**1. Introduction**

Occupational balance is defined as the state in which there is a positive evaluation between the number of occupations and their variations [1]. Traditionally, and from an intrapersonal perspective, occupational balance has been described as a satisfactory pattern that the subject presents when carrying out their occupations [2–4]. Occupations are defined as all types of life activities in which people, groups, or populations participate, including activities of daily living, instrumental activities of daily living, rest and sleep, education, work, play, leisure, and socializing [5]. In this sense, the actions cited by Meyer [5]—work, play, rest, and sleep—should always be taken into account when considering what each person needs to achieve balance, even in difficult situations.

In order to maintain an occupational balance over time, there must be harmony and variation in occupations, capacity and resources to be able to manage them, and congruence between occupational commitment, values, and personal meaning [6]. However, despite the fact that an adequate occupational balance has been positively related to the health and well-being [7,8] of a person, recent research has highlighted the importance of the interpersonal perspective, which involves having to satisfy needs, such as family, or to avoid harming others [9–11].

Factors such as quality and satisfaction with life [7] and subjective health [12] can affect the achievement of this balance by hindering access to necessary resources. In this situation, states of underemployment or overoccupation may occur as a consequence of a deficient or exaggerated processing of occupational and environmental stimuli, of few or too many occupational opportunities, or of understimulating, overstimulating, or inappropriate environments [7]. It is therefore a dynamic process in which occupations, roles, personal factors, and external factors vary throughout the lifecycle, with the existence of a certain degree of disturbances in occupational balance being normal, as long as it is not too intense and durable over time and the person has the necessary capacities and resources to adapt and regain balance by readjusting their occupations [13].

A lack of regulatory capacities and abilities can be detrimental to a person's health and lead to illness. Responses to the understimulating occupations or excess occupations, such as boredom or exhaustion, respectively, are the most frequent forms of stress when occupational balance is disturbed. These forms of stress are associated with a poor state of health and can lead to more severe medical conditions [14]. Based on all of the above, this disturbance is defined as any perception of decompensation in daily occupations, which translates into personal dissatisfaction and difficulty in adapting to particular circumstances [15]. It can be caused by both positive and negative situations [16]. In the former, it is the person himself who has chosen the disturbances directly, such as going to university or starting a new job. In the latter, the disturbances are not voluntarily chosen by the person, such as being unemployed, contracting a disease, or experiencing a global pandemic.

In the general population, the measures adopted by the Health Authorities to contain the spread of the coronavirus disease (COVID-19) outbreak, mainly focused on forced social distancing and home confinement, have produced negative psycho-emotional effects due to the loss of leisure and work, alterations in lifestyles, and the generation of stress [17]. The abrupt interruption in the performance of daily occupations has favored the adoption of health risk behaviors, such as physical inactivity, sedentary lifestyles, and excessive alcohol consumption [18], producing high levels of anxiety and depression [19–21]. All of this suggests that the lack of occupational balance translates into a general shortage of regulatory skills and capacities, with negative effects on health, which can lead to serious illnesses [22–25]. The feelings of loss of control and loneliness, caused by confinement and social distancing, have increased the incidence of daytime stress, altered sleep patterns [21,26–28], and increased irritability [21], as well as the almost-complete loss of structured occupations (school, work, and training) in young adults, one of the groups most affected by the effects of this situation [29,30]. In addition, adverse situations may encourage new lifestyle demands to exceed the individual's capacities to face them, negatively affecting their health status [14].

The analysis of the impact of confinement on occupational balance is key to provide meaningful data that allow an approach to the situation focused on reducing or eliminating changes in behaviors and lifestyles produced by the pandemic, increasing quality of life, and reducing its effects on psycho-emotional health. We hypothesized that there was a relationship between sociodemographic and COVID-19-related factors and occupational balance in the Spanish population during the forced social distancing. Therefore, the objective of this study was to determine the factors related to occupational balance in the Spanish population during the confinement that occurred as a consequence of the COVID-19 outbreak.
