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Irestorm E, Schouten-van Meeteren AYN, van Gorp M, Twisk JWR, van Santen HM, Partanen M, Grootenhuis MA, van Litsenburg RRL. The development of fatigue after treatment for pediatric brain tumors does not differ between tumor locations. Pediatr Blood Cancer 2024; 71:e31028. [PMID: 38698502 DOI: 10.1002/pbc.31028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/22/2024] [Accepted: 04/07/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Children and adolescents treated for a brain tumor suffer from more fatigue than survivors of other types of childhood cancer. As tumor location might be predictive of fatigue, our aim was to investigate the longitudinal development of fatigue in children with brain tumors and risk factors for fatigue separately for different tumor locations. METHODS Fatigue was assessed 1235 times for 425 participants. Self-report versions of PedsQL Multidimensional Fatigue Scale were used to repeatedly assess fatigue from the end of treatment up to 8 years later. Mixed models were used to analyze fatigue over time and determinants separately for infratentorial (N = 205), supratentorial hemispheric (N = 91), and supratentorial midline tumors (N = 129). RESULTS Cognitive fatigue worsened with time, while sleep-rest and general fatigue first decreased and then increased. There was no difference in fatigue between the tumor locations, but the risk factors differed when stratified by location. Radiotherapy was associated with more fatigue for infratentorial tumors, and centralization of care was associated with less fatigue for the supratentorial midline tumors. For supratentorial hemispheric tumors, female sex was associated with more fatigue. Higher parental education was associated with less fatigue regardless of tumor location. CONCLUSIONS The development of fatigue seems to be more related to sociodemographic and treatment variables than to tumor location. Healthcare providers need to be aware that fatigue may develop in the years following end of treatment, and that patients with a low/middle educational family background might be more vulnerable and in need of targeted support.
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Affiliation(s)
- Elin Irestorm
- Faculty of Medicine, Department of Paediatrics, Lund University, Lund, Sweden
- Department of Pediatric Endocrinology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Marloes van Gorp
- Department of Pediatric Endocrinology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, Location VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Hanneke M van Santen
- Department of Pediatric Endocrinology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, UMCU, Utrecht, The Netherlands
| | - Marita Partanen
- Department of Pediatric Endocrinology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Martha A Grootenhuis
- Department of Pediatric Endocrinology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Raphaele R L van Litsenburg
- Department of Pediatric Endocrinology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Nawi MA, Lau SCD, Chin ST, Teh KH, Ho LSB, Alias H. Caring for a child with cancer during COVID-19 pandemic: an assessment of the parents' perception and stress level. Front Public Health 2024; 12:1223362. [PMID: 38655523 PMCID: PMC11036860 DOI: 10.3389/fpubh.2024.1223362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Background The emergence of COVID-19 pandemic has led to heightened fear and uncertainty among parents of children with cancer. This study was conducted to evaluate the parental perceptions toward effects of COVID-19 infection to children with cancer, determine their stress level and factors contributing to high stress level during the pandemic. Methods This cross-sectional study was conducted in three paediatric oncology centres in Malaysia from September 2020 until December 2022. A total of 167 parents were recruited. Parents completed a set of questionnaires to assess their perception on effect of COVID-19 infection to children with cancer and COVID Stress Scale (CSS) to assess the parents' stress level. Results Patients' mean age at study entry was 8.75 years (SD 4.38). Ninety-one (54.5%) patients were still on active treatment. More than 80% of the parents obtained information regarding COVID-19 infection from mass media and social networking. Fear of their children contracting COVID-19 infection was high especially among patients who were still on treatment. Forty-nine (29.3%) parents were significantly affected by the pandemic leading to loss of job or monthly income. Twenty-nine (17.4%) patients required treatment modification during the pandemic. The median total score for CSS was 78.0 (IQR 25th 64.0; 75th 95.0). Ninety-one (54.5%) respondents were very/extremely stressed based on the CSS scores. Components with high scores were xenophobia (median score 18.0; IQR 25th 13.0, 75th 22.0), fear of danger (median score 17.0; IQR 25th 14.0, 75th 20.0) and contamination fears (median score 16.0; IQR 25th 12.0, 75th 19.0). Lower household income was associated with higher stress level (p = 0.006). Conclusion Our study demonstrated high awareness regarding risk of COVID-19 infection among parents of oncology children. Half of the parents had high stress level, with low household income identified as a factor associated with high stress level.
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Affiliation(s)
- Muhamad Aizat Nawi
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Sie Chong Doris Lau
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Shi Tying Chin
- Department of Paediatrics, Sarawak General Hospital, Kuching, Malaysia
| | - Kok Hoi Teh
- Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Lee Sue Betty Ho
- Department of Paediatrics, Sarawak General Hospital, Kuching, Malaysia
| | - Hamidah Alias
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Sutherland-Foggio MS, Stanek CJ, Buff K, Nahata L, Foster-Akard T, Gerhardt CA, Skeens MA. The experiences of families of children with cancer during the COVID-19 pandemic: A qualitative exploration. Palliat Support Care 2024; 22:281-288. [PMID: 37559193 DOI: 10.1017/s1478951523001098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
OBJECTIVES The COVID-19 pandemic posed new challenges to physical and psychological well-being. Families with pediatric cancer patients were particularly vulnerable due to changes like children staying at home, hospital policy shifts, and caring for an immunocompromised child. Limited research exists on COVID-19's effects on these families. This study aimed to assess the pandemic's impact and identify psychosocial support gaps. METHODS Participants (N = 256) were parents of children with cancer recruited via Facebook in partnership with Momcology®, a community-based organization for pediatric cancer, between February and May 2021. Qualitative analyses used open-ended responses about the pandemic's impact on the family. RESULTS Analysis revealed 6 themes, with positive and negative sentiments: family changes (n = 169; 61% negative), social isolation (n = 154; 100% negative), emotional impact (n = 143; 89% negative), school changes (n = 126; 80% negative), health-care changes (n = 111; 96% negative), and physical health (n = 49; 73% negative). Family changes overarched all themes and included financial strains, at-home schooling, and family bonding. Parents highlighted social isolation and the emotional impact of pandemic-related changes. School changes forced parents to balance remote-work and childcare. Health-care changes limited resources and visitation. Parents reported their children were less active and slept less but had fewer illnesses. SIGNIFICANCE OF RESULTS Many common pandemic challenges were exacerbated by the stress of caring for a child with cancer. Parents struggled most with loss of social support and feelings of isolation. Careful consideration should be given to providing resources for parents of children with cancer and their families.
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Affiliation(s)
- Malcolm S Sutherland-Foggio
- The Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Charis J Stanek
- The Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Leena Nahata
- The Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Cynthia A Gerhardt
- The Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Micah A Skeens
- The Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
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Skeens MA, Ralph JE, Olsavsky AL, Buff K, Shah N, Akard TF, Gerhardt CA. The Impact of the COVID-19 Pandemic on the Quality of Life of Children With Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:85-95. [PMID: 38008953 DOI: 10.1177/27527530231194592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
Background/objectives: Little is known about the COVID-19 pandemic and its impact on the quality of life (QoL) of children with cancer who may be more vulnerable to the pandemic's effects. We examined associations between COVID-19 exposure and impact on parent-proxy reported QoL in children with cancer, and potential moderation based on the child's cancer status (i.e., time since diagnosis, on/off treatment). Design/method: Parents of children with cancer were recruited February-April 2021 via Facebook and Momcology. Parents completed the COVID-19 Exposure and Family Impact Scale and a child QoL measure. Controlling for parent age, income, child age, and child sex, we examined the indirect effect of COVID-19 impact on the association between COVID-19 exposure and parent-proxy reported child QoL, as well as the moderating role of cancer status. Results: Parents (N = 401) reported lower child QoL scores (M = 59.74) than prepandemic reports of children with cancer, t(735) = -6.98, p < .001. Mediation analyses revealed a significant indirect effect, 95% CI [-0.47, -0.13]: Higher COVID-19 exposure was associated with higher COVID-19 impact (a = 0.47, p < .001), which was related to lower QoL (b = -0.56, p < .001). The association between impact and QoL was stronger as time since diagnosis increased (95%CI [-0.08, -0.001]), yet treatment status did not moderate this path. Conclusions: Parents who report greater COVID-19 impact may also report lower QoL in their children with cancer, especially further from diagnosis. Nurses and clinicians should be aware of the pandemic's negative impact and screen for COVID-19 related distress. Additionally, results highlight the importance of long-term, family-centered care, regardless of whether children receive treatment or survivorship care.
