During the last decade, social media has permeated most parts of society. Adolescents are particularly active users of social media, and their use has been suggested as a contributing factor to mental health issues in this group. Quantitative studies have found associations between the frequency and/or duration of social media use and more mental health issues. However, most studies are cross-sectional and the identified associations are weak and of questionable practical significance. The aim of this study was to investigate adolescents’ lived experiences of using social media, focusing on both negative and positive aspects, using a qualitative approach. Qualitative research enables in-depth explorations of the experiences of individuals, nuance quantitative findings, and offer the perspective of adolescents into policies regarding social media use.Experiences and perspectives of 27 adolescents from two senior high schools in Norway were gathered using focus group interviews . The data were analysed using thematic analysis.According to the participants, social media use catalyse changes to how people communicate and relate to each other (theme 1). Some changes were positive, in terms of facilitating social connectedness, while others were negative, such as people behaving worse than in face-to-face interactions. Further, social media use affected the participants at the individual level (theme 2); positively in terms of a sense of belonging and social support, and negatively in terms of perceived stress, body pressure, and displacing other activities such as sleep and homework. The motivations for using, or not using, social media were multifaceted (theme 3), reflecting the positive and negative aspects of social media in terms of interpersonal and personal consequences.Social media was described as an important part of the participants’ everyday life, with both a positive and negative impact on their mental health and well-being. Considering the compelling nature of social media and adolescents’ relatively limited self-regulatory capacities, efforts to modify social media use should avoid relying on self-regulation, while also recognizing the importance of social media as an arena for peer interaction.The online version contains supplementary material available at 10.1186/s40359-021-00582-x. During the last decade, social media has become embedded in most parts of society. Using the definition by Kietzmann and colleagues , p. 1, sDuring the last decade, increases in mental health problems such as anxiety and depression, and threats to mental health such as loneliness, have been reported among adolescents –9. The wAs a relatively new phenomenon, the relationship between social media use and mental health has, however, not been extensively studied, and the quality of published studies are in general low according to a recent review . The majQualitative research enables in-depth explorations of the experiences of individuals , 23, andThe aim of this study was to elaborate further on the different roles of social media use in relation to mental health, in the perspective of Norwegian adolescents. We aimed to explore adolescents’ lived experiences of using social media, with a specific focus on how they view social media as facilitating and/or hindering their mental health. This knowledge can be used as a stepping stone on the way to develop guidelines for healthy social media use.The present study was an exploratory study using a focus group interview methodology –30. The Respondents were recruited from two senior high schools in Norway. Five groups from two different schools were recruited, where one school was located in the city centre while the other was located in a rural area. Both schools offered general studies and different vocational education training programs. One of the schools had an e-sport program. The number of focus groups was set a priori, as aims to reach saturation was deemed non-relevant due to the highly exploratory nature of the study . As mostA contact person at each school recruited participants to the focus groups in collaboration with the research group. The contact person knew the pupils and could thus recruit participants who would willingly participate in a group discussion and ensure a good group dynamic. Gender was regarded a dimension that could affect group dynamics and a central prerequisite for optimal homogeneity (gender as a break characteristic). Thus, two groups consisted of females only and two of males only, while one group included both males and females. The mixed gender group consisted of pupils attending the student council. One of the all-male groups included some pupils attending an e-sport educational program.Prior to conducting the interviews, the researchers had a meeting with the participants at each school to talk about the project and to build initial rapport with the groups. Subsequently, the focus groups met once, for approximately 90 min, with a ten minute break halfway through. The interviews were completed at each school, using rooms located in the administrative parts of the buildings. The rooms had no windows or open sections leading into other indoor spaces, ensuring that the discussions among the participants could not be overheard or observed by others.The interview guide was developed by the research group in collaboration with four Master-level psychologist scientist-practitioner students. The interview guide consisted of two main questions, each followed by a set of follow-up prompts that the moderator could use if necessary, as well as one opening question and two closing questions. The main questions were: 1) “In what way is social media a positive factor in your lives?” and (2) “In what way is social media a negative factor in your lives?” The interview guide was based on a template adapted on the background of preliminary results from a scoping review , as well “In whatThe project coordinator (RTH) and one researcher (GJH) facilitated the interviews, alternately acting as the moderator and the secretary for each interview. The interviews were audiotaped and then transcribed verbatim. To ease the transcription of the interviews, the secretary wrote down the first few words of each sentence and who said it. In addition, the secretary took notes about aspects of the interview that are difficult to capture on tape, such as the non-verbal communication or the social climate of the group .Two researchers (GJH and RTH) read and re-read the material, drafting ideas for potential themes.Subsequently, the researchers (GJH and RTH) independently identified relevant text and defined codes. After coding each interview, codes were compared and discussed, developing a rich reading of the data and generating meaningful codes. A third researcher (JCS) read all the material and participated in discussions about the generated codes.GJH, RTH, and JCS sorted the codes into tentative themes. A fourth researcher (VS) provided an external perspective on the themes, following which all codes were collated under these themes.GJH reviewed the themes against the coded text segments and against the transcribed interviews in full and discussed the themes in face-to-face and online meetings with JCS, RTH, VS, and MV.When a consensus about the themes was reached, the themes were defined and given final names.We used reflexive thematic analysis (TA) to explore participants’ experiences , 36. FolReflexive TA was used to define patterns of meaning across the interviews. The coding process was guided by the overarching research questions in that we coded material that was relevant for mental health, well-being, and social media. The qualitative analysis included five meetings between the coders and four meetings with the whole group.Participation in the focus groups was voluntary. All participants gave their informed consent after being informed that they could withdraw at any time, and that they could choose how actively they wanted to participate in the discussion. Care was taken during the interviews to treat their experiences with dignity and respect, and we could see no indications that participants felt pressured to participate. However, the participants were recruited in a school setting, and the teacher–pupil relationship may have influenced willingness to participate.When the interviews were transcribed, all participants’ names were replaced with fictitious names. All other identifiable information such as user names on social media or which school they attended, were replaced or omitted. The transcribed interviews were only available to those directly involved in transcription, coding, and analysis of the material. The audio files were permanently deleted following analysis.Interpersonal consequences of social mediaPersonal consequences of social mediaMotivations affecting social media useThe participants’ experiences with social