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1.
J Dev Behav Pediatr ; 43(9): e581-e589, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2135649

ABSTRACT

OBJECTIVE: During the COVID-19 pandemic, caregivers who are facing high stress levels and decreased emotional well-being may parent their children differently. Certain children are experiencing greater fear in response to COVID-19, and research is needed to identify parenting behaviors significantly linked with children's COVID-19 fear. The purpose of this article was to evaluate whether the association between parenting stress and children's COVID-19 fear could be explained by parents' COVID-19 information management and emotional well-being. METHODS: Participants were recruited through Amazon Mechanical Turk. The sample consisted of 595 caregivers of children during the COVID-19 pandemic; 40.0% men, 69.2% non-Latinx White, 12.1% Black, 10.1% Latinx, 6.6% Asian, and <2% others. Children had an average age of 11.3 years. Parents completed self-report measures. RESULTS: The bootstrapped confidence interval (0.040, 0.148) for the indirect effect (0.090) revealed that parent emotional well-being significantly mediated the relation between parenting stress and children's COVID-19 fear. In addition, parent management of children's COVID-19 knowledge significantly mediated the relation between parenting stress and children's COVID-19 fear. CONCLUSION: We found that the combined effect of parents' emotional well-being and parents' management of children's COVID-19 knowledge significantly mediated the positive relation between parenting stress and children's COVID-19 fear. Based on our findings, once parents' parenting stress is decreased and their well-being increases, parents may be more likely to provide children with developmentally appropriate and accurate COVID-19 information.


Subject(s)
COVID-19 , Parenting , Child , Male , Humans , Female , Parenting/psychology , COVID-19/epidemiology , Pandemics , Parents/psychology , Fear , Information Management , Parent-Child Relations
2.
Curr Psychiatry Rep ; 24(11): 591-601, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2129143

ABSTRACT

PURPOSE OF REVIEW: Parental mental disorders, particularly borderline personality disorder (BPD), impair parenting behavior. Consequently, the children exhibit an elevated risk for psychopathology across their lifespan. Social support for parents is thought to moderate the relationship between parental mental illness and parenting behavior. It may dampen negative effects and serve as starting point for preventive interventions. This paper provides a literature overview regarding the impact of social support on the sequelae of parental mental illness and BPD for parenting behavior. RECENT FINDINGS: Current literature highlights the increased burden of families with a mentally ill parent and associated changes in parenting behavior like increased hostility and affective dysregulation, especially in the context of parental BPD. Literature further demonstrates the powerful impact of social support in buffering such negative outcomes. The effect of social support seems to be moderated itself by further factors like socioeconomic status, gender, or characteristics of the social network. Social support facilitates positive parenting in mentally ill parents and may be particularly important in parents with BPD. However, social support is embedded within a framework of influencing factors, which need consideration when interpreting scientific results.


Subject(s)
Borderline Personality Disorder , Child of Impaired Parents , Child , Humans , Parenting/psychology , Borderline Personality Disorder/psychology , Parents/psychology , Child of Impaired Parents/psychology , Social Support
3.
Sci Rep ; 12(1): 19601, 2022 Nov 15.
Article in English | MEDLINE | ID: covidwho-2119275

ABSTRACT

A large longitudinal study on the impact of the COVID-19 pandemic on mental health in children is limited. This large-scale longitudinal observational study examines the pandemic's effects on children's mental health while considering the effects of parental care styles. The Adolescent Brain Cognitive Development Study is a large-scale, longitudinal multicenter study in the United States. Of the 11,875 children aged 9-12 years in its database, 4702 subjects were selected for this study. The child behavior checklist and parental monitoring questionnaire (PMQ) were used to assess children's mental health and parental support styles, respectively. Data collected before and during the pandemic were compared. Withdrawn/depressed and attention problems significantly worsened during compared to before the COVID-19 pandemic (p < 0.001, withdrawn/depressed; 53.4 ± 5.7 to 53.7 ± 5.9, attention problems; 53.4 ± 5.4 to 53.6 ± 5.6). However, the T scores are in the normal range both before and during the crisis. Simple slope analysis found withdrawn/depressed problems and aggressive behavior worsened when the PMQ was 1 SD below the mean, and rule-breaking behavior was improved when the PMQ was 1 SD above the mean. While the COVID-19 pandemic exacerbated children's depressive symptoms and attention issues, the effects may be minor. Additionally, parental involvement serve as a protective factor for the child's mental health even during the pandemic.


