Department of Pediatric Neurology, CHU Angers, Angers, France.
Department of Physical Medicine and Rehabilitation, CHRU Brest, Brest, France.
Child Care Health Dev. 2022 Nov;48(6):942-955. doi: 10.1111/cch.12952. Epub 2022 Jan 4.
The first lockdown during COVID-19 pandemic in France led to an abrupt change in children's daily lives. For children with physical disabilities and their families, activities were limited, access to healthcare and therapy was disrupted, and family organization was altered. The objective was to report the impact of the lockdown on daily life activities and well-being of children with physical disabilities as perceived by caregivers.
Two online national surveys were addressed to the parents of children with physical disabilities (ECHO survey: 6 April to 11 May 2020) and without disabilities (E-COPAIN survey: 24 April to 11 May 2020), confined at home during the lockdown. A lockdown impact score was calculated from difficulties related to children's well-being (morale, behaviour and social interaction) and daily life activities (schooling and physical activity) and compared between groups. Data on family environment, parental stress and concerns were collected.
One thousand three hundred seventy-six children (9.45 ± 4.78 years, 54% girls) in ECHO survey and 367 children (7.3 ± 4.4 years, 48% girls) in E-COPAIN survey were included. A negative impact of lockdown was found on 81% of children with physical disabilities. Behavioural problems were significantly more frequent (59.5% vs. 47.4%, P < .005) and parental stress was higher (6.1 ± 3.33 vs. 5.3 ± 3.01, P = .005) in the ECHO group. Associated impairments (odds ratio [OR] = 1.45 [1.30-1.62], P < .001), parental stress (OR = 1.09 [1.06-1.12], P < .001) and continuation of rehabilitation (OR = 0.80 [0.72-0.89], P < .001) were determinants of the level of difficulty experienced.
The lockdown had a considerable, negative impact on the daily life of children with disabilities and their families. Guiding policymakers with the essential daily life activities and the services to provide for children with physical disabilities would offer valuable insights to manage such a sanitary crisis and allow to identify the most vulnerable population.
COVID-19 大流行期间法国的首次封锁导致儿童日常生活发生了急剧变化。对于有身体残疾的儿童及其家庭来说，活动受限，医疗保健和治疗中断，家庭组织也发生了变化。本研究旨在报告封锁对有身体残疾儿童的日常生活活动和幸福感的影响，这是由照顾者感知的。
对因 COVID-19 封锁而居家的有身体残疾（ECHO 调查：2020 年 4 月 6 日至 5 月 11 日）和无残疾（E-COPAIN 调查：2020 年 4 月 24 日至 5 月 11 日）的儿童的父母进行了两项全国性在线调查。根据儿童的幸福感（士气、行为和社会互动）和日常生活活动（学业和体育活动）相关困难程度，计算出封锁影响评分，并比较两组评分差异。还收集了家庭环境、父母压力和关注方面的数据。
ECHO 调查共纳入 1376 名儿童（9.45±4.78 岁，54%为女孩），E-COPAIN 调查共纳入 367 名儿童（7.3±4.4 岁，48%为女孩）。发现 81%的有身体残疾儿童受到封锁的负面影响。行为问题明显更频繁（59.5%比 47.4%，P<0.005），父母压力更高（6.1±3.33 比 5.3±3.01，P=0.005）。相关障碍（优势比 [OR] 1.45 [1.30-1.62]，P<0.001）、父母压力（OR 1.09 [1.06-1.12]，P<0.001）和康复治疗的延续（OR 0.80 [0.72-0.89]，P<0.001）是体验困难程度的决定因素。
封锁对残疾儿童及其家庭的日常生活产生了相当大的负面影响。为决策者提供残疾儿童的基本日常生活活动和服务，将为管理此类卫生危机提供宝贵的见解，并有助于确定最脆弱的人群。
