High Levels of Stress Due to the SARS-CoV-2 Pandemic among Parents of Children with and without Chronic Conditions across the USA
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample
2.2. Measures
- (1)
- Intrapersonal:
- Perceived Stress was measured by the 10-item Perceived Stress Scale, which has been widely validated and is highly reliable [13]. Cronbach’s alpha in the current sample was 0.83. An example item is: “In the last week, how often have you been upset because of something that happened unexpectedly?” scored on a 5-point Likert scale ranging from “never” (1) to “very often” (5). All items are summed to create a total score.
- Coping was measured by the Brief Resilient Coping Scale [14] as well as a COVID-19 self-efficacy scale. The Brief Resilient Coping scale contains four items scored on a 5-point Likert scale ranging from “does not describe me at all” to “describes me very well”. An example item is: “Please indicate how you have been dealing with stress in the past 7 days—I actively look for ways to replace the losses I encounter in life”. Internal reliability was high (0.83) in the current study. The COVID-19 self-efficacy scale was developed for this study based on guidelines by Bandura [15]. Cronbach’s alpha (0.93) for this scale was high in the current study, indicating good internal reliability. COVID-19 self-efficacy also correlated with anxiety (r = −0.24), coping (r = 0.41), and perceived stress (r = −0.38), indicating validity. An example item is: “Rate your level of confidence about your current ability to do these tasks:—Keep my family physically safe from the virus” rated on an 0–10 scale ranging from “cannot do at all” to “highly certain I can do”. All scores are summed to create a total score.
- (2)
- Microsystem/Family:
- Marital satisfaction was measured with the Kansas Marital Satisfaction Scale, a validated and reliable measure [16] (three questions scored on a 7-point Likert scale). Internal reliability in our sample was high (α = 0.96). An example item is: “In the past 7 days, how satisfied have you been with your marriage/relationship?” Items are summed to create a total score.
- Parenting Stress was measured by the Parental Stress Scale [17] (18 items scored on a 5-point Likert scale). Previous studies have shown this scale is highly reliable [17]. Cronbach’s alpha for this scale in the current study was reasonable (0.78). An example item is: “In the past 7 days, it is difficult to balance different responsibilities because of my child(ren).”, answered on 5-point scale ranging from “strongly disagree” to “strongly agree”. All items are summed to create a total score.
- (3)
- Mesosystem:
- Social support was assessed by indicating who is available to help with childcare besides the parent, as well as how much a spouse/partner is available for contributing to childcare, work and chores (rated on a 5-point Likert scale ranging from “I do most” to “partner does most”).
- Work stress was measured by asking about changes in job status (job loss, reduced hours/pay, working from home), and a rating of job stress (on a 10-point scale). Items included changes in child’s schooling as well as a rating of parent stress related to online schooling (if applicable, rated on 10-point scale).
- (4)
- Exosystem:
- The degree of restrictions in the community and worries around infection as well as exposure to SARS-CoV-2 infection were assessed.
2.3. Data Analysis
3. Results
3.1. Demographics
3.2. Pandemic Stressors
3.3. Stressors, Perceived Stress and Coping
3.4. Parenting-Related Stressors and Perceived Stress
3.5. Work-Related Stressors and Perceived Stress
3.6. Mental Health
