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Perspectives and experiences of Covid-19: Two Irish studies of families in disadvantaged communities.

ABSTRACT: The Covid-19 pandemic has been recognised to affect families' socio-emotional well-being. Collecting the views of families in diverse socio-economic contexts can contribute to understanding their specific needs and resources in relation to the Covid-19 pandemic. The overarching objective of the current research was to explore the views and experiences of families in relation to the Covid-19 pandemic, who were living in the Republic of Ireland, including in areas designated as disadvantaged. In Study 1, the objective was to explore changes, difficulties, and concerns experienced by parents of children up to six years old during the pandemic, and related associations with socio-demographic characteristics. Data were collected from 168 parents/carers via an online questionnaire, and examined using conceptual content analysis. The most frequently identified experiences related to restrictions, social isolation, negative impacts on parents' emotional and psychological well-being, negative impacts on children's emotional well-being and development, concerns with physical health, uncertainty about the future, and positive changes regarding family time and activities. Associations were found with parents' age and work situation, and family's income and composition. In Study 2, the objective was to explore the views of children, parents, and service providers about the impact of the Covid-19 pandemic on families' life, and relevant supports. Data were collected from 50 children aged between eight and 17 years old, 17 parents, and 20 service providers through focus group discussions, and examined using thematic analysis. The participants reported experiences related to challenges with online education, uncertainty regarding children's education, food poverty, and children's socio-emotional health. The findings of both studies reinforced the importance of implementing measures to promote parents' and children's socio-emotional well-being, combat educational inequalities, and ensure economic and employment security.

SUBMITTER: Leitao C

PROVIDER: S-EPMC9292082 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe COVID-19 pandemic had a major impact on the mental health and well-being of children with neurodevelopmental conditions (NDCs) and of their families worldwide. However, there is insufficient evidence to understand how different factors (e.g., individual, family, country, children) have impacted on anxiety levels of families and their children with NDCs developed over time.MethodsWe used data from a global survey assessing the experience of 8043 families and their children with NDCs (mean of age (m) = 13.18 years, 37% female) and their typically developing siblings (m = 12.9 years, 45% female) in combination with data from the European Centre for Disease Prevention and Control, the University of Oxford, and the Central Intelligence Agency (CIA) World Factbook, to create a multilevel data set. Using stepwise multilevel modelling, we generated child-, family- and country-related factors that may have contributed to the anxiety levels of children with NDCs, their siblings if they had any, and their parents. All data were reported by parents.ResultsOur results suggest that parental anxiety was best explained by family-related factors such as concerns about COVID-19 and illness. Children's anxiety was best explained by child-related factors such as children's concerns about loss of routine, family conflict, and safety in general, as well as concerns about COVID-19. In addition, anxiety levels were linked to the presence of pre-existing anxiety conditions for both children with NDCs and their parents.ConclusionsThe present study shows that across the globe there was a raise in anxiety levels for both parents and their children with NDCs because of COVID-19 and that country-level factors had little or no impact on explaining differences in this increase, once family and child factors were considered. Our findings also highlight that certain groups of children with NDCs were at higher risk for anxiety than others and had specific concerns. Together, these results show that anxiety of families and their children with NDCs during the COVID-19 pandemic were predicted by very specific concerns and worries which inform the development of future toolkits and policy. Future studies should investigate how country factors can play a protective role during future crises.

Project description:ObjectivesYoung people are considered at lower risk from coronavirus disease-19 (COVID-19). However, measures to limit the population health impact of the current COVID-19 pandemic have caused significant disruptions to their lives. The objective of this study was to explore the experiences of young people predominantly living in the south-west of England during the COVID-19 pandemic.Study designRapid qualitative study.MethodsFollowing advertisement on social media, a purposive sample of young people by age and gender who had expressed an interest were invited to participate. In June 2020, 21 young people (12-17 years) took part in 18 semi-structured interviews, either through a digital platform or by telephone. Interviews were recorded digitally and transcribed verbatim. Thematic analysis was undertaken, assisted by NVvivo Software.ResultsYoung people felt the greatest impacts of the pandemic have been disruption to how they learned because of school closures and limited face-to-face interaction with their social networks. There was variation in terms of how satisfied young people were with self-directed learning at home, and some anxieties in relation to its effectiveness outside the school environment. Most young people reported maintaining social relationships remotely, but some young people appeared to have little social interaction outside their household. High levels of adherence to social distancing and handwashing were reported, which could lead to a sense of injustice resulting from visibility of other people breaching social distancing guidance. Young people were willing to be vaccinated against COVID-19 if a vaccine became available, with the greatest motivator being to protect others above themselves.ConclusionsYoung people have experienced significant disruption to their education and social networks during the COVID-19 pandemic. During lockdown, high levels of compliance to government public health guidelines to reduce transmission of COVID-19 were reported by young people. If an effective vaccine is developed, a schools-based vaccination programme could be an efficient method to interrupt transmission to more at-risk populations and prevent further disruptions to young people's education.