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Affiliation(s)
- Micah A Skeens
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
- Division of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Jessica E Ralph
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Anna L Olsavsky
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Nilay Shah
- The Ohio State University College of Medicine, Columbus, Ohio, USA
- Division of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Cynthia A Gerhardt
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
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Guido A, Marconi E, Peruzzi L, Dinapoli N, Tamburrini G, Attinà G, Romano A, Maurizi P, Mastrangelo S, Chiesa S, Gambacorta MA, Ruggiero A, Chieffo DPR. Psychological Experiences of Parents of Pediatric Cancer Patients during and after COVID-19 Pandemic. Cancers (Basel) 2024; 16:891. [PMID: 38473253 DOI: 10.3390/cancers16050891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Family members dealing with the devastating impact of a cancer diagnosis are now facing even greater vulnerability due to the COVID-19 pandemic. Alongside the already overwhelming trauma, they must also bear the distressing burden of the infection risks. The purpose of this study was to examine and explore the effects in parents of pediatric cancer patients two years after the start of the COVID-19 pandemic to compare these data with the previous data. METHODS We conducted a single-center prospective observational study, enrolling 75 parents of 42 pediatric oncology patients. Four questionnaires (IES-R; PSS; STAI-Y and PedsQL) were given to the parents 2 years after the first evaluation. RESULTS The bivariate matrix of correlation found a strong significant positive correlation between IES-R and PSS scores (r = 0.526, p < 0.001) as in T1. Stress symptoms (t = 0.00, p < 0.001) and levels of anxiety (trait) (t = 0.32, p < 0.001) remained unchanged; anxiety state levels appeared to have increased (t = 0.425, p < 0.001); there was a significant decrease in the PedsQL tot (t = 5.25, p < 0.001). CONCLUSIONS The COVID-19 pandemic has influenced the levels of stress and anxiety of parents and the quality of life of patients, also correlating with the traumatic impact of the diagnosis.
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Affiliation(s)
- Antonella Guido
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Elisa Marconi
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Laura Peruzzi
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Nicola Dinapoli
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Gianpiero Tamburrini
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Giorgio Attinà
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Alberto Romano
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Palma Maurizi
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Woman and Child Health and Public Health, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Stefano Mastrangelo
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Woman and Child Health and Public Health, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Silvia Chiesa
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Maria Antonietta Gambacorta
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Antonio Ruggiero
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Woman and Child Health and Public Health, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Life Sciences and Public Health Department, Università Cattolica Sacro Cuore, 00168 Rome, Italy
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6
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Irestorm E, van Gorp M, Twisk J, Nijhof S, de Bont J, Grootenhuis M, van Litsenburg R. Longitudinal development of fatigue after treatment for childhood cancer: a national cohort study. Acta Oncol 2023; 62:1309-1321. [PMID: 37676687 DOI: 10.1080/0284186x.2023.2254477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/22/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Fatigue is a distressing and prevalent long-term sequela of treatment for childhood cancer, and there is a need for longitudinal studies to investigate the development of fatigue over time. The objective of this study was to calculate growth-curves for the longitudinal development of fatigue after treatment for childhood cancer, and to investigate the effects of biopsychosocial predictors. MATERIALS AND METHODS Participants were recruited from a patient monitoring program and data extracted from medical records. Parent-proxy and self-report versions of PedsQLTM Multidimensional Fatigue Scale were used to repeatedly assess fatigue up to 5 years after the end of treatment for childhood cancer. Fatigue was assessed 2440 times for 761 participants (median:3) with proxy-reports (age 2-8 years) and 2657 times for 990 participants with self-reports (above 8 years) (median:2). Mixed models were used to establish growth-curves and to analyze the effect of predictors separately for participants with solid tumors (ST), hemato-oncological malignancies and central nervous system-tumors (CNS). RESULTS CNS-tumors were associated with more cognitive fatigue than ST at the end of treatment, for both proxy-reports (-11.30, p<.001) and self-reports (-6.78, p=.002), and for proxy-reports of general fatigue (-6.78, p=.002). The only significant difference in change over time was for self-reports of sleep-rest fatigue. The raw scores for the CNS-group decreased with -0.87 per year (95% CI -1.64; -0.81, p=.031) compared to the ST-group. Parental distress was overall the variable most associated with increased fatigue, while immunotherapy was the most frequent medical predictor. National centralization of childhood cancer care decreased fatigue for the CNS-group, but not for other diagnoses. DISCUSSION Children and adolescents treated for CNS-tumors reported more fatigue than other participants after the end of treatment, and this difference remained over time. Results from this study may help to facilitate the early recognition of children with insufficient recovery of fatigue symptoms.
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Affiliation(s)
- Elin Irestorm
- Department of Paediatrics, Faculty of Medicine, Lund University, Lund, Sweden
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Marloes van Gorp
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jos Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, Location VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Sanne Nijhof
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Judith de Bont
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
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7
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van Gorp M, Irestorm E, Twisk JWR, Dors N, Mavinkurve-Groothuis A, Meeteren AYNSV, de Bont J, van den Bergh EMM, van der Meer WVDP, Beek LR, Aarsen FK, Streefkerk N, van Litsenburg RRL, Grootenhuis MA. The course of health-related quality of life after the diagnosis of childhood cancer: a national cohort study. BMC Cancer 2023; 23:855. [PMID: 37697253 PMCID: PMC10496372 DOI: 10.1186/s12885-023-11379-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Comprehensive insight in the longitudinal development of health-related quality of life (HRQOL) after childhood cancer diagnosis could improve quality of care. Thus, we aimed to study the course and biopsychosocial determinants of HRQOL in a unique national cohort of children with cancer. METHODS HRQOL of 2154 children with cancer was longitudinally reported (median: 3 reports) between diagnosis and 5 years after, using the pediatric quality of life inventory generic core scales (PedsQL). HRQOL was modelled over time since diagnosis using mixed model analysis for children 2-7 years (caregiver-reports) and ≥ 8 years (self-reports). Differences in the course between hematological, solid and central nervous system malignancies were studied. Additional associations of demographics, disease characteristics (age at diagnosis, relapse, diagnosis after the national centralization of childhood cancer care and treatment components) and caregiver distress (Distress thermometer) were studied. RESULTS Overall, HRQOL improved with time since diagnosis, mostly in the first years. The course of HRQOL differed between diagnostic groups. In children aged 2-7 years, children with a solid tumor had most favorable HRQOL. In children aged ≥ 8 years, those with a hematological malignancy had lower HRQOL around diagnosis, but stronger improvement over time than the other diagnostic groups. In both age-groups, the course of HRQOL of children with a CNS tumor showed little or no improvement. Small to moderate associations (β: 0.18 to 0.67, p < 0.05) with disease characteristics were found. Centralized care related to better HRQOL (β: 0.25 to 0.44, p < 0.05). Caregiver distress was most consistently associated with worse HRQOL (β: - 0.13 to - 0.48, p < 0.01). CONCLUSIONS The HRQOL course presented can aid in identifying children who have not fully recovered their HRQOL following cancer diagnosis, enabling early recognition of the issue. Future research should focus on ways to support children, especially those with a CNS tumor, for example by decreasing distress in their caregivers.
