Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland.
Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
Eur Child Adolesc Psychiatry. 2023 Jun;32(6):1037-1049. doi: 10.1007/s00787-022-02014-6. Epub 2022 Jul 22.
The objective of this study is to understand the long-term mental sequelae for families over the course of the COVID-19 pandemic by longitudinally investigating the well-being of children with and without complex medical histories and their parents. Well-being of 200 children (between 7 and 18 years of age; 73 typically developing, 46 born very preterm, 73 with complex congenital heart disease) and 175 of their parents was assessed prior to and during the first (April-May 2020), second (October-November 2020), third (April-May 2021), and fourth wave (October-November 2021) of the pandemic with standardized questionnaires. Linear mixed models were used to investigate longitudinal changes in child and parent well-being compared to before the pandemic. Social and COVID-19-specific determinants were investigated as predictors of impaired well-being. To illustrate clinical relevance, the proportion of children and parents scoring > 1 SD below normative mean/median was reported. Compared to before the pandemic, child proxy-reported well-being was lower during the first but not the second, third, and fourth waves. Child self-reported well-being was not lower during the pandemic compared to before. Parent well-being dropped during the first wave and remained low throughout the subsequent waves. Proxy-reported child and self-reported parent well-being was lower in families with sparse social support and poor family functioning. Parents of typically developing children reported lower well-being than parents of children born very preterm or with a complex congenital heart disease. In November 2021, 20% of children (both self- and proxy-report) and 24% of parents scored below the normal range compared to 11% (child self-report), 10% (child proxy-report), and 16% (parent self-report), respectively, before the pandemic. The pandemic continues to impact the well-being of parents of school-aged children with and without complex medical histories more than 1 year after its outbreak. Children's well-being was specifically affected during the first wave of the pandemic and has recovered thereafter. Families with sparse social support and poor family functioning are particularly at risk for compromised well-being and support should be provided to them.
本研究旨在通过纵向研究患有和不患有复杂病史的儿童及其父母的幸福感，了解 COVID-19 大流行期间家庭的长期心理后遗症。在大流行之前和期间，使用标准化问卷评估了 200 名儿童（7-18 岁；73 名正常发育，46 名早产，73 名患有复杂先天性心脏病）及其 175 名父母的幸福感。使用线性混合模型比较了儿童和父母幸福感的纵向变化与大流行前相比。调查了社会和 COVID-19 特定决定因素作为幸福感受损的预测指标。为了说明临床相关性，报告了得分超过正常均值/中位数 1 个标准差的儿童和父母的比例。与大流行前相比，儿童代理报告的幸福感在第一波中较低，但在第二波、第三波和第四波中没有。在大流行期间，儿童自我报告的幸福感没有比大流行前低。父母的幸福感在第一波中下降，并在随后的波次中保持低位。社会支持稀疏和家庭功能不良的家庭中，儿童代理报告和自我报告的幸福感较低。与早产或患有复杂先天性心脏病的儿童的父母相比，正常发育儿童的父母报告的幸福感较低。2021 年 11 月，与大流行前相比，分别有 20%（自我报告和代理报告）和 24%的儿童（自我报告和代理报告）的得分低于正常范围，而分别有 11%（儿童自我报告）、10%（儿童代理报告）和 16%（父母自我报告）。大流行对患有和不患有复杂病史的学龄儿童及其父母的幸福感的影响已经持续了 1 年多。儿童的幸福感在大流行的第一波中受到特别影响，此后已恢复。社会支持稀疏和家庭功能不良的家庭特别容易受到幸福感受损的影响，应向他们提供支持。
