Reconstruction of Meaning in Life: Meaning Made during the Pandemic of COVID-19

From the Document: This report will cover the following points: [1] Refugee arrivals by nationality and destination since the creation of the president's Coronavirus Taskforce;[2] Timeline of announcements by world health authorities and the U S government in response to Covid-19;[3] Placement of refugees in American communities: who gets to decide in which states refugees are resettled;[4] State and local say in the resettlement process, especially when state residents are asked to make important sacrifices amid a health and economic crisis;[5] Medical screening of refugees before and after resettlement: inadmissibility to the United States on health-related grounds, overseas medical examination of refugees to determine admissibility, domestic medical examination for newly arriving refugees in the United States, medical examination for adjustment of status;[6] Refugees' specific health needs;[7] Access to healthcare and benefits in the United States;and [8] Relief funds and resources available to refugees following the CARES [Coronavirus Aid, Relief, and Economic Security] Act Coronavirus Aid, Relief, and Economic Security (CARES) Act;Refugees--Government Policy;Healthcare

1 Introduction 2020 has been following a track different from the years before, as COVID-19 has made a huge impact worldwide. As for individuals, it has brought profound changes to our lives and the meaning in our lives.
China Youth Daily has found in their survey that, within their 2006 respondents, 66.5% developed good hygiene habits during the epidemic; 48.6% became more rational consumers; 42.3% claimed that they have learnt to cherish their jobs; 42% indicated that they gradually felt the significance of family and friends; 39.6% came to realize the happiness in each day of their life; 37.6% learnt to treasure the beauty of nature; 35.5% strengthened their ability to live independently, and 31.6% improved their self-learning ability and self-control ability [1].
Compared with huge losses and trauma caused by COVID-19, changes in individuals' life may seem to be insignificant. However, this incident provides us with insights on how a major traumatic event could also contain certain positive factors and have positive influences on individuals. As mentioned above, according to the survey conducted by China Youth Daily, positive changes are mainly demonstrated by changes in future pursuits and the meaning in life.
Frankl believes that the meaning in life is an individual's understanding and pursuit of a certain goal during a certain period of time. It also represents the specific meaning perceived during a specific moment [2]. According to Baumeister, the meaning in life typically refers to the sense of coherence in existence or the understanding of life [3]. It refers to the sense of mission in life, that is, the pursuit and realization of valuable goals, as well as the accompanying sense of achievement. Heintzelman et al. defined the meaning in life as the extent of an individual's own understanding of life as well as his or her future goals [4]. Many researches in psychology have found a crucial connection between the meaning in life and the regular functioning of mankind. For example, perception on the meaning in life holds a strong relationship with the individual's mental and physical health [5][6][7][8]. The meaning in life may also be an important component of happiness and personal growth [9,10]. Its absence may lead to negative results such as an increasing sense of loneliness [11], higher levels of anxiety and depression [12], helplessness and suicide [13,14]. Many studies have also found that obtaining a sense of meaning in life plays a positive role in an individual's psychological rehabilitation and growth [15][16][17].
Sources of meaning in life refers to the items which people believe would bring upon meanings to their lives [18]. A series of studies have shown that people may adjust their beliefs about the source of the meaning in life when faced with traumatic circumstances [19][20][21]. They may even develop misconceptions regarding the positive self-reinforcements in order to balance out negative emotions [22][23][24][25]. Hence, obtaining a sense of meaning in life can assist to alleviate fear and anxiety caused by loss, injury or death.
Since the meaning in life holds much importance to human kind, would an individual's understanding and perception differ towards the meaning in life as well as its sources under the pandemic of COVID-19?

Previous Studies on Sources of Meaning in China
Currently, main participants of studies on sources of meaning in life in China are university students, therefore resulting outcomes have varied. Liang et al. [26] proposed a verification analysis strategy along with other methods and measurements. Their results show that the Chinese edition of the meaning in life scale within Chinese college students (MLQ-C), had a high reliability. The Meaning in Life Questionnaire consists of two subscales: Presence of Meaning and Search for Meaning. Tan et al. [27] found 6 factors regarding the source of meaning in life amongst college students, including Purpose of Obtaining A Meaning in Life, Self-Fulfillment, Self-Dedication, Sense of Belonging and Love, Philosophy of Life, and Sense of Crisis in Meaning in Life. However, Zhang et al. [28] found 7 factors regarding the source of meaning in life amongst college students: Self-Development, Social Commitment, Interpersonal Relationship, Secular Pursuits, Experiences in Life, Civilization and Autonomy. Other research studies have also been conducted on specific social groups, such as high school students [29], medical students [30], seniors in nursing homes [31]. Meanwhile, the only research studying the general population (College students take up 29.92% of this group, while the remaining are not students) found 5 factors regarding the sources of meaning in life obtained by Chinese included Social Preoccupation, Self-Transcendence, Personal Relations, Life Enjoyment, Body and Mental Health [32].

