Family Resilience during COVID-19 Pandemic: A Literature Review

A longitudinal study on impact of emergency cash transfer payments during the COVID pandemic on coping among Australian young adults

The coronavirus (COVID-19) pandemic has caused financial hardship and psychological distress among young Australians. This study investigates whether the Australian Government's emergency cash transfer payments-specifically welfare expansion for those unemployed prior to the pandemic (known in Australia as the Coronavirus Supplement) and JobKeeper (cash support for those with reduced or stopped employment due to the pandemic)-were associated with individual's level of coping during the coronavirus pandemic among those with and without mental disorders (including anxiety, depression, ADHD and autism). The sample included 902 young adults who participated in all of the last three waves (8, 9C1, 9C2) of the Longitudinal Study of Australian Children (LSAC), a nationally representative cohort study. Modified Poisson regression models were used to assess the impact of emergency cash transfer payments on 18-22-year-old's self-rated coping level, stratifying the analysis by those with and without mental disorders. All models were adjusted for gender, employment, location, family cohesion, history of smoking, alcohol intake, and COVID-19 test result. Of the 902-person sample analysed, 41.5% (n = 374) reported high levels of coping, 18.9% (n = 171) reported mental disorders, 40.3% (n = 364) received the Coronavirus Supplement and 16.4% (n = 148) received JobKeeper payments. Analysing the total sample demonstrated that participants who received the JobKeeper payment were more likely to have a higher level of coping compared to those who did not receive the JobKeeper payment. Stratified analyses demonstrated that those with pre-existing mental disorder obtained significant benefit from the JobKeeper payment on their level of coping, compared to those who did not receive JobKeeper. In contrast, receipt of the Coronavirus Supplement was not significantly associated with higher level of coping. Among those with no mental health disorder, neither the Coronavirus Supplement nor JobKeeper had a statistically significant impact on level of coping. These findings suggest the positive impacts of cash transfers on level of coping during the pandemic were limited to those with a pre-existing mental disorder who received JobKeeper.

Brief report: caregivers' well-being in families with neurodevelopmental disorders members during COVID-19: implications for family therapy

Neurodevelopmental disorders affect the lifespan of diagnosed individuals and their families. COVID-19 challenged these families with daily routine unpredictability requiring rapid adaptations. Moreover, associations and schools were closed, leaving these families without regular social support. Here, we investigate which individual and family factors can predict the caregiver's depressive state and overall burden. An online study took place between 2021 and 2022. A total of 32 caregivers (30 women; 48 ± 8.22 years old; range 26 to 63 years old) reported having a family member with a neurodevelopmental disorder, the majority diagnosed with autism spectrum disorder. Caregivers responded to a protocol to assess the burden, resilience, depressive, anxious, and stress symptomatology, as well as the behavior of the diagnosed individual. Hierarchical multiple regressions were performed to identify protective and risk factors for the caregivers' well-being. Caregivers' depressive state was explained by 29.3% of the variance of the family cohesion factor, indicating that high levels of balanced family cohesion represent a crucial protective factor for reducing the caregiver's depressive state. Additionally, overall caregiver burden was explained by 17.8% of the variance due to self-perception and 26.4% due to family cohesion, with the caregiver's self-perception playing an important protective role in the overall perception of burden. The proportion of male and female respondents seems to corroborate the significant role of women in caregiving. These results emphasize the importance of considering both individual and family factors of caregivers during interventions, which have implications for family therapy with families of members diagnosed with neurodevelopmental disorders, specifically with autism.

Mapping the well-being of Norwegian mothers during the COVID-19 pandemic

The COVID-19 pandemic had negative effects on many people's well-being and quality of life. In the present work, we focused on Norwegian mothers with elementary school children, and investigated whether their well-being, stress, and worries (and the relationships between them) changed across the early months of the pandemic. We collected data at two time points in 2020. In June 2020, 231 mothers (mean age = 40.09, SD = 6.22) responded to an online questionnaire in which they were asked to indicate their well-being, stress, and worries before the pandemic, during the lockdown (i.e., March 2020), and currently (i.e., June 2020). Of these 231 mothers, 97 (mean age = 40.58, SD = 5.66) answered the same questionnaire again in November 2020. Mothers' well-being was lower in November 2020 than before the pandemic (retrospectively reported). The age of the youngest child showed the strongest and most consistent relationship with mothers' well-being across all time points. In addition, we found that the stress mothers felt during the national lockdown in March 2020 was strongly associated with their well-being both during the lockdown and in June 2020. Finally, in November 2020, mothers' financial pandemic-related worries were negatively related to their well-being. Implications and suggestions for future research and for how societies can cope with future health-related crises are discussed.

National trends and ecological factors of physical activity engagement among U.S youth before and during the COVID-19 pandemic: A cohort study from 2019 to 2021

BACKGROUND

This study aims to investigate the trends and ecological determinants of physical activity among U.S. children and adolescents during the 2019-2021 period, encompassing the COVID-19 pandemic's onset and subsequent years.

METHODS

Utilizing data from the National Survey of Children's Health over three years, this cohort study analyzed physical activity levels and ecological determinants among 82,068 participants aged 6-17. The sample included 36,133 children (44%) and 45,935 adolescents (56%), with variables assessed by caregiver reports.

RESULTS

The analysis revealed a significant decline in physical activity among children from 2019 to 2020, followed by a recovery in 2021, whereas adolescents showed a continued decrease without recovery. Over the study period, children were consistently more active than adolescents. Better health status, normal weight, less screen time, stronger peer relationships, higher parental involvement, better family resilience and greater school participation were consistently correlated with increased physical activity in both age groups. Sleep duration was a predictor of activity only in children, while mental health status was solely a predictor in adolescents. Neighborhood environment consistently predicted children's activity levels but was a significant factor for adolescents only in 2020.

CONCLUSIONS

These findings highlight the differing impacts of the pandemic on physical activity between children and adolescents, emphasizing the need for targeted public health interventions, particularly for adolescents whose activity levels have not recovered from the pandemic period. Age-specific physical activity interventions should consider sleep duration and neighborhood environmental factors when targeting children and mental health factors when focused on adolescents.

Family resilience in a social-ecological context - emotional difficulties and coping strategies

Introduction

This research explored how crises such as the pandemic influence the family dynamic and the way that the parents and the children face new difficulties and challenges. The present study investigates children's and young people's emotional states, the dimensions of family resilience, and the types of coping strategies and parents' emotional states during the coronavirus pandemic. The final sample for the research was represented by 1,010 parents from Romania.

Methods

The present scientific research is a transversal study with the scope to understand the emotional difficulties that parents and children/ young people face and the coping strategies that they adopt in a crisis, such as the time of the coronavirus pandemic.

Results

Parents with maladaptive coping strategies are more affected by the pandemic. Also, the results indicate that there is a significant correlation between parental coping strategies and the children's emotional states, and the adaptability level. Therefore, the high scores on the subscales which measure maladaptive coping indicate high scores of the levels of depression, anxiety, and stress of the parents. Family resilience, through the dimension of 'communication and problem-solving in the family' has a moderation role in the relationship between parental depression and the maladaptive coping strategy of rumination. Family resilience through 'maintaining a positive attitude' has a moderation role in the relationship between catastrophizing and the teenagers' level of adaptability.

Discussion

The results of the study pointed out the role and place of family resilience within the family system and how a period of crisis can affect this system.

Adolescent Mental Health and Resilience Before and During the COVID-19 Pandemic

PURPOSE

We aimed to assess levels of depression, anxiety, and resilience factors before and during the COVID-19 pandemic in a school sample of adolescents. We also aimed to examine the compensatory and protective effects of individual, family, and school resilience factors on adolescent mental health.

METHODS

We used fall 2019 and fall 2020 survey responses from a cluster randomized controlled trial implemented in 20 schools in a Midwestern county. The sample consisted of 3,085 responses from students in grades 5 and 6. Multilevel mixed-effects models with cluster robust standard errors were used to investigate the associations between exposure to the COVID-19 pandemic, mental health (anxiety, depression), and resilience factors (future orientation, family engagement, and having a caring school adult).

RESULTS

Anxiety, but not depression, was higher in fall 2020 compared to fall 2019. Family engagement increased during the pandemic, while future orientation of the student body was lower during that time and the prevalence of having a caring adult at school was unchanged. A positive future orientation was associated with lower levels of anxiety and depression, while having a caring school adult was associated with lower depression. Adolescents with less positive future orientations, low family engagement, and no caring school adults experienced the greatest increases in anxiety.