Subject(s)
COVID-19 , Mental Health , Child , Adolescent , Humans , Pandemics , COVID-19/epidemiology , Longitudinal Studies , Parents/psychology
4.
Trials ; 23(1): 942, 2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2117899

ABSTRACT

BACKGROUND: In the context of COVID-19, NHS Child and Adolescent Mental Health Services (CAMHS) and other children's mental health services have faced major challenges in providing psychological treatments that (i) work when delivered remotely and (ii) can be delivered efficiently to manage increases in referrals as social distancing measures have been relaxed. Anxiety problems are a common reason for referral to CAMHS, children with pre-existing anxiety problems are particularly vulnerable in the context of COVID-19, and there were concerns about increases in childhood anxiety as schools reopened. The proposed research will evaluate the clinical and cost-effectiveness of a brief online parent-led cognitive behavioural treatment (CBT) delivered by the OSI (Online Support and Intervention for child anxiety) platform with remote support from a CAMHS therapist compared to 'COVID-19 treatment as usual' (C-TAU) in CAMHS and other children's mental health services throughout the COVID-19 pandemic. METHODS: We will conduct a two-arm, multi-site, randomised controlled non-inferiority trial to evaluate the clinical and cost-effectiveness of OSI with therapist support compared to CAMHS and other child mental health services 'COVID-19 treatment as usual' (C-TAU) during the COVID-19 outbreak and to explore parent and therapists' experiences. DISCUSSION: If non-inferiority is shown, the research will provide (1) a solution for efficient psychological treatment for child anxiety disorders while social distancing (for the COVID-19 context and future pandemics); (2) an efficient means of treatment delivery as 'normal service' resumes to enable CAMHS to cope with the anticipated increase in referrals; and (3) a demonstration of rapid, high-quality evaluation and application of online interventions within NHS CAMHS to drive forward much-needed further digital innovation and evaluation in CAMHS settings. The primary beneficiaries will be children with anxiety disorders and their families, NHS CAMHS teams, and commissioners who will access a potentially effective, cost-effective, and efficient treatment for child anxiety problems. TRIAL REGISTRATION: ISRCTN ISRCTN12890382 . Registered prospectively on 23 October 2020.


Subject(s)
COVID-19 , Mental Health Services , Humans , Cost-Benefit Analysis , Pandemics , Anxiety Disorders/therapy , Parents/psychology , Anxiety/diagnosis , Anxiety/therapy , United Kingdom , Randomized Controlled Trials as Topic
5.
BMC Health Serv Res ; 22(1): 1350, 2022 Nov 14.
Article in English | MEDLINE | ID: covidwho-2115845

ABSTRACT

BACKGROUND: The global COVID-19 pandemic necessitated rapid adoption of remote provision across child and adolescent mental health services (CAMHS). The study aimed to understand young people's, parents'/carers', and professionals' experiences of remote provision across CAMHS in one NHS Trust in the North West of England to inform future recovery practice so that remote sessions can continue where they have been well received but re-thought or replaced where they have not. METHODS: The study sample comprised three groups: (i) young people, (ii) parents/carers, and (iii) clinical staff. Semi-structured interviews and focus groups were used to collect data. Data were analysed using thematic analysis. RESULTS: Three overarching themes were identified: 'Remote therapeutic experiences'; 'Spaces and places of therapy'; and 'Future of CAMHS'. Although remote appointments increased flexibility within the service, the quality of the relational experience was altered, typically for the worse. Clinicians felt less able to examine vital forms of non-verbal communication, which were considered instrumental in assessing and engaging people experiencing difficulties, leaving some questioning their professionalism. Although some young people suggested that remote provision increased comfort levels, others felt their place of comfort and safety was invaded. CONCLUSIONS: Reduced travel time for both clinicians and families may increase capacity, enabling the service to meet the increased demand if clinical effectiveness can be preserved. In considering future models of provision, assessing clinical need, patient and family preference, and access to space and hardware are all critical when deciding which modality to use for the best outcomes for each individual.


