Prevelance of Psychological Distress, Dysfunctional Coronavirus Anxiety and Impact of Covid 19 Pandemic Among Caregivers of Children With Mental Illness at Mathari National Teaching and Referral Hospital

Abstract

Introduction: Those who provide care to children with developmental disorders and other special needs are at increased risk of psychological distress due to emotional and physical demands of caregiving, predisposing them to developing psychological distress. The effects of COVID 19 pandemic as well as public health measures instituted to control it are significant contributors to a new range of stressors that threaten caregiver’s health, safety and economic well-being. Dysfunctional coronavirus anxiety occasioned by the COVID 19 pandemic places additional strain on these caregivers due to concerns about the health and safety of children under their care, especially if they have special needs, as well as the caregiver’s own wellbeing as a consequence of the emergent challenges. Purpose: the purpose of this study was to find out how prevalent is psychological distress as a result of caregiving, dysfunctional coronavirus anxiety due to the pandemic and the influence of COVID 19 among those who offer care to children with mental illnesses. Methodology: this study was a descriptive cross sectional study conducted in a hospital (clinical) setting. It was a quantitative study using a questionnaire with open and closed ended questions. One hundred caregivers of mentally ill children who attend child psychiatry clinic at Mathari National Teaching and Referral Hospital were recruited via purposive sampling to participate in the study. Upon giving informed consent, data was collected. The socio demographic questionnaire was used to collect sociodemographic characteristics of the caregivers. The overall impact of the COVID 19 pandemic on caregivers, as well as problems encountered and coping mechanisms were evaluated using open ended questions. To determine the severity of depressive, stress and anxiety symptoms, the depression, anxiety and stress scale was administered (DASS 21). To evaluate dysfunctional symptoms secondary to coronavirus anxiety, the Coronavirus Anxiety Scale was used. Data analysis: data collected was entered into Ms Excel software, checked for errors and analyzed using SPSS version 25.0 software. For discrete variables; frequency tables, pie and bar charts were used. For continuous variables means and standard deviations have been provided. For data gathered from open ended questions, main themes were identified, coded and presented in tabular format and graphs. For Bivariate analysis, correlation using Fischer’s exact test was done to investigate relationships between study variables. For Multivariate analysis, regression analysis was applied to provide adjusted odds ratios. In this study the confidence interval (C.I.) was 95%, with statistical significance level set at p<0.05. Study results: 75% of the caregivers were found to have psychological distress. The prevalence of depression was 36%, anxiety 38% and stress 29%. The prevalence of dysfunctional coronavirus anxiety was 20%. There was significant association between dysfunctional coronavirus anxiety with psychological distress (p=0.0212) and COVID 19 vaccination status (p=0.011). There was significant association (p<0.05) between depression with dysfunctional coronavirus anxiety, gender of caregiver, functional status of child and lack of psychosocial P a g e | 12 support. There was significant association (p<0.05) between anxiety with dysfunctional coronavirus anxiety, gender of caregiver, employment status and psychosocial support. There was significant association (p<0.05) between stress with education status and functional status of the children under care Conclusion: there was a high prevalence of psychological distress parameters among these caregivers. This was compounded by the effects of the COVID 19 pandemic. There were significant associations with gender, employments status, education level, functional status of the children and psychosocial support to the caregivers. Recommendation: Regular psychological support was noted to be protective from psychological distress associated with caregiving especially during COVID pandemic. Caregivers should be encouraged to seek psychological support (whether formal or informal) to avoid being overwhelmed