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1.
J Clin Ethics ; 34(2): 158-168, 2023.
Article in English | MEDLINE | ID: covidwho-20240773

ABSTRACT

AbstractAs we journey into the fourth year of the COVID-19 pandemic, a majority of Americans express relief at a "return to normal," experience pandemic fatigue, or embrace the idea of living with COVID-19 in much the same way we live with the seasonal flu. But transition to a new phase of life with SARS-CoV-2 does not diminish the importance of vaccination. The US Centers for Disease Control and the Food and Drug Administration recently recommended another round of booster dose for persons age 5 and up, or an initial series for those not previously vaccinated, with an updated bivalent formula that protects against both the original virus strain and Omicron subvariants that are now the dominant source of infection. By most accounts most of the population has been or will become infected with SARS-CoV-2. Suboptimal uptake of the COVID-19 vaccines among the approximately 25 million adolescents in the United States is a significant obstacle to population coverage, public health, and the health and well-being of adolescents. A major cause of low adolescent uptake is parental vaccine hesitancy. This article discusses parental vaccine hesitancy and argues that permitting independent adolescent consent to COVID-19 vaccination should be an ethical and policy priority as we continue to confront the threat of Omicron and other variants of the coronavirus. We discuss the central role of the pediatric healthcare team in caring for adolescent patients who disagree with their parents about vaccination.


Subject(s)
COVID-19 , Humans , Adolescent , Child , Child, Preschool , COVID-19/prevention & control , COVID-19 Vaccines , Pandemics/prevention & control , SARS-CoV-2 , Vaccination Hesitancy , Vaccination , Parents
2.
BMC Public Health ; 23(1): 1068, 2023 06 05.
Article in English | MEDLINE | ID: covidwho-20240510

ABSTRACT

COVID-19 testing is an important risk mitigation strategy for COVID-19 prevention in school settings, where the virus continues to pose a public health challenge for in-person learning. Socially vulnerable school communities with the highest proportion of low-income, minority, and non-English speaking families have the least testing access despite shouldering a disproportionate burden of COVID-19 morbidity and mortality. Through the Safer at School Early Alert (SASEA) program, we investigated community perceptions of testing in San Diego County schools, with a focus on barriers and facilitators from the perspective of socially vulnerable parents and school staff. Using a mixed-methods approach, we administered a community survey and conducted focus group discussions (FGDs) with staff and parents from SASEA-affiliated schools and childcares. We recruited 299 survey respondents and 42 FGD participants. Protecting one's family (96.6%) and protecting one's community (96.6%) were marked as key motivators to testing uptake. School staff in particular reported that the reassurance of a negative status mitigated concerns about COVID-19 infection in schools. Participants expressed that COVID-19-related stigma, loss of income as a result of isolation/quarantine requirements, and lack of multilingual materials were the most significant barriers to testing. Our findings suggest that the testing barriers faced by school community members are predominantly structural. Testing uptake efforts must provide support and resources to manage the social and financial consequences of testing while continuously communicating its benefits. There is a clear need to continue to incorporate testing as a strategy to maintain school safety and facilitate access for vulnerable community members.


Subject(s)
COVID-19 Testing , COVID-19 , Humans , COVID-19/diagnosis , COVID-19/prevention & control , Focus Groups , Poverty , Parents
3.
BMC Public Health ; 23(1): 1099, 2023 06 07.
Article in English | MEDLINE | ID: covidwho-20239982

ABSTRACT

BACKGROUND: The COVID-19 pandemic prompted rapid federal, state, and local government policymaking to buffer families from the health and economic harms of the pandemic. However, there has been little attention to families' perceptions of whether the pandemic safety net policy response was adequate, and what is needed to alleviate lasting effects on family well-being. This study examines the experiences and challenges of families with low incomes caring for young children during the pandemic. METHODS: Semi-structured qualitative interviews conducted from August 2020 to January 2021 with 34 parents of young children in California were analyzed using thematic analysis. RESULTS: We identified three key themes related to parents' experiences during the pandemic: (1) positive experiences with government support programs, (2) challenging experiences with government support programs, and (3) distress resulting from insufficient support for childcare disruptions. Participants reported that program expansions helped alleviate food insecurity, and those attending community colleges reported accessing a range of supports through supportive counselors. However, many reported gaps in support for childcare and distance learning, pre-existing housing instability, and parenting stressors. With insufficient supports, additional childcare and education workloads resulted in stress and exhaustion, guilt about competing demands, and stagnation of longer-term goals for economic and educational advancement. CONCLUSIONS: Families of young children, already facing housing and economic insecurity prior to the pandemic, experienced parental burnout. To support family well-being, participants endorsed policies to remove housing barriers, and expand childcare options to mitigate job loss and competing demands on parents. Policy responses that either alleviate stressors or bolster supports have the potential to prevent distress catalyzed by future disasters or the more common destabilizing experiences of economic insecurity.


