**2. Literature review**

#### **2.1 Quality of life and well-being in care workers**

Care is a fundamental activity for a society that affects the well-being of all and, in particular, of populations that require greater support. Although caregiving tasks represent a substantial physical and emotional burden for those who perform them, these responsibilities have not been recognized as a social need. They are usually carried out through the donation of time and energy by caregivers [9]. Likewise, people who provide care services have negative working conditions, with low salaries and limited recognition of the social value of such work [10].

Due to the disease generated by the SARS-CoV-2 virus, the precarious conditions associated with care work were even more stressed. The situations of stress, uncertainty, and permanent confinement [11] affected care workers who have faced more demanding confinement and isolation to take care of themselves and those they have to care for [12]. Hence, it is possible to assume that care workers have seen their wellbeing more affected by the pandemic than other populations for various reasons.

In the first place, the literature confirms that in conditions of regularity, those who care, especially women, have lower levels of well-being compared to different populations analyzed. It has been established that, compared to the general population, caregivers experience lower levels of self-reported health and psychological well-being while reporting a greater number of days with poor physical or mental health [13].

On the other hand, a second factor that allows understanding the decrease in caregivers' well-being, especially women again, is the situation experienced by formal caregivers who perform domestic work. The evidence shows how there would be a relationship between being a caregiver and playing other social roles with having a lower level of well-being and satisfaction with life, especially when playing the role of head of household [14, 15]. This statement becomes especially relevant when we analyze that domestic task also became tense and increased due to the crisis of care generated due to the pandemic [16].

#### *The Effect of COVID-19 on the Quality of Life of Care Workers: Challenges for Social Services… DOI: http://dx.doi.org/10.5772/intechopen.105603*

Thus, it is also possible to estimate higher levels of affectation on quality of life among caregivers based on their living conditions, such as family support, stress, frustration, and economic difficulties, which impact emotional difficulties and high levels of overload [17]. The negative effect of care work would not necessarily be given by care but is configured when other relevant factors appear, such as a high workload and not having the support of another person to perform these functions [18]. All factors have been emphasized during the socio-health crisis [11].

Finally, another way of entering to project the effect of COVID on the well-being of caregivers is by considering the relationship they establish with the people who receive care. This becomes especially relevant in caregivers who exercise their functions toward vulnerable populations, such as people with different types of disease, people with disabilities, and older people. For example, those who care for autistic children experience a deterioration due to the deterioration of daily skills of those who receive care, children's emotional and behavioral difficulties, the population's high educational level, and a low-income level of the population median [19]. In the same vein, caregivers who assist people who have suffered strokes present feelings of loss of life that once was, the daily workload, the creation of a new normal, and the interaction with health care providers [20].

In conclusion, evidence suggests that it is possible to project the effect of COVID-19 and the health crisis on carers' well-being and quality of life. Now, to advance the understanding of the phenomenon, it is relevant to analyze the level of affectation of COVID-19 on the well-being of different populations.

#### **2.2 The effect of COVID-19 on quality of life**

Due to the effect of the COVID-19 pandemic on people's routines globally and, therefore, on people's quality of life, different studies were quickly carried out that allowed us to know and measure the impact of the disease on people's lives. Although no measurements have been reported in people who care, different adult populations have been analyzed to understand a problem in full development.

A measure used globally to observe the effect of the pandemic on people's wellbeing and quality of life has been the COV19-QoL scale [21], which measures the effect of the pandemic on people's quality of life and was developed a few months after COVID-19 was declared a pandemic. Hence, the different results it has had in different populations worldwide are presented.

One of the first studies reported describes the application of the measure in Filipino teachers. It was found a significant difference in the impact of COVID-19 on the quality of life according to the degree program of the people, but not according to age, sex, marital status, employment status, monthly salary, presence of a case of COVID-19 near their residence, personal knowledge of someone who was infected or died of COVID-19, presence of a medical condition, and perceived threat [22].

On the other hand, a second study in the Philippines, but this time applied to nursing students, showed that the COVID-19 pandemic had a moderate impact on the quality of life of nursing students and that the effect varied significantly depending on sex and the close presence of COVID-19 cases. The study also revealed a significant moderate inverse relationship between psychological resilience and the impact of COVID-19 on quality of life [23].

