51.11 Pivoting in the Pandemic: A Qualitative Study of Child and Adolescent Psychiatrists in the Times of Covid-19

Abstract

Objectives: As COVID-19 spreads around the globe, parents are being presented with new challenges to meet their children's needs. We investigated parental stress and its impact on their parenting practices alongside focusing on the impact on mothers of hospitalized children, during the COVID-19 outbreak in Lahore, Pakistan. Methods: Following IRB approval, using a web-based questionnaire and telephonic interviews, data were collected in April 2020. Symptoms of depression and anxiety were assessed by the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scale. Parents were also asked to report on their parenting practices as well as emotional and behavior changes noticed in their children in the last 1 month. In-depth semi-structured telephonic interviews were also conducted with 24 mothers of COVID-19positive children admitted at Mayo Hospital Lahore. Results: A total of 355 parents participated, with a mean age of 35.3 years AE 8.2, and 64.3% were mothers. The majority (55%) of the mothers had at least 1 child between the ages of 1 and 5 years, and 9% had children with special needs. The overall prevalence of depressive symptoms and anxiety were 25.6% and 21.6%, respectively. Mothers of hospitalized COVID-19positive children reported stress, anxiety, irritability, grief, and fear of death and infecting others. The most commonly identified sources of worry were problems experienced during the hospital stay, worry about the admitted child's physical and emotional health, care provision for children left at home, rumors, and stigma. Parental stress was affecting parenting, with at least 50% of parents reporting more than the usual consequences (shouting at children, taking privileges away, and slapping child) in the past 1 month. However, positive impacts-that is, parents spending more time in activities with their children (93%)-were also observed. Unhealthy eating and sleeping patterns (24.5%), irritability (21.1%), anxiety (16.3%), aggression (14.6%), and sleep difficulties (12.7%) were the most common problems noticed by parents in their children since the COVID-19 outbreak. Conclusions: Significant parental stress observed during the COVID-19 outbreak can adversely impact a child's physical and mental health outcomes. Provision of effective strategies to support parents to respond to and care for children are urgently needed.