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Nicholas DB, Katz SL, Ciesielski J, Zulla RT. Psychosocial and Service Delivery Impacts of the COVID-19 Pandemic on Children With Respiratory Conditions, Their Parents and Their Health Care Providers. Inquiry 2024; 61:469580241246338. [PMID: 38602062 PMCID: PMC11008339 DOI: 10.1177/00469580241246338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 02/26/2024] [Accepted: 03/07/2024] [Indexed: 04/12/2024]
Abstract
The COVID-19 pandemic imposed widespread impacts on the health and well-being of children with respiratory challenges and their families, as well as on the health care system that supports them. An exploratory qualitative study was undertaken to examine how the pandemic impacted families' and health care providers' daily lives and experiences of care. Four youth, 12 parents and 7 health care providers participated in interviews via telephone or online technology. Content analysis of transcribed interviews revealed participant experiences, including initial responses to the pandemic, adjustment to pandemic shifts, and anticipation of the future. While deleterious physical health impacts were minimal for children with pre-existing respiratory conditions, their mental health was negatively impacted by the pandemic and related health protocols. Families and health care providers experienced strain, yet demonstrated resilience. Pandemic-related shifts profoundly impacted daily life at home, school, and work. Pediatric pandemic planning in clinical care is recommended to better address the needs of children with respiratory conditions and their families as well as pediatric health care providers.
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Affiliation(s)
- David B. Nicholas
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
| | - Sherri Lynne Katz
- Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
- University of Ottawa, Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Jill Ciesielski
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
| | - Rosslynn T. Zulla
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
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Rapoport A, Nicholas DB, Zulla RT. Balancing pandemic public health restrictions and family support at the end of life: palliative care and bereavement experiences of parents whose child died during the COVID-19 pandemic. BMC Palliat Care 2023; 22:162. [PMID: 37891620 PMCID: PMC10604781 DOI: 10.1186/s12904-023-01280-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Little is known about the impact of the COVID-19 pandemic on families of children with chronic life-limiting conditions who died during the COVID-19 pandemic. METHODS In this qualitative study, parents of a child (< 18 years) who died during the COVID-19 pandemic from an underlying chronic medical condition were interviewed to explore how the pandemic impacted end-of-life care and bereavement experiences. Parents of children followed by the pediatric palliative care service were recruited from a large children's hospital in eastern Canada. RESULTS Twenty bereaved parents, consisting of 12 mothers and 8 fathers, participated in individual interviews between January and December 2021. Findings identified impacts of the COVID-19 pandemic on children's end-of-life care, experiences in hospital and at home, and family bereavement processes and experiences. Most parents experienced substantial worry about their child's physical status and the additional risk of COVID-19 given her/his vulnerability. Parents also struggled to navigate public health protocols as they attended to their child's needs and their family's desire for engagement and support. Key facilitators that helped families cope included a strong network of formal and informal supports. CONCLUSION Implications highlight the need to critically reflect on pandemic care in the context of co-occurring end-of-life processes. Findings amplify the need to balance necessary infection control practices with access to essential supports for families.
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Affiliation(s)
- Adam Rapoport
- Departments of Paediatrics and Family & Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Emily's House Children's Hospice, Toronto, ON, Canada.
| | - David B Nicholas
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
| | - Rosslynn T Zulla
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
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Bright K, Cullen E, Conlon O, Zulla RT, Nicholas DB, Dimitropoulos G. Examining the experiences of pediatric mental health care providers during the early stage of the COVID-19 pandemic. BMC Psychol 2023; 11:147. [PMID: 37143138 PMCID: PMC10157584 DOI: 10.1186/s40359-023-01170-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 04/16/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic fundamentally impacted the way that mental health services were provided. In order to prevent the spread of infection, many new public health precautions, including mandated use of masks, quarantine and isolation, and closures of many in-person activities, were implemented. Public health mandates made it necessary for mental health services to immediately shift their mode of delivery, creating increased confusion and stress for mental health providers. The objective of this study is to understand the impact of pandemics on the clinical and personal lives of mental health providers working with children during the early months of the COVID-19 pandemic, March -June 2020. METHODS Mental health providers (n = 98) were recruited using purposive sampling from a public health service in Canada. Using qualitative methods, semi-structured focus groups were conducted to understand the experiences of mental health service providers during the beginning of the COVID-19 pandemic. RESULTS Data from the focus groups were analysed and three main themes emerged: (1) shift to virtual delivery and working from home; (2) concerns about working in person; (3) exhaustion and stress from working through the pandemic. DISCUSSION This study gave voice to mental health providers as they provided continuity of care throughout the uncertain early months of the pandemic. The results provide insight into the impact times of crisis have on mental health providers, as well as provide practical considerations for the future in terms of supervision and feedback mechanisms to validate experiences.