Subject(s)
Adolescent Health Services , COVID-19 , Mental Health Services , Humans , Adolescent , Child , Pandemics , COVID-19/epidemiology , Parents/psychology
7.
Int J Qual Stud Health Well-being ; 17(1): 2136090, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2087630

ABSTRACT

BACKGROUND: The global pandemic and subsequent denials, delays, and disruptions in essential daily activities created significant challenges for children with neurodevelopmental disorders (NDDs) and their parents. Public health restrictions during the COVID-19 pandemic limited access to supports and services required by children with NDDs to maintain their health and well-being. OBJECTIVE: This study sought to understand the impacts of these public health measures and restrictions on mental health from the perspective of parents with children with NDDs to inform pathways for public health policies responsive to the needs of this population. METHOD: Interpretive descriptive design was used to guide data collection and data analysis. Forty caregivers were interviewed about their experience with pandemic restrictions. FINDINGS: Generic policy measures contributed to many gaps in families' social support systems and contributed to mental health challenges for children and their parents. Four themes emerged: 1) lack of social networks and activities, 2) lack of access to health and social supports, 3) tension in the family unit, and 4) impact on mental health for children and their parents. RECOMMENDATIONS: Emergency preparedness planning requires a disability inclusive approach allocating resources for family supports in the home and community. Families identified supports to minimize further pandemic disruptions and enhance recovery.


Subject(s)
COVID-19 , Child , Humans , Pandemics , Mental Health , Parents/psychology , Social Support
8.
BMC Psychiatry ; 22(1): 328, 2022 05 10.
Article in English | MEDLINE | ID: covidwho-2084695

ABSTRACT

BACKGROUND: Previous studies on the association of online courses and mental health were mainly conducted in universities, and no study investigated the relationship between characteristics of online courses and children's mental health in primary and secondary school. This study aimed to explore the association of online courses and children's mental health in primary and secondary school. METHODS: A cross-sectional study was conducted through an online survey among 540 primary and secondary school students and their parents in the eastern, central and western region of China from April to May in 2020. Children's mental health was assessed by the Strengths and Difficulties Questionnaire (SDQ). Borderline mental health problems (SDQ total difficulties score ≥ 16) and mental health problems (SDQ total difficulties score ≥ 20) were defined according to Goodman's standard. Multivariable linear and logistic regression models were used to examine the association between online courses and children's mental health. RESULTS: Compared with those who did not have problems of online courses, children having the difficulty in understanding the content of online courses had a higher SDQ total difficulties score [ß = 1.80, 95% confidence interval (CI): 0.89, 2.71] and a higher risk of borderline mental health problems [odds ratio (OR) = 1.93, 95%CI: 1.07, 3.49], while device or internet connection problems were not significantly associated with children's mental health. Compared with children who had live courses, those having video-recorded courses had a higher SDQ total difficulties score (ß = 0.90, 95%CI: 0.01, 1.80). Children who spent more than 4 h on online courses had a higher SDQ total difficulties score than those of less than or equal to 4 h (ß = 0.95, 95%CI: 0.09, 1.81). CONCLUSION: We found that online courses with inappropriate characteristics were associated with children's mental health. The findings called for the efforts to optimize the online courses and improve children's mental health.


Subject(s)
Mental Disorders , Mental Health , Child , China , Cross-Sectional Studies , Humans , Parents/psychology , Surveys and Questionnaires
9.
BMC Pregnancy Childbirth ; 22(1): 302, 2022 Apr 09.
Article in English | MEDLINE | ID: covidwho-2079399

