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Elekanachi RU, Lajoie A, Tavukcu S, Snider LM, Dahan-Oliel N. The experience of caregiving for children with rare musculoskeletal conditions: a qualitative study in arthrogryposis multiplex congenita. Orphanet J Rare Dis 2024; 19:235. [PMID: 38877508 PMCID: PMC11179382 DOI: 10.1186/s13023-024-03224-8] [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: 11/08/2023] [Accepted: 05/19/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Arthrogryposis multiplex congenita (AMC) is a group of rare musculoskeletal conditions that is associated with complex healthcare needs and long-term follow up. The literature reports significant direct, indirect, and psychosocial costs for caregivers of children with neuromuscular conditions. Due to mobility limitations and frequent hospital visits, caring for a child with AMC is complex. Other challenges experienced by caregivers include financial strain, job changes, changes in interpersonal relationships and abandonment. This study was aimed at exploring the lived experience of caregivers of children with AMC. METHODS The present study is part of a larger global mixed methods study. In the initial quantitative aspect of the study, caregivers (n = 158) of children and youths with AMC (aged 0-21 years) responded to a cost of care survey on an electronic platform. Of the 158 participants, 13 caregivers then further consented to participate in the qualitative aspect of the study in which a 60-min semi-structured, individual interview was conducted remotely. Open-ended questions were developed to gain a deeper understanding of the direct and indirect costs of care, their impact on the caregivers' lives and the quality of the care-giving experience. Interviews were transcribed, and a coding scheme was developed drawing from both the existing literature and the content of the interviews. A deductive and inductive thematic analysis was used to analyze the qualitative data using the NVivo® qualitative data analysis software. RESULTS AND CONCLUSION Five themes describing the experiences of caregivers of children with AMC emerged from the analysis of the qualitative data: 1. Impact of the caregiving experience; 2. Cost of childcare; 3. Support system for care; 4. Managing and navigating care; 5. Supporting the child's growth and development. In addition to the results of the thematic analysis, specific recommendations shared by the caregivers included the need for support groups and provision of support to youths to prepare them for adolescence. These findings will inform resource allocation, policymaking, and support services for children with rare conditions, their caregivers and families.
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Affiliation(s)
- R U Elekanachi
- School of Physical & Occupational Therapy, McGill University, Montreal, Canada.
| | - A Lajoie
- School of Physical & Occupational Therapy, McGill University, Montreal, Canada
| | - S Tavukcu
- Shriners Hospitals for Children, Montreal, Canada
| | - L M Snider
- School of Physical & Occupational Therapy, McGill University, Montreal, Canada
| | - N Dahan-Oliel
- School of Physical & Occupational Therapy, McGill University, Montreal, Canada
- Shriners Hospitals for Children, Montreal, Canada
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Pajek J, Mancini K, Murray M. COVID-19 and children's behavioral health: An overview. Curr Probl Pediatr Adolesc Health Care 2023; 53:101491. [PMID: 38040607 DOI: 10.1016/j.cppeds.2023.101491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
The paper reviews the impact of the COVID-19 pandemic on children's and adolescents' well-being. A trauma-informed framework is employed to discuss the emerging evidence of notable changes in youth's psychological, developmental, academic, and social well-being since the start of the COVID-19 pandemic. Children and adolescents have been uniquely affected based on their age at the start of the pandemic. Despite multiple resiliency factors, COVID-19 and its ramifications have had an adverse effect on youth in general and have exacerbated preexisting racial and socioeconomic disparities. This review concludes with recommendations for child health clinicians.
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Affiliation(s)
- Julie Pajek
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
| | - Kathryn Mancini
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Marsheena Murray
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
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Morrison J, Poudyal N, Pun I, Prasai S, Shrestha N, Khadka D, Shrestha S, Rohwerder B, Wickenden M. Adolescents with disabilities and caregivers experience of COVID-19 in rural Nepal. Front Public Health 2023; 11:1189067. [PMID: 37361160 PMCID: PMC10288364 DOI: 10.3389/fpubh.2023.1189067] [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: 03/18/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Intersecting vulnerabilities of disability, low socio-economic status, marginalization, and age indicate that adolescents with disabilities in low-and middle-income countries were uniquely affected by the COVID-19 pandemic. Yet, there has been limited research about their experience. We conducted participatory research with adolescents with disabilities in rural, hilly Nepal to explore their experience of the pandemic and inform understanding about how they can be supported in future pandemics and humanitarian emergencies. Methods We used qualitative methods, purposively sampling adolescents with different severe impairments from two rural, hilly areas of Nepal. We collected data through semi-structured interviews with five girls and seven boys between the age of 11 and 17 years old. Interviews used inclusive, participatory, and arts-based methods to engage adolescents, support discussions and enable them to choose what they would like to discuss. We also conducted semi-structured interviews with 11 caregivers. Results We found that adolescents with disabilities and their families experienced social exclusion and social isolation because of COVID-19 mitigation measures, and some experienced social stigma due to misconceptions about transmission of COVID-19 and perceived increased vulnerability of adolescents with disabilities to COVID-19. Adolescents who remained connected with their peers throughout lockdown had a more positive experience of the pandemic than those who were isolated from friends. They became disconnected because they moved away from those they could communicate with, or they had moved to live with relatives who lived in a remote, rural area. We found that caregivers were particularly fearful and anxious about accessing health care if the adolescent they cared for became ill. Caregivers also worried about protecting adolescents from COVID-19 if they themselves got ill, and about the likelihood that the adolescent would be neglected if the caregiver died. Conclusion Contextually specific research with adolescents with disabilities to explore their experience of the pandemic is necessary to capture how intersecting vulnerabilities can adversely affect particular groups, such as those with disabilities. The participation of adolescents with disabilities and their caregivers in the development of stigma mitigation initiatives and strategies to meet their needs in future emergencies is necessary to enable an informed and inclusive response.