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Affiliation(s)
- Marloes van Gorp
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
| | - Elin Irestorm
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
- Faculty of Medicine, Department of Paediatrics, Lund University, Lund, Sweden
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, Location VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Natasja Dors
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
| | | | | | - Judith de Bont
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
| | | | | | - Laura R Beek
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
| | - Femke K Aarsen
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
| | - Nienke Streefkerk
- Princess Máxima Center for pediatric Oncology, Utrecht, The Netherlands
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Zucchetti G, Quarello P, Ferrari A, Silva M, Mercolini F, Sciarra P, Guido A, Peruzzi L, Colavero P, Montanaro M, Taormina R, Micheletti MV, Solari F, Perillo T, Paioli A, Canepa M, Migliozzi C, Zuliani L, Solfa V, Bertolotti M, Fagioli F. How Did Adolescents With Cancer Experience the COVID-19 Pandemic? A Report From Italian Pediatric Hematology Oncology Association Centers. J Pediatr Hematol Oncol 2023; 45:e683-e688. [PMID: 37314864 DOI: 10.1097/mph.0000000000002689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/04/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE This study set out to evaluate the psychosocial effects of coronavirus disease 2019 (COVID-19) among adolescents with cancer, and whether these effects are significantly different among adolescents who were undergoing therapy or had completed it. MATERIALS AND METHODS The AIEOP Adolescents Working Group and the AIEOP Psychosocial Working Group adapted a questionnaire, which was completed by 214 adolescent cancer patients ( Mage =16.3 y, range: 15 to 19 y old) treated at 16 AIEOP centers in the North (38%), South (31%), and Center (31%) of Italy. RESULTS The results highlighted that fear of the virus is equally distributed among adolescent cancer patients, with patients being particularly concerned about their parents and families. The adolescents reported that had no difficulty in following individual safety measures: they used personal protective equipment and they were attentive to their own health and adhering to the rules imposed by doctors and the wider community. There are very few, limited differences between adolescents undergoing treatment (active group) and those who have completed treatment (follow-up group). The reminder of their own therapy experience triggered by the use of personal protective equipment, and the more common refusal to follow some restrictions were the only 2 behaviors by which the follow-up group differed significantly from the adolescents in the active group. CONCLUSIONS Adolescents with cancer seem to have coped well with the pandemic: although they were very afraid of the virus for themselves and their families, and had to limit their social contact, they did comply with the restrictions. Their experience of cancer probably also had a positive effect in cultivating adolescents who are more responsible and resilient in emergency situations such as the pandemic.
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Affiliation(s)
- Giulia Zucchetti
- Paediatric Oncology Division, Regina Margherita Children's Hospital, A.O.U. City of Health and Science of Turin
- Department of Public Health and Paediatric Sciences, University of Turin, Turin
| | - Paola Quarello
- Paediatric Oncology Division, Regina Margherita Children's Hospital, A.O.U. City of Health and Science of Turin
- Department of Public Health and Paediatric Sciences, University of Turin, Turin
| | - Andrea Ferrari
- Paediatric Oncology Unit, National Cancer Institute of Milan
| | - Matteo Silva
- Paediatric Oncology Unit, National Cancer Institute of Milan
| | - Federico Mercolini
- Paediatric Oncology Unit, Department of Pediatrics, Hospital of Bolzano, Bolzano
| | - Pierpaolo Sciarra
- Paediatric Haemato-Oncology Unit, Hematology Department, General Hospital of Pescara, Pescara
| | | | - Laura Peruzzi
- Paediatric Oncology Unit, A. Gemelli University Polyclinic
| | | | | | - Rino Taormina
- Paediatric Hematology and Oncology Department, ARNAS Civico, G. Di Cristina and Benfratelli Hospitals, Palermo
| | - Maria V Micheletti
- Paediatric Hematology Oncology, Bone Marrow Transplant, A.O.U of Pisa, Pisa
| | - Federica Solari
- Department of Paediatrics, University-Hospital of Parma, Parma
| | - Teresa Perillo
- Department of Pediatrics, Paediatric Hematology-Oncology Division, University of Bari, Bari
| | - Anna Paioli
- Department of Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Rizzoli Orthopaedic Institute, Bologna
| | - Monica Canepa
- Department of Paediatric Hematology/Oncology-Bone Marrow Transplant Unit-Infectious Diseases, G. Gaslini Children's Research Institute, Genova
| | | | | | - Valentina Solfa
- Paediatric Hematology Oncology Unit, Department of Mother and Child, Verona, Italy
| | - Marina Bertolotti
- Paediatric Oncology Division, Regina Margherita Children's Hospital, A.O.U. City of Health and Science of Turin
- Department of Public Health and Paediatric Sciences, University of Turin, Turin
| | - Franca Fagioli
- Paediatric Oncology Division, Regina Margherita Children's Hospital, A.O.U. City of Health and Science of Turin
- Department of Public Health and Paediatric Sciences, University of Turin, Turin
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9
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Zhou Q, Zhao R, Shen X, Zhang H, Zhai Y, Gu Y, Shen Q, Xu H. Experience of the homecare of children on automatic peritoneal dialysis during the COVID-19 outbreak: A qualitative descriptive study. Nurs Open 2023; 10:2203-2212. [PMID: 36397267 PMCID: PMC10006596 DOI: 10.1002/nop2.1469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/24/2022] [Accepted: 10/22/2022] [Indexed: 11/19/2022] Open
Abstract
AIMS To describe the home care experience, challenges and coping strategies of caregivers with children on automatic peritoneal dialysis (PD) in mainland China during the early stage of the COVID-19 outbreak. DESIGN A qualitative descriptive approach was adopted. Semi-structured telephone interviews were conducted among 14 families with children on automatic peritoneal dialysis from February 2nd to 10th, 2020. The care routine, stress and coping strategies of caregivers of children on peritoneal dialysis were collected. The data were analysed using thematic analysis. METHODS Four key themes were defined: (1) concerns about PD treatment intertwined with worries about COVID-19; (2) retaining a sense of normality in the middle of the challenges; (3) staying safe; and (4) staying positive and carrying on. RESULTS Families with children on automatic PD addressed the stress from COVID-19 and its containment measures by closely adhering to COVID-19 preventative measures, actively adjusting mentality and maintaining a sense of normality during the outbreak. This implies that healthcare staff need to be more aware of the complex medical needs of families with children on automatic PD, advocate for them and facilitate their navigation through the repurposed healthcare system.
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Affiliation(s)
- Qing Zhou
- Department of Nephrology, Children's Hospital, Fudan University, Shanghai, China
| | - Rui Zhao
- Department of Nephrology, Children's Hospital, Fudan University, Shanghai, China
| | - Xia Shen
- Department of Nephrology, Children's Hospital, Fudan University, Shanghai, China
| | - Hui Zhang
- Department of Nephrology, Children's Hospital, Fudan University, Shanghai, China
| | - Yihui Zhai
- Department of Nephrology, Children's Hospital, Fudan University, Shanghai, China
| | - Ying Gu
- Department of Nursing, Children's Hospital, Fudan University, Shanghai, China
| | - Qian Shen
- Department of Nephrology, Children's Hospital, Fudan University, Shanghai, China
| | - Hong Xu
- Department of Nephrology, Children's Hospital, Fudan University, Shanghai, China
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10
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Schulze JB, Coker P, von Känel R, Euler S, Günther MP. Early Impact of the COVID-19 Pandemic on Psycho-Oncological Support: A Latent Class Analysis. Oncology 2023; 101:389-396. [PMID: 36977398 PMCID: PMC10871688 DOI: 10.1159/000530353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/07/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION Research suggests a global shortfall of psycho-oncological assessment and care during the COVID-19 pandemic in addition to delayed diagnosis of cancer. The present study is the first to explore the effect of the pandemic on the provision of psycho-oncological care, stage of cancer at first diagnosis, and duration of hospitalizations. METHOD Retrospective latent class analysis of 4,639 electronic patient files with all types, treatment types, and stages of cancer, 370 of which were treated during the pandemic prior to availability of vaccinations. DISCUSSION Latent class analysis identified four subgroups based on differences in screening for distress, provision of psycho-oncological support (consultation with a psychiatrist or clinical psychologist), administration of psychotropic medication, use of 1:1 observation, stage of cancer at first diagnosis, and duration of hospitalizations. Yet, the pandemic had no effect on subgrouping. Thus, the COVID-19 pandemic had no effect on the provision of psycho-oncological support. CONCLUSION Results are contrary to prior research. The efficiency and quality of procedures implemented to provide psycho-oncological support during and prior to the pandemic are critically reflected.