Current Study
Although college students are an important part of the population, factors such as age and life experience have the potential to make a difference in the meaning in life. Therefore, in order to explore the source of meaning in life among Chinese population, it was necessary to expand the range of participants beyond students.
The sources of meaning in life would remain stable for a certain period of time, however this would change upon the occurrence of special situations or events. The integrated model of meaning making proposed by Park [33] suggested that everyone has both a global meaning system (which includes beliefs, goals and subjective sense of meaning or purpose etc.) and a situational meaning. When differences occur between these two meanings, tension would appear. People would then reduce these differences by meaning-making in order to regain a meaning in life and adapt to these stressors. The survey done by China Youth Daily [1] implies that in face of a significant event such as the COVID-19 pandemic, people have indeed altered their perceptions on their values of importance of life.
Hence, in face of the COVID-19 pandemic, will people relieve their inner anxiety and stress via reconstructing the meaning in life? How is this process implemented? It is important that these questions are answered in order to help people during such severe times. We conducted two studies to explore the structure of sources of meaning under the COVID-19 pandemic in China. Then compared the changes regarding the sources of meaning in life between before and during the pandemic. In study 1, we develop a modified scale regarding the sources of meaning in life. We will use the new scale to measure the source of meaning in life of Chinese people under the COVID-19. In study 2, we put the results into comparison with a sample of 2017, in order to have a clear understanding of how traumatic events affect people's meaning of life.

Study 1
The current study mainly investigates the change in sources of meaning in life among Chinese people under the COVID-19 pandemic. However, if the completed scale, measuring the source of life's meaning amongst Chinese people, is the only scale being used for re-measurement under the circumstances of COVID-19, therefore, discussion of changes can only be based on the original sources (General Meanings), and the newly constructed sources (Situational Meanings) remain unseen. Hence, the current study aims to explore the source of meaning in life held by Chinese people under the pandemic of COVID-19, we also aim to modify and perfect the meaning source scale upon the original scale.

Methods: Participants and Measures
In this study, we chose the Chinese Sources of Meaning Scale (CSMS), which has been previously developed by Zhang et al. [28]. This scale contains seven dimensions, including social commitment, civilization, appreciation of life and experiences, change and creativity, interpersonal relationships, achievements and self-development and well-being, leading up to a total of 76 indigenous items related to the meaning in life. According to previous research [32,[34][35][36][37], four dimensions including religious belief, the raising of offspring, physical and mental health and equitable treatment were supplemented to the scale due to the fact that these 4 dimensions are mentioned in the literatures, however, they were not considered in CSMS. The newly added religious belief, raising of offspring, physical and mental health, equitable treatment consist of 10, 6, 7 and 7 items respectively, mainly from Debats' questionnaire [34], personal meaning profile (PMP) [37], Cheng's questionnaire [32], the rest of these items were self-edited with reference to relevant dimensions involved in referencing literatures. All these additional factors were discussed and confirmed by the research team. We ended up with 106 items, forming the new initial scale. Responses were made on a 7-point Likert scale ranging from 1 (not true at all) to 7 (definitely true).
In March 2020, China was still highly influenced by the COVID-19 pandemic. We released the questionnaire via WeChat, QICQ and other social media platforms and received 892 valid results (participants were non-students, 363 male, 529 female with the mean age of 35.09 years old, SD = 8.556). Participants willingly participated in the survey without pay.
We randomly divided the results of the 892 questionnaires into two parts. Sample one was processed with exploratory factor analysis (participants were non-students, 172 male, 274 females with the mean age of 38.54 years old, SD = 8.819), while sample two adopted confirmatory factor analysis (participants were non-students, 191 male, 255 females with the mean age of 33.26 years, SD = 8.024).