media use and mental health and well-being converged under three main themes:In relation to the main themes, several subthemes were developed Table . OverallAn overview of the commonality of each theme and subtheme can be found in Table The participants discussed several ways in which social media affected communication and interaction, both positively and negatively. Three subthemes were generated: i) expanding the social world, ii) different rules apply, and iii) people behave worse on social media.The participants said that social media facilitated their social lives by allowing them to communicate easier, maintain friendships, and also make new friends. Social networks were visible, and thus “everyone knew everyone” and going from that to being friends was easy: “Yes, I feel that it is much easier to get to know people. It’s like, you see that the people you are following are following someone, and then, like, everyone sort of knows each other” (Participant ID: FG3-M6). Further, social media facilitated group cohesion, for example within their class at school, by allowing multiple people to communicate continuously. One participant described how social media made him notice or pay more attention to his classmates. In a way, peoples’ social media profiles made them turn up on each other’s “social radar”.I feel that even though [social media] enables more contact with friends and give me more friends, I also feel that, really, I have lost many friends. Because I feel that many of the friendships I have aren’t real friendships (FG1-F2).Second, social media made them accessible to a wider range of people, including strangers. Unwanted attention on social media was discussed in four of the interviews, where the participants described receiving messages and group chat invitations from strangers. They were not particularly bothered by this, however, receiving sexualized content made them uncomfortable: “Nudes… people send you, like… A picture of their penis… I did not need to see that, I did not want to see that” (FG3-M5).This boost in social exchanges also had some downsides. Firstly, the participants talked about how many friendships on social media were superficial, and that they preferred face-to-face interactions. Some pruned their online network, deleting people that they did not see as real friends. One participant exemplified this side of social media:I feel that, I don’t how it was before, but that it is easier to get to know people. There are, like, different rules on social media than in real life. More is accepted. So it is easier, in a way, to make contact with new people, or you can say other things, I feel, on social media (FG1-F2).Conversely, online communications also had a downside, where communication was easily misinterpreted, as facial expressions, body language, and the tone of voice were largely missing. Beyond direct communication, actions or inactions on social media could be (mis)interpreted as social signals, and certain “norms” or rules of behaviour had to be followed. For example, failing to like and/or comment on a friend’s picture could be interpreted as a sign that something was wrong:Yes, the pictures were nice, but you don’t always have to comment on every single one. But still, you feel like you need to, because…otherwise it may be like: “Oh, she didn’t comment on my picture!” It may be interpreted negatively (FG2-F3).Some of the females discussed how they sometimes forgot to add someone to their private story, and worried that they had hurt someone unintentionally. Generally, both males and females agreed that the girls cared more and attached more meaning to social media than boys.Some of the participants described that a different set of communicative rules applied to social media, where the threshold for making contact was lower than in real life. Online communication was described as easy, informal, and less intrusive, compared to getting to know people outside social media:That is perhaps the worst thing about social media, that people may be anonymous. They don’t feel that their behaviour have consequences for them, but… then they may post a nasty comment on a picture posted by a 13 year old girl and her self-esteem takes a hit. And then… They just think like “OK, it’s funny, I’ll just post a comment, she doesn’t know who I am.” And then it goes to hell for her (FG5-M1).Negative and unwanted events on social media, actual or hypothesized, were thematised in all interviews. These events included backbiting, bullying, nasty comments, and threats to share content against one’s will.The nature of social media was described as having some unfortunate effects on how people behave towards one another. On social media, people could be anonymous or feel anonymous, and according to the participants, it was easier to be mean because there were no real consequences of their behaviour, or because you did not see the emotional reaction of the other person:Related to this, the girls in one interview expressed frustration about how the content people post on social media is freely discussed and criticized, where the social media profiles of celebrities and others are flooded with negative comments on their appearances: “It’s interesting that people bother to spend their time putting others down. Why would you, if you don’t care about that person, why would you spend your time commenting that you don’t think that person looks good in her picture?” (FG4-F2).During the interviews, the participants discussed how social media use had impacted them personally in both positive and negative ways. Five subthemes were developed: (i) there are pros and cons of being connected, (ii) social hierarchies are on display, (iii) upward social comparison, (iv) the visibility and permanency of content, and (v) use on the expense of other things.Social media was highly valued by the participants due to the possibility to effortlessly and continuously communicate with friends. Many highlighted that social media allowed them to stay in touch with friends and family living far away, making them “feel closer, even though they are on the other side of the world” (FG1-F2). In addition, social media provided a sense of connectedness with a wider community and gain insight into issues around the world.“I am in many different groups [on social media] with different groups of friends. And then, if one of my best mates see that I am in a group, and he’s sitting there and asks: “Hey, what is that? Why am I not in that group?” So, you can feel excluded” (FG3-M3)The opportunity provided by social media to keep up with what their friends were doing was both valued and came with some unwanted consequences. It provided a feeling of “having control” of what was going on among their peers, but keeping up with everything happening on social media was also stressful. Several mentioned the constant stream of notifications as annoying and overwhelming: “Yes, you are often overwhelmed by everything. So it only leads to stress, more stress in your everyday life.” (FG2-F4).Social media was further seen as positive in the sense that it allowed them to seek social support from friends, and that it was a means to express themselves and being heard/seen by others. Getting attention in terms of likes and comments, or being included in someone’s story, made them feel good. Conversely, the participants described how not being included in someone’s story or in a group chat made people feel excluded:FG1-F1: It’s that thing, that you feel that you should attend everything all the time.FG1-F2: Yes, that you should join… Yes, I think social media contributes a lot to me feeling that I should do something every weekend.FG1-M2: Yes.FG1-F2: If it is a Friday or Saturday and I don’t have any plans, and it would have been wise and probably very cosy to relax at home with my family, and yeah, eat snacks and watch a movie. But I feel that I can’t. Because then I will just have a bad time, because I will see that everyone else is out having fun, and I’m just at home and… Still, they only post stuff when they are out. It seems like they are out every weekend, but it just that I have so many people on Snapchat. And when people share that they are out, it feels like everyone is.Further, watching friends’ posts on social media of having fun without them, could make them feel unwanted or excluded. Also, it could trigger a feeling of missing out that drove them to attend social gatherings and parties despite having plans of relaxing at home, exemplified in the following dialogue:And about private stories, I feel many people, sometimes they see like “my friend can see my other friend’s private story, but I can’t”. That does something to your mental health. And “why did she not add me to her story, she is included in my private story”, and it becomes like… (FG2-F5)The participants described how the number of likes and comments