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Affiliation(s)
- Katherine Bright
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Emma Cullen
- The Mathison Centre for Mental Health Research & Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Olivia Conlon
- Faculty of Social Work, University of Calgary, Central and Northern Alberta Region, Edmonton, AB, Canada
| | - Rosslynn T Zulla
- Faculty of Social Work, University of Calgary, Central and Northern Alberta Region, Edmonton, AB, Canada
| | - David B Nicholas
- Faculty of Social Work, University of Calgary, Central and Northern Alberta Region, Edmonton, AB, Canada
| | - Gina Dimitropoulos
- The Mathison Centre for Mental Health Research & Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Faculty of Social Work, University of Calgary, 2500 University Dr NW MacKimmie Tower (MT) 301, Calgary, AB, T2N 1N4, Canada.
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Zulla RT, Nicholas DB, West LJ, Chan S, McCoy M, Urschel S. The experiences of children with a cardiac transplant, their families and health care providers in the COVID-19 pandemic. Pediatr Transplant 2022; 26:e14388. [PMID: 36101008 DOI: 10.1111/petr.14388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/26/2022] [Accepted: 08/22/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The COVID-19 pandemic has had deleterious impacts on pediatric patients and families, as well as the healthcare providers who have attended to their care needs. METHODS In this qualitative study, children with a cardiac transplant, as well as their families and healthcare providers were interviewed to explore the impact of the COVID-19 pandemic on pediatric care, as well as on patients' and their families' daily lives. Participants were recruited from a children's hospital in western Canada. Fifteen caregiving parents of transplanted children, 2 young patients, and 8 healthcare providers participated in interviews. RESULTS Findings highlighted how families and their healthcare providers experienced pandemic-related shifts. Themes highlighted experiences, which entailed (1) initially hearing about the COVID-19 pandemic; (2) learning about their new reality; (3) adjusting to the pandemic; (4) adjusting to shifts in pediatric services; (5) evolving a view on the future, and (6) offering recommendations for cardiac care in a pandemic. CONCLUSIONS Study implications emphasize the need to critically reflect on, and advance, methods of helping young patients and their families in pandemic circumstances, and supporting healthcare providers.
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Affiliation(s)
- Rosslynn T Zulla
- University of Calgary, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | - David B Nicholas
- University of Calgary, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | - Lori J West
- University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Sarah Chan
- Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Marie McCoy
- Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Simon Urschel
- University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
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Nicholas DB, Zulla RT, Conlon O, Dimitropoulos G, Urschel S, Rapoport A, Katz SL, Bruce A, West LJ, Belletrutti M, Cullen E, Zwaigenbaum L. Les effets de la pandémie de COVID-19 sur la santé mentale des enfants atteints de problèmes de santé physique ou d’incapacités, des familles et des professionnels de la santé. Paediatr Child Health 2022; 27:S115-S122. [PMID: 36092296 PMCID: PMC9455651 DOI: 10.1093/pch/pxac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Résumé
Objectifs
La pandémie de COVID-19 a influé sur la santé mentale de la population. Les familles des enfants qui ont des vulnérabilités en matière de santé ont été démesurément touchées par les politiques liées à la pandémie et les perturbations aux services, car elles s’appuient beaucoup sur le système de soins de santé et de services sociaux. Les chercheurs ont établi les répercussions de la pandémie de COVID-19 sur les enfants ayant des vulnérabilités en matière de santé physique et des incapacités, les familles et les professionnels de la santé.
Méthodologie
Des enfants ayant diverses vulnérabilités en matière de santé (transplantation cardiaque, affections respiratoires, anémie falciforme, trouble du spectre de l’autisme, troubles de santé mentale et approche de la fin de vie en raison d’une série de causes sous-jacentes), leurs parents et leurs professionnels de la santé ont participé à des entrevues semi-structurées. Les chercheurs ont utilisé des méthodes d’analyse qualitative et en ont extrait les thèmes liés aux effets et les recommandations en vue d’améliorer la pratique.
Résultats
Au total, 262 participants (30 enfants, 76 parents, 156 professionnels de la santé) ont été interviewés. Les enfants ont décrit leur solitude et leur isolement, les parents, leur épuisement, et les professionnels de la santé, la pression ressentie et un sentiment de détresse morale. Les thèmes reflétaient les effets de la pandémie sur la santé mentale des enfants, des familles et des professionnels de la santé, de même que les ressources insuffisantes pour soutenir la santé mentale, les influences organisationnelles et politiques qui ont façonné la prestation des services et les recommandations pour améliorer la prestation de ces services.