Subject(s)
COVID-19 , Pandemics , Humans , Child , Child, Preschool , COVID-19/epidemiology , Parents , Parenting , Government
4.
BMC Psychol ; 11(1): 179, 2023 Jun 08.
Article in English | MEDLINE | ID: covidwho-20239351

ABSTRACT

BACKGROUND: The Coronavirus disease 2019 (COVID-19) pandemic has impacted parental and child mental health and wellbeing in the UK. This study aimed to explore the experiences of parents of children with rare neurological and neurodevelopmental conditions with a known or suspected genetic cause (neurogenetic) across the first year of the pandemic in the UK. METHODS: Semi-structured interviews were conducted with 11 parents of children with rare neurogenetic conditions. Parents were recruited via opportunity sampling from the CoIN Study, a longitudinal quantitative study exploring the impact of the pandemic on the mental health and wellbeing of families with rare neurogenetic conditions. Interviews were analysed using Interpretative Phenomenological Analysis. RESULTS: Four main themes were identified: (1) "A varied impact on child wellbeing: from detrimental to 'no big drama'"; (2) "Parental mental health and wellbeing: impact, changes, and coping"; (3) "'The world had shut its doors and that was that': care and social services during the pandemic"; and (4) "Time and luck: abstract concepts central to parents' perspectives of how they coped during the pandemic". The majority of parents described experiencing an exacerbation of pre-pandemic challenges due to increased uncertainty and a lack of support, with a minority reporting positive effects of the pandemic on family wellbeing. CONCLUSIONS: These findings offer a unique insight into the experiences parents of children with rare neurogenetic conditions across the first year of the pandemic in the UK. They highlight that the experiences of parents were not pandemic-specific, and will continue to be highly relevant in a non-pandemic context. Future support should to be tailored to the needs of families and implemented across diverse future scenarios to promote coping and positive wellbeing.


Subject(s)
COVID-19 , Pandemics , Child , Humans , COVID-19/epidemiology , Parents/psychology , Adaptation, Psychological , Mental Health
5.
Epigenomics ; 15(7): 453-473, 2023 04.
Article in English | MEDLINE | ID: covidwho-20238843

ABSTRACT

The rate of substance use is rising, especially among reproductive-age individuals. Emerging evidence suggests that paternal pre-conception and maternal prenatal substance use may alter offspring epigenetic regulation (changes to gene expression without modifying DNA) and outcomes later in life, including neurodevelopment and mental health. However, relatively little is known due to the complexities and limitations of existing studies, making causal interpretations challenging. This review examines the contributions and influence of parental substance use on the gametes and potential transmissibility to the offspring's epigenome as possible areas to target public health warnings and healthcare provider counseling of individuals or couples in the pre-conception and prenatal periods to ultimately mitigate short- and long-term offspring morbidity and mortality.


More people, especially those of reproductive age, are using substances, and there is growing evidence to suggest that parental substance use before and during pregnancy may adversely affect offspring and result in issues later in life, including mental health challenges. Such relationships have been demonstrated with nicotine, alcohol, cannabis, opioids and illegal drugs (e.g., heroin, cocaine, methamphetamines). Some of these adverse impacts on offspring can potentially be passed down in families even after parents have quit using the substance. Because more individuals are using drugs, especially during the COVID-19 pandemic, it is important that families learn more about the potential impact of substance use on their future offspring before they try to get pregnant.