DISCUSSION

Positive future orientations, family engagement, and supportive nonparental adult relationships had compensatory and protective effects on adolescent mental health during the COVID-19 pandemic. Adding these measures to the inventory of modifiable resilience factors during natural disasters may promote healthy adaptation among adolescents.

Psychological Resilience among Orang Asli Youths in Selangor during COVID-19 and Its Associated Factors

Background

Coronavirus disease (COVID-19) has affected everyone and stress-related mental health issues affect young people more than other groups, including marginalised populations. As a result of this pandemic, society is being urged to examine indigenous psychological resilience, especially among Orang Asli (OA) communities in Malaysia. Hence, this study aims to identify factors associated with psychological resilience among OA youths of Kampung Orang Asli (KOA) in Gombak during the COVID-19 pandemic.

Method

A cross-sectional study comprising OA communities was conducted between January 2022 and September 2022 in the Gombak District, Selangor. A self-administered online questionnaire using Google Forms and a self-administered printed questionnaire was used to collect data from youths aged 18 years old-24 years old. The Malay version of Conner-Davidson Resilience Scale-25 (CD-RISC-25) was used to assess psychological resilience. Data analysis was performed using SPSS version 28.0, and multiple linear regression analyses were conducted to evaluate the associated factors and their significance level.

Result

A total of 158 participants were involved in this study. The mean score for psychological resilience was estimated at 69.28 (SD = 14.52). The social relationships domain recorded the highest mean score for quality of life (71.54, SD = 13.72). Meanwhile, the total mean score for self-esteem fell into the high-level category (35.77, SD = 4.94), and the domain of relationship and family dynamics under family environment scored the highest mean score of 18.83 (SD = 2.89). Psychological resilience was associated with youths of KOA Batu 12 (β = -14.274, P < 0.05), KOA Ulu Batu (β = -17.789, P < 0.05), less than four siblings (β = -6.495, P < 0.05), owner of residential property (β = -7.543, P < 0.05), high self-esteem (β = 0.612, P < 0.05) and good relationship and family dynamic (β = 1.391, P < 0.05).

Conclusion

Developing interventions aimed at psychological resilience determinants may assist OA youths in coping with future threats.

Child and Adolescent Health in the United States: The Role of Adverse and Positive Childhood Experiences

Background

Adverse childhood experiences (ACEs) have been associated with poorer health from childhood into adulthood. There has been limited prior research examining the associations between positive childhood experiences (PCEs) and health among children.

Objective

The present study examines the association between PCES and child health, controlling for ACE counts, using a nationally representative sample.

Participants and Setting

: The data for this study came from the 2019-2020 National Survey of Children's Health and were limited to children six years of age or older with complete demographic information and information on ACEs, PCEs, and child health (n = 46,913).

Methods

Bivariate analyses between PCEs, ACEs, child/adolescent characteristics, or caregiver's characteristics and child/adolescent health were examined using Pearson's Chi-square tests, weighted to produce nationally representative distributions. Multivariable regression models were used to examine the association between selected PCEs and good health, controlling for whether a child had two or more ACEs.

Results

In adjusted analyses, children who experienced any of the following PCEs had a higher odds of good health, compared to children who did not experience each type of these PCEs: after school activities (aOR 1.85; 95% CI 1.11-3.09), resilient family (aOR 2.22; 95% CI 1.45-3.41), supportive neighborhood (aOR 1.56; 95% CI 1.01-2.41), and connected caregiver (aOR 1.84; 95% CI 1.22-2.77).

Conclusions

Examining and understanding PCEs and how they are associated with child health is a unique opportunity to guide more targeted policies and intervention efforts. Efforts to provide PCEs in schools, homes, and communities may help to reduce health inequities early in childhood.

A home environment-moderated model of the influence of ergonomics on individual work performance among Filipino nurse educators working from home during the COVID-19 pandemic: An interaction moderation analysis using structural equation model

AIM

To determine the influence of ergonomics on individual work performance of nurse educators working at home during the COVID-19 pandemic and to develop a model of the moderating effect of home environment.

DESIGN

Cross-sectional, predictive-correlational design.

METHODS

Utilizing interaction moderation and structural equation modeling, 214 consecutively-selected educators from nursing schools in the Greater Manila Area, Philippines completed a four-part online survey.

RESULTS

Physical, cognitive, and organizational ergonomics positively influenced individual work performance. Home environment had a linear, positive moderation on the effects of physical and cognitive ergonomics on individual work performance but had a negative moderating effect with organizational ergonomics.

CONCLUSION

The moderated model underscored the positive effects of ergonomics and the moderating effect of home environment on the individual work performance of nurse educators working at home during the COVID-19 pandemic, and this knowledge can be used in developing appropriate programs, strategies, and policies.

IMPACT

The moderated model highlights the need for policies and programs, training and education, and organizational evaluation geared towards promoting healthy workplace and work-life balance among nurse educators transitioning to remote work and online teaching.

PATIENT OR PUBLIC CONTRIBUTION

Eligible participants contributed in the data collection with the survey responses.

Facing the Unknown: An Inductive Analysis of the Lived Experience of Medical Residents during the COVID-19 Pandemic

INTRODUCTION

The COVID-19 pandemic had significant repercussions for the everyday life and public health of society. Healthcare professionals were particularly vulnerable. Here, we interviewed medical residents about their lived experiences during the pandemic to offer a phenomenological analysis. To this end, we discuss their pandemic experiences considering Jaspers' "limit situation" concept - that is, a radical shift from their everyday experiences, to one causing them to question the basis of their very existence.

METHODS

We interviewed 33 medical residents from psychiatry and other specialties from the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) who either (a) worked directly with COVID-19 patients or (b) provided psychiatric care to other healthcare professionals. Semi-structured interviews were developed using the Inductive Process to Analyze the Structure of lived Experience (IPSE).

RESULTS

The descriptions of the lived experiences of medical residents during the pandemic were organized into four content themes: (a) existential defense, (b) limit situations during the COVID-19 pandemic, (c) changes in lived experience, and (d) new world meanings through lived experience.

CONCLUSION

During the COVID-19 pandemic, medical residents experienced what can be thought of as a "limit situation," as they encountered the healthcare delivery challenges coupled with the social isolation imposed by the COVID-19 pandemic. These challenges included fear of infection and potential death, uncertainty about the future, and the emotional overload caused by the sharp increase in patient deaths. That said, after facing such a limit situation, residents reported feeling strengthened by this experience. This is consistent with the notion that when confronted with limit situations, we draw on our resources to overcome adversity and, in turn, reap existential gains. Health care providers might use these experiences to energize their own professional approach.

Assessment of factors leading to resilience among adults in violence-affected area of Kashmir: an exploratory study employing content analysis and best-worst method

Exposure to violence can have profound and lasting effects on individuals and communities, impacting various aspects of their lives. Understanding the relationship between exposure to violence and resilience is crucial for designing effective interventions and support systems. This study aims to identify resilience factors among adults living in such areas and rank them from most to least important. Two staged mixed-method approaches, including face-to-face interviews and the best-worst method, were used to identify factors, assign weights, and rank them. A total of twenty-three sub-factors classified under seven broader factors were identified and ranked by triangulating the opinions of victims, experts, and scholars. Out of twenty-three sub-factors, the top-ranked six factors included family support, trusting higher powers, peer support, better interpersonal relationships, engaging in regular prayers, and better role models, which contributes fifty two percent to resilience formation. By promoting these factors, individuals and communities can better cope with the stress and trauma of violence, promote positive adaptation and growth, and build social support networks to help promote recovery and healing. Implications for practice, policy, and future directions are discussed.

Prediction of individual, community and societal resilience in the Czech Republic compared to Slovakia during the war in Ukraine

The present study examines, as research questions, which and to what extent psychological and demographic variables significantly predict individual, community, and societal resilience among a sample of Czech Republic adults (N = 1,100) six months after the Russian invasion of Ukraine. The research tools included the following scales: Societal, community, and individual resilience; hope, well-being; morale; distress symptoms; a sense of danger; and perceived threats. The results indicated the following: (a) Correlation analysis shows that resilience is significantly and positively correlated with supporting coping factors and significantly and negatively correlated with suppressing coping factors. (b) A comparison of supporting coping indicators (hope, well-being, and morale) and suppressing coping indicators (distress symptoms, sense of danger, and perceived threats) in the Czech Republic with those variables in Slovakia and Israel indicated that Israel reported higher resilience, higher supporting coping indicators, and lower suppressing coping factors. Three-path analysis among the Czech sample indicated that the best predictor of SR was the level of hope, the best predictor of CR was morale, and the best predictor of IR was the sense of danger. In an attempt to explain these findings in the discussion section, we refer to the background of Czech society and a possible connection to the findings.