ABSTRACT

BACKGROUND: The Covid-19 pandemic has put an unprecedented pressure on families with children. How parents were affected by the first Covid-19 lockdown during the early postpartum period, an already challenging period for many, is unknown. AIM: To investigate the associations between Covid-19 related stress, mental health, and insensitive parenting practices in mothers and fathers with young infants during the first Dutch Covid-19 lockdown. METHODS: The Dutch Covid-19 and Perinatal Experiences (COPE-NL) study included 681 parents of infants between 0 and 6 months (572 mothers and 109 fathers). Parents filled out online questionnaires about Covid-19 related stress, mental health (i.e. anxiety and depressive symptoms), and insensitive parenting. Hierarchical regression models were used to analyze the data. RESULTS: Parents of a young infant reported high rates of Covid-19 related stress, with higher reported stress in mothers compared to fathers. Additionally, the percentages of mothers and fathers experiencing clinically meaningful mental health symptoms during the pandemic were relatively high (mothers: 39.7% anxiety, 14.5% depression; fathers: 37.6% anxiety, 6.4% depression). More Covid-19 related stress was associated with more mental health symptoms in parents and increased insensitive parenting practices in mothers. CONCLUSIONS: The results emphasize the strain of the pandemic on young fathers' and mothers' mental health and its potential negative consequences for parenting. As poor parental mental health and insensitive parenting practices carry risk for worse child outcomes across the lifespan, the mental health burden of the Covid-19 pandemic might not only have affected the parents, but also the next generation.


Subject(s)
COVID-19 , Parenting , COVID-19/epidemiology , Child , Communicable Disease Control , Fathers/psychology , Female , Humans , Infant , Male , Mental Health , Mothers/psychology , Pandemics , Parenting/psychology , Parents/psychology , Pregnancy
10.
BMC Palliat Care ; 21(1): 177, 2022 Oct 10.
Article in English | MEDLINE | ID: covidwho-2064781

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, many children and young people have experienced the death of close family members, whilst also facing unprecedented disruption to their lives. This study aimed to investigate the experiences and support needs of bereaved children and young people from the perspective of their parents and guardians. METHODS: We analysed cross-sectional qualitative free-text data from a survey of adults bereaved in the UK during the pandemic. Participants were recruited via media, social media, national associations and community/charitable organisations. Thematic analysis was conducted on free text data collected from parent/guardian participants in response to a survey question on the bereavement experiences and support needs of their children. RESULTS: Free-text data from 104 parent/guardian participants was included. Three main themes were identified: the pandemic-related challenges and struggles experienced by children and young people; family support and coping; and support from schools and services. Pandemic-challenges include the impacts of being separated from the relative prior to their death, isolation from peers and other family members, and disruption to daily routines and wider support networks. Examples were given of effective family coping and communication, but also of difficulties relating to parental grief and children's existing mental health problems. Schools and bereavement organisations' provision of specialist support was valued, but there was evidence of unmet need, with some participants reporting a lack of access to specialist grief or mental health support. CONCLUSION: Children and young people have faced additional strains and challenges associated with pandemic bereavement. We recommend resources and initiatives that facilitate supportive communication within family and school settings, adequate resourcing of school and community-based specialist bereavement/mental health services, and increased information and signposting to the support that is available.


Subject(s)
Bereavement , COVID-19 , Adolescent , Adult , Child , Cross-Sectional Studies , Grief , Humans , Pandemics , Parents/psychology , Qualitative Research
11.
BMC Pregnancy Childbirth ; 22(1): 763, 2022 Oct 12.
Article in English | MEDLINE | ID: covidwho-2064761

ABSTRACT

Poor mental health in the postnatal period is experienced by high numbers of parents, with a high associated cost to society, however accessing therapeutic support during this time is complicated by parenting commitments. This has been further compounded by the covid-19 pandemic, where access to traditional therapy has been impacted. A lack of access to support for poor mental health in this period can have long term impacts on both the parents and their child. E-Health provides a potential solution to parents accessing support during this period by providing a convenient and flexible intervention which overcomes the barriers of traditional face-to-face therapy. However, without investigating the acceptability of such support for parents, it is not possible to predict uptake and consequent effectiveness. The current review synthesizes data available on acceptability of e-Health interventions in the post-natal period, finding that parents valued e-Health interventions however considerations must be made to certain, key areas impacting the acceptability of these interventions for parents. An element of therapist support and individualised content was preferred, along with a smooth user experience. Parents valued that e-Health fit into their routines and provided anonymity in their interactions. Further research needs to be completed into acceptability for minority social and ethnic groups where access and preference may differ.