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Affiliation(s)
- Jan Ben Schulze
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Penelope Coker
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Moritz Philipp Günther
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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11
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Gilbert R, Bates CR, Khetawat D, Dreyer Gillette ML, Moore R. Risk and Resilient Functioning of Families of Children with Cancer during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5208. [PMID: 36982118 PMCID: PMC10048924 DOI: 10.3390/ijerph20065208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Previous literature highlights the impact of COVID-19 on family functioning. Less is known about the impact of the pandemic on families of pediatric cancer patients. In order to determine universal and unique risk and resilience factors of these families during the pandemic, a qualitative analysis was conducted on families currently receiving cancer treatment at a Midwestern hospital. Results of the data analysis depict ways in which these families have been impacted by and have adapted to COVID-19. These findings suggest that families of pediatric cancer patients have unique experiences in the context of COVID-19, in addition to universal experiences outlined in previous literature.
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Affiliation(s)
- Renee Gilbert
- Clinical Child Psychology Program, Dole Human Development Center, University of Kansas, Lawrence, KS 66044, USA
| | - Carolyn R. Bates
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 64114, USA
- University of Kansas Cancer Center, 4001 Rainbow Blvd, Kansas City, KS 64114, USA
| | - Devanshi Khetawat
- Clinical Child Psychology Program, Dole Human Development Center, University of Kansas, Lawrence, KS 66044, USA
| | | | - Rachel Moore
- Department of Pediatrics, Children’s Mercy Kansas City, 2401 Gillham Rd, Kansas City, MO 64108, USA
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12
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Yaffe Ornstein M, Friedlander E, Katz S, Elhasid R. Prospective assessment of anxiety among pediatric oncology patients and their caregivers during the COVID-19 pandemic a cohort study. J Psychosoc Oncol 2023; 41:182-195. [PMID: 35703090 DOI: 10.1080/07347332.2022.2086092] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To assess COVID-19-pandemic related anxiety and emotional-behavioral difficulties among oncologic children and their caregivers. Prospective cohort study conducted from March to November 2020. 76 pediatric oncological and 28 nonmalignant hematological patients aged 1.6-23.4 years and their caregivers. A total of 104 families completed an age-specific self-report psychological assessment; of these, 20 oncologic families completed the assessment at two time points. Ten percent of the caregivers and 13.9% of the patients reported anxiety disorder. Additionally, 3.1% of the caregivers reported behavioral difficulties. No significant differences emerged between patients' self-reports and caregivers' reports. No differences emerged between oncological and nonmalignant hematological participants. The prevalence of anxiety associated with the COVID-19 pandemic was similar to the reported prevalence of anxiety following a diagnosis of pediatric malignancy. Real-time assessment of psychological effects revealed no COVID-19-associated anxiety. Nonetheless, late effects will need to be monitored.
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Affiliation(s)
- Michal Yaffe Ornstein
- Department of Pediatric Hemato-Oncology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Edwa Friedlander
- Department of Pediatric Hemato-Oncology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Shir Katz
- Department of Pediatric Hemato-Oncology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Ronit Elhasid
- Department of Pediatric Hemato-Oncology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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13
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Asper M, Osika W, Dalman C, Pöllänen E, Simonsson O, Flodin P, Sidorchuk A, Marchetti L, Awil F, Castro R, Niemi ME. Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review. BJPsych Open 2022; 8:e181. [PMID: 36214114 PMCID: PMC9551492 DOI: 10.1192/bjo.2022.587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A rise in mental illness is expected to follow the COVID-19 pandemic, which has also been projected to lead to a deep global economic recession, further adding to risk factors. AIMS The aim of this review was to assess the impact of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health. METHOD Searches were conducted in PubMed, Web of Science, PsycINFO and Sociological Abstracts. We included studies of all populations exposed to the COVID-19 pandemic, and other similar pandemics/epidemics and economic crises, compared with non-exposed time periods or regions. The outcome was mental health. RESULTS The 174 included studies assessed mental health impacts of the COVID-19 pandemic (87 studies), 2008 economic crisis (84 studies) and severe acute respiratory syndrome (SARS) epidemic (three studies). Outcomes were divided into affective disorders, suicides, mental healthcare utilisation and other mental health. COVID-19 pandemic studies were of lesser quality than those for the economic crisis or SARS epidemic. Most studies for all exposures showed increases in affective disorders and other mental health problems. For economic crisis exposure, increases in mental healthcare utilisation and suicides were also found, but these findings were mixed for COVID-19 pandemic exposure. This is probably because of quarantine measures affecting help-seeking and shorter follow-ups of studies of COVID-19 pandemic exposure. CONCLUSIONS Our findings highlight the importance of available, accessible and sustainable mental health services. Also, socioeconomically disadvantaged populations should be particular targets of policy interventions during the COVID-19 pandemic.
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Affiliation(s)
- Michaela Asper
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Walter Osika
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Elin Pöllänen
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Otto Simonsson
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Pär Flodin
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | | | | | - Rosa Castro
- Federation of European Academies of Medicine, Belgium
| | - Maria E Niemi
- Department of Global Public Health, Karolinska Institutet, Sweden
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14
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Agatha Nsamenang S, Anne Gutierrez C, Manayathu Jones J, Jenkins G, Anne Tibelius S, Maria DiGravio A, Chamas B, Efua Ewusie J, Geddie H, Punthakee Z, Constantine Samaan M, Wahi G, Morrison KM. Les effets de la pandémie de COVID-19 sur la santé mentale et physique des enfants inscrits à une clinique pédiatrique de gestion du poids. Paediatr Child Health 2022; 27:S158-S164. [PMID: 36092294 PMCID: PMC9455654 DOI: 10.1093/pch/pxac032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Historique L’obésité est un problème sanitaire mondial. Étant donné la perturbation généralisée causée par la pandémie de COVID-19, il est important d’en évaluer l’effet chez les enfants ayant des troubles de santé chroniques. La présente étude évalue la santé des patients pédiatriques obèses inscrits à un programme de gestion du poids d’un hôpital de soins tertiaires avant la pandémie de COVID-19, puis un an après le début de la pandémie. Méthodologie Les chercheurs ont mené une analyse rétrospective des dossiers de patients de deux à 17 ans inscrits à une clinique pédiatrique de gestion du poids. Ils ont comparé les effets en matière de santé mentale (nouvelles orientations en psychologie, en travail social, dans un programme de troubles alimentaires, incidence de dysrégulation de l’alimentation, idéation suicidaire ou automutilation) et de santé physique (mesures anthropométriques) avant la pandémie, puis un an après le début de la pandémie. Résultats Chez les 334 enfants vus pendant l’une ou l’autre période, le nombre d’orientations en psychologie (12,4 % par rapport à 26, 5 %; p=0,002) et le résultat composite sur la santé mentale (17,2 % par rapport à 30,2 %; p=0,005) se sont creusés pendant la pandémie comparativement à auparavant. Dans un sous-groupe d’enfants (n=30) dont ils connaissaient les mesures anthropométriques au cours des deux périodes, le taux de diminution du score z de l’indice de masse corporelle était plus faible (−1,5 [2,00] par rapport à −0,3 [0,73]/année; p=0,002) et l’adiposité, plus élevée (−0,8 [4,64] par rapport à 2,7 [5,54] %/année; p=0,043) pendant la pandémie. Exposé La pandémie a influé sur la santé mentale et physique des enfants obèses inscrits à une clinique de gestion du poids. L’étude démontre un effet négatif sur la santé mentale et une amélioration moins marquée des mesures anthropométriques, mais les futures recherches, lorsque les patients auront repris les soins en clinique, permettront d’examiner nos résultats à la lumière de nouvelles mesures objectives.