Subject(s)
Epigenesis, Genetic , Substance-Related Disorders , Pregnancy , Female , Humans , DNA Methylation , Parents , Reproduction , Substance-Related Disorders/genetics
6.
BMC Pregnancy Childbirth ; 23(1): 435, 2023 Jun 13.
Article in English | MEDLINE | ID: covidwho-20236855

ABSTRACT

BACKGROUND: The aim of the present paper was to explore the role of partners for the stressful life events of birth and the transition to parenthood. METHODS: In a first prospective longitudinal study (N = 304 dyads) we tested whether relationship quality positively predicted fewer interventions during labor and birth, a more positive birth experience, and better well-being during the first six weeks after birth. In a second study we surveyed mothers (N = 980; retrospective quasi-experimental design) who had given birth during the first lockdown of the COVID-19 pandemic in spring 2020 - some in the absence of their partners - to test the assumption that regardless of relationship quality, the presence of the partner was positively related to low-intervention births and the birth experience. RESULTS: The results of the longitudinal study (Study 1) could be integrated into a Single Indicator model. They revealed that a high relationship quality assessed between week 5 and week 25 of pregnancy had a positive effect on birth experience for the mother and on psychological well-being during the transition to parenthood for both mothers and fathers. Results of the retrospective quasi-experimental field study (Study 2) revealed that the continuous presence of the partner was associated with a higher probability of a low-intervention birth and a more positive birth experience. Presence of a partner for only part of the birth did not positively predict labor and birth, but did positively predict the birth experience. The effects were independent of relationship quality. CONCLUSION: The results of both studies highlight the importance of partners for psychological well-being during labor and birth and the transition to parenthood.


Subject(s)
COVID-19 , Pandemics , Female , Humans , Pregnancy , Communicable Disease Control , COVID-19/epidemiology , Longitudinal Studies , Prospective Studies , Retrospective Studies , Social Support , Parents
7.
Front Public Health ; 11: 1146792, 2023.
Article in English | MEDLINE | ID: covidwho-20235980

ABSTRACT

Introduction: Internal validation techniques alone do not guarantee the value of a model. This study aims to investigate the external validity of the Parental Attitude toward Childhood Vaccination (PACV) scale for assessing parents' attitude toward seasonal influenza vaccination. Methods: Using a snowball sampling approach, an anonymous online questionnaire was distributed in two languages (English and Arabic) across seven countries. To assess the internal validity of the model, the machine learning technique of "resampling methods" was used to repeatedly select various samples collected from Egypt and refit the model for each sample. The binary logistic regression model was used to identify the main determinants of parental intention to vaccinate their children against seasonal influenza. We adopted the original model developed and used its predictors to determine parents' intention to vaccinate their children in Libya, Lebanon, Syria, Iraq, Palestine, and Sudan. The area under the curve (AUC) indicated the model's ability to distinguish events from non-events. We visually compared the observed and predicted probabilities of parents' intention to vaccinate their children using a calibration plot. Results: A total of 430 parents were recruited from Egypt to internally validate the model, and responses from 2095 parents in the other six countries were used to externally validate the model. Multivariate regression analysis showed that the PACV score, child age (adolescence), and Coronavirus disease 2019 (COVID-19) vaccination in children were significantly associated with the intention to receive the vaccination. The AUC of the developed model was 0.845. Most of the predicted points were close to the diagonal line, demonstrating better calibration (the prediction error was 16.82%). The sensitivity and specificity of the externally validated model were 89.64 and 37.89%, respectively (AUC = 0.769). Conclusion: The PACV showed similar calibration and discrimination across the six countries. It is transportable and can be used to assess attitudes towards influenza vaccination among parents in different countries using either the Arabic or English version of the scale.