Subject(s)
COVID-19 , Telemedicine , Child , Humans , Mental Health , Pandemics , Parenting/psychology , Parents/psychology
12.
Fam Community Health ; 45(4): 288-298, 2022.
Article in English | MEDLINE | ID: covidwho-2063028

ABSTRACT

Many children have experienced unprecedented levels of stress as a result of the COVID-19 pandemic due to school closures, strained resources, and excess morbidity and mortality. The current study examines change in children's mental health and sleep during the early months of the US pandemic and identifies risk and protective factors. In May 2020, a total of 225 parents reported on the mental health and sleep of each child (N = 392 children) living in their household prior to the onset of the COVID-19 pandemic and about their functioning in the past month. McNemar's test examined change in mental health and sleep disturbance across developmental stage. Bivariate and multivariate generalized estimating equations examined predictors of change in mental health and sleep. Each age group showed a significant change in mental health and sleep outcomes, but the development of mental health problems was greater for older children. Parental caregiving strain (adjusted odds ratio [aOR] = 2.42; 95% confidence interval [CI], 1.11-5.27) was identified as a risk factor associated with children developing anxiety, and income loss was associated with developing sleep disturbances (aOR = 2.34; 95% CI, 1.06-5.17). Parental receipt of emotional support was identified as a protective factor for all child health outcomes. Policies and interventions that promote access to mental health services, provide financial safety nets, and strengthen social support networks for families are needed.


Subject(s)
COVID-19 , Mental Health , Adolescent , COVID-19/epidemiology , Child , Humans , Pandemics , Parents/psychology , Sleep , United States/epidemiology
13.
Front Public Health ; 10: 924434, 2022.
Article in English | MEDLINE | ID: covidwho-2055088

ABSTRACT

Background: A 3-month parent education program was designed and implemented in Hong Kong to improve physical literacy (PL) among primary school children and their parents during the COVID-19 pandemic. This study aims to probe into the acceptability of the intervention from parental perspectives, providing more insights for future implementation. Methods: Following the 3-month parent-focused PL program, 16 parents (mean age = 43.73 years, 15 mothers) were recruited to participate in semi-structured individual interviews in June 2021. Interviews were analyzed using thematic analysis in NVivo 12. Two coders analyzed interview transcripts deductively based on the interview guide and social cognitive theory (SCT). Results: Three themes were identified that captured the acceptability of the program: (1) Addressing needs through appropriate delivery enhances acceptability of intervention; (2) Positive behavioral and psychological changes to families; (3) Appropriate support of environmental factors can enhance the sustainability of program effects. The high levels of acceptability were attributable to the fact that parents were able to learn and be a gatekeeper to impact their children positively. Moreover, the design and contents of the program were appropriate for the participating parents because the program provided adequate learning resources and interactive learning support without being overly rigid, and the online learning mode was feasible and convenient. Consequent to their participation in the program, parents expressed that they became more aware of the importance of PL, established physical activity routines with their children, and modified their parenting styles which resulted in improved parent-child relationships. Conclusions: The current study provided evidence that engaging parents in the intervention was feasible and acceptable approach in supporting both parents and children to establish physically active routines in the family setting. The insights gained regarding the appropriateness and acceptability of the program in this specific context may be used to inform the design, implementation and sustainability of other parent-focused PL programs.


Subject(s)
COVID-19 , Literacy , Adult , COVID-19/prevention & control , Child , Female , Humans , Pandemics , Parenting/psychology , Parents/psychology
15.
Acta Paediatr ; 111(12): 2352-2358, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2052251