people received and the number of friends/followers they had, quantified popularity and social status, which was tiresome to think about. Participants in all focus groups talked about themselves or others being preoccupied with comments and likes, where the lack of comments or likes triggered negative thoughts about how others perceived them.Another aspect of social media that impacted the participants negatively was the visibility of social relationships and social status on social media. Who were friends or not, who were allowed to see someone’s private story, etc., was readily visible and carried important meanings about the nature of peoples’ relationships:But it’s not true. Every single one of those models have edited their photos. No one really looks like that. It is not true. Their skin is not that flawless, their bodies aren’t that perfect. And then you get ideas in your head that others are perfect and pretty, “I should look like that”. And then you get afraid and unsecure about yourself. Even though what you see is not real. But you choose to believe it. And that leads to poor health.” (FG4-F4).Digitally altered images impacted not only peoples’ view of themselves, according to the females in one group, but also created unrealistic expectations among boys about what girls should look like. The widespread use of filters that augmented people’s facial features made some of the girls feel unsecure about their looks. They explained how the filters made them aware of their flaws and how much prettier they could have been if they looked more like how the filters made them look .The participants in all five groups talked about how comparing oneself to people on social media could trigger negative thoughts and feelings, and eventually lead to poor health. They described how people tended to portray themselves on social media in a positive way, thus creating a “positive bias” where everyone told a one-sided story of how successful and pretty they were and how many friends and fun experiences they had. They described how even though they knew that what was posted on social media was only one side of the story, it was hard to not compare one’s own life and appearance to it. This pertained both to peers and to celebrities. Some of the females suggested that it should be mandatory to tag pictures that had been digitally altered (“photo-shopped”), in order to reduce insecurity among young people.Snap Map). Being visible on social media made them change their behaviour, or at least think about how their behaviour appeared on social media:Since I have Snap Map, then I can think like; I am afraid that people might see that I am at home, almost. You think about it. “What if people see that I am at home all the time? Should I go to the gym, so that people see…?” You can almost start like that (FG1-F2).On a similar note, the participants in three of the interviews described how easily photos could spread among peers and how people should be careful with sharing photos with others. Photos that they shared in confidence with one person could be distributed to other people without their consent or knowledge:They don’t say it directly, that “I have a photo of you, I’m going to send it to that and that person.” But you know. You have it in the back of your mind when you think about it. “Oh, shit. I sent that photo. Now he or she has it. They may share it whenever they want to”, like (FG4-F3).Further, the participants expressed worry that content they have posted never disappears and may harm them in the future. One participant stressed the necessity of using multiple user names so that what you do on social media would not be associated with you in real life.The participants addressed some issues related to online communication or other online behaviours being visible and often permanent. Several participants talked about a specific feature of social media where the locations of your friends are visible in a map .Several of the participants worried that their use of social media had some negative consequences for their personal development. Specifically, they talked about how they did not learn how to be bored or to get to know themselves because they always turned to social media when they had nothing to do: “I think that it’s very positive for your mental health to explore your thoughts and figure out who you are and stuff like that. And that is something that you lose [because of social media].” (FG1-F5) They described how they did not challenge themselves because they used social media as a sanctuary or protection if they found themselves in challenging social situations . For example, some mentioned that they picked up their phone instead of keeping conversations going and that social media use impaired their social skills.Finally, many of the participants thought that they spent too much time on social media. The time and energy spent on social media displaced other important activities, such as doing homework or getting enough sleep:Despite the negative effects discussed by the participants, they seemed highly motivated to use social media. Consequently, the participants gave the impression of being torn between the desire and perceived necessity to use social media and the negative consequences they experienced from it. Five subthemes were generated: (i) an unmissable social arena, (ii) self-presentation and impression management, (iii) from fun to addiction, (iv) a way to dodge what is difficult, and (v) awareness and regulation of own use.I think I would have become very stressed [without social media]. And that is because I think I’m afraid of the feeling of being left out. I would have felt like… it’s like if your friends went to hang out and you were left behind (FG1-F2).In addition to this drive or desire to use social media, the participants described peer pressure to reply and provide likes and comments on friends’ content, or to reciprocate messages they received :If my friend has posted a picture of herself, I feel that I have to comment on it, just because… it’s mandatory. But it’s not. I don’t know, it’s weird. It’s just the way it is, a culture that has evolved… (FG1-F1).From the interviews, it was clear that one of the main motivations for using social media was to stay connected to and socialize with friends. As social media constituted such an important social arena, many of the participants expressed a necessity of using social media to keep up socially. Several participants described a fear of, and experiences with, missing out on what was happening among friends on social media. The participants stressed that there was no split between social media and real life and that if they missed out on things happening on social media, then they had missed “half the conversation”:A second important motivation for using social media was self-presentation. On social media, they could decide how they wanted others to perceive them, and their self-presentation was partly guided by social norms of what was considered cool among peers and showing others that they had an exciting life. Some of the females described it as a competition, where they deliberately posted pictures at times when people were most active, to get more feedback . Although the feedback they received on social media could produce positive feelings, they regarded it as unhealthy to care too much about it. Many expressed a desire to care less, but that it was hard to resist. As one participant put it: “But, it takes, I feel, quite a lot, psychologically, to resist the Instagram-pressure. You, sort of, you want to have a nice feed, you want many likes, and of course you want a lot of comments.” (FG2-F1) Others expressed that they rarely posted pictures on social media and that they cared little about how many likes or comments they received.Most of the participants described social media as a source of entertainment and fun, and some described how they found creative inspiration on social media. In addition, they talked about their phone and social media as an easy escape from boredom, and that they had a habit of picking up their phone when they had nothing to do.Many also described themselves and their peers as being addicted to social media. They described some features of their social media behaviour that resembled addictive behaviour, for example that there was something satisfying about using social media, that time went fast while using social media, and that they often spent more time than they intended: “Only you can decide when to stop [scrolling on social media], but not quite. It’s kind of your brain that decides and it becomes an addiction, or, it is natural to become addicted.” Others, in contrast, had no trouble leaving their phone behind and forgetting about social media for hours.I think many people feel that it is easier to send a text message rather than saying things out loud, face-to-face. That