Children and adolescents coping with home isolation and social distancing during Covid-19 in Qatar: a cross sectional study with qualitative items.

BACKGROUND: Covid-19 related studies report psychological impacts during home isolation and social distancing. Despite that, children and adolescents were able to adopt coping strategies that assisted in lowering severe levels of psychological disorders. This study aims to report on the psychosocial implications of social distancing and isolation on children of different nationalities who reside in Qatar, and to reveal their coping ways. METHODS: This is a cross sectional study with qualitative component at its end. The study is a part of a larger study that reported the results of a national screening for psychological disorders experienced by children and adolescents in Qatar. A bilingual online questionnaire included close-ended and one open-ended question to screen for psychological changes and identify coping strategies practiced by children and adolescents (7-18 years) during home-isolation and social distancing. The quantitative questionnaire had five main sections as follows: the sociodemographic characteristics, Spence Children's Anxiety Scale, Kutcher Adolescent Depression Scale, and Clinical Anger Scale). The last section screened for eight different coping strategies. The summative content analysis was used to analyze the open-ended question "What practices do you do at home that make you happy?". First, open coding was used (for identification), followed by the axial coding (for comparison), and lasted by sorting of coping strategies inductively. RESULTS: Six thousand six hundred and eight (6608) subjects participated between June 23 and July 18, 2020. The clinical outcomes of the study had varying prevalence and levels of severity, which ranged from mild to severe. Higher prevalence was noted for adjustment disorder 66.5% (n = 4396), and generalized anxiety 60% (n = 3858), in comparison to depression 40% (n = 2588). Additionally, participants reported using cognitive, spiritual, social, and physical coping strategies. Eight higher order themes were identified to reflect the coping strategies: playing with siblings or pets, gardening, cooking, practicing arts and crafts, and doing chores. Furthermore, Sociodemographic factors such as ethnicity, religion and family status played a considerable role in choosing the type of coping strategy. CONCLUSION: The uniqueness of the study is bringing the psychosocial implications of social distancing through the voices of children and adolescents, and coping strategies from their perspective. These results are of importance for educational and healthcare systems that are recommended to collaborate even in "normal" times to prepare these age categories for any future crises. The importance of daily lifestyle and family is highlighted as protectors, and crucial factors in emotional management.

Psychological and Coping Strategies Related to Home Isolation and Social Distancing in Children and Adolescents During the COVID-19 Pandemic: Cross-sectional Study.

BACKGROUND: In December 2019, a novel coronavirus called SARS-CoV-2 was identified as the cause of a cluster of pneumonia cases in Wuhan, China. It rapidly spread due to human-to-human transmission, resulting in a global pandemic. Nearly every country, including Qatar, has established guidelines and regulations to limit the spread of the virus and to preserve public health. However, these procedures have been associated with negative effects on the psychological and intellectual well-being of individuals, including children and adolescents. OBJECTIVE: The objective of this study was to determine the psychological influence of home isolation and social distancing on children and adolescents during the COVID-19 pandemic in Qatar, and the strategies used to cope with these measures. METHODS: This cross-sectional study was undertaken using an online questionnaire administered through SMS text messaging. All home-isolated children and adolescents registered at the Primary Health Care Corporation aged 7-18 years were invited to participate in the study. Children and adolescents with intellectual disadvantages were excluded. A P value of .05 (two-tailed) was considered statistically significant. RESULTS: Data were collected from 6608 participants from June 23 to July 18, 2020. Nearly all participants adhered to the official regulations during the period of home isolation and social distancing; however, 69.1% (n=4568) of parents believed their children were vulnerable to the virus compared to 25% (n=1652) who expressed they were not vulnerable at all. Higher levels of anger, depression, and general anxiety were prevalent among 1.3% (n=84), 3.9% (n=260), and 1.6% (n=104) of participants, respectively. The mean score for the emotional constructs anger and depression decreased with increased compliance with regulations (P=.04 and P=.11, respectively). The differences in mean score for all psychological and coping strategies used among participants across the 3 levels of vulnerability to SARS-CoV-2 were statistically significant. The mean score varied little with increasing reported vulnerability to the virus. This mild variation can make a difference when the sample size is large, as is the case in this study. CONCLUSIONS: Screening for psychological and social disruptions is important for the development of strategies by schools and health care providers to assess and monitor behavioral changes and negative psychological impact during post-COVID-19 reintegration. Participants experiencing higher levels of anxiety should be given more attention during reintegration and transitional phases in schools. Although electronic devices and social media platforms may have lowered anxiety levels in some cases, it is important to address how they are used and how content is tailored to children and adolescents. It is also important to maintain an active lifestyle for children and young persons, and encourage them not to neglect their physical health, as this promotes a better psychological state of mind.