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Affiliation(s)
- Joanna Morrison
- University College London Institute for Global Health, London, United Kingdom
| | - Niraj Poudyal
- Kathmandu University School of Arts, Kathmandu University, Lalitpur, Nepal
| | | | | | | | - Dipesh Khadka
- Kathmandu University School of Arts, Kathmandu University, Lalitpur, Nepal
| | | | | | - Mary Wickenden
- Institute for Development Studies, Brighton, United Kingdom
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Moraes Silva Gomes C, Cassa Macedo A, Brunorio Salamão E, Valladão Schiavo K, Gazzoli Zanotelli L. Mental health and coping strategies of caregivers of people with intellectual and developmental disabilities: the initial impact of the COVID-19 pandemic in Brazil. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2023; 70:966-971. [PMID: 39131750 PMCID: PMC11308953 DOI: 10.1080/20473869.2022.2164781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/01/2022] [Accepted: 12/30/2022] [Indexed: 08/13/2024]
Abstract
Studies on the COVID-19 pandemic highlight detrimental effects of social distancing on mental health. These effects were also observed among caregivers of people with intellectual and developmental disabilities (IDD), who undergo particular challenges in this context. This study aimed to identify the coping strategies adopted by caregivers of people with IDD in the period of social isolation during the COVID-19 pandemic and their relationship to signs of mental illness. Forty-eight caregivers of people with IDD who were users of a non-governmental organization for the assistance of people with IDD and their families in southeastern Brazil undertook an on-line survey. Data analysis included descriptive statistics, Pearson's correlation, multiple regression, and the word cloud technique. Results indicate that most caregivers employed healthy coping strategies and used negative words to describe their feelings towards the pandemic. Confrontation, withdrawal, self-control, social support, acceptance, and escape correlated with psychological symptoms (stress, depression, or loneliness). Those symptoms were more prevalent among participants using escape as a coping strategy. These findings indicate that caregivers of people with National Deworming Day (NDD) used mostly positive coping strategies to face the COVID-19 pandemic, which may have contributed to the low prevalence of psychological burden in this population.
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Affiliation(s)
| | - Arthur Cassa Macedo
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte - Minas Gerais, Brazil
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Hvalič-Touzery S, Trkman M, Dolničar V. Caregiving Situation as a Predictor of Subjective Caregiver Burden: Informal Caregivers of Older Adults during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14496. [PMID: 36361373 PMCID: PMC9655837 DOI: 10.3390/ijerph192114496] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/26/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has created and exacerbated emotional, financial, and technical challenges for informal caregivers of older people. The aim of this study was to explore the caregiving situation and subjective burden of informal caregivers of older family members during COVID-19, and to investigate how a caregiving situation's characteristics predict the subjective burden of care in times of COVID-19. The study was conducted in April and May 2021 via an online access panel. The sample (n = 612) was determined using a screening test that enabled us to focus on a Slovenian population of informal caregivers aged 40+ caring for a person aged 65+ for at least four hours/week on average. Our findings reveal that the subjective burden of care was high among informal caregivers during COVID-19. Multiple regression analysis showed that the provision of activities of daily living, care duration, average hours of care per week, formal care status, and recipients' health problems related to dementia or other memory problems significantly predicted the subjective burden of caregivers. These findings call for better recognition of the role of informal caregivers. The time and effort devoted to informal care should be supported by legislation and social security.