Project description:BackgroundLack of control over life situations is an important social determinant that may negatively affect parental and child health. This study took place in an area of Stockholm, Sweden with high indications of socioeconomic disadvantage, a large part of the population with foreign background, as well as higher levels of poor health than the county average. It investigated staff perceptions of pathways from situations of low control, potentially leading to health inequities, affecting families enrolled in an early childhood home visiting programme during the Covid-19 pandemic.MethodsSemi-structured interviews were carried out with 23 child health care nurses and parental advisors working in a home visiting programme. The data was analysed using Reflexive Thematic Analysis.ResultsThe analysis resulted in five pathways on two explanatory levels, affecting parents' health and parenting capacity and children's health and well-being, potentially damaging health and leading to health inequities. The first four pathways related to control at the personal explanatory level: Families facing instability and insecurity; Caring for children in crowded and poor housing conditions; Experiencing restricted access to resources; and Parenting with limited social support. The fifth pathway, Living in a segregated society, covered the collective experience of lack of control on community level. The Covid-19 pandemic was observed to negatively affect all pathways and thus potentially aggravate health inequities for this population. The pandemic has also limited the delivery of home visits to the families which creates further barriers in families' access to resources and increases isolation for parents with already limited social support.ConclusionsThe diversity of pathways connected to health inequities presented in this study highlights the importance of considering this variety of influences when designing interventions for socioeconomically disadvantaged areas. The additional negative consequences of Covid-19 indicate the need for sustainable preventive early childhood interventions for families in such areas. The study also emphasizes the need for further research as well as policy action on possible long-term effects of changing behaviours during the Covid-19 period on child health and health equity.Trial registrationThe study was retrospectively registered (11 August 2016) in the ISRCTN registry ( ISRCTN11832097 ).

Project description:ImportanceLittle is known about how US clinicians have responded to resource limitation during the coronavirus disease 2019 (COVID-19) pandemic.ObjectiveTo describe the perspectives and experiences of clinicians involved in institutional planning for resource limitation and/or patient care during the pandemic.Design, setting, and participantsThis qualitative study used inductive thematic analysis of semistructured interviews conducted in April and May 2020 with a national group of clinicians (eg, intensivists, nephrologists, nurses) involved in institutional planning and/or clinical care during the COVID-19 pandemic across the United States.Main outcomes and measuresEmergent themes describing clinicians' experience providing care in settings of resource limitation.ResultsThe 61 participants (mean [SD] age, 46 [11] years; 38 [63%] women) included in this study were practicing in 15 US states and were more heavily sampled from areas with the highest rates of COVID-19 infection at the time of interviews (ie, Seattle, New York City, New Orleans). Most participants were White individuals (39 [65%]), were attending physicians (45 [75%]), and were practicing in large academic centers (≥300 beds, 51 [85%]; academic centers, 46 [77%]). Three overlapping and interrelated themes emerged from qualitative analysis, as follows: (1) planning for crisis capacity, (2) adapting to resource limitation, and (3) multiple unprecedented barriers to care delivery. Clinician leaders worked within their institutions to plan a systematic approach for fair allocation of limited resources in crisis settings so that frontline clinicians would not have to make rationing decisions at the bedside. However, even before a declaration of crisis capacity, clinicians encountered varied and sometimes unanticipated forms of resource limitation that could compromise care, require that they make difficult allocation decisions, and contribute to moral distress. Furthermore, unprecedented challenges to caring for patients during the pandemic, including the need to limit in-person interactions, the rapid pace of change, and the dearth of scientific evidence, added to the challenges of caring for patients and communicating with families.Conclusions and relevanceThe findings of this qualitative study highlighted the complexity of providing high-quality care for patients during the COVID-19 pandemic. Expanding the scope of institutional planning to address resource limitation challenges that can arise long before declarations of crisis capacity may help to support frontline clinicians, promote equity, and optimize care as the pandemic evolves.

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Perspectives and experiences of Covid-19: Two Irish studies of families in disadvantaged communities.

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