Association between love breakup and suicidal ideation in Peruvian medical students: a cross-sectional study during the COVID-19 pandemic

Objective

We aimed to determine the association between a major romantic breakup and suicidal ideation in medical students from three universities in Peru.

Methods

A cross-sectional study was conducted during the first pandemic wave in 2021 on medical students from three universities in northern Peru. The outcome was suicidal ideation, measured with question nine of the Patient Health Questionnaire-9 (PHQ-9). Generalized Anxiety Disorder Scale-7 (GAD-7) and Insomnia Severity Index (ISI) were also used to assess mental health symptoms. The exposure was the experience of a major love breakup during the pandemic. In addition, its association with other covariates (age, sex, family members infected with COVID-19, deceased family members with COVID-19, insomnia, and anxiety, among others) was examined.

Results and discussions

Out of 370 students, 19.5% reported a major love breakup during the pandemic (95%CI: 15.5-23.8), and 34.3% had suicidal ideation (95%CI: 29.4-39.4). Having a major love breakup was associated with a higher prevalence of suicidal ideation (PR: 1.49, 95%CI: 1.32-1.67, p < 0.001). Moderate insomnia (PR: 2.56, 95%CI: 1.70-3.87, p < 0.001) and anxiety symptoms (PR: 1.94, 1.10-3.44, p = 0.023) were also associated with suicidal ideation.

Conclusion

Our study provides evidence of a significant association between a major love breakup and suicidal ideation. This finding emphasizes the need for further research to better understand this association and inform the development of effective suicide prevention policies in medical education.

The relationship between family communication and family resilience in Chinese parents of depressed adolescents: a serial multiple mediation of social support and psychological resilience

BACKGROUND

Family resilience plays a crucial role in helping depressed adolescents overcome challenges. However, studies examining family resilience in depressed adolescents are currently scarce. This study, guided by the family resilience framework, aimed to investigate the serial-multiple mediation of social support and psychological resilience between family communication and family resilience in Chinese families of depressed adolescents.

METHODS

In 229 parents of adolescents with major depressive disorder, 20.1% comprises of fathers, while 79.9% comprises of mothers. The mean age of depressed adolescents was 14.84 (±1.76) years, and the mean age of parents of these depressed adolescents was 43.24 (±4.67) years. The Family Resilience Assessment Scale (FRAS), the Psychological Resilience of Parents of Special Children Questionnaire, and the Social Support Rating Scale, Family Assessment Device (FAD) were used to collected data. Descriptive, univariate, and Pearson correlation analyses were used in preliminary analyses. To explore mediation, we employed a serial-multiple mediation model (PROCESS model 6).

RESULTS

Family communication was positively correlated with family resilience, social support, and psychological resilience. Mediation analysis revealed indirect effects of family communication on family resilience, which were mediated solely by either social support or psychological resilience, or through multiple mediation pathways involving both social support and psychological resilience.

CONCLUSIONS

Family communication positively and directly affects the family resilience of depressed adolescents, and a higher level of social support and psychological resilience can help improve family resilience. These findings not only provide empirical evidence supporting the family resilience framework but also have practical implications for future family interventions targeting depressed adolescents.

Long-COVID in children: An exploratory case-control study from a bio-psycho-social perspective

OBJECTIVE

This study aimed to determine psychosocial differences between children with Long-COVID Syndrome (LCS) and two control groups (i.e., children who did not have COVID-19 and children who had previously had COVID-19 but did not develop LCS) from a bio-psycho-social and psychosomatic perspective. To classify children in these three groups, we examined the percentage of children meeting criteria for LCS, the type, frequency, perceived severity of symptoms, and their prevalence compared with children who never had SARS-CoV-2 infection.

METHODS

Data were collected from 198 Italian mothers of children aged 4 to 13 years using a cross-sectional web-based case-control survey. Of these, 105 were mothers of children who had contracted SARS-CoV-2 and 94 were mothers of children who had previously had COVID-19. Information was collected on the type and frequency of symptoms commonly referred to as "Long-COVID symptoms" and psychosocial dimensions (i.e., maternal and child health anxiety, COVID-19 anxiety, adjustment, and child deprivation). Descriptive analyses, chi-square tests, Student's T-Test, and analyses of variance were performed.

RESULTS

29 children (15% of the total sample) developed LCS, mostly in the neurological/neuropsychiatric domain (59%), and of mild intensity. Regarding psychosocial and psychological dimensions, maternal health anxiety, child deprivation, and fear of SARS-CoV-2 infection differed between groups, with the first two dimensions higher in children with LCS than in controls and the latter lower in children with LCS than in controls.

CONCLUSION

This study sheds light on the need of integrating a psychosocial approach into the medical care of children with LCS and their caregivers.

Individual Differences on Wellbeing Indices during the COVID-19 Quarantine in Greece: A National Study

The impact of COVID-19 and the associated lockdown measures on people's physical and mental wellbeing, as well as their daily lives and functioning, has been extensively studied. This study takes the approach of investigating the consequences of COVID-19 on a national scale, considering sociodemographic factors. The main objective is to make a contribution to ongoing research by specifically examining how age, gender, and marital status influence the overall impact of COVID-19 and wellbeing indicators during the second lockdown period that was implemented in response to the COVID-19 pandemic in the Greek population. The study involved a sample of 16,906 individuals of all age groups in Greece who completed an online questionnaire encompassing measurements related to personal wellbeing, the presence and search for meaning in life, positive relationships, as well as symptoms of depression, anxiety, and stress. Additionally, to gauge the levels of the perceived COVID-19-related impact, a valid and reliable scale was developed. The results reveal that a higher perception of COVID-19 consequences is positively associated with psychological symptoms and the search for meaning in life, while being negatively correlated with personal wellbeing and the sense of meaning in life. In terms of individual differences, the findings indicate that unmarried individuals, young adults, and females tend to report higher levels of psychological symptoms, a greater search for meaning in life, and a heightened perception of COVID-19-related impact. These findings are analyzed in depth, and suggestions for potential directions for future research are put forth.

The dyadic effects of individual resilience on family resilience among Chinese parents and children during COVID-19

Previous studies have mainly focused on examining families' struggles during the adaptive process of adversity, while the strength of family and how it arises were neglected. This study aims to explore the relationships between individual and family resilience among parents and children in families during COVID-19. Guided by the longitudinal actor-partner interdependence model, one parent and a child in 136 Chinese families completed assessments of pandemic media exposure and individual resilience in mid-February 2020 and family resilience in early March. Results showed that the child's individual resilience was positively associated with their own and their parents' family resilience, while parents' resilience was only positively associated with their own. The evidence indicated that a child's individual resilience was critical for all core family members' perceived family resilience and provided implications for family intervention programs.

"I couldn't see my friends; the internet was bad, and I hardly went out" - insights into children's and adolescents' experiences of COVID-19 in Germany

PURPOSE

We explored children's experiences of COVID-19 in terms of proximity and distance to significant others.

METHODS

Our qualitative study with children in Germany (6-15 years of age) explored their views and experiences of COVID-19 times via drawings and face-to-face semi-structured interviews (n = 13). We analysed data thematically and used the socio-ecological model as the theoretical underpinning. Case studies contextualized how children dealt with the COVID-19 precautions.

RESULTS

Salient motives in children's drawings were school scenarios showing distance-keeping and mask-wearing as an expression of interpersonal distance; in the home-schooling context, loneliness was highlighted. Drawings also illustrated the impact of COVID-19 in terms of separation, illness and death. A dynamic perception of proximity and distance emerged from drawings and interviews. COVID-19 barred children from spending "real" time together with close friends. Bridging physical distance virtually was easier for adolescents than for children.

CONCLUSION

To bolster children's mental and social resilience in future epidemics, participants' plea for maintaining social and physical interactions with significant others and for keeping schools open should be heeded by policy-makers. Our study also highlights the benefits of conducting direct research with children and using non-verbal methods of data collection.