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Affiliation(s)
- Sheri Agatha Nsamenang
- Département de psychiatrie et de neurosciences comportementales, Université McMaster, Hamilton (Ontario)Canada.,Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada
| | - Carline Anne Gutierrez
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada.,École de soins infirmiers, Université McMaster, Hamilton (Ontario)Canada
| | - Jane Manayathu Jones
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada.,École de soins infirmiers, Université McMaster, Hamilton (Ontario)Canada
| | - Glenn Jenkins
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada
| | - Stephanie Anne Tibelius
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada
| | - Anna Maria DiGravio
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada
| | - Basma Chamas
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada
| | - Joycelyne Efua Ewusie
- Unité de biostatistique de l'Institut de recherche, St. Joseph's Healthcare Hamilton, Hamilton (Ontario)Canada
| | - Hannah Geddie
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada.,Département de pédiatrie, Université McMaster, Hamilton (Ontario)Canada
| | - Zubin Punthakee
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada.,Département de médecine, Université McMaster, Hamilton (Ontario)Canada.,Centre de recherche sur le métabolisme, l'obésité et le diabète, Université McMaster, Hamilton (Ontario)Canada
| | - M Constantine Samaan
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada.,Département de pédiatrie, Université McMaster, Hamilton (Ontario)Canada.,Centre de recherche sur le métabolisme, l'obésité et le diabète, Université McMaster, Hamilton (Ontario)Canada
| | - Gita Wahi
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada.,Département de pédiatrie, Université McMaster, Hamilton (Ontario)Canada.,Centre de recherche sur le métabolisme, l'obésité et le diabète, Université McMaster, Hamilton (Ontario)Canada
| | - Katherine M Morrison
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton (Ontario)Canada.,Département de pédiatrie, Université McMaster, Hamilton (Ontario)Canada.,Centre de recherche sur le métabolisme, l'obésité et le diabète, Université McMaster, Hamilton (Ontario)Canada
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15
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Perceived stress, family impact, and changes in physical and social daily life activities of children with chronic somatic conditions during the COVID-19 pandemic. BMC Public Health 2022; 22:1106. [PMID: 35658938 PMCID: PMC9163527 DOI: 10.1186/s12889-022-13544-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 05/25/2022] [Indexed: 11/15/2022] Open
Abstract
Background The COVID-19 pandemic has inevitably affected children and their families. This study examines the impact of the COVID-19 measures in children with chronic somatic conditions (CSC) and their parents and compares them with a Dutch general population sample. Methods We included a sample of children with CSC (0–18 years, n = 326) and compared them with children (8–18 years, n = 1,287) from the Dutch general population. Perceived stress, coping, social interaction with friends and family, physical activity, eating behavior, family support, parenting perception, and financial situation were assessed once with the self-reported and parent-reported COVID-19 child check questionnaire, between November 2020 and May 2021. Comparisons between the two samples were made by using t-tests and chi square tests. Results The proportion of children who reported being less physically active and having less social interaction with friends since the COVID-19 pandemic was higher in children with CSC than in children from the general population. Children with CSC and their parents experienced less stress than children and parents from the general population. Moreover, parents of children with CSC aged 0–7 years and parents of children aged 8–18 years from the general population experienced less support and more financial deterioration than parents of children with CSC aged 8–18 years. In the parents from the general population only, this deteriorated financial situation was associated with more stress, worse family interaction and parenting perception, and less received support. Conclusions The impact of COVID-19 on children with CSC and their parents differed from those in the general population. Addressing the collateral damage of COVID-19 measures in children and their families may give direction to policy and potentially prevent lifelong impact. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13544-8.
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16
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Nsamenang SA, Gutierrez CA, Manayathu Jones J, Jenkins G, Tibelius SA, DiGravio AM, Chamas B, Ewusie JE, Geddie H, Punthakee Z, Samaan MC, Wahi G, Morrison KM. Impact of SARS-CoV-2 pandemic on the mental and physical health of children enrolled in a paediatric weight management clinic. Paediatr Child Health 2022; 27:S72-S77. [PMID: 35620561 PMCID: PMC9126271 DOI: 10.1093/pch/pxac014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Obesity is a global public health concern. Given the widespread disruption caused by the SARS-CoV-2 pandemic, it is important to evaluate its impact on children with chronic health conditions. This study examines the health of paediatric patients with obesity enrolled in a tertiary hospital weight management program, before and 1 year into the COVID-19 pandemic. Methods This is a retrospective chart review of patients aged 2 to 17 years enrolled in a paediatric weight management clinic. Mental health outcomes (i.e., new referrals to psychologist, social work, eating disorder program, incidence of dysregulated eating, suicidal ideation, and/or self-harm) and physical health (anthropometric measures) were compared before and 1 year into the pandemic. Results Among the 334 children seen in either period, there was an increase in referrals to psychologist (12.4% versus 26.5%; P=0.002) and the composite mental health outcome (17.2% versus 30.2%; P=0.005) during the pandemic compared with pre-pandemic. In a subset of children (n=30) with anthropometric measures in both periods, there was a lower rate of decline in BMIz score (-1.5 [2.00] versus -0.3 [0.73]/year; P=0.002) and an increase in adiposity (-0.8 [4.64] versus 2.7 [5.54]%/year; P=0.043) during the pandemic. Discussion The pandemic has impacted the mental and physical health of children with obesity engaged in a weight management clinic. While our study provides evidence of a negative impact on mental health outcomes and less improvement in anthropometric measures, future research when patients return to in-person care will enable further examination of our findings with additional objective measures.
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Affiliation(s)
- Sheri Agatha Nsamenang
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Carline Anne Gutierrez
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada.,School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Jane Manayathu Jones
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada.,School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Glenn Jenkins
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Stephanie Anne Tibelius
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Anna Maria DiGravio
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Basma Chamas
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Joycelyne Efua Ewusie
- The Research Institute Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Hannah Geddie
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Zubin Punthakee
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University, Hamilton, Ontario, Canada.,Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
| | - Gita Wahi
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
| | - Katherine M Morrison
- Children's Exercise and Nutrition Centre, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
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17
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Early Evidence of the Interplay between Separation Anxiety Symptoms and COVID-19-Related Worries in a Group of Children Diagnosed with Cancer and Their Mothers. CHILDREN 2022; 9:children9040481. [PMID: 35455525 PMCID: PMC9028105 DOI: 10.3390/children9040481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/11/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022]
Abstract
Having cancer in childhood is a risk factor for separation anxiety symptoms, with negative effects on the disease and psychological wellbeing. The Covid-19-pandemic-related concerns could have a negative effect. The present study explores the interplay between separation anxiety symptoms and COVID-19-related worries in pediatric cancer patients and their mothers, compared to a group of healthy children and their mothers, during the pandemic. Thirty-three subjects with cancer, aged 7–15 years, and their mothers were compared to a control sample of 36 healthy children and caregivers. They were administered a pandemic-related psychological experience survey and standardized questionnaires assessing psychological wellbeing, anxiety, and separation anxiety symptoms. Children with cancer reported significantly higher prosocial behaviors, fear of being alone, and fear of abandonment. Their mothers had worse psychological wellbeing, higher COVID-19 concerns, anxiety, and separation anxiety symptoms. The multiple linear regression model showed that an increase in children’s separation anxiety symptoms was associated with younger age, more recent diagnosis, more mother-child time, lower mothers’ worry for children’s contagion, and higher mothers’ and children’s anxiety. COVID-19-related worries of clinical children’s mothers seem to be protective for children’s psychological wellbeing. Early psychosocial support interventions for mothers are essential in health services for cancer.
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18
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Akdağ B, Önder A, Gizli Çoban Ö, Kocacık Uygun DF, Sürer Adanır A, Erdem A, Çelik E, Soğucak ZE, Bingöl A. Psychological State of Parents of Children with Primary Immunodeficiencies During the COVID-19 Pandemic. PEDIATRIC ALLERGY, IMMUNOLOGY, AND PULMONOLOGY 2022; 35:12-18. [PMID: 35180363 DOI: 10.1089/ped.2021.0081] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background: COVID-19 has affected humanity not only physically but also mentally. It was expected to have impact on high-risk groups such as the immunocompromised patients and parents/caregivers of them. Our study was aimed to investigate the COVID-19 related anxiety, post-traumatic stress levels, and sleep-related parameters of the parents of children with primary immunodeficiency. Methods: Parents of children with primary immunodeficiency and age and gender-matched control group completed questionnaires. Results: Anxiety and post-traumatic stress levels of the study group were found to be significantly higher than the control group. Furthermore, sleep time of the study group was significantly lower than the control group. The subjective sleep quality of the study group was also lower in the study group, but the difference did not reach a significant level. Conclusions: In the ongoing and other possible pandemic processes, professional support for the parents of these children is of great importance.
