Psycho-social impact of social distancing and isolation due to the COVID-19 containment measures on patients with physical disabilities.

ABSTRACT

BACKGROUND: While the COVID-19 pandemic was spreading worldwide, the Italian government stated lockdown, with a drastic reorganization of healthcare systems. The psychological and social effects of the pandemic and the restrictions of freedom could have had a detrimental impact on people with physical disabilities, for whom well-being depends strongly on their social environment. AIM: Our main aim was to describe the overall impact of the pandemic on mental health, social condition and illness perception among patients with disabilities, to provide early interventions for this particularly vulnerable population. For this purpose, we performed a specific screening protocol to detect the prevalence of any psychological distress. DESIGN: Cross-sectional observational study. SETTING: Telephonic interview administered to patients and their caregivers attending the Unit of Neurorehabilitation at the University Hospital of Pisa. POPULATION 134 patients with physical disability related to neurological disorders, who had their outpatient appointment cancelled, because of the government dispositions, were enrolled. METHODS: A specific questionnaire (COVID19-q) was designed to test patients' psycho-social state, including a section addressed to the caregiver. Moreover, a standardized psychological evaluation, using the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), was also performed. RESULTS: Results show a different impact in our study population compared to the general population on psychological aspect. Patients did not manifest any clinically relevant distress, as assessed with CORE-OM. However, patients with higher disability degree reported a statistically lower outcome in the social function, in the well-being domains and an increase in risk behavior. Results from COVID19-q show that most of our patients reported none or mild change in their psycho-social habits and perception of illness during lockdown. However, reduction of family cohesion and lack of healthcare support are two important aspects that people with disability had to face with during the pandemic emergency. CONCLUSIONS: People with physical disabilities surprisingly shown milder effects of the pandemic on their psychological state and good coping skills in facing social isolation, manifesting resilience resources. However, the is a need to give concrete support to healthcare and social care, especially in the management of severe disability. CLINICAL REHABILITATION IMPACT This unexpected and reassuring result may reveal a worrying scenario regarding-the social participation and quality of life of people with disabilities were they already in lockdown?