Preschool Emotional Problems in the Post-Pandemic Era between Parental Risk and Protective Factors

The psychosocial adaptation of children born or experiencing their early years during the COVID-19 pandemic remains uncertain. In order to implement prevention strategies, it is, therefore, a priority to deeply analyze children's mental health in this post-pandemic phase and to identify family risk and protective factors. Indeed, recent studies reveal that children's emotional distress increased with the COVID-19 pandemic, especially in situations of high parental stress. The study investigates associations between some parental characteristics (coping strategies, parental burnout, resilience, perception of social support, and promotion of children's social-emotional competence) and children's emotional symptoms, considering gender differences. A total of 358 parents of children aged 2 to 6 years participated in this study. Regression analyses show that parental burnout is a predictor of emotional symptoms; moreover, for females, higher levels of emotional symptoms are associated with parental maladaptive coping strategies, whereas for males, the parent's ability to promote children's emotional competence is a protective factor. Results emphasize the importance of supporting parental well-being as a critical factor in shielding children from the repercussions of adverse situations.

Social Vulnerability, COVID-19, Racial Violence, and Depressive Symptoms: a Cross-sectional Study in the Southern United States

BACKGROUND

In March 2020, the novel 2019 coronavirus disease (COVID-19) was declared a pandemic. In May 2020, George Floyd was murdered, catalyzing a national racial reckoning. In the Southern United States, these events occurred in the context of a history of racism and high rates of poverty and discrimination, especially among racially and ethnically minoritized populations.

OBJECTIVES

In this study, we examine social vulnerabilities, the perceived impacts of COVID-19 and the national racial reckoning, and how these are associated with depression symptoms in the South.

METHODS

Data were collected from 961 adults between June and November 2020 as part of an online survey study on family well-being during COVID-19. The sample was majority female (87.2%) and consisted of 661 White participants, 143 Black participants, and 157 other racial and ethnic minoritized participants. Existing social vulnerability, perceived impact of COVID-19 and racial violence and protests on families, and depressive symptoms were assessed. Hierarchical regression analysis was used to predict variance in depressive symptoms.

RESULTS

Half of the sample (52%) reported a negative impact of COVID-19, and 66% reported a negative impact of national racial violence/protests. Depressive symptoms were common with 49.8% meeting the cutoff for significant depressive symptoms; Black participants had lower levels of depressive symptoms. Results from the hierarchical regression analysis indicate social vulnerabilities and the perceived negative impact of COVID-19 and racial violence/protests each contribute to variance in depressive symptoms. Race-specific sensitivity analysis clarified distinct patterns in predictors of depressive symptoms.

CONCLUSION

People in the South report being negatively impacted by the confluence of the COVID-19 pandemic and the emergence of racial violence/protests in 2020, though patterns differ by racial group. These events, on top of pre-existing social vulnerabilities, help explain depressive symptoms in the South during 2020.

Family Resilience and Dyadic Coping during the Outbreak of the COVID-19 Pandemic in Italy: Their Protective Role in Hedonic and Eudaimonic Well-Being

The COVID-19 pandemic outbreak has dramatically worsened people's psychological well-being. Our aim was to examine for the first time the concurrent and longitudinal relations of family resilience with hedonic and eudaimonic well-being, and the moderating role of socio-demographics. For people having a romantic partner, we also explored whether family resilience and dyadic coping were uniquely related to well-being. One cross-sectional study (N = 325) and one 10-week follow-up study (N = 112) were carried out during the outbreak of the COVID-19 pandemic (April-May 2020) in Northern Italy. Adult participants completed an online questionnaire in both studies. Correlation, multivariate regression, and moderation analyses were carried out with IBM SPSS version 28 and its PROCESS macro. Significance of differences in correlation and regression coefficients was tested through Steiger's procedure, Wald test, and SUEST method. Family resilience was found to relate more strongly to eudaimonic (versus hedonic) well-being concurrently and to hedonic (versus eudaimonic) well-being longitudinally. The concurrent or longitudinal relations with hedonic well-being were generally stronger for females, part-time workers, and people undergoing multiple stressors. For people having a romantic partner, family resilience was concurrently associated with well-being independently of dyadic coping, whereas dyadic coping was longitudinally related to well-being independently of family resilience. Family resilience was found to protect, in the short term, the psychological well-being of people facing the pandemic outbreak. Its protective role mainly concerned hedonic well-being and was more pronounced for more vulnerable people. For persons having a romantic partner, however, dyadic coping seemed to have equal, if not greater, positive short-term effects.

Positive and negative effects of the COVID-19 pandemic on families of young children in rural Colombia and implications for child outcome research

BACKGROUND

The COVID-19 pandemic has impacted the lives of children and families worldwide. The objective of this study is to examine exposures and impact of the COVID-19 pandemic on preschool-aged children and caregivers in the Atlántico region of Colombia.

METHODS

The COVID-19 Exposure and Family Impact Scales (CEFIS) questionnaire was administered in Fall 2021 to 63 caregivers of children in Sabanalarga, Colombia enrolled in a neurodevelopment study as healthy controls. The CEFIS assesses pandemic-related exposures/events and impact; higher scores indicate greater exposure and negative impact. Descriptive and correlation analyses among exposure and impact scores were conducted.

RESULTS

Caregivers reported a mean (standard deviation[SD]) of 11.1 (3.2) among 25 COVID-19-related exposures/events; most common types included stay-at-home orders, school closures, disruptions to living conditions and income loss. Total number of events was correlated with higher caregiver (P < .001) and child distress (P = .002). However, the mean (SD) impact score of 2.0 (0.6) suggests a trend toward more positive impact than negative. Caregivers reported improvements to sleep, exercise and family interactions. Some caregivers (n = 21) qualitatively reported negative effects including unemployment, fear/anxiety and inability to visit family, and positive effects such as unification, family closeness and spending more time with children.

CONCLUSIONS

This study highlights the importance of comprehensively exploring positive and negative impacts of COVID-19 and families' subsequent resilience and transformation. Using tools like the CEFIS, those seeking to mitigate negative impacts can contextualize data to better understand study outcomes and tailor services, resources and policy to families' unique needs. CEFIS data likely depend on timing, economic/public health resources and cultural values; future work should prioritize understanding the generalizability of CEFIS findings across samples.

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 burden of caregivers of schizophrenia outpatients during the COVID-19 pandemic: A same-sample comparison with the pre-pandemic burden

BACKGROUND

The coronavirus disease 2019 (COVID-19) has affected the vulnerable Brazilian population. In this study, we investigated the burden of COVID-19 on caregivers for patients with schizophrenia.

OBJECTIVE

This study assessed objective and subjective burden of caregivers for patients with schizophrenia during the COVID-19 pandemic and compared the measurements obtained in the study to that before the pandemic.

METHODS

The study included 50 caregivers who were assessed using the Sociodemographic Questionnaire, and the Family Burden Interview Schedule, Brazilian version (FBIS-BR). An adaptation of the Clinical Global Impression-Improvement (CGI-I) was made, in which caregivers evaluated their 'clinical' impression about the patient during the COVID-19 pandemic in comparison to pre-pandemic mental status.

RESULTS

Most caregivers were female, aged between 24 and 80 years, who were in contact with the patient for about 88.56 hours/week. In relation to caregiver burden, there was a significant increase in the total subjective burden (p < .001), but not in the total objective burden. The following subjective domains of the burden showed a significant increase: assistance in daily life (p < .001) and worries about patients' present and future life (p = .033). There was a decrease in the objective burden related to supervision of patients' problematic behaviors (p = .031). Although the caregiver's income did not change significantly during the COVID-19 pandemic, there was an increase in the percentage of caregivers who perceived the frequency of financial burden imposed by the patient as 'very frequent' and 'always or almost always'; conversely there was a significant decrease in the subjective perception of the caregiver that the patient imposed financially 'no burden' or a 'seldom burden' (from 34% to 4%).

CONCLUSION

Although the objective burden of the caregivers, during the pandemic, was similar the pre-pandemic levels, caregivers' subjective burden increased reinforcing the need for special attention to the caregiver in this global emergency.

Association between Love Breakup and Suicidal Ideation in Peruvian Medical Students: A Cross-Sectional Study during the COVID-19 Pandemic

Objective

We aimed to determine the association between a major romantic breakup and suicidal ideation in medical students from three universities in Peru.