it is easier to send it over the phone, because then the person receiving the text message can’t see how you react (FG4-F2).The participants discussed how they actively used their phone/social media to distract themselves from negative thoughts and feelings, and to escape awkward or uncomfortable social situations. It was also easier to talk about difficult things through social media because it became more distanced and less personal, and they could also take time to think about what they wanted to reply:I don’t know, if I’m having a good day then I usually don’t use my phone at all. Then I’m in such a good mood that I don’t need attention from anyone. I just sit and have a good time and just watch a really good movie and eat junk food. Just be pleased with that day, sort of. And then I forget my phone, forget social media, forget Snapchat, and just don’t answer and people will have to call me (FG4-F4).One participant explained how he could be more vulnerable to social comparison if he had a bad day.The participants expressed a high level of awareness and reflection about their own use of social media. The participants described how they were less socially active on social media if they were having a bad day, and that they then would use social media mostly for entertainment. On a good day, some would be more socially active on social media, while others said they spent less time on social media when they are having fun.I have put it behind me now. Because I’m thinking, does it matter? They’re not real. But before it was like: “Oh, they’re so pretty and skinny, blah, blah.” And then I let myself be affected and my health was affected, or I put myself down (FG4-F4).Several expressed the importance of being able to put away their phone, for example when doing homework. Many of the participants expressed a desire to use social media less, and several told about positive experiences while not having access to social media, typically when on vacation:FG2-F1: Then it was nice to have, like, a week of relaxation. Like a… yes, cell phone rehab.Moderator: What was nice about that, not having…FG2-F1: Well, you didn’t have to write, like write text messages to anyone or, you sort of had an excuse not to be online. If that makes sense. You relax more, like, I was much more relaxed, and like, I could, rather than spending time on Instagram, I could talk to my family. Something that happens rarely in my everyday life. I enjoyed that very much.Many of the participants took specific actions to regulate their use of social media, such as muting their phone and disabling notifications. The participants stressed how the algorithms of social media were designed to encourage more use.The participants talked about how they had become more relaxed about social media as they aged. At a younger age, they were more affected in terms of body image, social comparison, or negative comments, and had grown more robust based on their own experiences.FG5-M3: There is a lot of positive sides to social media as well. But teachers and parents often bring up the negative sides. “You spend too much time on it” and “can you please put it away now?” and “social media is negative for your mental health”. That is what we are told by parents and other grown-ups.Moderator: What do you think of that?FG5-M3: It’s a bit annoying. Many of them haven’t really familiarized themselves with social media, they don’t know what we do in our world, on social media and stuff.Similarly, the males in one of the focus groups talked about how parents were disinterested in gaming and how they wished their parents were more engaged.In three of the interviews, the participants expressed the need for more relevant information about the negative effects of social media. They pointed out that children and adolescents need rules regarding social media use, and that when they start using social media, it is hard to stop. Conversely, some of the participants thought that grown-ups had a very negative view of social media, and that social media use was seen as more problematic than it was:In this study, 27 adolescents gave their perspectives on the relationship between social media use and mental health. Three main themes were developed, offering an in-depth account of the issues that were discussed in the focus group interviews. Figure The present findings show that adolescents consider social media to have a range of negative influences on their mental health and well-being. In line with another qualitative study , the parAnonymity is a well-established facilitator of negative online behaviour , 44, whibe in public without always being public” reported in other research [According to Marwick and Boyd , adolescresearch , p. 1052research . AlthougDespite recognizing a range of ways social media affected them negatively, the participants were highly motivated to use them. Our subtheme “An unmissable social arena” captures the importance of social media as an arena for peer interaction, which arguably is the main reason adolescents use social media. The need to be a part of the online community has also been found in other qualitative studies , 27. TheOne important finding was the desire to use social media less, captured under the theme “Motivations affecting social media use”. Several participants described periods without internet access as liberating. Not having internet access was perceived as an excuse to not respond on social media, escaping the expectation of reciprocity and constant availability. They did not, however, manage to maintain abstinence when they returned to their everyday life. In fact, many of the participants described themselves and their peers as addicted to social media, which has also emerged in other qualitative studies . A few oThe present results highlight that adolescents depend on social media as a source of peer interaction. Thus, any interventions or guidelines regarding social media use among adolescents need to take this into consideration in order to avoid hampering their social lives.Conversely, the participants discussed a range of negative consequences of social media, and expressed a desire to reduce their social media use. Thus, social media should not plainly be accepted as something that “is here to stay”. Rather, users should actively consider how they want to utilize the positive aspects of social media and limit the negative consequences. And in theory, it is fully possible to regulate the level of engagement with social media. From this study, however, it was clear that adolescents are highly motivated to use social media despite recognizing that social media have several negative effects on them. Thus, protecting children and adolescents from the potential harmful effects of social media, while utilizing the positive aspects, should be a task for parents, teachers, policymakers, and scientists now and in the future. Responsibility also lie with the providers of social media platforms, and some have highlighted providers’ unwillingness or inability to effectively account for children’s heightened vulnerability on social media , 58. In Adolescents now face some specific challenges that were not faced by previous generations. Specifically, as much of their social lives and their self-expression happen online, their behaviour may become permanent and retrievable, which may cause worry and embarrassment. Another challenge is to be productive and focused while having access to their mobile phones , 61, whiThe results of the present study should be interpreted in light of the specific context of Norwegian adolescents. With this limitation in mind, the participants can be argued to represent a diverse subset of adolescents as they attended two different schools  and different educational programs, including general studies, vocational training programs, and an e-sport program. Considering the widespread use of social media among adolescents, the participants may be considered highly competent on the subject of interest.Qualitative research can contribute to develop knowledge and lead us to think differently about subjects where knowledge is weak or lacking . Focus gAnother important limitation is that this study is based on self-reported experiences, and future studies also need to investigate what adolescents actually do on social media, and how this behaviour is related to mental health and well-being. This may for example be achieved by sampling moment-to-moment behaviour and emotional states.It is important to consider how the background of the analytic team might have influenced the results, i.e., the interpretative validity of the study . The resIn conclusion, this study shows that the adolescents had a range of negative perceptions about, attitudes towards, and experiences with social media. At the same time, they were highly motivated to use social media by aspects they experienced as positive. The adolescents struggled to balance social media and real life, expressing a desire to be less preoccupied with social media. Considering the compelling nature of social media and adolescents’ relatively limited self-regulatory capacities, efforts to regulate social media use should avoid relying on self-regulation, and rather draw on parents, teachers, policy makers, and social media providers, while also recognizing the importance of social media as an arena for peer interaction. The present study shows that social media use is multifaceted, driven by a range of motivational factors, and is highly varied across individuals, and thus that broad generalizations about social media are unlikely to be helpful. The results also hints about gender differences. The findings may inform future studies and provide adolescent’s perspectives into interventions and policies.Additional file 1: The interview guide


