RESUMEN
Abstract Objective: To evaluate physical and mental health indicators in adolescents with preexisting chronic immunocompromised conditions during coronavirus disease 2019 (COVID-19) quarantine. Methods: A cross-sectional study included 355 adolescents with chronic conditions and 111 healthy adolescents. An online self-rated survey was used to investigate socio-demographic features, healthcare routine, and the quarantine impact on physical and mental health. The validated self-reported version of the Strengths and Difficulties Questionnaire (SDQ) was also applied. Results: The median of age [14 (10-18) vs. 15 (10-18) years, p = 0.733] and frequencies of female (61% vs. 60%, p = 0.970) were similar between adolescents with preexisting chronic conditions and healthy adolescents during quarantine of COVID-19 pandemic. The frequencies of abnormal total difficulties score of SDQ were similar in patients and controls (30% vs. 31%, p = 0.775). Logistic regression analysis showed that being female (OR = 1.965; 95% CI = 1.091-3.541, p = 0.024), fear of underlying disease activity/complication (OR = 1.009; 95%CI = 1.001-1.018, p = 0.030) were associated with severe psychosocial dysfunction in adolescents with chronic conditions, whereas school homework (OR = 0.449; 95% CI = 0.206-0.981, p = 0.045) and physical activity (OR = 0.990; 95% CI = 0.981-0.999, p = 0.030) were protective factors. Further analysis of patients with chronic immunocompromised conditions and previous diagnosis of mental disorders (9%) compared with patients without diagnosis showed higher median of total difficulties score (p = 0.001), emotional (p = 0.005), conduct (p = 0.007), peer problems (p = 0.001) and hyperactivity (p = 0.034) in the former group. Conclusion: Adolescents with preexisting chronic immunocompromised conditions during COVID-19 quarantine were not at higher risk of adverse health indicators. Being female, fear of underlying disease activity/complication, and household members working outside of the home were relevant issues for adolescents with preexisting chronic conditions. This study reinforces the need to establish mental health strategies for teens with chronic conditions, particularly during the pandemic.
RESUMEN
Com a pandemia de COVID-19,os atendimentos clínicos de crianças e adolescentes migraram do presencial para o teleatendimento, uma prática inédita que exigiu esforço dos profissionais para refletir teoricamente sobre as possibilidades de flexibilização do setting e da técnica. Para que essa mudança pudesse ser feita, um trabalho de luto e elaboração foi necessário. A partir de vinhetas clínicas, discutimos como as crianças e adolescentes, os pais e as escolas se apresentaram em nossas clínicas durante os primeiros meses de pandemia e como lidaram com as mudanças que se impuseram. Ressaltamos que, apesar de todos nós estarmos imersos no mesmo contexto, as vivências foram singulares. Por fim, discutimos as possibilidades e os desafios do atendimento on-line. No caso das crianças, a prática se mostrou mais desafiadora, especialmente a longo prazo
Con la pandemia de COVID-19, la atención clínica de niños y adolescentes migró del modo presencial a la teleatención, una práctica inédita que requirió esfuerzo de reflexión teórica de los profesionales acerca de las posibilidades de flexibilización del encuadre y de la técnica. Para concretar este cambio, fue necesario un trabajo de duelo y elaboración. Mediante recortes clínicos, discutimos aquí de qué manera llegaron a nuestros consultorios niños y adolescentes, sus padres y las escuelas durante los primeros meses de la pandemia, y cómo afrontaron los cambios que surgieron. Remarcamos que, pese a que todos estamos inmersos en este contexto, las vivencias fueron singulares. Por último, debatimos las posibilidades y los retos de la atención online. En casos de niños, la práctica se erigió como un desafio a largo plazo
Due to the COVID-19 pandemic, the counseling sessions of children and adolescents migrated from in-person to telepsychology, an uprecedented practice that required professionals to make great efforts to reflect theoretically on the possibilities of making both the setting and technique flexible. In order to enable such change, grief work was necessary. Based on vignettes, we, hereby, discuss how children and adolescents, parents and schools were presented in the clinical setting during the first months of the pandemic and how they handled the imposed changes. We highlight that, despite being immersed in the same context, the experiences were unique. Finally, we discuss the possibilities and challenges of online counseling. In the case of children, the practice revealed itself as more challenging, especially long term
Avec la pandémie du COVID19, les séances des enfants et adolescents ont migré du présentiel vers la télé-séance, pratique inédite qui a exigé de l'effort des professionnels pour réfléchir théoriquement sur les possibilités d'assouplissement du setting et de la technique. Pour ce changement, un travail de deuil et d'élaboration a été nécessaire. À partir des vignettes, nousavons discuté comment les enfants, adolescents, parents et écoles se sont présentés dans nos cliniques pendant les premiers mois et comment ils ont géré les changements imposés. Bien que nous soyons tous immergés dans le même contexte, les vécus ont été singuliers. Enfin, nous avons discuté les possibilités et défis des séances en ligne. Auprès des enfants, la pratique s'est avérée un plus grand défi, spécialement à long terme