Methods

A cross-sectional study was conducted during the first pandemic wave in 2021 on medical students from three universities in northern Peru. The outcome was suicidal ideation, measured with question nine of the PHQ-9. The exposure was the experience of a major love breakup during the pandemic. In addition, its association with other covariates (age, sex, family members infected with COVID-19, deceased family members with COVID-19, insomnia, and anxiety, among others) was examined.

Results and discussions

Out of 370 students, 19.5% reported a major love breakup during the pandemic (95%CI: 15.5-23.8), and 34.3% had suicidal ideation (95%CI: 29.4-39.4). Having a major love breakup was associated with a higher prevalence of suicidal ideation (PR: 1.49, 95%CI: 1.32-1.67). Moderate insomnia (PR: 2.56, 95%CI: 1.70-3.87) and anxiety symptoms (PR: 1.94, 1.10-3.44) were also associated with suicidal ideation.

Conclusion

Our study provides evidence of a significant association between a major love breakup and suicidal ideation. This finding emphasizes the need for further research to better understand this association and inform the development of effective suicide prevention policies in medical education.

Were we happy and we didn't know it? A subjective dynamic and financial assessment pre-, during and post-COVID-19

The COVID-19 pandemic has brought many changes into people's lives. Fear, job insecurity, changes in their financial stability, concerns about their future lives have changed the entire lives of people and have affected the cognitive well-being of individuals. The purpose of the present analysis is to measure how the COVID-19 pandemic, along with financial factors, has affected the perceived level of well-being of individuals. We are also interested whether there are differences between life before COVID-19, life now with COVID-19, and life after the COVID-19 pandemic, in terms of future expectations. To address this objective, we performed an ANOVA approach and a GLM estimate on repeated measures for a large sample (1572 respondents) from 43 worldwide countries, during the period May 2020 and July 2021. Our results show that financial factors reflected by both the size of income and changes in personal or family income affect the levels of happiness. Robustness checks using stress as an alternative estimator for happiness have consolidated our results. Additionally, we find that well-being during COVID-19 compared to the previous period decreased, while in future, people expect to be happier, but not more than in the past when they did not know about the existence of this virus. This is one of the first studies to investigate the relationship between happiness and income before, during, and after COVID-19. These findings are important for policymakers to improve the conditions of living in the areas of health and financial stability.

COVID-19-Related Stress and Resilience Resources: A Comparison Between Adoptive and non-Adoptive Mothers

Despite an increasing interest in how adoptive parents deal with situations appraised as stressful, there is a lack of research regarding adoptive parents' adjustment to the challenges posed by the prolonged COVID-19 pandemic. The current study explores similarities and differences between adoptive and non-adoptive mothers in terms of risks (i.e., COVID-19-related stress) and individual (i.e., sense of coherence [SOC]), couple (i.e., partner's support), parent-child (i.e., parent-child relationship satisfaction), and social (i.e., friends' support) resources in the face of the prolonged COVID-19 pandemic. Specifically, the present study was aimed at predicting which variables discriminate more effectively between the two groups. Participants were 445 Italian mothers (40.9% adoptive mothers), who were asked to fill in an anonymous online survey between May 2021 and October 2021. Results showed that adoptive and non-adoptive mothers reported different resilience resources to face the stressors posed by the health emergency. Specifically, COVID-19 traumatic stress symptoms, parent-child relationship satisfaction, and SOC were found to contribute most in discriminating between the two groups. Findings are discussed in relation to future research developments and practical implications.

Mental Health and Health-Related Quality of Life of Children and Youth during the First Year of the COVID-19 Pandemic: Results from a Cross-Sectional Survey in Saskatchewan, Canada

For children and youth, the COVID-19 pandemic surfaced at a critical time in their development. Children have experienced extended disruptions to routines including in-person schooling, physical activities, and social interactions-things that bring meaning and structure to their daily lives. We estimated the prevalence of anxiety and depression symptoms of children and youth and their experiences of health-related quality of life (HRQoL), during the first year of the pandemic, and identified factors related to these outcomes. Further, we examined these effects among ethnocultural minority families. We conducted an online survey (March-July 2021) with 510 children and youth aged 8-18 years and their parents/caregivers. The sample was representative of the targeted population. We modelled the relationship between anxiety, depression (measured using the Revised Child Anxiety and Depression Scale), HRQoL (measured using KIDSCREEN-10), and sociodemographic, behavioural, and COVID-19-contributing factors using binary logistic regression. A priori-selected moderating effects of sociodemographic characteristics and self-identified ethnocultural minority groups on the outcomes were tested. The point-in-time prevalence of medium-to-high anxiety symptoms and depression symptoms was 10.19% and 9.26%, respectively. Almost half (49.15%) reported low-to-moderate HRQoL. Children reporting medium-to-high anxiety symptoms, depression symptoms, and low-to-moderate HRQoL were more likely to be aged 8-11 years, 16-18 years, ethnocultural minority participants, living in rural/urban areas, having good/fair MH before COVID-19, experiencing household conflicts, having less physical activity, and having ≥3 h of recreational screen time. Those who had more people living at home and ≥8 h of sleep reported low anxiety and depression symptoms. Ethnocultural minority 16-18-year-olds were more likely to report low-to-moderate HRQoL, compared to 12-15-year-olds. Additionally, 8-11-year-olds, 16-18-year-olds with immigrant parents, and 16-18-year-olds with Canadian-born parents were more likely to report low-moderate HRQoL, compared to 12-15-year-olds. Children and youth MH and HRQoL were impacted during the pandemic. Adverse MH outcomes were evident among ethnocultural minority families. Our results reveal the need to prioritize children's MH and to build equity-driven, targeted interventions.

Resilience to COVID-19 challenges: Lessons for school psychologists serving school-attending black South African youth aged 10 to 19 years old

Several studies have highlighted the mental health challenges of children and youth during the COVID-19 pandemic lockdown period, especially, in relation to an escalation of depression, anxiety, and stress. Whilst this may be the reality, it is unfortunate that most of the studies adopt a psychopathological point of departure often portraying doom and gloom. Adopting a social ecological resilience perspective the author focuses on the resilience of school-attending black South African youth during the COVID-19 lockdown period. The Child and Youth Resilience Measurement (CYRM-28) was completed by 4165 respondents in grades 4 to 12 (females = 2431, 58.4%; males = 1734, 41.6%) from the Gauteng, Mpumalanga and North-West provinces in South Africa. The findings indicate that school psychologists must consider gender, age and school levels when they design school-based resilience programmes for black South African children. Particular emphasis should be placed on contextual resilience highlighting spiritual, religious, cultural and educational factors. A major lesson for school psychologists is to ensure that school-based resiliency programmes adopt a whole school approach that includes children, their families and local communities for the successful promotion of resilience during adverse situations as postulated by the social ecological resilience model.

The Impact of COVID-19 Household Isolation on Conflict and Cohesion in One-, Two-, and Three-Generation Households With Older Adults

The current cross-sectional study examined the effect of coronavirus disease 2019 (COVID-19) household isolation on household conflict and cohesion in one-, two-, and three-generation households with older adults (aged ≥65 years). Participants were 757 adults (aged ≥18 years) with at least one older adult in their household. Respondents were from 51 countries. Study variables were measured with the COVID-19 Household Environmental Scale. Non-parametric tests were used to assess differences between groups. Most participants (n = 437, 57.7%) lived in three-generation homes. Three-generation homes reported greater increases in conflict (p < 0.001) and cohesion (p < 0.001) during household isolation compared to oneand two-generation homes. Findings suggest that older adults living in multigenerational households experienced more cohesive and conflictive household environments as a function of the COVID-19 pandemic. Further research should explore how family or health care interventions could better support older adults and families as a unit of care to avoid adverse outcomes and boost resilience. [Journal of Gerontological Nursing, 49(4), 47-56.].

Social Policies and Theories on Quality of Life under COVID-19: In Search of the Missing Links

COVID-19 has generated many negative impacts on the family, including impaired psychological well-being of family members (parents and children) and family processes (such as parenting and family functioning). Regarding social policies to support families under the pandemic, there are several missing links. First, COVID-19 related policies mainly focus on physical well-being with a relatively weaker emphasis on psychological well-being. Second, with social policies primarily aiming at stabilizing the "financial capital" of the public, human capital (particularly personal resilience) and social capital (particularly family resilience) are relatively neglected. Third, while "general" social policies may help "averaged" individuals and families, there is a need to take pre-existing family vulnerabilities (such as poverty and caregiving burdens) and inequalities into account when formulating "down to earth" social policies. Fourth, while social science knowledge and theories have important potential contributions to help develop relevant policies and services to promote quality of life under COVID-19, explicit utilization is not strong. With reference to these missing links, we proposed several research and practice directions for the promotion of quality of life under the pandemic.