Subject(s)
COVID-19 , Influenza, Human , Child , Adolescent , Humans , Influenza, Human/prevention & control , Vaccination , Parents , Intention
8.
Psychol Trauma ; 15(5): 888-894, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-20234244

ABSTRACT

OBJECTIVE: This study was conducted to determine psychological stress experienced by parents and posttraumatic emotional stress experienced by children during the COVID-19 pandemic. METHOD: The study has cross-sectional design and included parents who have 3- to 10 year-old children studying at kindergartens and primary schools under the Yozgat Directorate of National Education in Turkey, and who volunteered to participate in the study. The study was completed with 1,109 parents. School administrators were informed of the study and an online data collection form was distributed through parent WhatsApp groups. RESULTS: Fathers at or above the age of 37 were found to have lower Kessler Psychological Distress Scale (K10-PDS) scores (p < .05). In the study, K10-PDS scores of parents working as health care employees and Pediatric Emotional Distress Scale (PEDS) scores of their children were significantly higher than those of other groups (p < .05). K10-PDS scores of parents with children in the 3-6 age group who had behavioral changes, increased screen usage, and disturbed sleep and diet were found to be higher than those of other groups (p < .05). According to regression analysis K10-PDS scores of parents significantly explained 34% of children's PEDS score (R² = .340) (p < .001). CONCLUSIONS: This study determined that COVID-19 causes children to experience posttraumatic stress disorder. In addition, the study found increased stress levels of parents and children experiencing posttraumatic stress disorder. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
COVID-19 , Psychological Distress , Humans , Child , Child, Preschool , Cross-Sectional Studies , Pandemics , Parents/psychology , Stress, Psychological/etiology
9.
PLoS One ; 18(5): e0285375, 2023.
Article in English | MEDLINE | ID: covidwho-20233496

ABSTRACT

UK 'Lockdown' measures introduced in March 2020 aimed to mitigate the spread of COVID-19. Although seeking healthcare was still permitted within restrictions, paediatric emergency department attendances reduced dramatically and led to concern over risks caused by delayed presentation. Our aim was to gain insight into healthcare decisions faced by parents during the first wave of the COVID-19 pandemic and to understand if use of urgent healthcare, self-care, and information needs differed during lockdown as well as how parents perceived risks of COVID-19. We undertook qualitative telephone interviews with a purposive sample of parents living in the North East of England recruited through online advertising. We used a semi-structured interview schedule to explore past and current healthcare use, perceptions of risk and the impact of the pandemic on healthcare decisions. Interviews were transcribed and analysed using Thematic Analysis. Three major themes were identified which concerned (i) how parents made sense of risks posed to, and by their children, (ii) understanding information regarding health services and (iii) attempting to make the right decision. These themes contribute to the understanding of the initial impact of COVID-19 and associated restrictions on parental decisions about urgent healthcare for children. These findings are important to consider when planning for potential future public health emergencies but also in the wider context of encouraging appropriate use of urgent healthcare.


Subject(s)
COVID-19 , Emergency Medical Services , Child , Humans , COVID-19/epidemiology , Pandemics , Communicable Disease Control , United Kingdom/epidemiology , Parents
10.
BMC Public Health ; 23(1): 1106, 2023 06 07.
Article in English | MEDLINE | ID: covidwho-20245032

ABSTRACT

BACKGROUND: The COVID-19 pandemic has brought challenges to families around the world. The prolonged school closures in Hong Kong have forced young students to stay at home and adapt to remote learning for over a year, putting their mental health conditions at risk. Focusing on primary school students and their parents, the main objective of our research is to investigate the socioemotional factors and their associations with mental health conditions. METHODS: A total of 700 Hong Kong primary schoolers (mean age = 8.2) reported their emotional experiences, loneliness, and academic self-concept via a user-friendly online survey; 537 parents reported depression and anxiety, perceived child depression and anxiety, and social support. Responses from students and parents were paired to account for the family context. Structural Equation Modeling was used for correlations and regressions. RESULTS: The results of students' responses showed that positive emotional experiences were negatively associated with loneliness and positively related to academic self-concept among students. Furthermore, the paired sample results showed that, during the one-year societal lockdown and remote learning period, the socioemotional factors were associated with mental health conditions among primary school students and their parents. Among our family sample in Hong Kong, evidence supports the unique negative association between students-reported positive emotional experiences and parents-reported child depression and anxiety, as well as between social support and parents' depression and anxiety. CONCLUSIONS: These findings highlighted the associations between socioemotional factors and mental health among young primary schoolers during the societal lockdown. We thus call for more attention to the societal lockdown and remote learning context, especially since the social distancing practice could be "the new normal" for our society to handle the future pandemic crisis.