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Affiliation(s)
- Berhan Akdağ
- Department of Child and Adolescent Psychiatry and Akdeniz University School of Medicine, Antalya, Turkey
| | - Arif Önder
- Department of Child and Adolescent Psychiatry and Akdeniz University School of Medicine, Antalya, Turkey
| | - Özge Gizli Çoban
- Department of Child and Adolescent Psychiatry and Akdeniz University School of Medicine, Antalya, Turkey
| | | | - Aslı Sürer Adanır
- Department of Child and Adolescent Psychiatry and Akdeniz University School of Medicine, Antalya, Turkey
| | - Aybike Erdem
- Department of Child and Adolescent Psychiatry and Akdeniz University School of Medicine, Antalya, Turkey
| | - Enes Çelik
- Department of Pediatric Allergy and Immunology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Zehra Ece Soğucak
- Department of Child and Adolescent Psychiatry, Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ayşen Bingöl
- Department of Pediatric Allergy and Immunology, Akdeniz University School of Medicine, Antalya, Turkey
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19
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Kahn AR, Schwalm CM, Wolfson JA, Levine JM, Johnston EE. COVID-19 in Children with Cancer. Curr Oncol Rep 2022; 24:295-302. [PMID: 35113354 PMCID: PMC8811341 DOI: 10.1007/s11912-022-01207-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW This study aims to describe what is currently known about how children with cancer have been affected by the COVID-19 pandemic, including morbidity and mortality, interruptions in cancer care and delays in diagnosis, and psychosocial effects. Here we summarize the literature on how this patient population has fared during the pandemic, reviewing multiple smaller reports along with two large registries. RECENT FINDINGS Although children with cancer generally have better outcomes with COVID-19 infection than adults with cancer, their risks of hospitalization, ICU admission, and death are greatly increased compared to the general pediatric population. There are socioeconomic and ethnic disparities present in these effects. Children with cancer experience significant risks from the COVID-19 pandemic. It has yet to be seen how delays and interruptions of cancer treatment and direct organ toxicities caused by the virus itself may affect long-term outcomes in these patients.
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Affiliation(s)
- Alissa R Kahn
- Pediatric Hematology-Oncology, Department of Pediatrics, Saint Joseph's University Medical Center, 703 Main Street, Paterson, NJ, 07503, USA.
| | - Carla M Schwalm
- Pediatric Hematology-Oncology, Department of Pediatrics, Bronson Methodist Hospital, 601 John Street, Kalamazoo, MI, 49007, USA
| | - Julie Ann Wolfson
- Pediatric Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Avenue S, Lowder Suite 500, Birmingham, AL, USA
| | - Jennifer M Levine
- Pediatric Hematology-Oncology, Department of Pediatrics, Weill Cornell Medicine, 525 East 68th St, Payson 6, New York, NY, 10024, USA
| | - Emily E Johnston
- Pediatric Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Avenue S, Lowder Suite 500, Birmingham, AL, USA.,Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL, USA
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20
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Davies J, O'Connor M, Halkett GKB, Kelada L, Gottardo NG. Parents' Experiences of Childhood Cancer During the COVID-19 Pandemic: An Australian Perspective. J Pediatr Psychol 2021; 47:148-157. [PMID: 34865100 PMCID: PMC8690259 DOI: 10.1093/jpepsy/jsab125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/17/2021] [Accepted: 11/01/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction COVID-19 has had far-reaching impacts including changes in work, travel, social structures, education, and healthcare. Objective This study aimed to explore the experiences of parents of children receiving treatment for cancer during the COVID-19 pandemic. Methods Parents whose children were currently in treatment for childhood cancer or had completed treatment in the previous 12 months, participated in semi-structured interviews, face-to-face or via teleconferencing. Thematic analysis was used to analyze the data. Results The sample consisted of 34 participants (17 fathers and 17 mothers) from all states across Australia. Median age 37.5 years (range 29–51, years, SD = 6.3). Five main themes were identified: “Welcome to the Club”; “Remote Work and Study”; “Silver Linings”; “The Loneliest Experience” with three sub-themes “Immediate Family”; “Friends”; and “Overseas Family” and “Lack of Support” with two sub-themes: “Community Support” and “Organized Support.” Conclusion These findings revealed contrasting experiences of the impact of the COVID-19 pandemic. For parents whose children were neutropenic, the pandemic provided benefits in increased community understanding of infection control. Parents also reflected that the movement to remote work made it easier to earn an income. In contrast, some parents observed that restrictions on visitors and family intensified feelings of isolation. Parents also described how the COVID-19 reduced access to support services. These findings contribute to an understanding of the multifaceted impacts of the COVID-19 pandemic on families of children with cancer.
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Affiliation(s)
- Jenny Davies
- School of Population Health, Faculty of Health Sciences, Curtin University, Australia
| | - Moira O'Connor
- School of Population Health, Faculty of Health Sciences, Curtin University, Australia.,WA Cancer Prevention Research Unit, School of Population Health, Curtin University, Australia
| | - Georgia K B Halkett
- Faculty of Health Sciences, Curtin School of Nursing, Curtin University, Australia
| | - Lauren Kelada
- School of Women's and Children's Health, UNSW Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Australia
| | - Nicholas G Gottardo
- Brain Tumour Research Programme, Telethon Kids Institute, Australia.,Paediatrics, School of Medicine, University of Western Australia, Australia.,Department of Paediatric and Adolescent Oncology/Haematology, Perth Children's Hospital, Australia
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21
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Momenimovahed Z, Salehiniya H, Hadavandsiri F, Allahqoli L, Günther V, Alkatout I. Psychological Distress Among Cancer Patients During COVID-19 Pandemic in the World: A Systematic Review. Front Psychol 2021; 12:682154. [PMID: 34650469 PMCID: PMC8506116 DOI: 10.3389/fpsyg.2021.682154] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/10/2021] [Indexed: 11/24/2022] Open
Abstract
Aim: Patients with malignancies, experience high rates of psychological distress. Fear of Corona-infection combined with the interruptions in some treatment programs might affect the psychological health of cancer patients. This review study was conducted to investigate the psychological distress among cancer patients during COVID-19 pandemic to offer system-adapted individual solutions. Materials and methods: To identify the psychological distress of cancer patients, a comprehensive search was carried out in PubMed, Web of Science, and Scopus. English language and original articles were included in this study. Articles that addressed any psychological distress among cancer patients during COVID-19 pandemic were included. Results: At first 1,410 articles, were included in the study. After removing duplicate articles and reviewing the title and abstract, 55 articles were selected for the review. The findings of this study revealed COVID-19 greatly affects psychological health of cancer patients. Fear of COVID-19, fear of disease progression, disruption of oncology services, cancer stage, and immunocompromised status were the most common causes of psychological distress in oncology patients which can influence patients' decisions about treatment. Conclusion: The COVID-19 related anxiety is an expected reaction to the current situation. Although psychological distress affects many people, it can confuse cancer patients to the point that they refuse to continue treatment for the fear of infection and worsening of their condition. Since the end of this pandemic is unknown, this action can endanger the health and prognosis of this group of patients, so it seems that using psychological interventions and intensive counseling in the current situation is one of the main priorities for cancer patients.
