Abstract
The COVID-19 pandemic has changed individuals' lifestyles to a great extent, particularly in Italy. Although many concerns about it have been highlighted, its impact on children and adolescents has scarcely been examined. The purpose of this study was to explore behavioral consequences and coping strategies related to the pandemic among families in Italy, by focusing on developmental ages from the caregivers' perspective, 3 weeks into quarantine. An exploratory cross-sectional online survey was conducted over 14 days. Google Forms was employed to conduct the survey. Demographic variables and pre-existing Psychological Weaknesses (PsW) were asked. Adults' sleep difficulties (SleepScore) and coping strategies during quarantine were assessed. Behavioral changes related to quarantine of both subjects completing the form (COVIDStress) and their children (when present) were questioned. Of the 6,871 respondents, we selected 6,800 valid questionnaires; 3,245 declared children aged under 18 years of age (caregivers). PsWs were recognizable in 64.9% among non-caregivers and in 61.5% of caregivers, with a mean PsW score of 1.42 ± 1.26 and 1.30 ± 1.25 over 3 points, respectively. The 95.5% of the non-caregivers and the 96.5% of caregivers presented behavioral changes with a mean COVIDStress of 3.85 ± 1.82 and 4.09 ± 1.79 over 8, respectively (p<0.001). Sleep difficulties were present in the 61.6% of the non-caregivers and in the 64.4% of the caregivers (p < 0.001), who showed higher SleepScores (2.41 ± 1.26 against 2.57 ± 1.38 points over 6, p < 0.001). COVIDStress (and SleepScore) strongly correlated with PsW (p < 0.001). Caregivers observed behavioral changes in their children in the 64.3% of the <6 years old and in 72.5% of 6–18 years old. Caregivers' discomfort related to quarantine (COVIDStress, SleepScore) was strongly associated to behavioral changes in both age groups of <6 and 6–18 (p < 0.001). Presence of caregivers' coping strategies was less associated to behavioral changes in the <6 sample (p = 0.001) but not in the 6–18 (p = 0.06). The COVID-19 pandemic has adversely impacted families in Italy with regard to behavioral changes, especially in high-risk categories with PsWs and caregivers, especially the ones with children aged <6 years. While coping strategies functioned as protective factors, a wide array of stress symptoms had implications for children's and adolescents' behaviors. It is recommended that public children welfare strategies be implemented, especially for higher-psychosocial-risk categories.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic [1] has rapidly changed countries’ lifestyles
For the validity analyses we considered questions assessing the malaise of the respondents and divided them in 3 sets: [1] those related to the adults’ condition of discomfort and stress; [2] those related to the discomfort of children aged under 6 years; [3] those related to the discomfort of children aged 6–18 years
The ones regarding consistency of questions regarding behavioral changes in children aged under 6 years and over 6 years of age were, respectively 0.654 and 0.667
Summary
The coronavirus disease 2019 (COVID-19) pandemic [1] has rapidly changed countries’ lifestyles. Numerous concerns about the long-term consequences of COVID-19 on the public health, economy, and sociality of the global human population have been sharply highlighted [2, 3]. Was the first European country to experience the unpredictable consequences of the pandemic [4]. Between March 1 and April 30, 2020, the average number of daily deaths recorded in Italy was 2,564. The majority of deaths occurred in the northern region, that is, Lombardy. To limit the rapid spread of the virus, a quarantine period was induced in Italy on March 9 [5]
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