Subject(s)
COVID-19 , Mental Health , Child , Humans , Pandemics , COVID-19/epidemiology , Communicable Disease Control , Students , Schools , Parents
11.
BMC Public Health ; 23(1): 1028, 2023 05 31.
Article in English | MEDLINE | ID: covidwho-20243669

ABSTRACT

OBJECTIVE: To understand the public perceptions of the schools Covid-19 testing programme in England. DESIGN: Qualitative social media analysis. SETTING: Online users of parenting forums (Mumsnet and Netmums), Facebook newspaper pages and Daily Mail online readers, who responded to posts or articles about the schools testing programme in England, between 1 and 31 March, 2021. RESULTS: Overall, seven main themes were identified, these were divided into barriers and facilitators to engaging in testing for Covid-19. Barriers were: uncertainty around testing in the absence of symptoms; concerns about testing; implications about testing positive; mistrust in the Government. Facilitators were: desire to protect others; desire to return to normality; and hearing others' positive experiences. CONCLUSIONS: Our analysis highlighted that alongside well-established barriers to engaging in asymptomatic testing, parents were having to negotiate additional complex decisions around balancing their child's anxiety over testing alongside acknowledgement of the implications of regular testing, such as return to normality and protecting others. Parents and children would benefit from additional practical and social support to facilitate engagement with the schools testing programme.


Subject(s)
COVID-19 , Child , Humans , COVID-19/diagnosis , COVID-19 Testing , England , Parents , Social Support
12.
PLoS One ; 18(6): e0286578, 2023.
Article in English | MEDLINE | ID: covidwho-20243054

ABSTRACT

INTRODUCTION: Companionship in antenatal care is important for facilitating positive parental experiences. During the COVID-19 pandemic, restrictions on partner attendance at fetal ultrasound scans were introduced nationally to minimise transmission of the virus. This study aimed to explore the effect of these restrictions on maternal and paternal experiences of pregnancy scans and evaluate their potential effect on parent-fetal bonding. METHODS: A UK-wide, anonymous cross-sectional survey was completed by new and expectant parents (n = 714) who had, or were awaiting a pregnancy scan during the COVID-19 pandemic. The CORE-10 and an adapted version of the Prenatal Attachment Inventory were used to evaluate psychological distress and prenatal bonding. Additional survey questions captured parental experiences of scans. Separate statistical and thematic analyses of the data were undertaken. A joint display matrix was used to facilitate integration of quantitative and qualitative claims to generate a comprehensive interpretation of study findings. FINDINGS: When fathers did not attend the scan, feelings of excitement and satisfaction were significantly reduced (p<0.001) and feelings of anxiety increased (p<0.001) in both parents. Mothers were concerned about receiving unexpected news alone and fathers felt excluded from the scan. Mean paternal bonding (38.22, SD 10.73) was significantly lower compared to mothers (47.01, SD 7.67) although no difference was demonstrated between those who had attended the scan and those who had not. CORE-10 scores suggested low-to-mild levels of psychological distress, although the mean difference between mothers and fathers was not significant. Key themes described both parents' sense of loss for their desired pregnancy scan experience and reflected on sonographers' central role in providing parent-centred care during scans. CONCLUSION: Restrictions on partner attendance at scans during the COVID-19 pandemic had a negative effect on parental experiences of antenatal imaging. Provision of parent-centred care, which is inclusive of partners, is essential for improved parental experiences.


Subject(s)
COVID-19 , Prenatal Care , Male , Female , Pregnancy , Humans , Prenatal Care/methods , Cross-Sectional Studies , Pandemics , COVID-19/epidemiology , Parents/psychology , Mothers/psychology , United Kingdom/epidemiology
13.
BMC Health Serv Res ; 23(1): 530, 2023 May 23.
Article in English | MEDLINE | ID: covidwho-20241851

