Therapeutic landscapes, networks, and health and wellbeing during the COVID-19 pandemic: A mixed-methods study among female domestic workers

The COVID-19 pandemic has had profound impacts on access to and use of therapeutic landscapes and networks, especially for people who are vulnerable due to economic, social, and work-related disadvantage. For one such vulnerable population, Indonesian female domestic workers (FDWs) in Hong Kong, this study employed a mixed methods approach to examine the associations between perceptions of therapeutic landscapes (TLs), therapeutic networks (TNs), subjective wellbeing, and self-rated health during the COVID-19 pandemic. Data from an online survey were analyzed via structural equation modeling (SEM) and confirmatory factor analysis (CFA) to investigate the direct and indirect associations between TLs, TNs, and health and wellbeing. The findings demonstrate little or no association among FDWs’ perceptions of TLs and TNs and FDWs’ self-rated health and subjective wellbeing, except for a negative total association between TL and subjective wellbeing. Using insights gleaned from thematic analysis of in-depth interviews with FDWs, we suggest that these unexpected findings are mainly due to restricted access to public places, reduced social gatherings, and the fact that employers rarely granted days off during the lockdown. Although processes at the employer and municipal scales limited FDWs’ access to therapeutic places, increased use of digital communications and spaces provided an important source of social and emotional support during the pandemic.