"We survived the pandemic together": The impact of the COVID-19 pandemic on Canadian families living with chronic pain

Introduction

Pediatric chronic pain is a significant problem in Canada, affecting one in five youth. This study describes the impact of the pandemic on the experiences of Canadian families living with chronic pain through interviews with youth living with chronic pain, parents, and siblings.

Methods

Employing a qualitative descriptive design, in-depth semistructured interviews were completed with Canadian youth living with pain, as well as parents and siblings. Participants were not required to be related. Interviews were analyzed using a reflexive thematic analysis approach.

Results

Forty-four interviews were completed with 14 parents, 19 youth with chronic pain, and 11 siblings from across the country. Three key themes were developed: (1) absorbing and shifting: the toll of the pandemic on the family system (e.g., loss of coping mechanisms, shifting roles to respond to the pandemic), (2) social ambiguity and abandonment (e.g., social sacrifice and abandonment by the health care system), and (3) building community resilience: familial adaptation to the pandemic (e.g., family cohesion, confidence, and self-management).

Discussion/Conclusions

Youth, parents, and siblings reported that the pandemic impacted coping strategies across the family system. These results outline the challenges youth experienced managing their pain and overall health throughout the pandemic and the resilience built within families during this time. Going forward, it would be relevant to examine how racialized and structurally marginalized youth with chronic pain and their families experienced the pandemic. Future research should examine how unexpected benefits of the pandemic (e.g., increased confidence and self-management) may be sustained into the future.

The Resilience of Caregivers and Children in the Context of COVID-19: A Systematic Review

The COVID-19 pandemic has necessitated caregivers and school-aged children to adapt to ongoing changes and uncertainty. Understanding why some caregivers and school-aged children area able to adapt and others are not could be attributed to resilience. The relationships between caregiver or child resilience and socioeconomic status (SES) in the context of COVID-19 remain largely un-explored. Therefore, the purpose of this qualitative systematic review was to explore (1) what is currently known about the relationship between caregiver and child resilience in the context of COVID-19; and (2) the role of SES on caregiver or child resilience throughout the COVID-19 pandemic. Four databases (i.e., MEDLINE, Scopus, PsycINFO, and CINAHL) were systematically searched, title/abstract and full-text screening were conducted, and 17 articles met the inclusion criteria (i.e., discussed resilience of caregivers/children during COVID-19, mean age of children between 7-10, primary research/grey literature, English), including 15 peer-reviewed and two grey literature sources. Thematic analysis revealed five themes: (1) the mitigating effects of child resilience; (2) overcoming the psychological toll of the pandemic; (3) the unknown relationship: caregiver and child resilience; (4) family functioning during COVID-19; and (5) the perfect storm for socioeconomic impacts. Results from this review provide the first synthesis of the impact of the COVID-19 pandemic on the resilience of caregivers and school-aged children. Future research should conduct longitudinal data collection to understand the possible long-term impacts of the pandemic on these populations' resilience. Understanding these impacts will be integral to assisting families in bouncing back from the long-lasting adverse circumstances caused by the COVID-19 pandemic.

Development and Validation of the Chinese Family Resilience Scale in Families in Hong Kong

Family resilience is an important protective factor mitigating the negative impact of adversities on individuals and families. As there are very few validated measures of family resilience in the Chinese context, we have developed the Chinese Family Resilience Scale (C-FRS) based on the family resilience framework of Froma Walsh. In this paper, we outline the development and the validation of the C-FRS with reference to the socio-cultural context of Hong Kong. Based on content validation involving family experts, the initial 51 items were assessed in terms of their relevance, clarity, and representativeness. The results showed that these items possessed adequate content validity. In order to validate the 51-item measure, we examined its convergent validity, its factorial validity, and its internal consistency based on the responses of 1020 Chinese families (N = 2858 participants). After removing the items with unsatisfactory psychometric properties, we retained 35 items in the final scale. The results showed that the C-FRS scores were significantly related to family functioning, thus providing support for its convergent validity. This study also provided support for the conceptual model of Walsh (i.e., three high-order domains involving nine primary indicators). Most importantly, the measurement invariance tests showed that the dimensions of the C-FRS were invariant among fathers, mothers, and adolescent children. As the findings support the reliability and the validity of the 35-item C-FRS, we suggest that this measure can be objectively used to assess family resilience in Chinese communities.

Family context as a double-edged sword for psychological distress amid the COVID-19 pandemic with the mediating effect of individual fear and the moderating effect of household income

Background

The COVID-19 pandemic drives psychological distress. Previous studies have mostly focused on individual determinants but overlooked family factors. The present study aimed to examine the associations of individual and family factors with psychological distress, and the mediating effect of individual fear and the moderating role of household income on the above associations.

Methods

We conducted a population-based cross-sectional survey on Chinese adults in Hong Kong from February to March 2021 (N = 2,251) to measure the independent variables of anti-epidemic fatigue, anti-epidemic confidence, individual and family members' fear of COVID-19, and family well-being (range 0-10), and the dependent variable of psychological distress (through four-item Patient Health Questionnaire, range 0-4).

Results

Hierarchical regression showed that anti-epidemic fatigue was positively (β = 0.23, 95% CI [0.18, 0.28]) while anti-epidemic confidence was negatively (β = -0.29, 95% CI [-0.36, -0.22]) associated with psychological distress. Family members' fear of COVID-19 was positively (β = 0.11, 95% CI [0.05, 0.16]) while family well-being was negatively (β = -0.57, 95% CI [-0.63, -0.51]) associated with psychological distress. Structural equation model showed that individual fear mediated the above associations except for family well-being. Multi-group analyses showed a non-significant direct effect of anti-epidemic confidence and a slightly stronger direct effect of family well-being on psychological distress among participants with lower incomes, compared to those with higher incomes.

Conclusion

We have first reported the double-edged effect of family context on psychological distress, with the positive association between family members' fear of COVID-19 and psychological distress fully mediated by individual fear and the negative association between family well-being and psychological distress moderated by income level. Future studies are warranted to investigate how the contagion of fear develops in the family and how the inequality of family resources impacts family members' mental health amid the pandemic.

Communication with Kin in the Wake of the COVID-19 Pandemic

This study investigates patterns of communication among non-coresident kin in the aftermath of the COVID-19 pandemic using data from the New York City Robin Hood Poverty Tracker. Over half of New Yorkers spoke to their non-coresident family members several times a week during the pandemic and nearly half increased their communication with non-coresident kin since March 2020. Siblings and extended kin proved to be especially important ties activated during the pandemic. New Yorkers were most likely to report increased communication with siblings. A quarter of respondents reported that they increased communication with at least one aunt, uncle, cousin, or other extended family member. While non-Hispanic White respondents reported the highest frequency of communication with kin, it was those groups most impacted by COVID-19 - foreign-born, Black, and Hispanic New Yorkers - who were most likely to report that they increased communication with kin in the wake of the pandemic.

Family Health among Families with Primary School Children during the COVID Pandemic in Thailand, 2022

Despite evidence suggesting that the COVID pandemic has negatively affected the mental health and well-being of school aged children and parents, there are limited studies describing the state of family well-being. This study aimed to use the family health lens to assess the well-being of Thai families with primary school children and to identify its associated factors. A cross-sectional survey was conducted during January and March 2022, a period of school closure when onsite education was replaced by online education from time to time. The family health scale (FHS) questionnaire survey was carried out among 701 parents of Thai families with primary school children. The questionnaire comprised 10 questions regarding family belief, health, relationships, financial security, and housing environment. Independent variables included: (1) parental/household factors; (2) online learning related issues; (3) children's mental health; and (4) parents' health behaviors. Multinomial logistic regression was undertaken. Results showed that half of Thai families (54.6%) reported having moderate health status. Factors that were associated with lower levels of family health, such as poor or moderate levels, included families with a child that had mental health problems (adjusted odd ratio (AOR) = 5.0 [95% CI = 2.6-9.5] for poor v. excellent, and AOR = 2.7 [95% CI = 1.9-4.0] for moderate v. excellent), single parents (AOR = 2.5 [95% CI = 1.2-5.2] for poor v. excellent), a higher number (≥3) of children (AOR = 2.1 [95% CI = 1.0-4.0] for moderate v. excellent), and smoking parents (AOR = 6.5 [95% CI =1.2-34.8] for poor v. excellent). During health emergencies, health policy for providing adequate assistance to single parents, especially those that have a child with mental health problems, is of utmost importance. The design of health promotion activities and interventions should be targeted not only at single families, but also families with higher numbers of children and parents who smoke at home.