ABSTRACT

BACKGROUND: The purpose of thispaper is to explore the experiences of parents and carers of children with chronic health conditions in accessing healthcare during the Covid-19 pandemic. Children with chronic conditions typically rely on both planned and unplanned care, and contact with healthcare professionals over extensive periods of time. Their distinct care needs render these children vulnerable to even to minor changes in healthcare provision. The wide-ranging care disruptions during the pandemic were therefore likely drastically to affect their health and wellbeing; an assessment of the effects of Covid-19 policies on healthcare access and quality of care delivered for this group is needed. METHODS: From 25/01/2022 to 25/05/2022, four focus groups were held with parents/carers of children with diabetes, neurodivergence, mental health conditions, and medical complexities to explore their experiences in navigating the healthcare system during the pandemic. Interviews were transcribed and then subjected to thematic analysis using NVivo qualitative research software. RESULTS: Our results indicate that children with chronic health conditions (and their parents/carers) experienced difficulties accessing healthcare during the pandemic. Problems with late diagnosis, prolonged waiting times, and deficiencies with telemedicine were identified, as were impacts of healthcare disruptions on children's wellbeing, and the wellbeing of wider families. We found that children with neurodivergence and those with mental health conditions were particularly affected with their health needs repeatedly de-prioritised. Furthermore, the loss of contact with multi-specialty clinical teams profoundly affected parents and carers, leaving them feeling isolated in managing their children's health. These diminished relationships became another vector for uncertainty in supporting children's health. CONCLUSION: The effects of healthcare disruptions on the welfare of children with chronic conditions (and their families), are well evidenced in this work, providing deeper understandings of the relationships between these children, their families and clinicians. The evidence in this paper aims to inform future policy and ethical guidelines so that the needs of children with long-term health conditions can be properly considered in times of crisis.


Subject(s)
COVID-19 , Telemedicine , Humans , Child , Caregivers , Pandemics , Health Services Accessibility , Chronic Disease , Parents , Policy
14.
Horm Behav ; 153: 105375, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-20230743

ABSTRACT

The Developmental Origins of Health and Disease (DOHaD) hypothesis describes how maternal stress exposures experienced during critical periods of perinatal life are linked to altered developmental trajectories in offspring. Perinatal stress also induces changes in lactogenesis, milk volume, maternal care, and the nutritive and non-nutritive components of milk, affecting short and long-term developmental outcomes in offspring. For instance, selective early life stressors shape the contents of milk, including macro/micronutrients, immune components, microbiota, enzymes, hormones, milk-derived extracellular vesicles, and milk microRNAs. In this review, we highlight the contributions of parental lactation to offspring development by examining changes in the composition of breast milk in response to three well-characterized maternal stressors: nutritive stress, immune stress, and psychological stress. We discuss recent findings in human, animal, and in vitro models, their clinical relevance, study limitations, and potential therapeutic significance to improving human health and infant survival. We also discuss the benefits of enrichment methods and support tools that can be used to improve milk quality and volume as well as related developmental outcomes in offspring. Lastly, we use evidence-based primary literature to convey that even though select maternal stressors may modulate lactation biology (by influencing milk composition) depending on the severity and length of exposure, exclusive and/or prolonged milk feeding may attenuate the negative in utero effects of early life stressors and promote healthy developmental trajectories. Overall, scientific evidence supports lactation to be protective against nutritive and immune stressors, but the benefits of lactation in response to psychological stressors need further investigation.


Subject(s)
Breast Feeding , Lactation , Infant , Female , Pregnancy , Animals , Humans , Lactation/physiology , Milk, Human/physiology , Mothers/psychology , Parents
15.
Prax Kinderpsychol Kinderpsychiatr ; 72(4): 323-341, 2023 May.
Article in German | MEDLINE | ID: covidwho-2327456

ABSTRACT

Behavioural strengths and psychosocial problems in children and adolescents between the ages of 3 and 15 are reported. The survey is based on a household-representative sample of 2,421 parents or guardians providing information on their everyday family-life in summer 2021 by online-questionnaire. 704 of the respondents participated again in the spring of 2022. In result, the behaviour of a quarter of the children and adolescents is described as psychosocially borderline/abnormal over the survey period (SDQ total). About a third of children and adolescents have emotional problems, behavioural problems or problems with their peers (respective SDQ-subscales). The proportion of primary-school children with emotional problems increases from summer 2021 to the following spring. Families in which children with disabilities live are disproportionally more affected. The results are discussed with regard to the SDQ standard values available for Germany, as well as the families' self-reported supportneeds and their planned use of professional support-services. Given the psychosocial burden of children, adolescents and their families presented here, which become apparent well after the closures of day-care centres and schools, or other contact-restricting measures to contain the pandemic, have ended, it remains of interest to observe how their well-being will further develop over time.


