Poor Mental Health in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder and Its Relationships with Caregivers’ Difficulties in Managing the Children’s Behaviors and Worsened Psychological Symptoms during the COVID-19 Pandemic
Abstract
:1. Introduction
1.1. Impact of Coronavirus Disease 2019 on the Mental Health of Caregivers of Children
1.2. Mental Health Problems among Caregivers of Children with Neurodevelopmental Disorders during the COVID-19 Pandemic
1.3. Study Aim
2. Methods
2.1. Participants
2.2. Measures
2.2.1. General Mental Health State of the Caregivers
2.2.2. Difficulties Faced by Caregivers in Asking Their Child to Adopt Self-Protective Behaviors against COVID-19
2.2.3. Caregivers’ Difficulties in Managing Their Child’s Daily Performance
2.2.4. Changes in the Psychological Symptoms of the Children
2.2.5. Medication Use among Children for Treating ADHD
2.2.6. Demographics
2.3. Statistical Analysis
3. Results
4. Discussion
4.1. Difficulties in Managing Children’s Behaviors and Poor Caregiver Mental Health
4.2. Worsened Psychological Symptoms of Children with ADHD and Poor Caregiver Mental Health
4.3. Implications
4.4. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Measures | Items | Response Scale | |
---|---|---|---|
Caregivers’ difficulties in asking their child to adopt self-protective behaviors against COVID-19 | How often do you find it difficult to ask your child to do the following things during the COVID-19 pandemic? | 0 = never, 1 = seldom, 2 = sometimes, 3 = often | |
Item 1: Washing hands frequently | |||
Item 2: Keeping the mask on at all times | |||
Item 3: Not touching the mouth and/or nose | |||
Item 4: Not touching anything in public places | |||
Item 5: Not going to crowded places | |||
Item 6: Practicing social distancing and not touching others | |||
Caregivers’ difficulties in managing their child’s daily performance | How often do you find it difficult to manage the following day-to-day activities of your children during school closures and delayed school openings due to the COVID-19 pandemic? | 0 = never, 1 = seldom, 2 = sometimes, 3 = often | |
After-school learning | Item 1: Asking my child to finish homework | ||
Sleep routine | Item 1: Asking my child to go to bed on time | ||
Item 2: Asking my child to wake up on time | |||
Internet use | Item 1: Managing my child’s internet use via smartphone phones | ||
Item 2: Managing my child’s internet use via personal computers | |||
Changes in psychological symptoms | Compared with those before the pandemic, do the psychological symptoms change during the COVID-19 pandemic? | 0 = improved, 1 = no change, 2 = mildly worsened, 3 = significantly worsened | |
Item 1: Not being able to concentrate | |||
Item 2: Being overactive physically | |||
Item 3: Not being able to control their impulsive behavior | |||
Item 4: Being easily angered and upset | |||
Item 5: Having a tendency to argue and rebel | |||
Item 6: Feeling depressed and down | |||
Item 7: Feeling anxious and getting worried easily | |||
Child’s taking medication for treating ADHD | How often does your child take medication prescribed by doctors for treating ADHD? | 0 = never, 1 = seldom, 2 = sometimes, 3 = often |
Variables | n (%) | Mean (SD) | Range |
---|---|---|---|
Caregivers | |||
General mental health state | |||
Good | 124 (77) | ||
Poor | 37 (23) | ||
Gender | |||
Male | 22 (13.7) | ||
Female | 139 (86.3) | ||
Age (years) | 42.8 (5.9) | 22–71 | |
Difficulties in managing child’s behaviors | |||
Self-protective behaviors against COVID-19 | 6.5 (4.6) | 0–18 | |
After-school learning | 1.4 (1.1) | 0–3 | |
Sleep routine | 2.6 (1.9) | 0–6 | |
Internet use | 2.6 (2.0) | 0–6 | |
Children | |||
Gender | |||
Boys | 131 (81.4) | ||
Girls | 30 (18.6) | ||
Age (years) | 11.3 (3.8) | 5–18 | |
Taking medication for ADHD | |||
No or irregular | 48 (29.8) | ||
Regular | 113 (70.2) | ||
Worsened psychological symptoms | |||
ADHD | |||