The Association between Resilience and Psychological Distress during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

This study examined the association between resilience and psychological distress in healthcare workers, the general population, and patients during the COVID-19 pandemic. We searched the PubMed, Web of Science, PsycInfo, Science Direct, and Nursing and Allied Health databases. Included articles examined healthcare workers (e.g., physicians and nurses), the general population, and patients during the COVID-19 pandemic. Studies of exposure to other infectious diseases related to epidemics or pandemics (e.g., SARS and MERS) were excluded. This study was performed following the Cooper matrix review method and PRISMA guidelines, followed by a meta-analysis of study results using R version 4.1.2. A random effect model was used for the pooled analysis. This study was registered with PROSPERO (registration No. CRD42021261429). Based on the meta-analysis, we found a moderate negative relationship between overall resilience and psychological distress (r = -0.42, 95% confidence interval [CI]: -0.45 to -0.38, p < 0.001). For the subgroup analysis, a moderately significant negative relationship between overall resilience and psychological distress was found among healthcare workers (r = -0.39, 95% CI: -0.44 to -0.33, p < 0.001), which was weaker than in the general population (r = -0.45, 95% CI: -0.50 to -0.39, p < 0.001) and in patients (r = -0.43; 95% CI: -0.52 to -0.33; p < 0.001). This association was robust, although the heterogeneity among individual effect sizes was substantial (I² = 94%, 99%, and 74%, respectively). This study revealed a moderate negative relationship between resilience and psychological distress in healthcare workers, the general population, and patients. For all these populations, interventions and resources are needed to improve individuals' resilience and ability to cope with psychological distress during the COVID-19 pandemic and in future disease outbreaks.

Positive mental health in Slovenia before and during the COVID-19 pandemic

Background

Mental health has been heavily affected during the COVID-19 pandemic. In this study we compared the prevalence of flourishing and languishing mental health during the pandemic and examined which factors are associated with either category of positive mental health respectively.

Methods

Data from two cross-sectional surveys with nationally representative samples of adult population in Slovenia conducted in 2019 (n = 9,047) and in 2021 (n = 3,429) are used. Positive mental health was measured with Mental Health Continuum-Short Form instrument. Logistic regression was used to examine the associations between flourishing and languishing mental health and relevant COVID-19 specific and other health-related factors.

Results

There was a substantial decrease in the prevalence of flourishing and an increase in the prevalence of languishing mental health during the pandemic. Distribution of both flourishing and languishing mental health followed the socio-economic gradient. Resilience, COVID-19 literacy and changes in family relations, social interactions, and dietary habits were associated with both flourishing and languishing mental health.

Conclusion

Positive mental health of the population worsened during the pandemic, more so in traditionally disadvantaged populations. Public health efforts need to be focused appropriately with an increased emphasis on strengthening resilience and health literacy.

Faith-Based Community Members, Family, and COVID-19: The Role of Family Cohesion, Social Support, and Spiritual Support on Quality of Life, Depression, and COVID-19-Prevention Behaviors

This study examined relationships between family cohesion, social support/spiritual support, and quality of life and depression among faith-based community members during the 2020 COVID-19 restrictions. Drawing upon the buffering model of social support and family cohesion as theoretical frameworks, the authors examined these factors in a survey of 551 faith-based community members between March 2020 and June 2020. Family cohesion had a direct and indirect effect (mediated by overall social support and spiritual support on quality of life). Moreover, family cohesion only had a direct effect on depression (e.g., not mediated by overall social support or spiritual support). Greater family cohesion and overall social support were predictive of increased COVID-19-prevention behaviors, while spiritual support was predictive of reduced COVID-19-prevention behaviors.

Psychosocial Distress among Family Members of COVID-19 Patients Admitted to Hospital and Isolation Facilities in the Philippines: A Prospective Cohort Study

This study determined the psychosocial impact of COVID-19 on families of adult COVID-19 patients in isolation facilities in Metro Manila, Philippines. This prospective cohort study was conducted in COVID-19 healthcare facilities. Data collection was undertaken 2 weeks and 8 weeks after discharge. Logistic regression was performed to determine the socioeconomic and clinical factors influencing anxiety, depression, and family function. Based on HADS-P, 43.2% of the participants had anxiety symptoms, and 16.2% had depression symptoms 2 weeks after the discharge of their relative with COVID-19 infection. The prevalence of anxiety and depression significantly decreased to 24.3% and 5.4%, respectively, 8 weeks after discharge. The percentage of participants with a perceived moderate family dysfunction was 9.5% in the 2nd week and 6.8% in the 8th week post discharge. Participants with perceived severe family dysfunction increased from none to 4.1%. The most inadequate family resources for the participants were economic, medical, and educational resources. Patient anxiety (p = 0.010) and perceived inadequate family resources (p = 0.032) were associated with anxiety symptoms among family members. Patient anxiety (p = 0.013) and low educational attainment (p = 0.002) were associated with anxiety symptoms among family members 8 weeks after discharge. On the other hand, patient depression (p = 0.013) was a factor related to depressive symptoms among family members 2 weeks after discharge. This study provided an in-depth understanding of the mental health status of family members caring for relatives with COVID-19 infection. This can be used to guide healthcare professionals caring for COVID-19 patients and their family members.

Assessing positive adaptation during a global crisis: The development and validation of the family positive adaptation during COVID-19 scale

The COVID-19 pandemic has negatively impacted the psychosocial functioning of children and families. It is important to consider adversity in relation to processes of positive adaptation. To date, there are no empirically validated multi-item scales measuring COVID-related positive adaptation within families. The aim of the current study was to develop and validate a new measure: the Family Positive Adaptation during COVID-19 Scale (Family PACS). The sample included 372 female and 158 male caregivers (73% White-European/North American; median 2019 income = $50,000 to $74,999 USD) of children ages 5–18 years old from the United Kingdom (76%), the United States (19%), Canada (4%), and Australia (1%), who completed measures in May 2020. Participants responded to a 14-item survey indexing a range of perceived coping and adaptation behaviors at the beginning of the pandemic. An exploratory factor analysis yielded an optimal one-factor solution comprised of seven items related to family cohesion, flexibility, routines, and meaning-making (loadings from 0.44 to 0.67). Multigroup confirmatory factor analysis demonstrated measurement invariance across female and male caregivers, demonstrating that the factor structure, loadings, and thresholds did not vary by caregiver sex. There was evidence for concurrent validity with significant bivariate correlations between the Family PACS scores and measures of caregiver positive coping, parenting practices, couple satisfaction, and family functioning (correlations from 0.10 to 0.23), but not negatively-valenced constructs. Findings inform our conceptualization of how families have adapted to adverse pandemic-related conditions. Further, we provide preliminary support for the Family PACS as a practical tool for evaluating positive family adaptation during this global crisis, with implications for future widespread crises.

Krisenthemen in Familien zu Beginn der COVID-19-Pandemie

Während der COVID-19-Pandemie in Deutschland standen besonders Familien mit Kindern vor großen Herausforderungen. Der erste Lockdown erscheint im Zeitverlauf markant, da sich das ausdifferenzierte Familienleben fast ausschließlich auf die häusliche Umgebung konzentrierte und Bildungs- und Betreuungsstätten geschlossen waren. Das Wegbrechen der öffentlichen Infrastruktur definieren wir hier als zentrales Krisenphänomen für Familien.

Im Fokus dieses Beitrags steht eine Auswertung von 5075 Kommentaren aus dem Online-Fragebogen der Studie „KiCo – Kinder, Eltern und ihre Erfahrungen während der Corona-Pandemie“, an der im April/Mai 2020 über 25.000 Eltern mit Kindern unter 15 Jahren teilnahmen. Hauptsächlich stammen die Kommentare von Müttern zwischen 30 und 50 Jahren, die zum Zeitpunkt der Befragung größtenteils im Homeoffice arbeiteten und ein bis zwei Kinder unter 15 Jahren hatten.