Data Analyses and Results
Exploratory factor analysis (EFA) was conducted to examine the underlying structure of sources of meaning among the 446 Chinese participants (Sample one). The data were deemed suitable for factor analysis as the Bartlett's test of sphericity indicated that the variables were not independent, χ 2 (351) = 6601.124, p < 0.001, and with KMO = 0.91. We used principle component analysis with Oblimin rotation for factor extraction. After removing items with small loadings (<0.4) on all factors and items that loaded on multiple factors, 23 items were retained in the scale of Chinese Sources of Meaning in Life (CSMIL). We obtained six factors with eigenvalues above 1.0, which explained 67.47% of the total variance. All communities were larger than 0.50, indicating that variances in the items were adequately accounted for by the factors. The factor structure is presented in Tab. 1. To stay close to nature -0.664 To live a simple life -0.606 Carpe diem -0.795 To gain material satisfaction -0.725 To accumulate wealth -0.657 To enjoy leisure and entertainment -0.657 We named factor 1 Autonomy, factor 2 Family Responsibility, factor 3 Social Responsibility, factor 4 Religious Belief, factor 5 Minimalistic Living (e.g., To have a life that is peaceful but not boring) and factor 6 Pleasure and Wealth.
Based on the exploratory factor analysis, upon inputting sample two into a confirmatory factor analysis, the following fitting indexes were obtained: χ 2 /df = 3.74, TLI = 0.887, CFI = 0.903, RMSEA = 0.077, SRMR = 0.066. Reliability analyses indicated that the item-total correlations within each factor in CSMIL were all significant, and Cronbach's a for each subscale ranged from 0.78 (religious belief) to 0.91 (family responsibility). Therefore, the scale has good reliability and validity indicators.

Discussion
Using the EFA, we developed a new scale of Chinese Sources of Meaning in Life (CSMIL) which included 23 items. CSMIL includes 6 factors: Autonomy, Family Responsibility, Social Responsibility, Religious Beliefs, Minimalistic Living, Pleasure and Wealth. CFA and other test indicate that the reliability and validity of CSMIL have not only met the requirements of psychometrics but have also proven to have good applicability.
One of our collaborators in this study had attempted to use a consistent initial scale as adopted by this study in her 2017 study in her master thesis, in which she investigated upon 642 participants [38]. The research of Cheng et al. [32] is the only published case study based on the source of the life meanings amongst the general population of Chinese people. Zhang et al. [28] used CSMS to measure the source of life meanings amongst university students. Compared the two studies, factors such as Personal Development, Interpersonal Relationships, Body and Mental Health, Experiences in Life, Civilization disappeared in CSMIL, our study retained the factors Autonomy, Social Responsibility, Pleasure and Wealth. Among the three factors emerged from our study, Family Responsibility and Religious Beliefs have been indicated in previous studies [25][26][27][28][29][30][31][32][33][34]37]. This leaves the factor of minimalistic living the only factor that has not appeared in any previous studies. This indicates that during the COVID-19 pandemic, people's source of life meaning has indeed underwent some level of changes.

Study 2
Through Study 1, we developed the CSMIL scale to measure the source of people's meaning in life during the COVID-19 outbreak. Based on this, the current study aims to explore people's changes of understanding and construction of the meaning in life in response to the major traumatic event. In order to do so, once again, we chose to use the measurement sample of a collaborator of this study in her master thesis of 2017 [38].

Participants
Sample one: In 2020, 892 participants were measured using CSMIL (All of which were non-students, 363 male, 529 females, with a mean age of 35.90 years old, SD = 8.830).
Sample two: In 2017, 642 participants were measured using a revised initial scale (adding a series of items to CSMS) (All of which were non-students, 290 male, 352 females with the mean age of 29.47 years old, SD = 7.961). The scale for measuring this ample contains all the items of CSMIL used in this study.

Measures
CSMIL: In order to compare the differences between the level of importance people feel towards the different sources of life's meaning, we have used CSMIL as a measuring tool and separately calculated the scoring of the 23 categories under the two samples, and proceeded to receive an average score of the 6 sources of life's meaning.

Data Analyses and Results
In order to better test the distinction in participants values regarding the sources of meaning in life during the COVID-19 pandemic, we took the 6 subscales from 2020 as the standard and compared these results with the results obtained in 2017. We further calculated the average score of each participant in relative to the subscales in 2017 and 2020 respectively. Then the average score of each participant in the 6 subscales were converted into a T score in order to balance out the error between the subjects on the selected scale.

