Comparing parental distress and children's difficulties between parents of children with rheumatic diseases and parents of healthy children in families facing the COVID-19 pandemic

Abstract

The COVID-19 pandemic could be a threat for the health status of children with a chronic condition. The present study aimed to explore parents' and children's psychological adjustment during the current pandemic, pursuing a triple objective: to compare the psychological adjustment of parents of children with pediatric rheumatic diseases (PRDs) and parents of healthy children; to analyze children's psychological symptoms (emotional problems and hyperactivity) before and during the COVID-19 pandemic, and with or without a PRDs diagnosis; to explore the associations of children's emotional problems and hyperactivity with parents' psychological adjustment, parent-child interactions and belonging or not to families with PRDs. This cross-sectional study involved 56 parents of children with PRDs and 53 parents of healthy children. Self-report questionnaires about parents' depression, anxiety, parenting stress, and children's emotional symptoms and hyperactivity-inattention were administered. No differences were detected on psychological adjustment between parents of children with PRDs and parents of healthy children. Parents of children with PRDs reported statistically significant higher levels of children's emotional problems and hyperactivity before the pandemic, compared to parents of healthy children; during COVID-19 pandemic, emotional symptoms increased for both groups, while hyperactivity-inattention symptoms increased only in the group of healthy children. Children's emotional difficulties were associated with higher levels of parental anxiety, worse parent-child interaction and having PRDs; children's hyperactivity symptoms were related to parent-child difficult interaction and higher levels of parental depression. Findings suggest the importance to target the children in relation to their parents, when approaching the psychological aspects of PRDs.

Keywords: COVID-19; Chronic and recurrent pain; Hyperactivity and ADHD; Parent psychosocial functioning; Rheumatology; School-age children.

Fig. 1

The 2 X 2 ANOVAs performed on emotional symptoms (1A) and hyperactivity-inattention (1B) scores (Mean ± Standard Errors of Mean). Note. On the left side (Fig. 1A) the graph underlies the main effects of the Group (higher scores for CL) and of the Period (higher scores during pandemic) with no interaction. On the right side (Fig. 1B) the graph underlies the main effect of the Period (higher scores during the pandemic) and the interaction Group X Period, with the HC group reported an increase of their child’s hyperactivity-inattention difficult during the pandemic and a lower difficult compared the CL sample but only before the pandemic. Different letters on the graphs indicate significant comparisons (p < . 05)