ABSTRACT

AIM: To examine the impact of the COVID-19 pandemic on the mental health of parents of infants with colic and on healthcare use. METHODS: Retrospective cohort study. Data of 64 parents of infants with colic prepandemic and 43 parents of infants with colic during the pandemic were analysed using validated questionnaires on parental stress, depression and anxiety. Additionally, we evaluated the number of outpatient clinic visits and admission rates pre- and during the pandemic by collecting data on the diagnosis treatment combination 'excessive crying' from electronic patient files in three secondary hospitals in the Netherlands. RESULTS: Mothers in the pandemic group reported significantly higher levels of depression than mothers in the prepandemic group (12.3 ± 7.0 and 8.8 ± 5.2; p = 0.04). Moreover, mothers showed a trend towards higher stress levels during the pandemic (29.6 ± 9.6 and 25.2 ± 8.1; p = 0.06). During the pandemic, admission numbers of infants with colic compared to prepandemic data increased with 34% (146 vs. 196). CONCLUSION: Mothers of infants with colic reported significantly more feelings of depression during the COVID-19 pandemic. Furthermore, the pandemic was associated with increased healthcare use amongst infants with colic. With the continuing pandemic, we recommend active perinatal support for this vulnerable population.


Subject(s)
COVID-19 , Colic , Infant , Female , Humans , Colic/epidemiology , Crying/psychology , Mental Health , Pandemics , COVID-19/epidemiology , Retrospective Studies , Parents/psychology , Delivery of Health Care
16.
Medicine (Baltimore) ; 101(26): e29741, 2022 Jul 01.
Article in English | MEDLINE | ID: covidwho-2051690

ABSTRACT

Older individuals are more vulnerable to severe coronavirus disease 2019 and medical complications. Vaccination stands as an efficient and safe vanguard against infection. However, negative attitudes and perceptions pertaining to available vaccines might hinder community inoculation. The aim of this study was to assess vaccine hesitancy and its psychosocial determinants among the elderly in Qatar. We conducted a cross-sectional study between October 15 and November 15, 2020, using a composite online survey including the Vaccine Attitudes Examination Scale in addition to questions on sociodemographic correlates and the role of healthcare professionals. The vaccine hesitancy rate was 19.5%. The main reasons for willingness to vaccinate included understanding the nature of disease and role of vaccination, in addition to information provided by physicians. Fears mainly centered around vaccine safety. Vaccine hesitators were more likely to be non-Qatari and having received the influenza vaccine at least once. Gender, marital status, socioeconomic status, educational level, and having completed childhood vaccinations were not associated with vaccine hesitancy. Efforts should be directed toward raising awareness of vaccine efficacy and safety profiles. Physicians should additionally be educated about their pivotal role in advocating vaccine acceptance. We recommend reassessing vaccine hesitancy and its associated factors following a year of campaigning and vaccine administration to identify and target vulnerable groups.


Subject(s)
COVID-19 , Influenza Vaccines , Urogenital Abnormalities , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Humans , Parents/psychology , Prevalence , Vaccination Hesitancy
17.
Sci Diabetes Self Manag Care ; 48(6): 522-532, 2022 12.
Article in English | MEDLINE | ID: covidwho-2043098

ABSTRACT

PURPOSE: The purpose of this study was to understand impacts of the coronavirus (COVID-19) pandemic on pediatric type 1 diabetes management. METHODS: In-depth qualitative interviews were conducted with 15 parents of children (age 6-12 years) with type 1 diabetes. Parents responded to 8 open-ended questions about their experiences managing their children's type 1 diabetes during the COVID-19 pandemic. All interviews were transcribed, coded, and analyzed using qualitative thematic methods. RESULTS: Parents reported both positive and negative aspects of managing their children's type 1 diabetes during the COVID-19 pandemic. Facilitators of diabetes management included spending more time together at home and enhanced convenience of telehealth appointments and online supply ordering. Parents also described difficulties managing their children's type 1 diabetes during the COVID-19 pandemic, including a lack of structure in their child's daily routine, which led to increases in sedentary behavior. Furthermore, they reported psychosocial challenges of type 1 diabetes management, which were exacerbated by the pandemic. CONCLUSION: While the COVID-19 pandemic was described as having overall positive impacts on pediatric type 1 diabetes management, efforts to support parents in increasing children's physical activity and reducing screen time are needed, along with readily accessible mental health resources for both parents and their children with type 1 diabetes.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 1 , Humans , Child , COVID-19/epidemiology , Pandemics , Diabetes Mellitus, Type 1/epidemiology , Qualitative Research , Parents/psychology
18.
Matern Child Health J ; 26(10): 2060-2069, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2035168