Anhand der Kommentare können wir nachzeichnen, wie das Krisenerleben verhandelt wurde bzw. wie auf das Narrativ der Krise in den ersten zwei Monaten der Pandemie in Deutschland Bezug genommen wurde. Folgende Kategorien konnten identifiziert werden: Die Dauer der Krise (Zeit), Krise als Chance für gesellschaftlichen Wandel, die Krise der Demokratie, Krise als Chance für die Familie, Leidtragende der Krise.

Examining the Relationship Between Pediatric Behavioral Health and Parent Productivity through a Parent-Reported Survey in the time of COVID-19: An Exploratory Study

BACKGROUND

Pediatric behavioral health needs skyrocketed during the COVID-19-pandemic. Parents and caregivers lacked access to well-established tools to identify risk and protective factors while also experiencing decreased access to treatment options to meet their families' behavioral health needs.

OBJECTIVE

The aim of this study was to investigate the associations of known pediatric behavioral health risk factors and parents' reports of workplace productivity.

METHODS

A clinical research team at Brightline-a virtual, pediatric behavioral health solution-drew on standardized instruments to create a survey designed to understand pediatric behavioral health conditions, child stress, and family resilience and connection during the COVID-19 pandemic. Multivariable linear regression was used to characterize the relationship between these variables and parents' reports of workplace productivity.

RESULTS

Participants (n=361) completed the survey between October 2020 and November 2021. In the multivariable model, higher pediatric stress and time spent managing children's behavioral health needs were associated with greater productivity loss among working parents, whereas higher family connection was associated with lower productivity loss. COVID-19 diagnoses among parents and dependents, financial impact of COVID-19 on households, and family resilience were not associated with parents' workplace productivity.

CONCLUSIONS

This survey captured child stress, family connection, and productivity as reported by parents and caregivers during the COVID-19 pandemic. Exploratory studies are the first-step in understanding the relationship between these variables. Results from this study can empower parents by providing insights to help manage their child's behavioral health concerns and identify pediatric behavioral health services to aid working parents who are caregivers.

CLINICALTRIAL

Pulse Wave Velocity, a Predictor of Major Adverse Cardiovascular Events, and Its Correlation with the General Stress Level of Health Care Workers during the COVID-19 Pandemic

Background and Objectives: In the COVID-19 epidemiological context, the health care workers who were treating patients with COVID-19 were exposed daily to additional stress. Pulse wave velocity (PWV) is a predictive parameter for possible major adverse cardiovascular events. The present study aimed to evaluate the correlation between the general stress levels and PWVs of medical workers during the COVID-19 pandemic. Materials and Methods: The study group was heterogeneous in terms of the medical profession. PWV was measured using a TendioMed arteriograph. Assessment of stress level was performed using a general stress questionnaire with questions grouped on the areas that contribute to stress: lifestyle, environment, symptoms, job, relationships and personality. PWV measurements and stress assessment were performed both during the period with many patients with COVID-19 and during the period with few patients with COVID-19. Results: The stress levels and PWVs of subjects were higher in the period when they cared for patients with COVID-19 than in the period when they did not have patients with COVID-19. Conclusions: The study shows a positive correlation between the PWV of each subject and his/her stress score (the higher the stress score, the higher the PWV).

Early Adolescents' Experiences During the COVID-19 Pandemic and Changes in Their Well-Being

Background

Early adolescence is a time of psychological and social change that can coincide with declines in mental health and well-being. This study investigated the psychological and social impacts of the COVID-19 pandemic from the perspective of students who responded to a survey in Grades 7 and 8 (ages 12–14) in British Columbia (BC), Canada. The objectives of this study were (i) to provide an overview on early adolescents' experiences and social-emotional well-being during the pandemic; and (ii) to examine whether changes in social experiences as well as feeling safe from getting COVID-19 at school were associated with changes in well-being outcomes over the course of a year.

Methods

A sample of n = 1,755 students from a large public school district self-reported on their life satisfaction, optimism, and symptoms of sadness across two time points: First, in their Grade 7 year (pre-pandemic; January to March, 2020) and then 1 year later in their Grade 8 year (during the pandemic; January to March, 2021). In Grade 8, students also reported on pandemic-specific experiences, including changes in mental health, social relationships, and activities, as well as coping strategies and positive changes since the pandemic. Data were collected online using the Middle Years Development Instrument (MDI), a population-based self-report tool that assesses children's social-emotional development and well-being in the context of their home, school, and neighborhood. Multivariable linear regression analyses were used to examine associations between pandemic-related changes in relationships and perceived safety from getting COVID-19 at school with changes in well-being outcomes.

Results

Students reported a range of experiences, with a large proportion reporting moderate concerns and impacts of the pandemic, including worries about their mental health and missing school activities. Students reported significantly lower optimism, lower life satisfaction, and higher sadness compared to the previous year. Within the sample, improvements in relationships with parents and other adults at home was associated with higher well-being during the pandemic.

Implications

Results from this study can inform decision making of policy-makers, educators, and practitioners working with youth, by providing information on students' experiences during the pandemic and identifying factors that may be protective for students' mental health during and beyond the pandemic.

Family Resilience and Adolescent Mental Health during COVID-19: A Moderated Mediation Model

Background: The COVID-19 pandemic has impacted and is still impacting people’s lives, including physical and mental health. Family plays an important role in adolescent mental health due to the long staying at home. Aims: This paper aimed to investigate the impact of family resilience on adolescent mental health during the COVID-19 pandemic, and the mediation role of pandemic stress perception and the moderation role of meta-mood. Methods: A total of 2691 Chinese adolescents were recruited using convenient sampling. Their mental health, family resilience, pandemic stress perception and meta-mood were surveyed. Multivariate statistics were used to analyze the data. Results: Our results showed that (1) about 36.7% adolescents in our sample have some mental health problems; (2) family resilience can positively predict adolescent mental health, whereas pandemic stress perception can negatively predict mental health; (3) pandemic stress perception mediates the relationship between family resilience and adolescent mental health; (4) meta-mood moderates the relationship between family resilience and pandemic perception, i.e., the first half of the mediation role. Conclusions: Our results indicate that one can either improve family resilience or improve adolescents’ meta-mood to relieve adolescents’ mental health problems.

Combining Family Systems Approaches to Address BIPOC Families' Racial Trauma Amidst the Global Pandemic

The ACE study (Felitti et al., 1998) led to the recognition of the prevalence and impact of trauma. However, since the ACE study sample was mostly white and middle class, the Philadelphia task force implemented their own study to account for trauma of a more diverse sample. A result of the study was a list of evidence-based treatments to be utilized with BIPOC populations. Of the evidence-based treatments was, ecosystemic structural family therapy (ESFT). A similar effective approach is the family resilience framework. When combined, the approaches can be effective with BIPOC families during the global pandemic and racial trauma, something not typically at the forefront of family counseling goals. In this article, I explain the four steps family counselors should follow when combining the approaches to better approach and treat racial trauma while also partaking in effective advocacy to enhance family resilience of BIPOC families. A case study is provided for family counselors to understand how to effectively utilize this combined approach.

Impacts of the COVID-19 Pandemic on Family Mental Health in Canada: Findings from a Multi-Round Cross-Sectional Study

Pandemic-related disruptions, including school, child care, and workplace closures, financial stressors, and relationship challenges, present unique risks to families' mental health. We examined the mental health impacts of the coronavirus disease 2019 (COVID-19) pandemic among parents with children <18 years old living at home over three study rounds in May 2020 (n = 618), September 2020 (n = 804), and January 2021 (n = 602). Data were collected using a cross-sectional online survey of adults living in Canada, nationally representative by age, gender, household income, and region. Chi-square tests and logistic regression compared outcomes between parents and the rest of the sample, among parent subgroups, and over time. Parents reported worsened mental health compared with before the pandemic, as well as not coping well, increased alcohol use, increased suicidal thoughts/feelings, worsened mental health among their children, and increases in both negative and positive parent-child interactions. Mental health challenges were more frequently reported among parents with pre-existing mental health conditions, disabilities, and financial/relationship stressors. Increased alcohol use was more frequently reported among younger parents and men. Sustained mental health challenges of parents throughout nearly a year of the pandemic suggest that intervention efforts to support family mental health may not be adequately meeting families' needs. Addressing family stressors through financial benefit programs and virtual mental health supports should be further explored.