The effects of the COVID-19 pandemic on children's lifestyles and anxiety levels

Education for Health Care Providers on Implementation of Trauma-Informed Care in Practice

BACKGROUND

Traumatic experiences can adversely affect a child's health. These effects often continue into adulthood, especially when trauma is not addressed. Although the evidence shows benefits with addressing trauma earlier in life, trauma-informed care of children is underused in primary care. Health care providers (nurses, nurse practitioners, physicians) report gaps in knowledge of trauma-informed care and in their comfort level addressing trauma in primary care.

METHOD

This project investigated the use of continuing education sessions to increase health care providers' knowledge and readiness to implement trauma-informed care into their practice.

RESULTS

The education sessions improved health care providers' knowledge and comfort with trauma-informed care.

CONCLUSION

This intervention improved providers' readiness to implement trauma-informed care into their primary care practice. [J Contin Educ Nurs. 2024;55(5):246-252.].

Anxiety in Children and Adolescents in the Covid-19 Pandemic: A Systematic Review

The aim of this study was; to define the anxiety and anxiety-related factors experienced by children/adolescents during the Covid-19 pandemic on a global scale. Study data were collected between 15.04.2021 and 30.04.2021 by using keywords (child, children, adolescents, adolescents, mental health, anxiety, anxiety and stress) in Turkish and English. The data sources of this study are PubMed, Web of Science, and Google Scholar t. As a result of the evaluations, a total of n=6185 articles were reached from all databases. After the evaluation of the full texts, the study was completed with n=31 articles. Eleven of the articles evaluated in this study were published in China. The anxiety prevalence of children and adolescents varies between 1.84-45.0%. As a result of the evaluated studies; It has been observed that women, those with chronic-psychiatric diseases, those who are older, separated from family members, migrant children and adolescents are more likely to experience anxiety. Some of the anxiety symptoms of children and adolescents are nervousness, irritability, anxiety, and suicidal ideation. In conclusion, anxiety levels and anxiety-related factors of children and adolescents living in various countries of the world during the Covid-19 pandemic were determined.

Qualitative study of the association between psychosocial health and physical activity/sleep quality in toddlers

Physical activity and sleep are important factors of mental and physical health in children, with some reports indicating that their effects can persist into adulthood. However, there is limited research on the qualitative aspects of physical activity and sleep in preschool children, particularly in those aged < 3 years. Therefore, to elucidate the association between psychosocial health and physical activity/sleep in early childhood in terms of qualitative aspects, we conducted a retrospective cohort study in 2985 3-year-old children (37.2 ± 0.75 months) in Shanghai, China. An analysis using structural equation modeling indicated that current physical activity had a direct and moderate impact on current psychosocial health evaluated using the Strength and Difficulties Questionnaire. In particular, past physical activity had an indirect and mild effect on current psychosocial health via current physical activity in girls. However, regardless of sex, past sleep quality had slight impact on current psychosocial health, not only indirectly via current sleep quality, but also directly. These findings highlight the importance of considering the qualitative aspects of physical activity and sleep quality as significant factors influencing the current and future psychosocial health of children, even at a very early age (< 3 years).

Exploring the Caregiver-Reported Impact of the COVID-19 Pandemic on Children with Traumatic Brain Injury

The COVID-19 pandemic is expected to have a persistent, negative, and disproportionate impact on children with disabilities. Children with traumatic brain injury (TBI) may be expected to experience a disproportionate impact given the deficits often associated with childhood TBI (e.g., family functioning, fatigue, executive functioning, quality of life). This study aimed to explore the impact of the COVID-19 pandemic on children with TBI and their families, compared to typically developing (TD) children and their families. Thirty caregivers (TBI = 15; TD = 15) completed a series of electronic survey measures. Overall, caregivers reported no negative impact of the COVID-19 pandemic on their family's or child's functioning and association with demographic factors and domains of functioning showed no clear patterns. The findings of this exploratory study support continued longitudinal investigation with larger sample sizes of the provision of supports for all families and children in light of the COVID-19 pandemic. Additional research is needed to understand the effectiveness of targeted services for students with TBI in domains of functioning that are significantly poorer than TD children (e.g., quality of life, executive functioning, fatigue).

The Effects of COVID-19 Lockdown on the Sleep Quality of Children

INTRODUCTION

The COVID-19 lockdown has caused important changes in children's routines, especially in terms of nutrition, physical activity, screen time, social activity, and school time. Regarding these changes, recent studies show that the COVID-19 lockdown is associated with higher levels of anxiety and depression in children. The objective of this study was to assess changes in sleep quality in Spanish children during the lockdown decreed by the Spanish government between March and June 2020.

METHODOLOGY

We compared the BEAR (bedtime, excessive daytime sleepiness, awakening during the night, and regularity and duration of sleep) scores of 478 participants (median age = 7.5 years; 48% girls) in the SENDO project during the periods before, during, and after lockdown. The questionnaires were filled out by one of the parents. We used hierarchical models with two levels of clustering to account for the intra-cluster correlation between siblings. The interaction of time with a set of a priori selected variables was assessed by introducing the interaction term into the model and calculating the likelihood ratio test.