Subject(s)
Pandemics , Problem Behavior , Humans , Child , Adolescent , Child, Preschool , Surveys and Questionnaires , Self Report , Germany , Parents/psychology
16.
BMJ Open ; 13(5): e068759, 2023 05 18.
Article in English | MEDLINE | ID: covidwho-2327387

ABSTRACT

INTRODUCTION: Parental presence in the neonatal intensive care unit (NICU) has been demonstrated to enhance infant growth and development, reduce parental anxiety and stress and strengthen parent-infant bonding. Since eHealth technology emerged, research on its utilisation in NICUs has risen substantially. There is some evidence that incorporating such technologies in the NICU can reduce parental stress and enhance parent confidence in caring for their infant.Several countries, including China, restrict parental attendance in NICUs, citing infection control challenges, issues of privacy and confidentiality and perceived additional workload for healthcare professionals. Due to COVID-19 pandemic-related shortages of personal protective equipment and uncertain mode of transmission, many NICUs around the world closed to parental visiting and engagement in neonatal care.There is anecdotal evidence that, given pandemic-related restrictions, eHealth technologies, have increasingly been used in NICUs as a potential substitute for in-person parental presence.However, the constraints and enablers of technologies in these situations have not been exhaustively examined. This scoping review aims to update the literature on eHealth technology utilisation in the NICU and to explore the literature on the challenges and facilitators of eHealth technology implementation to inform future research. METHODS AND ANALYSIS: The five-stage Arksey and O'Malley methodological framework and the Joanna Briggs Institute scoping review methodology will serve as the foundation for this scoping review. Eight databases will be searched for the relevant literature published between January 2000 and August 2022 in either English or Chinese. Grey literature will be manually searched. Data extraction and eligibility screening will be carried out by two impartial reviewers. There will be periods of both quantitative and qualitative analysis. ETHICS AND DISSEMINATION: Since all data and information will be taken from publicly accessible literature, ethical approval would not be necessary. A peer-reviewed publication will be published with the results of this scoping review. TRIAL REGISTRATION NUMBER: This scoping review protocol was registered in Open Science Framework and can be found here: https://osf.io/AQV5P/.


Subject(s)
COVID-19 , Telemedicine , Infant, Newborn , Humans , Infant , Intensive Care Units, Neonatal , Pandemics , COVID-19/epidemiology , Parents , Research Design , Review Literature as Topic
17.
Front Public Health ; 11: 1158698, 2023.
Article in English | MEDLINE | ID: covidwho-2327111

ABSTRACT

Introduction: This study aims to shed light on parent-child relationships and the psychological health of parents from low-income families after the easing of the COVID-19 pandemic restrictions. Methods: This cross-sectional study recruited 553 parents of children aged 13-24 years in low-income community settings. The Parent-Child Conflict scale of the Parental Environment Questionnaire (PEQ) was used to measure parent-child conflict. Psychological distress was assessed using the Depression, Anxiety, and Stress Scale short form (DASS-21). Results: The study revealed a low level of parent-child conflict in the overall study population, with a median PEQ of 48.0 (interquartile range [IQR] 36 to 48). Concerning demographics, married parents reported a likelihood of having a higher level of parent-child conflict over 3 times higher than single parents (OR = 3.18 95%, CI 1.30-7.75). More parent-child conflicts were also found in parents aged 60-72 years old who were unemployed, retired, or housewives and from lower-income groups. In regard to lifestyle factors, a higher level of physical activity and having enough sleep were associated with lower levels of parent-child conflict. Only approximately 1% of the participants reported symptoms of depression, anxiety, or stress. Discussion: Low risk exists for parent-child conflict and psychological sequelae following the easing of the COVID-19 pandemic restrictions, which could be due to various support measures implemented by the government. Vulnerable parents identified as being at risk of parent-child conflict warrant attention in future advocacy efforts.