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Affiliation(s)
- Zohre Momenimovahed
- Department of Reproductive Health, Qom University of Medical Sciences, Qom, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Fatemeh Hadavandsiri
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Allahqoli
- School of Public Health, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Veronika Günther
- Kiel School of Gynecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany
| | - Ibrahim Alkatout
- Kiel School of Gynecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany
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22
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Guido A, Marconi E, Peruzzi L, Dinapoli N, Tamburrini G, Attinà G, Balducci M, Valentini V, Ruggiero A, Chieffo DPR. Psychological Impact of COVID-19 on Parents of Pediatric Cancer Patients. Front Psychol 2021; 12:730341. [PMID: 34630243 PMCID: PMC8493250 DOI: 10.3389/fpsyg.2021.730341] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/23/2021] [Indexed: 12/12/2022] Open
Abstract
The changes and general alarm of the current COVID-19 pandemic have amplified the sense of precariousness and vulnerability for family members who, in addition to the emotional trauma of the cancer diagnosis, add the distress and fear of the risks associated with infection. The primary objectives of the present study were to investigate the psychological impact of the COVID-19 pandemic on the parents of pediatric cancer patients, and the level of stress, anxiety, and the child's quality of life perceived by the parents during the COVID-19 epidemic. The parents of 45 consecutive children with solid and hematological tumors were enrolled. Four questionnaires (Impact of Event Scale-Revised - IES-R; Perceived Stress Scale - PSS; Spielberger State - Trait Anxiety Inventory - STAI-Y; Pediatric Quality of Life Inventory - PedsQL) were administered to the parents at the beginning of the pandemic lockdown. A 75% of parents exhibited remarkable levels of anxiety, with 60 subjects in state scale and 45 subjects in trait scale having scores that reached and exceeded the STAI-Y cut off. The bivariate matrix of correlation found a significant positive correlation between the IES-R and PSS scores (r = 0.55, P < 0.001). There was a positive correlation between the PSS and PedsQL (emotional needs) scale (P < 0.001) and a negative correlation between IES-R and STAI-Y (P < 0.001). The results confirm that parents of pediatric cancer patients have a high psychological risk for post-traumatic symptoms, high stress levels, and the presence of clinically significant levels of anxiety.
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Affiliation(s)
- Antonella Guido
- UOS Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy
| | - Elisa Marconi
- UOS Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy
- UOC Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Laura Peruzzi
- UOS Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy
| | - Nicola Dinapoli
- UOC Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gianpiero Tamburrini
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giorgio Attinà
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy
| | - Mario Balducci
- UOC Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vincenzo Valentini
- UOC Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Ruggiero
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy
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23
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Cheriyalinkal Parambil B, Goswami S, Roy Moulik N, Sonkusare L, Dhamne C, Narula G, Vora T, Prasad M, Chichra A, Jatia S, Sarda H, Paradkar A, Deodhar J, Chinnaswamy G, Banavali S. Psychological distress in primary caregivers of children with cancer during COVID-19 pandemic-A single tertiary care center experience. Psychooncology 2021; 31:253-259. [PMID: 34435720 PMCID: PMC8646668 DOI: 10.1002/pon.5793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/04/2022]
Abstract
Objective Families of children with cancer undergoing treatment during COVID‐19 pandemic represent a vulnerable population for psychological distress and early identification and remedial measures are imperative for wellbeing of both the children and the caregivers. This article reports the results of assessment of psychological distress in primary caregivers of children with cancer undergoing treatment at a tertiary care center. Methods Primary caregivers of children with cancer (≤15 years) taking treatment at our institute during the period of July 2020 to August 2020 were prospectively evaluated for psychological distress using Patient Health Questionnaire‐9 (PHQ‐9) and Generalized Anxiety Disorder‐7 (GAD‐7) tools over a telephonic call. There were 2 cohorts, A and B (50 participants each) depending on whether child was diagnosed with COVID‐19 or not respectively during the study period. Results The assessment tool, PHQ‐9 showed a score of ≥10 in 13% (n = 13) participants (95%CI:7.1%–21.2%) in the entire cohort and in 16% (n = 8, 95%CI:5.8%–26.2%) and 10% (n = 5, 95%CI:1.7%–18.3%) participants in cohort A and cohort B respectively. GAD‐7 showed a score of ≥8 in 18% (n = 18) participants (95%CI:11.0%–27.0%) in the entire cohort and in 20% (n = 10, 95%CI:8.9%–31.1%) and 16% (n = 8, 95%CI:5.8%–26.2%) participants in cohort A and cohort B respectively. All participants were assessed, and supportive psychotherapeutic interventions administered over telephonic call. Conclusions Primary caregivers should be assessed and followed up for psychological distress irrespective of other co‐existing factors. Robust support systems built over time could help withstand the exceptional strain of a major surge during a pandemic.
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Affiliation(s)
| | - Savita Goswami
- Department of Psycho-Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Nirmalya Roy Moulik
- Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Lekhika Sonkusare
- Department of Psycho-Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Chetan Dhamne
- Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Gaurav Narula
- Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Tushar Vora
- Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Maya Prasad
- Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Akanksha Chichra
- Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Shalini Jatia
- Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Harshita Sarda
- Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Amey Paradkar
- Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Jayita Deodhar
- Department of Psycho-Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Girish Chinnaswamy
- Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Shripad Banavali
- Department of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India
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24
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McKune SL, Acosta D, Diaz N, Brittain K, Beaulieu DJ, Maurelli AT, Nelson EJ. Psychosocial health of school-aged children during the initial COVID-19 safer-at-home school mandates in Florida: a cross-sectional study. BMC Public Health 2021; 21:603. [PMID: 33781220 PMCID: PMC8006116 DOI: 10.1186/s12889-021-10540-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/03/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Given the emerging literature regarding the impacts of lockdown measures on mental health, this study aims to describe the psychosocial health of school-aged children and adolescents during the COVID-19 Safer-at-Home School mandates. METHODS A cross-sectional study was conducted in April 2020 (n = 280) among K-12 students at a research school in North Central Florida. Bivariate analysis and logistic and multinomial logistic regression models were used to examine socio-demographic and knowledge, attitude, and practice (KAP) predictors of indicators of anxiety-related, depressive, and obsessive-compulsive disorder(OCD)-related symptoms. Outcomes (anxiety, OCD, and depressive related symptoms) were measured by indices generated based on reported symptoms associated with each psychosocial outcome. RESULTS Loss of household income was associated with increased risk for all three index-based outcomes: depressive symptoms [aOR = 3.130, 95% CI = (1.41-6.97)], anxiety-related symptoms [aOR = 2.531, 95%CI = (1.154-5.551)], and OCD-related symptoms [aOR = 2.90, 95%CI = (1.32-6.36)]. Being female was associated with being at higher risk for depressive symptoms [aOR = 1.72, 95% CI = (1.02-2.93)], anxiety-related symptoms [aOR = 1.75, 95% CI = (1.04-2.97)], and OCD-related symptoms [aOR = 1.764, 95%CI = (1.027-3.028)]. Parental practices protective against COVID-19 were associated with children being at higher risk of depressive symptoms [aOR = 1.55, 95% CI = (1.04-2.31)]. Lower school level was associated with children being at higher risk of anxiety-related and OCD-related symptoms. CONCLUSIONS As the COVID-19 pandemic continues, schools should prioritize mental health interventions that target younger, female students, and children of families with income loss. Limiting the spread of COVID-19 through school closure may exacerbate negative psychosocial health outcomes in children, thus school administrators should move quickly to target those at greatest risk.
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Affiliation(s)
- Sarah L McKune
- Departments of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
| | - Daniel Acosta
- Departments of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Nick Diaz
- Departments of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Kaitlin Brittain
- Departments of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Diana Joyce- Beaulieu
- Department of Special Education, School Psychology, & Early Childhood Studies, College of Education, University of Florida, Gainesville, FL, USA
| | - Anthony T Maurelli
- Departments of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Eric J Nelson
- Departments of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
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25
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van Gorp M, Maurice‐Stam H, Teunissen LC, van de Peppel – van der Meer W, Huussen M, Schouten‐van Meeteren AY, Grootenhuis MA. No increase in psychosocial stress of Dutch children with cancer and their caregivers during the first months of the COVID-19 pandemic. Pediatr Blood Cancer 2021; 68:e28827. [PMID: 33251717 PMCID: PMC7744828 DOI: 10.1002/pbc.28827] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/15/2022]
Abstract
We studied the psychosocial impact of the start of the COVID-19 pandemic on Dutch children with cancer in outpatient care and their caregivers (n = 799) using regular monitoring and screening outcomes. No differences were observed between the pre-COVID-19 and early-COVID-19 periods in health-related quality of life and fatigue of children. Fewer caregivers were distressed during the COVID-19 period than pre-COVID-19. In conclusion, the additional stress of COVID-19 did not deteriorate psychosocial functioning of children with cancer and their caregivers. Results may be explained by alleviating daily life changes, experience in coping with medical traumatic stress, and appropriate care and support.
