Impact of COVID-19 outbreak on mental health and perceived strain among caregivers tending children with special needs

• Published in: Research in developmental disabilities Vol. 107; no. NA; p. 103790
• Main Authors: Dhiman, Sapna, Sahu, Pradeep Kumar, Reed, William R., Ganesh, G. Shankar, Goyal, Ramesh K., Jain, Shilpa
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.12.2020
• Subjects: Age Factors; Anxiety - epidemiology; Anxiety - psychology; Attention Deficit Disorder with Hyperactivity - physiopathology; Attention Deficit Disorder with Hyperactivity - rehabilitation; Attitude to Health; Autism Spectrum Disorder - physiopathology; Autism Spectrum Disorder - rehabilitation; Caregiver Burden - epidemiology; Caregiver Burden - psychology; Caregiver strain; Caregivers - psychology; Caregivers - statistics & numerical data; Cerebral Palsy - physiopathology; Cerebral Palsy - rehabilitation; Child; Child, Preschool; Children with special needs; COVID-19; Depression - epidemiology; Depression - psychology; Developmental Disabilities - physiopathology; Developmental Disabilities - rehabilitation; Down Syndrome - physiopathology; Down Syndrome - rehabilitation; Female; Financial Stress; Functional Status; Home Care Services; Humans; Income; India - epidemiology; Learning Disabilities - physiopathology; Learning Disabilities - rehabilitation; Male; Mental Health; Neurodevelopmental Disorders - physiopathology; Neurodevelopmental Disorders - rehabilitation; Parents - psychology; Prevalence; Spinal Dysraphism - physiopathology; Spinal Dysraphism - rehabilitation; Stress, Psychological - epidemiology; Stress, Psychological - psychology; Telerehabilitation; Teleworking; Workload; India; COVID-19; Telerehabilitation; Caregiver strain; Children with special needs; Mental health
• ISSN: 0891-4222; 1873-3379; 1873-3379
• DOI: 10.1016/j.ridd.2020.103790

•The COVID-19 outbreak has had a significant impact on caregiver strain compared to perceived strain before the pandemic.•Prevalence of depressive symptoms is high among caregivers of children with special needs.•Negative perception of homecare therapy is associated with higher perceived strain and poor mental health.•Not using tele-rehabilitation and perception of it being a poor medium for rehabilitation pose greater mental health risks. While COVID-19 outbreak has had adverse psychological effects in children with special needs, the mental state and burden on their caregivers during this pandemic has yet to be reported. The objectives of this study were to describe the mental health status and the change in perceived strain among caregivers during the COVID-19 outbreak. Two hundred sixty four caregivers completed an online survey that assessed demographics, use and perspective on tele-rehabilitation, homecare therapy, caregiver’s strain and mental health. The prevalence of depression, anxiety and stress symptoms were found to be 62.5 %, 20.5 % and 36.4 % respectively. A significant difference in caregiver strain (p <  0.001, effect size = 0.93) was observed during the outbreak compared to levels pre-outbreak (pre-outbreak strain was measured retrospectively). Caregivers not using tele-rehabilitation along with a perception of it being a poor medium for rehabilitation were at greater risks for poor mental health whereas a negative perception on homecare therapy were strongly associated with higher psychological symptoms and strain. This study identified a high prevalence of depression and significant change in strain displayed by caregivers during the COVID-19 outbreak. We identified several factors associated with poor mental health and perceived strain that can be used to help safeguard caregivers.