The purpose of this qualitative study is to provide an in-depth understanding and description of the disease experiences of COVID-19 patients. The participants were 16 patients discharged from hospitals after receiving treatment for COVID-19 in isolation. Data collection was conducted through individual in-depth interviews until data saturation, and the interviews were recorded and transcribed verbatim. Data were analyzed using Colaizzi’s phenomenological method. The participants were quarantined after their COVID-19 diagnosis was confirmed, and they experienced desperate and uncertain times during treatment. The participants expressed shock and dissatisfaction due to an excessive invasion of privacy during the quarantine process and in the quarantine system. As confirmed COVID-19 cases, the participants experienced social stigma and feelings of guilt, negative attitudes from others and society, and negative influences from social networking services and the media. The participants also experienced mental and physical difficulties due to COVID-19 symptoms. However, they rediscovered meaningful relationships through the support of their family and friends in the midst of adversity. It is necessary to provide an integrated psychosocial rehabilitation program to reduce social stigma and improve the resilience of COVID-19 patients. With the number of coronavirus disease 2019 (COVID-19) diagnoses and deaths increasing rapidly worldwide ,4. DespiIn response to the increasing number of COVID-19 patients globally, many studies have examined their physical symptoms and changes in mental conditions ,7,8,9. CSouth Korea was able to halt the massive spread of COVID-19 nationwide through conducting intensive contact tracing, implementing timely diagnosis and treatment, and promoting national physical distancing campaigns . HoweverAs phenomenological qualitative studies are conducive to examining meaning in individually perceived and interpreted experiences , such a This study used a qualitative phenomenological design. A phenomenological study is a form of qualitative research, with its epistemological grounds based on phenomenology, and it allows for the exploration of individuals’ lived experiences through researchers’ phenomenological reduction examine the meaning and essential structure of these experiences. Thus, we deemed this methodology to be appropriate to explore the following research question: “What are the meanings and essence of the disease experiences of COVID-19 patients?”We used purposive sampling to recruit 16 adults with a prior history of COVID-19-related hospitalization who were able to read and communicate in Korean. The research team obtained a list of COVID-19 patients who expressed willingness to participate in the study from a public official in charge at the public health center through a formal procedure with a local health and administration agency. We contacted the participants via telephone and reconfirmed their consent before enrolling them in the study. The participants were in their 20s to 70s, with nine men and seven women enrolled in the study. At the time of hospitalization, 14 were symptomatic, while 2 were asymptomatic, and the route of infection varied widely, including religious facilities, work, and relatives. The mean length of hospital stay was 34 days, and 13 had sequelae, while 3 did not .The researchers are experts in qualitative research or infection control who share a consensus on the need to explore the phenomenon of interest. The researchers have rich knowledge and understanding of the collection and analysis of qualitative data based on their experiences conducting multiple qualitative studies. To avoid their specializations from becoming a bias during the study, the researchers interacted as active listeners while collecting the data and shared and discussed their notes with each other throughout the study procedure.Individual in-depth interviews were conducted by researchers in a conference room at the public health center or hospital at the participant’s convenience and lasted approximately 1–2 h. All interviews were audio-recorded. The key interview questions were as follows: “How did you feel when you received the COVID-19 screening test and were confirmed to have COVID-19?”, “How was your experience with the disinfection procedures and hospitalization in an isolation ward after being diagnosed with COVID-19?”, and “How did COVID-19 affect you psychosocially?” The interviews began with small talk to build a rapport with each participant. Data were collected until saturation was reached, and the interview recordings were transcribed. We obtained written consent from the participants and collected general information before beginning the interviews. Data were collected between September and November 2020.Data were analyzed using the phenomenological method proposed by Colaizzi . We readThis study was approved by the institutional review board at the first researcher’s affiliated university (1040968-A-2020-014). We provided an information sheet explaining the study to the participants and obtained their written consent. Specifically, we informed the participants that the interviews would be recorded, the collected data would be coded with participant IDs to protect personal information and stored in a locked file on a computer, and they had the freedom to withdraw from the study at any time.To ensure the trustworthiness of the research, we applied the criteria for credibility, fittingness, auditability, and confirmability . To estaThis study enrolled patients from one region in South Korea who had been diagnosed with COVID-19 early in the pandemic; thus, the experiences of our participants may differ from those of patients who contracted the virus after COVID-19 disinfection measures were relatively settled.In this study, 75 significant statements, 18 themes, and 5 theme clusters emerged .Most participants took the COVID-19 screening test because they had developed a high fever. Although they took the screening test after careful contact tracing and suspicion of COVID-19, their true intention was to rule out COVID-19, as opposed to being diagnosed with it, and to stop worrying about it. While waiting for the test results, the participants felt anxious and nervous about being diagnosed with COVID-19. Even while hoping that they had not contracted the infection, they intuitively knew that they could have. Receiving the confirmation of COVID-19 infection was an unexpected disaster.“I was worried because I didn’t know whether I have confirmed COVID-19 or not. I think I’m not (COVID-19 confirmed), but I don’t know what the results will be.”(Participant 10)While living on the isolation ward, the participants had to sever all outside communication and were deprived of their freedom. The participants described the environment as being similar to confinement, jail, imprisonment, restriction, and animal pens. They were downhearted regarding the physical weakness brought on by the infection and felt lonely and scared alone on the ward. The negative-pressure wards were dry and cold, and the participants missed the fresh air and landscape of the outside world. Most significantly, all visitors were prohibited, and their cellphones were the participants’ only means of communication. Some participants also discussed the positive aspects of isolation, stating that it offered an opportunity to reflect on their lives. Most participants were admitted in the winter and discharged in the spring, and as they recalled the long hospital stay that spanned several months, they felt relieved to have survived and grateful for regaining their freedom.“I just lost my temper. I was like, this isn’t even a disease, and why are you keeping me here? Give me proof I don’t have the disease—give it to me.”