No | 103 (64) | ||
Yes | 58 (36) | ||
Oppostion/defiance | |||
No | 99 (61.5) | ||
Yes | 62 (38.5) | ||
Emotion | |||
No | 115 (71.4) | ||
Yes | 46 (28.6) |
Variables | Caregiver Mental Health | χ2 or t | p | |
---|---|---|---|---|
Good (n = 124) | Poor(n = 37) | |||
Caregivers | ||||
Gender, n (%) | ||||
Male | 21 (16.9) | 1 (2.7) | 4.893 | 0.027 |
Female | 103 (83.1) | 36 (97.3) | ||
Age (years), mean (SD) | 42.9 (6.1) | 42.2 (5.4) | 0.619 | 0.537 |
Difficulties in managing child’s behaviors, mean (SD) | ||||
Self-protective behaviors | 5.9 (4.5) | 8.8 (4.2) | −3.514 | 0.001 |
After-school learning | 1.2 (1.1) | 1.9 (1.2) | −3.232 | 0.001 |
Sleep routine | 2.4 (1.9) | 3.2 (2.0) | −1.992 | 0.048 |
Internet use | 2.4 (2.0) | 3.1 (2.2) | −1.901 | 0.059 |
Children | ||||
Gender, n (%) | ||||
Boys | 100 (80.6) | 31 (83.8) | 0.185 | 0.667 |
Girls | 24 (19.4) | 6 (16.2) | ||
Age (years), mean (SD) | 11.3 (3.7) | 11.2 (4.2) | 0.112 | 0.911 |
Taking medication for ADHD, n (%) | ||||
No or irregular | 37 (29.8) | 11 (29.7) | 0.000 | 0.990 |
Regular | 87 (70.2) | 26 (70.3) | ||
Worsened psychological symptoms, n (%) | ||||
ADHD | ||||
No | 87 (70.2) | 16 (43.2) | 8.959 | 0.003 |
Yes | 37 (29.8) | 21 (56.8) | ||
Oppostion/defiance | ||||
No | 85 (68.5) | 14 (37.8) | 11.350 | 0.001 |
Yes | 39 (31.5) | 23 (62.2) | ||
Emotion | ||||
No | 98 (79.0) | 17 (45.9) | 15.286 | <0.001 |
Yes | 26 (21.0) | 20 (54.1) |
Variables | Caregivers’ Poor General Mental Health State | ||
---|---|---|---|
Model 1 | Model 2 | Model 3 | |
OR (95% CI) | OR (95% CI) | OR (95% CI) | |
Female caregivers a | 6.018 (0.762–47.552) | 5.424 (0.685–42.938) | 7.433 (0.882–62.662) |
Caregivers’ age | 0.987 (0.908–1.074) | 0.968 (0.895–1.046) | 0.992 (0.917–1.072) |
Girl child b | 0.658 (0.232–1.866) | 0.814 (0.294–2.249) | 0.793 (0.272–2.312) |
Child’s age | 1.050 (0.928–1.187) | 1.017 (0.900–1.150) | 0.967 (0.849–1.101) |
Child’s regularly taking medication for ADHD c | 0.803 (0.341–1.889) | 0.823 (0.348–1.946) | 0.976 (0.399–2.384) |
Caregivers’ difficulty in asking their child to adopt self-protective behaviors | 1.152 (1.054–1.259) ** | ||
Caregivers’ difficulty in managing their child’s after-school learning | 1.534 (1.006–2.340) * | ||
Caregivers’ difficulty in managing their child’s sleep routine | 1.050 (0.831–1.327) | ||
Caregivers’ difficulty in managing their child’s smartphone and internet use | 1.037 (0.817–1.317) | ||
Worsened ADHD symptoms | 1.350 (0.501–3.639) | ||
Worsened opposition/defiance | 2.204 (0.819–5.932) | ||
Worsened emotional symptoms | 2.999 (1.224–7.350) * |
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Tseng, H.-W.; Tsai, C.-S.; Chen, Y.-M.; Hsiao, R.C.; Chou, F.-H.; Yen, C.-F. Poor Mental Health in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder and Its Relationships with Caregivers’ Difficulties in Managing the Children’s Behaviors and Worsened Psychological Symptoms during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2021, 18, 9745. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189745
Tseng H-W, Tsai C-S, Chen Y-M, Hsiao RC, Chou F-H, Yen C-F. Poor Mental Health in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder and Its Relationships with Caregivers’ Difficulties in Managing the Children’s Behaviors and Worsened Psychological Symptoms during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health. 2021; 18(18):9745. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189745
Chicago/Turabian StyleTseng, Hui-Wen, Ching-Shu Tsai, Yu-Min Chen, Ray C. Hsiao, Fan-Hao Chou, and Cheng-Fang Yen. 2021. "Poor Mental Health in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder and Its Relationships with Caregivers’ Difficulties in Managing the Children’s Behaviors and Worsened Psychological Symptoms during the COVID-19 Pandemic" International Journal of Environmental Research and Public Health 18, no. 18: 9745. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189745