ABSTRACT

OBJECTIVES: Despite evidence for heightened psychiatric risk and unique parenting challenges during the COVID-19 pandemic, no research exists on the specific needs of parents of infants and responsiveness of pediatric care to their needs. We aimed to describe the support needs of new parents and explore their experiences with pediatric care. METHODS: In late 2020 we conducted semi-structured interviews with 30 mothers of babies born or due that year. Interviews addressed perinatal experiences during the pandemic, with an emphasis on experiences related to social support. In an iterative, inductive process, thematic analysis was used to analyze the data. RESULTS: This study identifies a set of support needs specific to the context of parenting an infant during the COVID-19 crisis: coping with the compound psychological impacts of the postpartum period and a pandemic; parenting in the absence of expected social support; risk assessment to keep infant and family safe. This study finds that policies implemented by health care providers to reduce risk of COVID-19 transmission came at a cost to new parents and parent-provider relationships. Participants reported mixed experiences with in-person and telehealth pediatric care, including inadequate and/or uncomfortable postpartum mental health screening and breastfeeding support, and identified specific features that constituted responsive care during the pandemic. CONCLUSIONS: Normative changes associated with the postpartum period combined with complex adaptations necessitated by the COVID-19 pandemic presented substantial challenges for families with infants, even relatively privileged families. Providers can incorporate these findings to enhance support for families and promote maternal and child health.


Subject(s)
COVID-19 , Mothers , Parenting , COVID-19/epidemiology , Child , Female , Humans , Infant , Mothers/psychology , Pandemics , Parenting/psychology , Parents/psychology , Pregnancy
19.
J Clin Ethics ; 33(3): 236-239, 2022.
Article in English | MEDLINE | ID: covidwho-2034085

ABSTRACT

Mandatory vaccination against COVID-19 is a highly controversial issue, and many members of the public oppose it on the grounds that they should be free to determine what happens to their own body. Opinion has generally favored parental authority with respect to vaccination of children, but less attention has been paid to the ethical complexities of how to respond when mature minors refuse vaccination that is requested by their parents. We present a case in which an mature minor, who was psychiatrically hospitalized, refused vaccination that had been requested by her parents, which lead to significant moral distress for her caregivers.


Subject(s)
COVID-19 Vaccines , COVID-19 , COVID-19/prevention & control , Child , Female , Humans , Inpatients , Morals , Parents/psychology , Vaccination
20.
Soc Sci Med ; 312: 115373, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2031692

ABSTRACT

Poverty is known to be associated with poorer child mental wellbeing. Relatedly, the security and quality of employment are reported to affect adult wellbeing. Less is known about how both poverty and parental employment affect children's mental wellbeing. This paper uses nine waves (2005/06-2017/18) of the Growing Up in Scotland (GUS) study to examine how the longitudinal trajectories of poverty and work intensity are associated with the longitudinal trajectories of mental wellbeing in a nationally representative sample of 3994 children (ages 0 to 12). This analysis was conducted via a bivariate multilevel non-linear growth curve model for the widely used Strengths and Difficulties Questionnaire (SDQ) subscales of conduct problems and emotional symptoms. Results show that unstable work intensity and poverty trajectories arising from the 2008 financial crisis are associated with substantial changes in the trajectories of conduct and emotional problems, but with key differences between the individual outcomes: increasing work intensity is associated with around a fifth of a standard deviation increase in conduct problems; decreasing work intensity over time is associated with around a fifth of a standard deviation increase in emotional problems; material deprivation is associated with an increase in both conduct and emotional problems, at around a tenth of a standard deviation; and longitudinal income poverty trajectories are associated with up to around a fifth of a standard deviation increase in conduct problems, but not emotional symptoms. These findings are discussed with the purpose of informing policies to tackle the effects of unstable and/or changing socioeconomic circumstances on children's mental health wellbeing in the context of an economic crisis, as well as its implications for the contemporary socioeconomic landscape and the devastating effects expected of the COVID-19 crisis.


Subject(s)
COVID-19 , Problem Behavior , Adult , Child , Child, Preschool , Family , Humans , Infant , Infant, Newborn , Parents/psychology , Poverty/psychology
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