(Participant 4)Aside from when the participants were treated for COVID-19 symptoms, most of the time on the ward was meaningless repetition while waiting for negative COVID-19 results and discharge, which seemed perpetual and boring. The participants felt helpless, resulting in even more stress.Some participants engaged in small activities such as laundry, exercise, reading, drawing, writing, listening to music, religious activities, and games to relieve the boredom and helplessness they felt in the ward.“I asked my dad to bring me my ukulele. So, he brought it, and I played it. Playing an instrument seemed to relieve my stress. Just the fact that I could do something in there relieved my stress and relaxed my body.”(Participant 3)The participants were grateful for the health care providers who took care of them while risking infection, and they depended on health care providers who consoled them with kind words. In particular, they felt sorry for the nurses as they watched them work tirelessly in heavy anti-contamination clothing and gear. Some participants tried to lessen nurses’ burden by doing some chores on their own, such as dumping their trash. In contrast, some participants complained about ineffective communication with health care providers and inappropriate treatment due to these providers visiting infrequently.“I think the nurses probably suffered the most. They would sweat like crazy, and you could see that their goggles were foggy from the sweat. I felt so sorry. I mean, wouldn’t they be horrified (of getting COVID-19), too? It must’ve been so terrifying, but when they come in all sweaty, they would try to only say good things and not say bad things. I think that mattered a lot.”(Participant 10)The participants were infuriated at the disinfection measures that utterly disregarded the patients themselves and their families. Once COVID-19 was confirmed, admission to a health care facility and disinfection of the patient’s residence occurred immediately, night or day. The sight of an ambulance with blaring sirens and disinfection personnel in their protective gear announced to the entire neighborhood that the participants had contracted COVID-19.“So, I went to the hospital, and people who weren’t transferred don’t know how that felt. It even rained when I was taken. They disinfected the entire house, and I went outside, and I thought about what this would look like to people in my neighborhood. It’s not like I was sick with something else. I caught an infectious disease.”(Participant 13)In particular, the disclosure of personal information and thorough contact tracing reported in the press or on social media was absolutely terrifying and a downright violation of privacy. The repercussions of disclosing information about confirmed patients were serious in the early days of the COVID-19 outbreak. One participant said that it was very embarrassing, and he likened himself to a biblical story of a woman who had committed adultery. Further, the participants were offended by the oppressive attitudes of the epidemiological investigators, who displayed mistrust and interrogated them despite the fact that they were fully cooperative with the investigation. They felt like they were being treated as convicted criminals by the police. Having to talk about places they had gone when they could not remember them well was the most difficult. As they were stripped of their personal privacy during the disinfection procedure, the participants asserted that even confirmed patients need to be protected as any other citizen would be.“My name, someone told me that my name was out everywhere. My work and department, my apartment, how many kids I have, even my son and daughter. They saw it in the news. I felt like I was being stripped naked. I felt that they were just throwing me out of this land.”(Participant 12)Disinfection measures in the early days of the COVID-19 outbreak were not firmly established, and even the relevant public officials were confused about the system. The participants were frustrated by the impractical disinfection guidelines and manuals enforced by infection management personnel with no flexibility. Due to the lack of a single epidemiological investigation facility and system, the participants had to respond to several epidemiological investigators repeatedly in each relevant facility, amid confusion and chaos, which aggravated their stress.“I got three calls, from epidemiological investigators, a public health center, and the Korea Disease Control and Prevention Agency (KDCA). It was lunch time, but I couldn’t eat. I couldn’t even eat dinner. I was taking these calls, and I talked to the point that my mouth tasted bitter. The same thing, repeatedly.”(Participant 10)The participants stated that detailed disinfection guidelines needed to be applied to specific situations. They suggested that asymptomatic and symptomatic patients should be separated, and quarantine requirements should vary according to the patient’s condition. They also mentioned the problems of epidemiological investigations that do not take the incubation period into consideration. In particular, they pinpointed the severe financial repercussions suffered by individuals and businesses due to the strictly uniform disinfection guidelines applied during the early days of the COVID-19 outbreak and stated that the criteria for business closures should be established according to the level of contact.“This isn’t right. What are they going to do by tracing you from 3–4 days before? They said that there’s a week of incubation period, and that some people even have 10 days of incubation. That’s why they’re isolating us like that for a month. For 15 days. I don’t think it’s right not to investigate earlier on and only investigate (contact tracing) for a few days.”(Participant 2)The participants wished for individualized and practical help to alleviate the stress they had experienced during the process of COVID-19 diagnosis confirmation, isolation, and the return to their normal lives after discharge. Some participants were automatically fired for missing work, and some participants took several months to return to their job even after completely recovering from the illness.“As soon as I was isolated after being diagnosed, my mom basically got fired. They told her to take a leave of absence. At first, they would say they’d call her back in a month, and then that became two months, three months. She had to keep waiting.”(Participant 3)Furthermore, the participants mentioned that there are negative social views about COVID-19 patients returning to their normal lives, even after they are completely recovered, and stated the need for the government to work toward changing social perceptions of COVID-19 survivors. While discussing the need for improved government disinfection policies, the participants also expressed gratitude for the government’s disinfection efforts, coverage of treatment costs, supply of basic necessities during quarantine, and consolation telephone calls.“Well, the public tries to avoid us. They have the wrong perception (about COVID-19 patients). The government should look at the data and at least say that it was okay thus far. Our country has more than 10,000 confirmed patients, right? All of them are knowingly or unknowingly restricted in their activities. They are Korean citizens, too.”(Participant 4)The participants mentioned that they contracted COVID-19 by accident without realizing it at the time. They did not know how they contracted the virus, and after receiving a confirmed diagnosis, they tried to pinpoint the possible source of the infection in hindsight. The participants expressed that they were unfortunate to catch COVID-19, which could affect anyone, and were frustrated for not being able to avoid it. Some participants stated that they do not blame anyone because COVID-19 is no one’s fault but that they are also victims of the infection.“You know, it (COVID-19) is something that anyone can have in their lives.”(Participant 2)The participants were constantly worried and felt guilty about their acquaintances receiving confirmed COVID-19 diagnoses and being admitted to the hospital or quarantined as well as the continued spread of the infection linked to their cases. They could not even apologize to their acquaintances.“If that person did not get infected by me, it might have been a little better. Maybe I would have had less of a burden. This burden was too heavy.”(Participant 14)In particular, the participants were stressed by the feeling that they were the sole culprit behind the financial blow to their acquaintances’ businesses or employment, separation from their families, and inconvenience caused for important family events, such as weddings. Employed individuals felt sorry to their bosses and directors for the harm they caused to their workplace. The participants hoped not to infect anyone else and felt relieved when their acquaintances tested negative.