The same scale was implemented in a study applied to populations from different parts of the world. In this case, Khodami and his colleagues [24] analyzed changes in quality of life and psychological changes due to the pandemic in 3002 people

worldwide. The results showed that quality of life decreases significantly over time, perceived stress increases significantly, and the regulation of emotions is problematic.

To these cases is added the study of the impact on the quality of life in Saudi Arabia. In this country, Islam and Alharthi [25] examined the effects of the pandemic on the quality of life in 506 households in Saudi Arabia. The results show that the quality of life of households was significantly reduced due to the COVID-19. At the same time, negative quality of life was related to low-income households, large households, male-headed households, urban households, households with unemployed or low-educated heads, and households with the elderly.

A group of researchers in Singapore [26] sought to determine the impact of COVID-19 stress syndrome on quality of life and gratitude in Singapore. A sample of 199 people confirmed that fear of foreigners spreading SARS-CoV2 was the most stressful fear among Singaporeans, while traumatic stress from COVID-19 was the least stressful fear. Similarly, COVID-19 stress syndrome was positively correlated with negative quality of life and negatively correlated with gratitude.

The same scale used in the previous studies was used in mental health patients in Serbia. Considering a sample of 251 patients, the research led by Maric et al. [27] confirmed that the effect of the pandemic on quality of life was above the theoretical mean of a 5-point scale. On the other hand, no association was found between the total VOC19-QoL score, demographic characteristics, and patient diagnoses.

Finally, the study by Bolatov et al. [28] aimed to investigate the influence of psychological well-being and different study formats on the academic motivation of medical students during the pandemic. The study concluded that the effect of COVID-19 quality of life on academic motivation was minimal.

In conclusion, based on these various studies, it is possible to establish that the affectation of quality of life does not necessarily depend on some demographic aspect, but eventually on external effects such as the time of experience of pandemic and traumas and stress previously experienced.

#### **2.3 The COVID-19 disease in Chile**

Recognizing that the COVID-19 pandemic is a global phenomenon, it is necessary to recognize that the crisis is shaped in a particular way in different social, political, and economic contexts. Specifically, in the Chilean case, the same month in which the WHO declared COVID-19 as a pandemic, in March 2020, Chile reported its first case [29], and like other countries in South America, the cases began to rise rapidly.

However, in the case of Chile, the health crisis that has had political, social, and economic repercussions has occurred in parallel with a social, economic, and political crisis that became evident months before the appearance of the disease caused by the SARS CoV-2 virus.

On October 18, 2019, Chile witnessed a "social explosion." This was characterized by massive marches in the country's main cities that had as their center the historical, social demands associated with an unacceptable level of inequality in a context of neoliberal policies that marked individualism and the lack of social cohesion [30]. This search for social transformations was not without its difficulties. The large mobilizations were accompanied by the use of violence by demonstrators and the police [31], causing looting, fires, and the vandalization of emblematic sites and spaces [32], which in turn had an impact on the mental health of the population [31].

*The Effect of COVID-19 on the Quality of Life of Care Workers: Challenges for Social Services… DOI: http://dx.doi.org/10.5772/intechopen.105603*

Thus, in October 2019, the country was immersed in the most relevant social and political crisis of the last 40 years, and months later, the Chile faced one of the most significant health crises in its history, which severely exacerbated the above in economic terms.

In this scenario, the demand for assistance for workers in the so-called psychosocial area had to face new scenarios and challenges in a context of precarious work [33]. Thus, these workers, not only in Chile, had consequences and implications for their mental health [34]. On the other hand, the neoliberal policies on social welfare implemented in Chile during the Pinochet dictatorship [35] have exposed the necessary coordination between chiefs and frontline workers, stressing the work with budget cuts, demands for results, and other matters in terms of efficiency [36]. In addition, the institutional support to have sufficient resources—internet for the home, adequate mobile phones, computers—for a quality social intervention were not present [33].

Demands in Chile for greater social care were characterized by increased poverty, overcrowding, and precarious settlements, leading to an increase in infections [33]. Individuals and families experienced fragility and uncertainty, and professionals in care industries inhabit the same contradictions: social distancing policies include mandatory quarantines, periods of isolation and fear of getting sick, suspension of productive activity or radical changes, loss of income, and fear of the future [37].