Discussion
In comparison to sample two in 2017, the scores of the source factors of the meaning in life, we found that under the COVID-19 pandemic, people's attention to the factors Social Responsibility, Autonomy and Minimalistic Living has increased significantly, while the factors Family Responsibility, Religious Belief, Wealth and Pleasure decreased significantly.
When China was investing in a large amount of personnel and materials to battle the pandemic of COVID-19, thousands of people were making their own efforts, or even great sacrifices. This gave life a special meaning. Many studies have shown that the meaning of life can promote organizational identity via mobilizing intrinsic resources such as intrinsic motivation and purpose, thereby producing the behaviors consistent with the organization requires [39][40][41]. During the pandemic of COVID-19, society participated in fighting against it as a whole and one organization. Through acknowledging the influence of others or being personally involved in the process, people's social identification was improved significantly, so the attention to Social Responsibility was significantly improved. This is also consistent with previous research. After a traumatic event, people will turn more to altruistic services [42], showing an increase in social behaviors [43]. Previous studies have shown that after experiencing different traumatic events, people will show more intimacy with family members and pay more attention to the harmony of interpersonal relationships [44][45][46]. However, our study demonstrates a decline towards attention to Family Responsibility. This is estimated to be related to the particularity of COVID-19. Due to its high contagion, people were ordered to maintain certain "social distance", making it harder for them to be around and supportive like other traumatic events.
Meanwhile, the vast majority of people are restricted to their houses. Losing the opportunities to make daily trips outside evoked their desire for freedom. On the other hand, although this seems to be an opportunity to spend time at home, it might not come off as a chance for reunion. Contradictions and conflicts are likely to occur between family members, especially teenagers, yet they are unable to avoid such dilemmas through their "alone times", like they used to in the past. In circumstances like these, people on one hand begin to pay less attention to Family Responsibility, especially those of children, on the other hand, they are eager to have their own personal time and space without interference. All of the factors mentioned above enhance the importance of Autonomy in life. This is seen as consistent with previous research. After experiencing trauma, we value our relationships with others on one hand, but on the other hand, we also crave "flexible and freedom" so that we can return to "being ourselves" [44].
As mentioned previously, shortage of supplies partially reflected the importance of wealth, and religious beliefs, to a certain extent, has also relieved the negative emotions caused throughout the epidemic, however, wealth, pleasure and religion are unable to effectively increase a sense of security and control, therefore, people's attention towards these has declined. Relatively simple concepts, such as individuals' having more control of their life and having a harmonious lifestyle with nature, have entered their vision. These ideas have also been repeatedly strengthened when people began to reflect upon the root cause of this epidemic and repeated advocated through various media propagandas, which have encouraged people to live a minimalistic lifestyle. Previous research on the Chinese population also supports this theory [32,42,44]. This seem is unanimous with wuwei (effortless action or no action, to behave spontaneously, yet in accord with the way of nature) which is advocated by Taoism in Chinese traditional culture [47].

