and its far-reaching effects. \u003cem\u003eSCIENCE PROGRESS\u003c/em\u003e, \u003cem\u003e104\u003c/em\u003e(2), 1\u0026ndash;18. https://doi.org/10.1177/00368504211019854\u003c/li\u003e\n \u003cli\u003ePascalev, A. K. (2006). We and they: Animal welfare in the era of advanced agricultural biotechnology. \u003cem\u003eLivestock Science\u003c/em\u003e, \u003cem\u003e103\u003c/em\u003e(3), 208\u0026ndash;220. https://doi.org/10.1016/J.LIVSCI.2006.05.007\u003c/li\u003e\n \u003cli\u003ePietromonaco, P. R., \u0026amp; Overall, N. C. (2022). Implications of social isolation, separation, and loss during the COVID-19 pandemic for couples\u0026rsquo; relationships.\u0026nbsp;\u003cem\u003eCurrent Opinion in Psychology\u003c/em\u003e, \u003cem\u003e43\u003c/em\u003e, 189\u0026ndash;194. https://doi.org/10.1016/J.COPSYC.2021.07.014\u003c/li\u003e\n \u003cli\u003eProcentese, F., Esposito, C., Gonzalez Leone, F., Agueli, B., Arcidiacono, C., Freda, M. F., \u0026amp; di Napoli, I. (2021).\u0026nbsp;Psychological Lockdown Experiences: Downtime or an Unexpected Time for Being?\u0026nbsp;\u003cem\u003eFrontiers in Psychology\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e, 1159. https://doi.org/10.3389/FPSYG.2021.577089/BIBTEX\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eREDES SOCIALES Y FAMILIA EN ESPA\u0026Ntilde;A. CONSISTENCIA Y DEBILIDADES\u003c/em\u003e. (n.d.). Retrieved July 29, 2022, from https://www.redalyc.org/articulo.oa?id=161017350012\u003c/li\u003e\n \u003cli\u003eRodr\u0026iacute;guez-Larrad, A., Ma\u0026ntilde;as, A., Labayen, I., Gonz\u0026aacute;lez-Gross, M., Espin, A., Aznar, S., Serrano-S\u0026aacute;nchez, A., Vera-Garcia, F. J., Gonz\u0026aacute;lez-Lamu\u0026ntilde;o, D., Ara, I., Carrasco-P\u0026aacute;ez, L., Castro-Pi\u0026ntilde;ero, J., Carmen G\u0026oacute;mez-Cabrera, M., M\u0026aacute;rquez, S., Tur, J. A., Gusi, N., Benito, P. J., Moliner-Urdiales, D., Ruiz, J. R., \u0026hellip;\u0026nbsp;Irazusta, J. (2021). Impact of COVID-19 Confinement on Physical Activity and Sedentary Behaviour in Spanish University Students: Role of Gender. \u003cem\u003eInt. J. Environ. Res. Public Health\u003c/em\u003e, \u003cem\u003e18\u003c/em\u003e, 369. https://doi.org/10.3390/ijerph18020369\u003c/li\u003e\n \u003cli\u003eRood, L., Tanzillo, T., \u0026amp; Madsen, N. (2022). \u003cem\u003eStudent nurses\u0026rsquo; educational experiences during COVID-19: A qualitative study\u003c/em\u003e. https://doi.org/10.1016/j.nedt.2022.105562\u003c/li\u003e\n \u003cli\u003eSand\u0026iacute;n, B., Valiente, R. M., Garc\u0026iacute;a-Escalera, J., \u0026amp; Chorot, P. (2020). Impacto psicol\u0026oacute;gico de la pandemia de COVID-19: Efectos negativos y positivos en poblaci\u0026oacute;n espa\u0026ntilde;ola asociados al periodo de confinamiento nacional. \u003cem\u003eRevista de Psicopatolog\u0026iacute;a y Psicolog\u0026iacute;a Cl\u0026iacute;nica\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(1), 1\u0026ndash;22. https://doi.org/10.5944/RPPC.27569\u003c/li\u003e\n \u003cli\u003eShamay-Tsoory, S. G., \u0026amp; Eisenberger, N. I. (2021). Getting in touch: A neural model of comforting touch. \u003cem\u003eNeuroscience and Biobehavioral Reviews\u003c/em\u003e, \u003cem\u003e130\u003c/em\u003e, 263\u0026ndash;273. https://doi.org/10.1016/J.NEUBIOREV.2021.08.030\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eSpain: WHO Coronavirus Disease (COVID-19) Dashboard With Vaccination Data | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data\u003c/em\u003e. (n.d.). Retrieved July 25, 2022, from https://covid19.who.int/region/euro/country/es\u003c/li\u003e\n \u003cli\u003eTrani, M. di, Tanzilli, A., Candidi, M., Esteves, J. E., Mcparlin, Z., Cerritelli, F., \u0026amp; Friston, K. J. (2022). Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony.\u0026nbsp;\u003cem\u003eHYPOTHESIS AND THEORY\u003c/em\u003e, 17. https://doi.org/10.3389/fpsyg.2022.783694\u003c/li\u003e\n \u003cli\u003eV\u0026aacute;squez, G., Urtecho-Osorto, \u0026Oacute;. R., Ag\u0026uuml;ero-Flores, M., D\u0026iacute;az-Mart\u0026iacute;nez, M. J., Paguada, R. M., Varela, M. A., Landa-Blanco, M., \u0026amp; Echenique, Y. (2020). Mental health, confinement, and coronavirus concerns: a qualitative study. \u003cem\u003eRevista Interamericana de Psicolog\u0026iacute;a/Interamerican Journal of Psychology\u003c/em\u003e, \u003cem\u003e54\u003c/em\u003e(2), e1333\u0026ndash;e1333. https://doi.org/10.30849/RIPIJP.V54I2.1333\u003c/li\u003e\n \u003cli\u003evon Mohr, M., Kirsch, L. P., \u0026amp; Fotopoulou, A. (n.d.). \u003cem\u003eThe soothing function of touch: affective touch reduces feelings of social exclusion\u003c/em\u003e. https://doi.org/10.1038/s41598-017-13355-7\u003c/li\u003e\n \u003cli\u003eWang, J., Bu, L., Li, Y., Song, J., \u0026amp; Li, N. (2021). The mediating effect of academic engagement between psychological capital and academic burnout among nursing students during the COVID-19 pandemic: A cross-sectional study. \u003cem\u003eNurse Education Today\u003c/em\u003e, \u003cem\u003e102\u003c/em\u003e, 104938. https://doi.org/10.1016/J.NEDT.2021.104938\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eWHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data\u003c/em\u003e. (n.d.). Retrieved July 29, 2022, from https://covid19.who.int/\u003c/li\u003e\n \u003cli\u003eWorden, J. W. (n.d.).\u0026nbsp;\u003cem\u003eEL TRATAMIENTO DEL DUELO: Asesoramiento psicol\u0026oacute;gico y terapia\u003c/em\u003e.\u003c/li\u003e\n \u003cli\u003eZhang, J., \u0026amp; Zheng, Y. (2017). \u003cem\u003eHow do academic stress and leisure activities influence college students\u0026rsquo; emotional well-being? A daily diary investigation\u003c/em\u003e. https://doi.org/10.1016/j.adolescence.2017.08.003\u003c/li\u003e\n \u003cli\u003eZins, A. H., \u0026amp; Ponocny, I. (2022). On the importance of leisure travel for psychosocial wellbeing.\u0026nbsp;\u003cem\u003eAnnals of Tourism Research\u003c/em\u003e, \u003cem\u003e93\u003c/em\u003e. https://doi.org/10.1016/J.ANNALS.2022.103378\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Grief, COVID-19, Students, Physical therapy specialty, Education, Universities","lastPublishedDoi":"10.21203/rs.3.rs-4041991/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4041991/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground \u003c/strong\u003eDuring the COVID 19 Pandemic situation, young people experienced numerous personal losses in many aspects, which impacted their quality of life.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e To explore and analyse the losses in physiotherapy students during the first year of the COVID-19 pandemic.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA qualitative phenomenological study was carried out using an open format exercise carried out during the Clinical Specialties class from February-May 2021. Thirty-four (83% female) third-year physical therapy students participated. ATLAS.ti software was used for the analysis and coding of the data by three researchers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e After the analysis of the categories, different losses by the participants were found: losses in psychological well-being, losses in physical health, losses in the social sphere (friendships, partners and family relationships, as well as deaths) and spiritual losses (loss of freedom and identity), losses in leisure time (travel, recreational activities and physical exercise) and different losses related to university studies (motivation and enthusiasm and clinical practices).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The COVID-19 pandemic has generated losses worldwide in physiotherapy students, with losses in the social sphere being the most expressed. The present study can be used to generate resources that improve the well-being of physiotherapy students, both for optimal academic performance and greater self-care, and reduce psychosocial problems.\u003c/p\u003e","manuscriptTitle":"Analysis of Losses in Physiotherapy Students During the Covid-19 Pandemic: a Phenomenological Approach.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-29 15:05:52","doi":"10.21203/rs.3.rs-4041991/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-04-23T10:07:15+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-04-23T08:22:23+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-04-22T08:45:22+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2024-03-08T10:32:51+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fe1fdb79-4510-40d7-9e88-06c22f44b653","owner":[],"postedDate":"April 29th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-06-10T11:44:12+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-29 15:05:52","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4041991","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4041991","identity":"rs-4041991","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}