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Polizzi C, Giordano G, Burgio S, Lavanco G, Alesi M. Maternal Competence, Maternal Burnout and Personality Traits in Italian Mothers after the First COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19169791. [PMID: 36011427 PMCID: PMC9408086 DOI: 10.3390/ijerph19169791] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/29/2022] [Accepted: 08/06/2022] [Indexed: 05/07/2023]
Abstract
This study aimed to investigate the maternal sense of competence and maternal burnout in Italian mothers during the COVID-19 pandemic. The sample was composed of 278 mothers of children/adolescents aged 4 to 17 years old. Participants were recruited after the end of the first spring total Italian lockdown (June-October 2020) through online advertisements on websites and social media. We hypothesized a model in which a specific personality trait, such as neuroticism, affected maternal competence by the mediating role of maternal burnout. Results showed that neuroticism was directly and negatively predictive of perception of maternal competence, and it was negatively associated with maternal burnout, specifically specific antecedents that were strictly related to parental burnout. ANOVA results highlighted that the maternal level of education affected maternal competence in terms of satisfaction. In contrast, the working regimen during the first lockdown for COVID-19 affected maternal competence in terms of efficacy. Maternal burnout was affected by atypical child development in terms of both common (job burnout, stress management abilities) and specific (parental burnout) antecedents. COVID-19 strongly increased the risk of maternal burnout, resulting in mothers having a poor perception of their own competency. This is particularly the case in the presence of a neurotic personality.
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Lewis RK, Martin PP, Guzman BL. COVID-19 and vulnerable populations. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2537-2541. [PMID: 35567541 PMCID: PMC9348380 DOI: 10.1002/jcop.22880] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 05/23/2023]
Abstract
At the time of this special issue, coronavirus disease 2019 (COVID-19) is the leading cause of death in the United States and has contributed to millions of deaths worldwide. The world had no idea how the pandemic was going to impact our lives. COVID-19 exposed the inequities in our world and the individuals that were most impacted by it: vulnerable populations. Vulnerable populations may be defined as those living in poverty, living with disability, and racial, ethnic, sexual, and gender minorities. Additionally, as community psychologists we understand that the impact of inequities do not appear singlehandedly since as human beings we do not exist in a vacuum and there are multiple factors that create our level of health and well-being. Therefore, the idea of examining COVID-19 in a syndemic framework allows us to explore how a synergistic epidemic (i.e., the aggregation of two or more concurrent or sequential epidemics or disease clusters in a population with biological interactions) exacerbates the prognosis and burden of disease, which can impact vulnerable populations simultaneously. The main goal of this special issue concentrates on how COVID-19 had a synergistic impact on vulnerable populations and how these populations reacted and coped with these events.
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Affiliation(s)
- Rhonda K. Lewis
- Department of Psychology, Fairmount College of Arts and SciencesWichita State UniversityWichitaKansasUSA
| | - Pamela P. Martin
- Department of Psychology and African American Studies, College of Arts and SciencesUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Bianca L. Guzman
- College of Natural & Social SciencesCalifornia State University, Los AngelesLos AngelesCaliforniaUSA
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Cadenas GA, Cerezo A, Carlos Chavez FL, Capielo Rosario C, Torres L, Suro B, Fuentes M, Sanchez D. The citizenship shield: Mediated and moderated links between immigration status, discrimination, food insecurity, and negative health outcomes for latinx immigrants during the COVID-19 pandemic. JOURNAL OF COMMUNITY PSYCHOLOGY 2022:10.1002/jcop.22831. [PMID: 35243656 PMCID: PMC9088249 DOI: 10.1002/jcop.22831] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 01/10/2022] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
A framework termed "the citizenship shield" is introduced to conceptualize how legal protections buffer against negative health outcomes among Latinx immigrants in the United States. In this study, we tested the citizenship shield framework in the context of the disproportionate impact of the COVID-19 pandemic on Latinx immigrants. We investigated the connection between immigration status, discrimination, food insecurity, and negative health outcomes. Analyses involved testing mediation and moderation models among a community-based sample of 536 Latinx immigrants holding five statuses (i.e., U.S. citizenship, permanent residency, Deferred Action for Childhood Arrivals, undocumented, and temporary status). Results suggested that food insecurity mediated the link between discrimination and negative impacts from the pandemic for Latinx immigrants across all statuses. Follow up analyses suggested that two of the three paths were moderated by immigration status. This research provides novel, important data to inform health interventions and federal policy targeted for the most vulnerable immigrants in the United States.
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Affiliation(s)
| | - Alison Cerezo
- Gevirtz Graduate School of EducationUniversity of California Santa BarbaraSanta BarbaraCaliforniaUSA
| | | | | | - Lucas Torres
- Department of PsychologyMarquette UniversityMilwaukeeWisconsinUSA
| | - Beatriz Suro
- College of EducationLehigh UniversityBethlehemPennsylvaniaUSA
| | | | - Delida Sanchez
- Department of PsychologyUniversity of Maryland College ParkCollege ParkMarylandUSA
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