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Affiliation(s)
- Marloes van Gorp
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands
| | | | | | | | - Maaike Huussen
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands
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26
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Önal G, Güney G, Huri M. Quality of life and occupational performance of children with cancer in the era of the COVID-19 pandemic in terms of rehabilitation. Qual Life Res 2021; 30:2783-2794. [PMID: 33939075 PMCID: PMC8091154 DOI: 10.1007/s11136-021-02857-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE This study was designed to determine the changes in the quality of life (QOL) and occupational performance of children with cancer and to examine their rehabilitation needs during the pandemic period in Turkey. METHODS 60 children with cancer and their families participated in the study. The first and second assessments were carried out in April and September 2020, respectively. The pediatric quality of life inventory parent proxy-report was used to evaluate the QOL, and the Canadian occupational performance measurement was used to evaluate children's occupational performance and satisfaction. A qualitative interview was planned to determine the impact of the pandemic on children with cancer alongside their families and therefore determining the rehabilitation needs of the children. RESULTS While there is no statistically significant change in the pain-related conditions of the children in the first six months of the pandemic (p > 0.05), procedural and treatment anxieties of the children increased during the treatment. Their QOL including cognitive state, perceived physical appearance and communication skills also showed a statistically significant decrease (p < 0.05). Both the occupational performance and satisfaction scores decreased significantly, covering the pre-pandemic and pandemic era (p < 0.01). In the qualitative interview parents expressed their children's need for physical, psychological and social participation support. Also, they emphasized the need for time management. CONCLUSIONS During the COVID-19 pandemic, the QOL and occupational performance level of children with cancer decreased significantly. Holistic rehabilitation approaches complying with pandemic conditions are likely to benefit these children.
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Affiliation(s)
- Gözde Önal
- Therapy and Rehabilitation Department, Hacı Bektaş Veli University, Nevşehir, Türkiye
| | - Güleser Güney
- Therapy and Rehabilitation Department, Kütahya Health Sciences University, Kütahya, Türkiye
| | - Meral Huri
- Occupational Therapy Department, Hacettepe University, Ankara, Turkey
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27
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Zijlmans J, Teela L, van Ewijk H, Klip H, van der Mheen M, Ruisch H, Luijten MAJ, van Muilekom MM, Oostrom KJ, Buitelaar J, Hoekstra PJ, Lindauer R, Popma A, Staal W, Vermeiren R, van Oers HA, Haverman L, Polderman TJC. Mental and Social Health of Children and Adolescents With Pre-existing Mental or Somatic Problems During the COVID-19 Pandemic Lockdown. Front Psychiatry 2021; 12:692853. [PMID: 34305685 PMCID: PMC8295554 DOI: 10.3389/fpsyt.2021.692853] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/07/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The COVID-19 lockdown increases psychological problems in children and adolescents from the general population. Here we investigate the mental and social health during the COVID-19 lockdown in children and adolescents with pre-existing mental or somatic problems. Methods: We included participants (8-18 years) from a psychiatric (N = 249) and pediatric (N = 90) sample, and compared them to a general population sample (N = 844). Measures were assessed during the first lockdown (April-May 2020) in the Netherlands. Main outcome measures were Patient-Reported Outcomes Measurement Information System (PROMIS®) domains: Global Health, Peer Relationships, Anxiety, Depressive Symptoms, Anger, and Sleep-Related Impairment, as reported by children and youth. Additionally, socio-demographic variables, COVID-19-related questions, changes in atmosphere at home from a parent and child perspective, and children's experiences of lockdown regulations were reported by parents. Results: On all measures except Global Health, the pediatric sample reported least problems. The psychiatric sample reported significantly more problems than the general population sample on all measures except for Anxiety and Peer Relationships. Having a COVID-19 affected friend/relative and a COVID-19 related change in parental work situation negatively moderated outcome, but not in the samples with pre-existing problems. All parents reported significant decreases in atmosphere at home, as did children from the general population. Conclusion: We observed significant differences in mental and social health between three child and adolescent samples during the COVID-19 pandemic lockdown and identified COVID-19-related factors influencing mental and social health.
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Affiliation(s)
- Josjan Zijlmans
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands
| | - Lorynn Teela
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Hanneke van Ewijk
- Curium-Leiden University Medical Center, Leiden University Medical Center, Leiden, Netherlands
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands
| | - Malindi van der Mheen
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
| | - Hyun Ruisch
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Michiel A J Luijten
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands.,Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam Public Health, Amsterdam, Netherlands
| | - Maud M van Muilekom
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Kim J Oostrom
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Jan Buitelaar
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ramón Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands.,Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
| | - Wouter Staal
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands
| | - Robert Vermeiren
- Curium-Leiden University Medical Center, Leiden University Medical Center, Leiden, Netherlands
| | - Hedy A van Oers
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Lotte Haverman
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Tinca J C Polderman
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands.,Curium-Leiden University Medical Center, Leiden University Medical Center, Leiden, Netherlands.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands.,Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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28
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Bussières EL, Malboeuf-Hurtubise C, Meilleur A, Mastine T, Hérault E, Chadi N, Montreuil M, Généreux M, Camden C. Consequences of the COVID-19 Pandemic on Children's Mental Health: A Meta-Analysis. Front Psychiatry 2021; 12:691659. [PMID: 34925080 PMCID: PMC8672800 DOI: 10.3389/fpsyt.2021.691659] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/01/2021] [Indexed: 12/11/2022] Open
Abstract
Background: The COVID-19 pandemic has exacerbated mental health problems in many individuals, including children. Children with pre-existing socio-demographic or developmental risk factors may be particularly vulnerable to the negative effects of the pandemic and associated public health preventive measures. Objective: This systematic review and meta-analysis explored the impacts of the COVID-19 pandemic on the mental health of children aged 5-13 years-old, while highlighting the specific difficulties experienced by children with neurodevelopmental issues or chronic health conditions. Methods: A systematic search of the published literature was conducted in Medline, ERIC, PsycINFO, and Google Scholar, followed by a quantitative meta-analysis of the eligible studies. Results: Out of the 985 articles identified, 28 empirical studies with prospective or retrospective longitudinal data were included in the quantitative synthesis. COVID-19 lockdown measures were associated with negative general mental health outcomes among children (g = 0.28, p < 0.001, and k = 21), but of small magnitude. Sleep habits were also changed during the pandemic, as sleep duration significantly increased in children (g = 0.32; p = 0.004, and k = 9). Moreover, results did not differ between children from the general population and those from clinical populations such as children with epilepsy, oncology, neurodevelopmental disorders, or obesity. Effect sizes were larger in European vs. Asian countries. Conclusions: Studies included in this review suggest that children's mental health was generally negatively impacted during the COVID-19 pandemic. More research is needed to understand the long-term effects of the COVID-19 pandemic on children's mental health and the influence of specific risks factors as they evolve over time.
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Affiliation(s)
- Eve-Line Bussières
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | | | - A Meilleur
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Trinity Mastine
- Department of Psychology, Bishop's University, Sherbrooke, QC, Canada
| | - Elodie Hérault
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Nicholas Chadi
- Division of Adolescent Medicine, Department of Pediatrics, Sainte-Justine University Hospital Centre, Université de Montréal, Montreal, QC, Canada
| | | | - Mélissa Généreux
- Department of Psychology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Chantal Camden
- Department of Psychology, University of Sherbrooke, Sherbrooke, QC, Canada
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