RESULTS

The mean scores in the BEAR questionnaire referred to the periods before, during, and after lockdown were 0.52 (sd 1.25), 1.43 (sd 1.99), and 1.07 (sd 1.55), respectively. These findings indicate a deterioration in sleep quality during the period of confinement. Parental level of education was found to be an effect modifier (p for interaction = 0.004). Children whose parents had higher education (university graduates or higher) showed a smaller worsening than those without.

CONCLUSION

Our study shows that the COVID-19 lockdown was associated with a significant worsening of sleep quality. Moreover, although the end of the lockdown brought about a slight improvement, mean scores on the BEAR scale remained significantly higher than before the lockdown, suggesting that the consequences for sleep quality could persist over time. This worsening was higher in children whose parents had lower educational degrees. Helping children maintain healthy sleeping habits despite the circumstances and providing early psychological support when needed is important to prevent negative psycho-physical symptoms due to lockdown that could persist over the years.

Children and adolescents' mental health during the COVID-19 pandemic: A qualitative study of their experiences

TOPIC

Public health measures implemented in response to the COVID-19 pandemic severely disrupted children and adolescents' (C&A) lives, affecting their sense of structure, predictability, and security.

PURPOSE

To examine C&A' experiences during the COVID-19 pandemic to better understand how this context and its associated public health measures affected them and their mental health, and to identify helpful coping strategies.

SOURCES USED

The study was guided by a participatory hermeneutic framework. Semistructured interviews were conducted with 25 C&A aged 6-17 years during the first and second pandemic waves. Participants' interviews were analyzed following a narrative synthesis approach, through which C&A' experiences were contrasted and contextualized to highlight relevant themes.

CONCLUSIONS

Participants described a distinct pattern related to their mental health as the pandemic unfolded, which followed the severity of the pandemic in the province. Negative repercussions on their mental health were linked to the loss of social activities, imposed public health measures, transition to online learning, and challenges with family relationships. Certain youth shared positive societal and moral reflections triggered by the pandemic context. Coping strategies reported include: having a variety of hobbies; expressing their emotions; and accessing financial and material resources. This study highlights the importance of supporting C&A' mental health during crisis situations such as a pandemic. Their perspectives are vital for clinical practice and policy improvement, particularly to find means for social engagement while maintaining safety.

Effects of the COVID-19 pandemic on sleep health among Middle Eastern and North African (MENA) populations: a systematic review of the literature

OBJECTIVES

This study sought to conduct a systematic review of the literature on the impact of the COVID-19 pandemic on sleep health among Middle Eastern and North African (MENA) populations, understudied geographic regions including with regards to sleep health.

SETTING

A systematic literature search of studies published from inception to 27 March 2022 was conducted on multiple databases using developed keywords.

PARTICIPANTS

Studies were included if they (1) investigated one or more aspects/dimensions of sleep health as an outcome (eg, sleep duration, sleep quality, sleep problems); (2) measured the impact of a COVID-19 pandemic-related domain (eg, impact of quarantine, work from home, lifestyle changes); (3) focused on at least one MENA region population; (4) were peer-reviewed; (5) included ≥100 participants; (6) were written in English and (7) had full-text article publicly available.

PRIMARY AND SECONDARY OUTCOMES MEASURED

Primary outcomes were sleep duration, sleep quality and sleep problems.

RESULTS

In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 164 studies were included for data extraction. The Newcastle-Ottawa scale for cross-sectional studies was used to assess the quality of the studies. Overall, the COVID-19 pandemic significantly impacted sleep duration, sleep quality and presence and severity of sleep disorders in MENA populations, including adults, children, students, healthcare workers and people with chronic illnesses. The directionality and strength of associations, as well as the determinants of sleep health, varied by subpopulations.

CONCLUSIONS

Longitudinal studies are needed to understand the longer-term impact of the COVID-19 pandemic on the sleep health of MENA populations. Sleep health interventions and policy measures should be tailored to the need of each subpopulation.

PROSPERO REGISTRATION NUMBER

CRD42022321128.

Beyond lockdowns: a systematic review of the impacts of COVID-19 lockdowns on dietary pattern, physical activity, body weight, and food security

Context

COVID-19 lockdowns may have impacted dietary patterns and nutritional outcomes in many populations.

Objective

The aim of this review was to evaluate the impacts of COVID-19 lockdowns on nutritional patterns, investigating behaviors in the periods before, during, and after lockdowns.

Data Source

This systematic review followed the PRISMA-P methodology. The articles included were identified by searching the key words in Web of Science, PubMed, and Scopus. The key words used in the search included: “COVID19” AND “diet*”, “coronavirus” AND “diet*”, “coronavirus 2” AND “diet*”, “COVID19” AND “nutri*”, “coronavirus” AND “nutri*”, “coronavirus 2” AND “nutri*”, “COVID19” AND “food”.

Data Extraction

Twenty-two original studies were included in this review. Data extraction tables were created for recording author names, year of publication, location of study, duration, lockdown phase, design, methods, aims, number of participants, age, gender, health status, education, socioeconomic status, dietary patterns, food security, physical activity, body weight change or body mass index, and associations with sociodemographic characteristics.