Conclusion
Les restrictions sanitaires imposées par la pandémie et les modifications aux soins ont eu de profondes répercussions sur la santé mentale des enfants qui ont des vulnérabilités en matière de santé, les familles et les professionnels de la santé. Les recommandations incluent la rédaction et l’adoption d’information ciblée sur la pandémie et la mise en œuvre de services de soutien en santé mentale. Ces résultats amplifient la nécessité de renforcer les capacités, y compris des stratégies proactives et la planification de mesures d’atténuation du risque dans l’éventualité d’une future pandémie.
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Affiliation(s)
- David B Nicholas
- Université de Calgary, Faculté de travail social, Région du centre et du nord de l'Alberta, Edmonton (Alberta)Canada
| | - Rosslynn T Zulla
- Université de Calgary, Faculté de travail social, Région du centre et du nord de l'Alberta, Edmonton (Alberta)Canada
| | - Olivia Conlon
- Université de Calgary, Faculté de travail social, Région du centre et du nord de l'Alberta, Edmonton (Alberta)Canada
| | - Gina Dimitropoulos
- Faculté de travail social, Université de Calgary, Calgary (Alberta)Canada
| | - Simon Urschel
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada
| | - Adam Rapoport
- The Hospital for Sick Children, Toronto (Ontario)Canada.,Emily's House Children's Hospice, Toronto (Ontario)Canada.,Département de pédiatrie, Université de Toronto, Toronto (Ontario)Canada
| | - Sherri Lynne Katz
- Centre hospitalier pour enfants de l'est de l'Ontario, Ottawa (Ontario)Canada.,Département de pédiatrie, Université d'Ottawa, Ottawa (Ontario)Canada.,Institut de recherche du Centre hospitalier pour enfants de l'est de l'Ontario, Ottawa (Ontario)Canada
| | - Aisha Bruce
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada
| | - Lori J West
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada
| | - Mark Belletrutti
- British Columbia Children's Hospital, Vancouver (Colombie-Britannique)Canada.,Départment de pédiatrie, Université de la Colombie-Britannique, Vancouver (Colombie-Britannique)Canada
| | - Emma Cullen
- Faculté de travail social, Université de Calgary, Calgary (Alberta)Canada
| | - Lonnie Zwaigenbaum
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada.,Glenrose Rehabilitation Hospital, Edmonton (Alberta)Canada
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Nicholas DB, Zulla RT, Conlon O, Dimitropoulos G, Urschel S, Rapoport A, Katz SL, Bruce A, West LJ, Belletrutti M, Cullen E, Zwaigenbaum L. Mental health impacts of the COVID-19 pandemic on children with underlying health and disability issues, and their families and health care providers. Paediatr Child Health 2022; 27:S33-S39. [PMID: 35620553 PMCID: PMC9126279 DOI: 10.1093/pch/pxab103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/21/2021] [Indexed: 11/14/2022] Open
Abstract
Objectives The COVID-19 pandemic has impacted mental health at a population level. Families of children with health vulnerabilities have been disproportionately affected by pandemic-related policies and service disruptions as they substantially rely on the health and social care system. We elicited the impact of the COVID-19 pandemic on children with health and disability-related vulnerabilities, their families, and their health care providers (HCPs). Methods Children with diverse health vulnerabilities (cardiac transplantation, respiratory conditions, sickle cell disease, autism spectrum disorder, mental health issues, and nearing the end of life due to a range of underlying causes), as well as their parents and HCPs, participated in semi-structured interviews. Data were analyzed using qualitative content analysis in determining themes related to impact and recommendations for practice improvement. Results A total of 262 participants (30 children, 76 parents, 156 HCPs) were interviewed. Children described loneliness and isolation; parents described feeling burnt out; and HCPs described strain and a sense of moral distress. Themes reflected mental health impacts on children, families, and HCPs, with insufficient resources to support mental health; organizational and policy influences that shaped service delivery; and recommendations to enhance service delivery. Conclusion Children with health vulnerabilities, their families and HCPs incurred profound mental health impacts due to pandemic-imposed public health restrictions and care shifts. Recommendations include the development and application of targeted pandemic information and mental health supports. These findings amplify the need for capacity building, including proactive strategies and mitigative planning in the event of a future pandemic.
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Affiliation(s)
- David B Nicholas
- University of Calgary, Faculty of Social Work, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | - Rosslynn T Zulla
- University of Calgary, Faculty of Social Work, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | - Olivia Conlon
- University of Calgary, Faculty of Social Work, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | | | - Simon Urschel
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Adam Rapoport
- The Hospital for Sick Children, Toronto, Ontario, Canada.,Emily's House Children's Hospice, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Sherri Lynne Katz
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Aisha Bruce
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Lori J West
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Mark Belletrutti
- British Columbia Children's Hospital, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emma Cullen
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada.,Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
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