College of Health Service, Second Military Medical University, Shanghai, China.
School of Nursing, Second Military Medical University, Shanghai, China.
JMIR Public Health Surveill. 2023 Feb 7;9:e43689. doi: 10.2196/43689.
The COVID-19 pandemic represents a global health crisis. The Shanghai municipal government in China implemented strict and comprehensive pandemic control strategies in the first half of 2022 to eliminate a wave of COVID-19 infection. The pandemic and the resulting government responses have led to abrupt changes to families' daily lives, including the mental health of children and adolescents.
The aim of this paper is to examine the impact of COVID-19 exposure and the stringent lockdown measures on the daily life and mental health of children and adolescents and to provide suggestions on maintaining their mental health when similar public health emergencies occur in the future.
In this cross-sectional study, an anonymous survey was distributed online in May 1-15, 2022, in Shanghai. Individuals were eligible to participate if they were currently the caregiver of a child or adolescent (aged 4-17 years). Outcomes were psychosocial functioning of children and adolescents, as reported by parents, using the Pediatric Symptom Checklist-17. COVID-19 exposure and life changes were also reported. Multivariate logistic regression was used to analyze risk factors for poor psychosocial functioning.
In total, 2493 valid questionnaires were analyzed. The rate of positive scores on the global Pediatric Symptom Checklist-17 scale was 16.5% (n=411). Internalizing, attention, and externalizing problem subscale positivity rates were 17.3% (n=431), 10.9% (n=272), and 8.9% (n=221), respectively. Caregivers reported that 64.2% (n=1601) and 20.7% (n=516) of the children's interactions with friends or peers and parents deteriorated, respectively. Compared with male caregivers, female caregivers were less likely to report psychosocial problems in children and adolescents (adjusted odds ratio [aOR] 0.68; 95% CI 0.53-0.88). Older children and those with lower COVID-19 Exposure and Family Impact Scales scores were less likely to have psychological problems (aOR 1.15; 95% CI 1.10-1.21). Compared with children with screen times <1 hour per day for recreation, those using screens for >3 hours had higher odds of psychological distress (aOR 2.09; 95% CI 1.47-1.97). Children who spent 1-2 hours exercising and had better interactions with friends or peers and parents showed a trend toward lower odds of psychological problems. Children and adolescents with worse sleep compared with preclosure were more likely to have psychological problems.
The prevalence of psychosocial problems among children and adolescents is relatively high. Being young, having more COVID-19 exposure, and having more screen times (>3 h/day), less exercise time (<30 min), worse sleep, and deteriorated interactions with friends or peers and parents were risk factors for poor psychosocial functioning. It is necessary for governments, communities, schools, and families to take appropriate countermeasures to reduce the negative impact of the stringent control measures on caregivers' parenting and psychosocial functioning of children and adolescents.
COVID-19 大流行是一场全球性的卫生危机。中国上海市政府在 2022 年上半年实施了严格而全面的大流行控制策略，以消除一波 COVID-19 感染。大流行和由此产生的政府应对措施导致家庭日常生活发生了突然变化，包括儿童和青少年的心理健康。
本文旨在探讨 COVID-19 暴露和严格的封锁措施对儿童和青少年日常生活和心理健康的影响，并就未来类似突发公共卫生事件时如何维护他们的心理健康提供建议。
在这项横断面研究中，于 2022 年 5 月 1 日至 15 日在上海在线分发了匿名调查。如果他们目前是儿童或青少年（4-17 岁）的照顾者，则符合参与条件。使用儿童症状清单-17 评估儿童和青少年的心理社会功能，由父母报告。还报告了 COVID-19 暴露和生活变化。使用多变量逻辑回归分析不良心理社会功能的危险因素。
共分析了 2493 份有效问卷。全球儿童症状清单-17 量表的阳性评分率为 16.5%（n=411）。内部化、注意力和外化问题亚量表阳性率分别为 17.3%（n=431）、10.9%（n=272）和 8.9%（n=221）。与朋友或同龄人互动以及与父母互动恶化的照顾者分别报告了 64.2%（n=1601）和 20.7%（n=516）。与男性照顾者相比，女性照顾者报告儿童和青少年心理问题的可能性较小（调整后的优势比[aOR]0.68；95%置信区间[CI]0.53-0.88）。年龄较大的儿童和 COVID-19 暴露和家庭影响量表评分较低的儿童不太可能出现心理问题（aOR 1.15；95%CI 1.10-1.21）。与每天屏幕娱乐时间<1 小时的儿童相比，屏幕时间>3 小时的儿童出现心理困扰的几率更高（aOR 2.09；95%CI 1.47-1.97）。每天运动 1-2 小时且与朋友或同龄人以及父母互动较好的儿童出现心理问题的几率呈下降趋势。与关闭前相比睡眠较差的儿童和青少年更有可能出现心理问题。
儿童和青少年心理问题的患病率相对较高。年龄较小、COVID-19 暴露较多、屏幕时间较长（>3 小时/天）、运动时间较少（<30 分钟/天）、睡眠较差、与朋友或同龄人以及父母的互动恶化是心理社会功能不良的危险因素。政府、社区、学校和家庭有必要采取适当的对策，减少严格控制措施对照顾者育儿和儿童青少年心理社会功能的负面影响。