“I got cursed at, and someone said that his daughter couldn’t get married on the set date because of me. A close friend of mine couldn’t even go home or stay in a hotel, and he had to stay in his car all night for several days. And a lot of my friends stayed in a hotel, and someone checked into an inn and stayed there for several days.”(Participant 10)In high-context Korean society, the participants had difficulties in interpersonal relationships due to the negative views of others. People equated them with COVID-19 itself, calling them things such as a “virus” and “virus spreader” and calling them by their confirmed case number instead of their names in public places. Some participants were annoyed by the fact that they were treated like lepers and were hurt by the COVID-19-related jokes people made inadvertently. The participants felt betrayed as their friends avoided them and talked about them behind their backs.“There were so many people there, and there was one person who yelled 00 number seven is here, isn’t that 00 number seven? I really wanted to hide somewhere.”(Participant 10)The participants experienced the people around them being hesitant to eat, talk, or come into physical contact with them even after they were fully recovered. People were hypersensitive, avoiding riding the same elevator and raising claims unrelated to COVID-19. The negative responses from the people around them exposed the cold reality of interpersonal relationships. The participants used this as an opportunity to sort out their interpersonal network, distinguishing between people who are friendly and those who are not. Nevertheless, the participants also mentioned that they could understand the negative responses of others because COVID-19 is a first-time experience for everyone, and people do not understand it accurately.“I mean, they criticized me like crazy. Normally, they would say hi like this. It’s not like I’m a heretic or an anti-government terrorist or anything. This happened one time, and it’s been so hard on me. How can a person change like that all of a sudden?”(Participant 2)The participants also stated that it was not necessary to disclose to other people that they were indeed the rumored COVID-19 patients. Moreover, they felt dejected as they witnessed people tense up when they disclosed that they recovered from COVID-19. In particular, the participants who proactively received a screening test stated that they would not take screening tests proactively if another outbreak occurred due to their harsh experiences with COVID-19.The participants became keenly aware of how society defined them as if they were sinners. Their children were rejected from private academies, their return to work was delayed as a result of irresponsible decisions made by their companies, and they were denied new health-related insurance.The participants stated that the negative social views would likely continue until the COVID-19 pandemic is over. To them, it seems that the “scarlet letter” they have on their chest as a COVID-19 patient will never be forgotten.“We will only be forgotten after COVID-19 is eradicated. Before then, COVID-19 patients are just COVID-19 patients.”(Participant 9)Social and mass media rapidly spread distorted, unfiltered information about the participants and made them merely subjects of gossip. The participants suffered from a bombardment of cyber-bullying, and some even thought about committing suicide. They experienced firsthand the perils of social and mass media that escalate the severity of a situation through distorted information.“That is when I realized the cruelty of the press and Internet comments. From “didn’t you go to the Lotte Mall to intentionally spread the virus” to “why did you go there?” I was defined as a scumbag for intentionally spreading it. All the comments were like that in all communities, like mothers’ communities.”(Participant 10)The participants were curious about the current status of COVID-19 but did not feel brave enough to look at social media or mass media and intentionally avoided them. They turned off their cellphones, avoided watching television, and even if they did watch television, they avoided the news. However, to understand the current COVID-19 situation, some participants did not miss news programs. The reason that the participants distanced themselves from social and mass media was to manage their mental health because they feared the psychological turmoil, such as anxiety and fear, it would cause them.“I just shut myself off intentionally and disappeared from group chats.”(Participant 9)Even after recovering from the illness, returning to their homes, and reentering society, the participants were still had a victim mentality because they had been COVID-19 patients and because of the emotional injury they had suffered. They wanted to erase the fact that they had been COVID-19 patients from their memory, but it persisted as a mental scar that psychologically intimidated them. They lost confidence, still feared other people’s views, and became nervous when COVID-19 was brought up as a topic. As they experienced social phobia and anxiety symptoms, such as increased heart rate and a trembling voice, they felt pity for themselves for the dramatic changes they had undergone.“My son tells me mom, let’s go outside, but I just hated it. I was scared and thought, wouldn’t someone recognize me? Being absorbed back into society was really difficult.”(Participant 1)Further, the participants worried that they and other people would be reinfected with COVID-19. They dreaded the possibility of being quarantined and becoming the target of a social witch hunt again; thus, they always wore facemasks and practiced physical distancing.“I went to see my girlfriend a month later. The biggest problem was whether I could hold her hand and kiss her. I still worry that, what if I still have the virus and she gets infected?”(Participant 3)“I still armor myself when I go outside. I wear my mask and carry my sanitizer and wash my hands. Why? Because I’m scared because I had it once. You know they say people who have been beaten know it, you know I’m scared. So, I control myself even more.”(Participant 11)When they felt even slightly off, the participants immediately suspected reinfection with COVID-19 or were concerned about their health. Thus, the participants strictly managed their health. For example, they used personal plates when eating, strictly followed personal hygiene practices, exercised, and took health supplements.While some participants only experienced mild muscle pain for a day or two, most participants experienced typical COVID-19 symptoms, including high fever, chills, upper respiratory tract symptoms, headache, muscle pain, loss of smell and taste, hair loss, indigestion, and weakness. Some participants experienced severe symptoms, such as pneumonia and dyspnea, as well as sequelae and adverse drug reactions.“I didn’t know that hair loss was even a symptom. I was like, why is my hair falling out so much? It was like I was going through chemo. When I would tie my hair once, the floor would become all dark.”(Participant 9)The greatest topic of interest among the participants was quickly recovering from COVID-19 without any sequelae; thus, they tried various methods they learned on their own to test negative for the virus. They tried to raise their body temperature and maintain an appropriate level of humidity in the cold and dry negative-pressure ward, and they actively cooperated with their health care providers during treatment. Some participants even employed medically unfounded strategies, such as rinsing their nose with salt and brushing their teeth with hand sanitizer, in order to receive a negative COVID-19 test.“They say when you go into the negative-pressure ward, keep your body warm and don’t take a shower too often. People who used to stink and not take showers were the first ones to go [be discharged], and those who washed frequently couldn’t get out.”(Participant 11)As they were transported in the ambulance, the participants developed a fear of death for the first time in their lives, and when they were admitted to the hospital, they were overwhelmed by a fear of whether they would be able to walk out of the hospital alive. The anxiety triggered by COVID-19 symptoms progressed to thoughts about death. The participants felt they had come close to death when they experienced COVID-19 symptoms and adverse events from the treatment agents and were overwhelmed by the fear of death when they were alone or went to bed in a multi-patient ward. Their wards felt like the morgue, and they had nightmares about meeting the Angel of Death. They were also inundated with the feeling that they would spend the last moments of their lives in a hospital ward.“The moment I got in the ambulance, I thought, okay, I’m going to my deathbed. I was so sick, so I was like, okay, I’m going to die. People in the news said that you’re going to die. Oh well, let’s leave it to fate.”