Previously submitted to: JMIR Mental Health (no longer under consideration since Sep 09, 2020)
Date Submitted: Jul 31, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Association of Children’s Behavioral Changes and Parent-Child Relationship with Parental Anxiety under Home Confinement during the COVID-19 Pandemic: A Cross-sectional Study
ABSTRACT
Background:
Coronavirus Disease-19 (COVID-19) has become a global pandemic, and mental health of children and parents are affected by confinement in home. While parental mental health is critical to the whole family’s psychological reaction to unusual situations, they are also affected by their children’s behaviors and parent-child relationship.
Objective:
To examine how the changes of children’s behaviors and parent-child relationship affect parental anxiety during this difficult time.
Methods:
A cross-sectional online investigation was conducted with snowbell sampling to collect the information about the behavioral changes of children and the anxiety of parents from February 23 to March 3, 2020. 642 participants who had children aged 3-17 yeas included in this study. Information about behavioral change of children was reported by parents with a questionnaire, parental anxiety was assessed with Self-rating Anxiety Scale (SAS, Chinese Version). The descriptive analysis were used to display the distribution of variables in respective domains. Multiple logistic regression was used to estimate the Odds ratios (ORs) and 95% confidence intervals (CI) of parental anxiety and potential variables.
Results:
This study included 642 participants (mean age 38.59±4.58, female 78.82%). The mean SAS-C score was 38.04±8.43. The percentage of anxiety was 9.81% (63/642) overall, and 8.10% (52/6642) for mild anxiety, 1.40% (9/642) for moderate anxiety, and 0.31% (2/642) for severe anxiety. Among children’s behaviors, decreased time of outdoor activity than usual was associated with a lower odd of parental anxiety, with an adjusted OR of 0.31 (95% CI, 0.11-0. 87). Parents’ satisfaction with children's behaviors was associated with a lower odd of parental anxiety (OR, 0.13; 95% CI, 0.05-0.35). In addition, we observed a significant association of worse behavioral performance than usual and worse family relationship than usual with anxiety among parents with the adjusted OR of 2.78 (95% CI, 1.35-5.73), and 2.67 (95% CI, 1.13-6.32), respectively.
Conclusions:
Under the stay-at-home order during COVID-19 outbreak in China, worse behavioral performance of children than usual and worse family relationship than usual were associated with increased parental anxiety, while less outdoor activities time among children and being satisfied with children's behaviors were associated with reduced parental anxiety. Our finding suggested that family mental health support and promotion should consider the children’s behavioral regulation and parent-child relationship as essential components.
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