Data Analysis

Impacts of lockdowns on eating patterns, physical activity, body weight or body mass index, and food security were the primary outcomes investigated. Secondary outcomes investigated were associations with sociodemographic characteristics.

Conclusion

COVID-19 lockdowns were associated with significant changes in dietary and lifestyle behaviors of worldwide populations. Impacts were seen during and post-lockdown likely due to more time spent at home, working from home, decreased food availability and accessibility, and augmented stress associated with lockdown.

The Impact of the COVID-19 Pandemic on School-Aged Children with Fragile X Syndrome

The pandemic caused by the spread of the coronavirus disease (COVID-19), beginning in early 2020, had an impact beyond anything experienced in recent history. People with Fragile X Syndrome (FXS), the leading known heritable cause of ASD and intellectual disability, were uniquely vulnerable to pandemic-related changes. This study surveyed parent perspectives of the impact on 33 school-aged children with FXS across daily living skills, education, therapies, behaviors, health visits, and mask wearing. Academic performance was perceived to have decreased in most of the children (58%). Students in online school had the most reports of decline and those in person had the most reported improvement. Parents were significantly more satisfied with services that remained in person compared to those delivered online or in hybrid settings. Additionally, depression (75%), sleep problems (80%), attention problems (73%), and social skills (61%) were reported to have worsened the most. Parents reported that in addition to continuing with a structured schedule, the most helpful strategies were increasing face-to-face social interactions and outdoor activities. Future research should explore strategies to help online interventions and education to be more successful with individuals with FXS, given this may become a resource for families not geographically able to access in-person resources.

[Psychological and behavioral problems in children and adolescents during the coronavirus disease 2019 epidemic: a Scoping review]

OBJECTIVES

To investigate the psychological and behavioral problems and related influencing factors in children and adolescents during the coronavirus disease 2019 (COVID-19) epidemic.

METHODS

China National Knowledge Infrastructure, Wanfang Data, PubMed, and Web of Science were searched using the method of subject search for articles published up to March 31, 2022, and related data were extracted for Scoping review.

RESULTS

A total of 3 951 articles were retrieved, and 35 articles from 12 countries were finally included. Most of the articles were from the journals related to pediatrics, psychiatry, psychology, and epidemiology, and cross-sectional survey was the most commonly used research method. Psychological and behavioral problems in children and adolescents mainly included depression/anxiety/stress, sleep disorder, internet behavior problems, traumatic stress disorder, and self-injury/suicide. Influencing factors were analyzed from the three aspects of socio-demographic characteristics, changes in living habits, and ways of coping with COVID-19.

CONCLUSIONS

During the COVID-19 epidemic, the psychological and behavioral problems of children and adolescents in China and overseas are severe. In the future, further investigation and research can be carried out based on relevant influencing factors to improve the psychological and behavioral problems.

Impact of COVID-19 pandemic lockdown on movement behaviours of children and adolescents: a systematic review

INTRODUCTION

Several studies have examined how the lockdown restrictions enforced to halt the spread of COVID-19 have affected children and adolescents' movement behaviours, but there is a need to synthesise these findings. Therefore, we conducted this systematic review to examine the impact of COVID-19 lockdown on children and adolescents' movement behaviours.

METHODS

We searched eight databases and grey literature for relevant studies of all study designs; and conducted a narrative analysis of the results following synthesis without meta-analysis guidelines. We used appropriate tools to assess the risk of bias in quantitative and qualitative studies. We compared changes in physical activity, screen time and sleep duration and quality from before to during the COVID-19 lockdown.

RESULTS

This review included 71 studies reporting data from 35 countries and territories, mostly from high-income economies. A majority of the studies used a cross-sectional design and had fair to poor-quality ratings. Most studies reported reduced physical activity, increased screen time and longer sleep hours among children and adolescents. Children and adolescents facing strict lockdowns saw a larger decline in physical activity and a sharper increase in screen time than those under mild restrictions.

CONCLUSION

COVID-19-related lockdowns were detrimental to children and adolescents' movement behaviours, with stricter lockdowns tending to have a bigger impact. Children and adolescents under COVID-19 restrictions are likely to be less active, spend more time on screen, and sleep longer hours than before the lockdown. More studies from low-income and middle-income countries could provide a clearer picture of the impact.

PROSPERO REGISTRATION NUMBER

CRD42021245924.

Experiences of children (ages 6-12) during COVID-19 pandemic from mothers' perspectives

PURPOSE

This study evaluated the experiences of children between ages 6 and 12 based on their mothers' perspectives during the COVID-19 pandemic.

METHODS

Ten mothers living in Ankara, Turkey with children in the aforementioned age range, participated in this study. Data were collected through focus group interview with a qualitative phenomenological approach followed by thematic data analysis.

FINDINGS

Three categories were obtained relating to the pandemic, including negative effects, positive effects, and the resultant needs and expectations of parents.

CONCLUSION

The findings show that the pandemic has significantly affected children in psychological, social, developmental, and academic realms. Therefore, it is necessary to plan interventions with a multidisciplinary approach to increase children's physical and psychosocial health, minimizing children's level of negative influences.