(Participant 14)In particular, prolonged hospital stays as a result of failure to receive a negative COVID-19 test had a mental toll on the participants. Some experienced severe depression and even considered suicide. The isolated situation itself was a painful reality they wanted to avoid, and, as a result, they refused to accept telephone calls or text messages from their family or friends and lost the will to carry on. To control their suicidal ideation, the participants took tranquilizers and antidepressants and were also placed on a watchlist by their health care providers.“By the second month, I developed a serious depression. I wanted to jump out of the window and die, and I often had this urge to jump. I was going to die (sobbing), but I couldn’t because of my poor wife. So, I endured and endured and endured (sobbing).”(Participant 11)The first thing that came to mind at the moment they were diagnosed with COVID-19 was their families; the participants could not bear the suffering their relatives had to endure just for being their family. They felt sorry for their family members as they witnessed reality abruptly stormed them, such as undergoing a screening test and being quarantined away from family once their positive diagnosis was confirmed. In particular, those who had older adults or people with underlying conditions in their family were extremely concerned and became keenly aware of this crisis.“My sister-in-law has cancer. That really killed me. I was caught and isolated the day before, and then, until her COVID-19 results came out, I was so psychologically pressured. I felt like dying every second, every minute. That time felt like billions of years.”(Participant 4)The participants were dismayed as they watched their families suffer from a harsh reality just for being their family. In particular, the negative impact on children left a large scar on their hearts. Children who had seen their parents being taken away like a felon at the time of transport were mentally shocked and had to receive therapy. In one case, a high school senior suffered a drop in their grades due to the absence of their mother during the quarantine period. Even after returning to their normal lives, children still displayed separation anxiety, always checking to make sure their parents were there.“I just shoved this and that [into a bag], and I didn’t even take my scrunchies. I just shoved everything into my bag and went. I was going out, and I turned back, and my kids were just frozen (tearing up). For my kids, their mom was just gone all of a sudden, so they have this serious trauma.”(Participant 1)Family support enabled the participants to push through the difficulty times experienced in isolation. The participants felt safe and supported, thanks to their families, who endured their emotional breakdowns, encouraged them, and remained beside them over the telephone when they were alone. One participant’s husband tried to calm her with white lies. The participants were moved by their family’s sacrifices and commitment as they tried hard to deliver necessities and food to them amid the strict no-visitor policy. As they experienced genuine love and care from their families, the participants were reminded of the value of family, and their relationships, including those with their spouses, were improved. However, some participants felt disappointed by family members who were inconsiderate of them, and some participants had conflicts with family members who had to take charge of all of the household chores and parenting during their spouse’s isolation.“My mom is 91 years old, and she would call me and ask me how I am doing. She would tell me you need to eat a lot and recover and come out. If my mom prays for me like that, then I have this hope that I can recover.”(Participant 14)The participants were grateful to their friends for consoling and understanding them. They were thankful that their friends and acquaintances comforted them through telephone calls and text messages during their isolation and welcomed them back when they returned to their normal lives. People helped the participants by giving them food, supplies, and money.“I was really thankful for that person who texted me saying not to worry because I will be fine once I get treated. Not because I received money. So, I can’t forget that in my heart, and it just makes me cry.”(Participant 6)However, the participants were also extremely worried about how their colleagues would treat them once they returned to work. They felt grateful to colleagues who simply welcomed them back and comforted them as if nothing had happened. The participants also developed bonds with other patients and became supportive of each other. They felt a sense of camaraderie with their fellow patients as they asked questions about COVID-19 symptoms, shared information, and listened to and encouraged one another through social media.“We are in the same group and feel similar things, so we can empathize with one another. When this person says one thing, we all get mad for them and share that emotion. That’s the kind of atmosphere we have.”(Participant 9)This study aims to understand the meanings and essence of the lived experiences of COVID-19 patients in one region in South Korea, from undergoing a screening test to receiving treatment in isolation and, finally, returning to their normal lives. In this study, it was confirmed that patients infected with COVID-19 suffered more from psychosocial problems than the physical problems caused by infectious diseases. Therefore, in a high-context society like South Korea, psychosocial issues beyond simply being infected with an infectious disease such as COVID-19 can be important.The participants expressed feeling continuous desperation amid uncertainty as they were diagnosed and treated for COVID-19, a novel disease, and underwent the recovery process with limited information. This was similar to the findings of Sun N. et al. , whereinThis study’s participants felt shocked and complained of being completely stripped of privacy during the disinfection process. However, studies conducted in other countries have not reported experiences related to disclosure of personal information during quarantine ,17,19,20The participants experienced social stigma for accidentally contracting COVID-19, in which they were viewed negatively and rejected by others in society. Social stigma from COVID-19 in South Korea’s high-context society was like a “scarlet letter” that could remain on their chests for the rest of their lives. Due to the novelty of the disease, high infection rate, and lack of effective treatments, people tend to attribute the responsibility of the outbreak to others ,27, and The participants mentioned the need for psychological therapy for patients and policy measures to change social perceptions. Social institutional approaches are needed to reduce social stigmatization, and, particularly, multilateral approaches are required to improve public health communication and implement promotional campaigns to improve public awareness. Furthermore, individualized psychosocial rehabilitation programs should be provided for COVID-19 patients to boost their self-esteem, confidence, and sense of belonging to improve their resilience. As social stigma has more persistent adverse psychological, emotional, and cognitive effects on individuals than physical injuries , qualitaIn contrast to past outbreaks, COVID-19 induced an infodemic , which escalated public anxiety and caused the public to put their faith in ineffective treatments and to refuse to comply with preventive measures while stirring up prejudice  and causCOVID-19 patients participating in this study felt sorry to their family members who suffered as a result of their infection, and they were grateful that their family still remained steadfast supporters regardless of such hardships. Infections such as COVID-19 impact all members of a family , so it iThus, this study is significant in that it provides in-depth data for understanding the experiences of patients who contracted COVID-19 in the early days of the pandemic, increasing awareness of the need to provide psychosocial rehabilitation to improve patient resilience and develop relevant interventions.This study presents an in-depth understanding of and describes the physical, psychological, and social problems experienced by COVID-19 patients based on their lived experiences. In particular, social stigma is a barrier to the patients’ return to their normal lives in South Korea’s high-context society. Therefore, individualized and comprehensive psychosocial rehabilitation programs should be implemented to improve these patients’ resilience. Subsequently, qualitative studies on the stigma experienced by COVID-19 patients and longitudinal studies on their resilience are needed.