ABSTRACT
BACKGROUND: The present study investigated the impact of the COVID-19-related rehabilitation services lockdown on the mental health of caregivers of children with neurodevelopmental disabilities. METHODS: Between 26 March and 11 May 2020, 84 caregivers filled out ad-hoc and standardized questionnaires through an online survey in order to measure their psychological response to the emergency and lockdown as well as their levels of parenting stress, anxiety and depression. RESULTS: Worries about COVID-19 contagion and concerns for the child left without rehabilitation programs were the greatest sources of mental health burden for caregivers. Nonetheless, only the concerns for the child were significantly associated with caregivers' reports of stress, depressive and anxious symptoms. DISCUSSION: These findings highlight the burden faced by caregivers of children with neurodevelopmental disabilities during the COVID-19 emergency in Italy. These families should be considered as a high-risk population that requires dedicated healthcare attention, such as promoting continuity of care by investing in tele-rehabilitation programs. Implications for rehabilitation Caregivers of children with disability reported symptoms of anxiety and depression during COVID-19 emergency. Major concerns regarded COVID-19 contagion risk and child development during rehabilitation lockdown. Caregivers' psychological symptoms were associated with concerns for child development during the lockdown. Parents of children with disability may face relevant stress during and after COVID-19 psychological burden. During COVID-19 recovery, policy-makers and clinicians should dedicate specific care actions for families of children with disability.
Subject(s)
COVID-19/psychology , Caregivers/psychology , Mental Health/statistics & numerical data , Neurodevelopmental Disorders/psychology , Parents/psychology , Telerehabilitation/methods , Adult , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Child , Child, Preschool , Communicable Disease Control , Delivery of Health Care , Female , Health Services Needs and Demand , Humans , Italy , Male , Neurodevelopmental Disorders/rehabilitation , Pandemics/prevention & control , SARS-CoV-2 , Social Isolation/psychology , Social Support , Stress, Psychological , Surveys and QuestionnairesABSTRACT
BACKGROUND: While COVID-19 outbreak has had adverse psychological effects in children with special needs, the mental state and burden on their caregivers during this pandemic has yet to be reported. AIMS: The objectives of this study were to describe the mental health status and the change in perceived strain among caregivers during the COVID-19 outbreak. METHODS AND PROCEDURES: Two hundred sixty four caregivers completed an online survey that assessed demographics, use and perspective on tele-rehabilitation, homecare therapy, caregiver's strain and mental health. OUTCOMES AND RESULTS: The prevalence of depression, anxiety and stress symptoms were found to be 62.5 %, 20.5 % and 36.4 % respectively. A significant difference in caregiver strain (pâ¯<⯠0.001, effect size = 0.93) was observed during the outbreak compared to levels pre-outbreak (pre-outbreak strain was measured retrospectively). Caregivers not using tele-rehabilitation along with a perception of it being a poor medium for rehabilitation were at greater risks for poor mental health whereas a negative perception on homecare therapy were strongly associated with higher psychological symptoms and strain. CONCLUSIONS AND IMPLICATIONS: This study identified a high prevalence of depression and significant change in strain displayed by caregivers during the COVID-19 outbreak. We identified several factors associated with poor mental health and perceived strain that can be used to help safeguard caregivers.
Subject(s)
Anxiety/psychology , COVID-19 , Caregiver Burden/psychology , Caregivers/psychology , Depression/psychology , Neurodevelopmental Disorders/rehabilitation , Parents/psychology , Stress, Psychological/psychology , Telerehabilitation , Age Factors , Anxiety/epidemiology , Attention Deficit Disorder with Hyperactivity/physiopathology , Attention Deficit Disorder with Hyperactivity/rehabilitation , Attitude to Health , Autism Spectrum Disorder/physiopathology , Autism Spectrum Disorder/rehabilitation , Caregiver Burden/epidemiology , Caregivers/statistics & numerical data , Cerebral Palsy/physiopathology , Cerebral Palsy/rehabilitation , Child , Child, Preschool , Depression/epidemiology , Developmental Disabilities/physiopathology , Developmental Disabilities/rehabilitation , Down Syndrome/physiopathology , Down Syndrome/rehabilitation , Female , Financial Stress , Functional Status , Home Care Services , Humans , Income , India/epidemiology , Learning Disabilities/physiopathology , Learning Disabilities/rehabilitation , Male , Mental Health , Neurodevelopmental Disorders/physiopathology , Prevalence , Spinal Dysraphism/physiopathology , Spinal Dysraphism/rehabilitation , Stress, Psychological/epidemiology , Teleworking , WorkloadABSTRACT
Objective: To describe the challenges related to COVID-19 affecting pediatric neuropsychologists practicing in inpatient brain injury rehabilitation settings, and offer solutions focused on face-to-face care and telehealth.Methods: A group of pediatric neuropsychologists from 12 pediatric rehabilitation units in North America and 2 in South America have met regularly since COVID-19 stay-at-home orders were initiated in many parts of the world. This group discussed challenges to clinical care and collaboratively problem-solvedsolutions.Results: Three primary challenges to usual care were identified, these include difficulty providing 1) neurobehavioral and cognitive assessments; 2) psychoeducation for caregivers and rapport building; and 3) return to academic instruction and home. Solutions during the pandemic for the first two areas focus on the varying service provision models that include 1) face-to-face care with personal protective equipment (PPE) and social distancing and 2) provision of care via remote methods, with a focus on telehealth. During the pandemic,neuropsychologists generally combine components of both the face-to-face and remote care models. Solutions to the final challenge focus on issues specific to returning to academic instruction and home after an inpatient stay.Conclusions: By considering components of in-person and telehealth models of patient care during the pandemic, neuropsychologists successfully serve patients within the rehabilitation setting, as well as the patient's family who may be limited in their ability to be physically present due to childcare, illness, work-related demands, or hospital restrictions.