Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Department of Medical and Surgical Neuroscience and Rehabilitation (DINOGMI), University of Genoa, Genoa, Italy.
Front Public Health. 2021 Feb 5;9:608358. doi: 10.3389/fpubh.2021.608358. eCollection 2021.
The COVID-19 pandemic has changed individuals' lifestyles to a great extent, particularly in Italy. Although many concerns about it have been highlighted, its impact on children and adolescents has scarcely been examined. The purpose of this study was to explore behavioral consequences and coping strategies related to the pandemic among families in Italy, by focusing on developmental ages from the caregivers' perspective, 3 weeks into quarantine. An exploratory cross-sectional online survey was conducted over 14 days. Google Forms was employed to conduct the survey. Demographic variables and pre-existing Psychological Weaknesses (PsW) were asked. Adults' sleep difficulties (SleepScore) and coping strategies during quarantine were assessed. Behavioral changes related to quarantine of both subjects completing the form (COVIDStress) and their children (when present) were questioned. Of the 6,871 respondents, we selected 6,800 valid questionnaires; 3,245 declared children aged under 18 years of age (caregivers). PsWs were recognizable in 64.9% among non-caregivers and in 61.5% of caregivers, with a mean PsW score of 1.42 ± 1.26 and 1.30 ± 1.25 over 3 points, respectively. The 95.5% of the non-caregivers and the 96.5% of caregivers presented behavioral changes with a mean COVIDStress of 3.85 ± 1.82 and 4.09 ± 1.79 over 8, respectively (<0.001). Sleep difficulties were present in the 61.6% of the non-caregivers and in the 64.4% of the caregivers ( < 0.001), who showed higher SleepScores (2.41 ± 1.26 against 2.57 ± 1.38 points over 6, < 0.001). COVIDStress (and SleepScore) strongly correlated with PsW ( < 0.001). Caregivers observed behavioral changes in their children in the 64.3% of the <6 years old and in 72.5% of 6-18 years old. Caregivers' discomfort related to quarantine (COVIDStress, SleepScore) was strongly associated to behavioral changes in both age groups of <6 and 6-18 ( < 0.001). Presence of caregivers' coping strategies was less associated to behavioral changes in the <6 sample ( = 0.001) but not in the 6-18 ( = 0.06). The COVID-19 pandemic has adversely impacted families in Italy with regard to behavioral changes, especially in high-risk categories with PsWs and caregivers, especially the ones with children aged <6 years. While coping strategies functioned as protective factors, a wide array of stress symptoms had implications for children's and adolescents' behaviors. It is recommended that public children welfare strategies be implemented, especially for higher-psychosocial-risk categories.
COVID-19 大流行极大地改变了个人的生活方式，尤其是在意大利。尽管人们对它有很多担忧，但对儿童和青少年的影响却鲜有研究。本研究旨在从照顾者的角度探讨意大利家庭在隔离期间与大流行相关的行为后果和应对策略，重点关注从发育年龄 3 周到隔离期。进行了为期 14 天的探索性横断面在线调查。使用 Google 表单进行调查。询问了人口统计学变量和预先存在的心理脆弱性（PsW）。评估了成年人在隔离期间的睡眠困难（SleepScore）和应对策略。询问了填写表格的主体（COVIDStress）及其子女（如果存在）的隔离相关行为变化。在 6871 名受访者中，我们选择了 6800 份有效问卷；3245 名受访者宣布其子女年龄在 18 岁以下（照顾者）。在非照顾者中，64.9%的人存在 PsWs，在照顾者中，61.5%的人存在 PsWs，平均 PsW 评分分别为 1.42 ± 1.26 和 1.30 ± 1.25，超过 3 分。95.5%的非照顾者和 96.5%的照顾者出现行为变化，平均 COVIDStress 分别为 3.85 ± 1.82 和 4.09 ± 1.79，超过 8 分（<0.001）。61.6%的非照顾者和 64.4%的照顾者存在睡眠困难（<0.001），他们的睡眠评分（SleepScore）更高（分别为 2.41 ± 1.26 和 2.57 ± 1.38，超过 6 分，<0.001）。COVIDStress（和 SleepScore）与 PsW 强烈相关（<0.001）。在 64.3%的<6 岁儿童和 72.5%的 6-18 岁儿童中，照顾者观察到儿童的行为变化。隔离期间照顾者的不适（COVIDStress，SleepScore）与<6 岁和 6-18 岁两组儿童的行为变化密切相关（<0.001）。照顾者应对策略的存在与<6 岁样本中的行为变化相关性较低（= 0.001），但与 6-18 岁样本相关性不高（= 0.06）。COVID-19 大流行对意大利家庭产生了不利影响，尤其是在存在 PsWs 和照顾者的高风险人群中，尤其是<6 岁的儿童。虽然应对策略起到了保护作用，但一系列广泛的压力症状对儿童和青少年的行为产生了影响。建议实施公共儿童福利策略，特别是针对高社会心理风险群体。