Influence of COVID-19 on Meaning in Life
Upon the occurrence of a major traumatic event, for the members involved, many meaningful existences are faced with destruction and reconstruction. Therefore, through strong comparison, subtle and vague elements of life are emphasized, in order to be relocated once again [48]. During our 2020 survey period, COVID-19 was in its middle and late stages of outbreak in China. The loss of life, fear of death and the sense of helplessness was impacting the original values held by people. Therefore, the measurement of the source of meaning in life during this epidemic did not find factors such as Achievements and Status, Secular Values, Self-development, Experiences in Life, Personal Relations, Body and Mental Health that are normally found [27,28,32,38].
As described in Park's integrated model, in stressful circumstances, individuals are potentially likely to process assimilation or adaptation, seek understanding or importance, cognitive or emotionally process. Through the process, one's global meaning in life becomes aligned with the special situation [33]. Traumatic situations such as COVID-19 has created a huge impact on the global meaning in life that individuals originally formed. Thus, individuals' resort to reconfiguring the source of life's meaning and conforming to cope with the difficult traumatic situations. Throughout this process, people began to dissect and clarify the intertwined and complex meanings of life, reassess the value, meaning of life and lifestyle that they originally pursued, in order to reduce the pain [33,[49][50]. In this study, we discovered that, people gave up the sources of meaning in life that could not bring one security or control to themselves. In terms of wealth and religion, they were only partially relieving the pressure caused through traumatic events, and their importance had also decreased. This also shows that, unlike the western culture, religion has a strong "utility" towards the Chinese people and is accompanied by the nature or "Hidden Religion" [32,51].
On the contrary, among people's sources of meaning in life, emphasis on Autonomy and Minimalistic Living that can effectively enhance the sense of security and control have increased significantly. It is worth mentioning that Minimalistic Living has recently entered our vision as a special situational meaning in life. During this time, people have formed new general goals and beliefs, changing positively along with their life. This is the status of "meaning made" stated by Park [33]. During the pandemic of COVID-19, people's tendency to promote Social Responsibility is the most significant. They tend to hope to contribute to their country and society during such crisis. This shows two forms of meaning making: to gain value and enhance their sense of meaning in life. Chinese culture is known to accept high faithfulness and put great emphasis on collectivism over individualism [47,[52][53], hence, it is a matter of course to contribute to the country and society as a meaning in life. This is a process of meaning making is a responding mechanism that people adapt after a traumatic event. Under the incident a significant negative event such as trauma or disaster, this process allows them to psychologically and spiritually explore the positive meanings for themselves and the society [44,[54][55][56]. The process of achieving "meaning made" through "meaning-making efforts" seems to be common among Chinese culture. In the study on the sources of life's meaning amongst cancer patients in China, it was found that the interviewees have all experienced to a certain extent the instability of pursuing special characteristics prior to the illness. Therefore, they experienced a visibility change on the thoughts of life's meaning, they began to look past materials and paid more attention to possessing a positive attitude towards life, such as "treating life well" (Minimalistic Living), and "to be myself" (Autonomy) [57].
While causing huge losses, COVID-19 and other similar significant traumatic events can also change people's perspectives and promote active reconstruction of the meaning in life. In the face of loss, and possibly the continuous state of loss, people's perspective may change from "looking forward" to "looking back", that is, from a strong desire for what they lack to a focus on what they already have or are capable of controlling themselves. Research done by Bower et al. [19] found that males who have experienced loss are more likely to undergo a positive change in their rank of valuables after actively contemplating death. The current study shows that, factors that were considered common sources of life meaning such as wealth and pleasure, achievements and status, harmonious interpersonal relationships either disappeared during the pandemic, or people tend to pay less attention to them under such circumstances. This indicates a rearranging of the most important source of life meaning. Similarly, the current study, whether it is willing to take more social responsibilities, or hope to restore the sense of meaning in life by regaining control over their life or achieving harmony with nature and adapting to minimalistic living. These all show individuals' attempt to reconstruct the meaning in life under the pandemic of COVID-19. This often occurs in the context of Chinese culture. Reinterpreting the death of a child is an important factor when rebuilding the meaning in life of parents [42]. Since the Great Sichuan earthquake, studies have shown that the traumatic events of the earthquake have reduced people's sense of meaning in life [58]. Some teachers have a more positive sense of life significance while others do not, or show little sense. Teachers with positive senses are visibly less affected and impacted by the earthquake [59]. The more severely affected students in the disaster showed more positive psychological qualities [60]. The subjective well-being of elderly people in disaster-stricken areas tends to increase overtime [61]. The survey conducted by China Youth Daily also indicates that people tend to show a positive change upon their sense of value and meaning [1].
The results of this study proved the possibility of a positive psychological change experienced after responding to a significant life crisis (i.e., posttraumatic growth) [21], but more importantly it confirms the authenticity of the integrated model of meaning making proposed by Park [33], and shows that people will recover after traumatic events by endowing an alternative explanation or reconstructing the meaning. Therefore, it suggests that during the posttraumatic psychological assistance, we can assist people by reconstructing their understanding of the meaning of lost, trauma and life, thus reducing stress and reliving their sorrow which would then lead to promotion of their personal growth.

Limitations
The study was conducted in March, 2020, which fell into the middle and late stages of the COVID-19 situation in China. We have only chosen a static period of time for measurement, therefore the result cannot fully reflect dynamic changes of people's views on meaning in life. If this limitation was to be made up, selecting a suitable time point and undergoing continuous measurements would be needed, in order to build a dynamic model of people's concern towards the meanings of life.
In Park's integrated model [33], this model distinguishes between the constructs of "meaning-making efforts" and "meaning made", and it elaborates subconstructs within these constructs. Confined by the survey method of this research (questionnaires), we are unable to pinpoint the exact meaning-making efforts that people have chosen in the COVID-19 environment, as well as the different statuses of meaning made. Therefore, we cannot figure out the connection between the two.
All of the limitations mentioned above need further explanation through different research methods.

Conclusion
The current study developed a new scale of Chinese Sources of Meaning in Life (CSMIL) which involves 6 factors, containing Autonomy, Family Responsibilities, Social Responsibility, Religious Belief, Minimalistic Living, Pleasure and Wealth. By comparing the results with the samples obtained in 2017, it was found that during the COVID-19 pandemic of 2020, people's understanding of the source of life meaning has changed. First of all, people have shown to attention to different contents. They no longer pay attention to what was known to be secular values such as personal achievements and social status. Instead, showing desire towards a simple and harmonious lifestyle. Secondly, the amount of attention in which people pay to a certain factor has also changed. They show reduction in attention towards pleasure and religion, they want to contribute to the community and obtaining autonomy were focus on as an alternative. This study found that during the pandemic of COVID-19, people's attention to family members and interpersonal relationships have decreased, which might be due to the particularity of this traumatizing event. It can be seen that, in traumatic circumstances, people do in fact make an attempt to alleviate the negativity and achieve psychological balance through meaning-making efforts.