Subject(s)
COVID-19 , Psychological Distress , Humans , Middle Aged , Aged , Cross-Sectional Studies , Pandemics , COVID-19/epidemiology , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Parents/psychology , Parent-Child Relations , Surveys and Questionnaires
18.
J Community Health ; 48(3): 390-397, 2023 06.
Article in English | MEDLINE | ID: covidwho-2326732

ABSTRACT

The more than one million COVID-19 deaths in the United States include parents, grandparents, and other caregivers for children. These losses can disrupt the social, emotional, and economic well-being of children, their families, and their communities, and understanding the number and characteristics of affected children is a critical step in responding. We estimate the number of children who lost a parent or other co-residing caregiver to COVID-19 in the U.S. and identify racial, ethnic, and geographic disparities by aligning COVID-19 death counts through mid-May 2022 with household information from a representative sample of individuals. We estimate that 216,617 children lost a co-residing caregiver to COVID-19; 77,283 lost a parent and more than 17,000 children lost the only caregiver with whom they lived. Non-White children were more than twice as likely as White children to experience caregiver loss, and children under 14 years old experienced 70% of caregiver loss. These losses are a salient threat to the functioning of families and the communities in which COVID-19 deaths are concentrated, compounding additional challenges to physical and mental health and economic stability disproportionately imposed by the pandemic on historically disadvantaged populations. Policymakers and systems should take steps to ensure access to appropriate supports.


Subject(s)
COVID-19 , Humans , Child , United States/epidemiology , Adolescent , COVID-19/epidemiology , Caregivers/psychology , Prevalence , Parents , Family Characteristics
19.
J Youth Adolesc ; 52(7): 1374-1389, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-2325278

ABSTRACT

Although literature states that individual, relational, and contextual factors contribute to adolescents' sense of agency, more research is needed to clarify and understand how adolescents develop this belief over time. The current study examined the stability/change trajectories of the sense of agency during adolescence, specifically across high school, analyzing whether attachment to parents over time, adolescents' sex, cumulative risk in baseline, and pandemic-related stress explained these trajectories. The sample included 467 Portuguese adolescents (40.7% were males; Mage = 15.58 years, SD = 0.80), evaluated three times across 18 months. This work yielded three significant findings. First, adolescents' sense of agency significantly increased over time, with significant between-subject variance at the initial levels but not at the growth rate. Second, attachment to parents consistently links to adolescents' sense of agency across time, despite the differential contributions from attachment to mothers and fathers. Third, boys reported greater growth in the sense of agency than girls. Adolescents' cumulative risk at T1 predicted lower initial levels of sense of agency, whereas higher pandemic-related stress predicted less growth of the sense of agency. These findings emphasize the contributions of individual and family characteristics and the role of the broader social context in shaping the development of adolescents' sense of agency. The findings underline the need to consider further the differential influences of adolescents' relationships with mothers and fathers to understand changes in adolescents' sense of agency.


Subject(s)
Adolescent Behavior , Pandemics , Male , Female , Humans , Adolescent , Parents , Mothers , Schools
20.
Int J Qual Stud Health Well-being ; 18(1): 2215578, 2023 Dec.
Article in English | MEDLINE | ID: covidwho-2323853

ABSTRACT

PURPOSE: The COVID-19 pandemic restrictions have had a major impact on the organization of health services in Europe. Co-parents' experiences of not being allowed to fully participate during pregnancy, childbirth, and the postpartum period is poorly understood. We investigated how the non-birthing partner experienced becoming a parent during the pandemic. METHODS: We applied a qualitative design. We recruited the participants from all part of the country by using snowball sampling. 18 individual interviews were conducted by using videotelephony software program/telephone. The transcripts were analysed using a six-step model for thematic analysis. RESULTS: The non-birthing participants were not considered by the healthcare system to be equal partners in terms of their involvement in the process of becoming parents. Three themes were constructed from the interview analysis- deprivation of the opportunity of "doing their part" of the job; participation by proxy to enhance togetherness; and choosing between obedience or opposition to the restrictions. CONCLUSION: The non-birthing co-parents felt deprived of doing what they considered to be their most important job-namely, to support and comfort their partners during pregnancy and childbirth. The healthcare system's decision to exclude co-parents from being physically present thus requires further reflection and discussion.


Subject(s)
COVID-19 , Female , Pregnancy , Humans , Pandemics , Parturition , Postpartum Period , Qualitative Research , Parents
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