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Parents of Healthy Children | Parents of Children with Chronic Conditions | p-Value * | |
---|---|---|---|
N = 308 | N = 302 | ||
Mean (SD) or Frequency (%) | Mean (SD) or Frequency (%) | ||
Age | 40.61 (10.6) | 40.61 (9.7) | 0.998 |
Race | 0.021 | ||
Caucasian | 208 (67.5%) | 232 (76.8%) | |
African American | 51 (16.6%) | 47 (15.6%) | |
Hispanic | 46 (14.9%) | 50 (16.6%) | 0.582 |
Median income | USD 50.000–75.000 | USD 50.000–75.000 | 0.105 |
Number of children | 1.74 (1.0) | 1.90 (1.0) | 0.064 |
Age youngest child | 8.30 (5.2) | 9.47 (4.9) | 0.005 |
Private insurance | 195 (63.7%) | 178 (59.5%) | 0.190 |
Chronic health condition (At least n = 10 children; other conditions can be requested from authors) | N/A | ||
Asthma | 111 (18.2%) | ||
Autism | 37 (6.1%) | ||
Attention deficit | 50 (8.2%) | ||
disorder | |||
Anxiety | 32 (5.2%) | ||
Diabetes | 22 (3.5%) |
Parents of Healthy Children | Parents of Children with Physical Conditions | Parents of Children with Mental Conditions | p-Value * | |
---|---|---|---|---|
N = 308 | N = 168 | N = 134 | ||
Mean (SD) or N (%) | Mean (SD) or N (%) | Mean (SD) or N (%) | ||
Parent SARS-CoV-2 | ||||
Confirmed by test | 12 (3.9%) | 23 (13.7%) | 7 (5.2%) | <0.001 |
Suspected | 15 (4.9%) | 25 (14.9%) | 6 (4.5%) | <0.001 |
Child SARS-CoV-2 | ||||
Confirmed by test | 11 (3.6%) | 23 (13.7%) | 8 (6.0%) | <0.001 |
Suspected | 14 (4.5%) | 22 (13.1%) | 6 (4.5%) | <0.001 |
Work Stressors due to Pandemic | ||||
Lost job | 43 (14%) | 35 (20.8%) | 16 (11.9%) | 0.063 |
Reduced pay | 118 (38.3%) | 77 (45.8%) | 56 (41.8%) | 0.277 |
Work from home | 121 (39.3%) | 74 (44.0%) | 61 (45.5%) | 0.386 |
Essential worker | 94 (30.5%) | 55 (32.7%) | 57 (42.5%) | 0.046 |
Parenting Stressors/Stress | ||||
Children switched to home/online school | 221 (72.70%) | 148 (88.63%) | 114 (85.07%) | <0.001 |
How stressful is online schooling? | 5.25 (2.9) | 5.86 (3.0) | 5.75 (2.6) | 0.099 |
1–10 scale | ||||
Parenting more stressful due to pandemic | 135 (44.9%) | 68 (40.7%) | 67 (50.0%) | 0.014 |
Kansas Marital Satisfaction Scale | 6.34 (4.7) | 6.07 (3.7) | 6.34 (4.2) | 0.825 |
General Stress | ||||
Perceived Stress Scale | 16.41 (7.1) moderate ** | 18.69 (5.5) moderate ** | 17.99 (7.7) moderate ** | 0.001 |
Stress related to pandemic | 6.25 (2.6) | 7.49 (2.3) | 6.63 (2.6) | <0.001 |
1–10 scale | ||||
Dealing with Stress | ||||
COVID self-efficacy | 69.64 (15.8) | 66.92 (16.7) | 65.94 (16.0) | 0.049 |
Resilient coping | 15.2 (2.9) | 15.05 (3.1) | 14.42 (3.4) | 0.065 |
Mental Health | ||||
PROMIS depression (T-score) | 52.52 (13.1) none ** | 59.33 (13.0) mild ** | 56.16 (13.0) mild ** | <0.001 |
PROMIS anxiety (T-score) | 55.8 (10.7) mild ** | 61.31 (10.6) moderate ** | 59.09 (10.8) mild ** | <0.001 |
Stomachaches (#days/week) | 1.45 (1.2) | 2.77 (2.0) | 2.01 (1.5) | <0.001 |
Headaches (#days/week) | 1.93 (1.3) | 3.17 (2.7) | 3.01 (1.9) | <0.001 |
Sleep problems (#days/week) | 2.13 (1.9) | 3.45 (2.4) | 3.59 (2.4) | <0.001 |
Eating problems (#days/week) | 1.48 (1.4) | 2.57 (2.1) | 2.24 (2.1) | <0.001 |
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A.L. van Tilburg, M.; Edlynn, E.; Maddaloni, M.; van Kempen, K.; Díaz-González de Ferris, M.; Thomas, J. High Levels of Stress Due to the SARS-CoV-2 Pandemic among Parents of Children with and without Chronic Conditions across the USA. Children 2020, 7, 193. https://doi.org/10.3390/children7100193
A.L. van Tilburg M, Edlynn E, Maddaloni M, van Kempen K, Díaz-González de Ferris M, Thomas J. High Levels of Stress Due to the SARS-CoV-2 Pandemic among Parents of Children with and without Chronic Conditions across the USA. Children. 2020; 7(10):193. https://doi.org/10.3390/children7100193
Chicago/Turabian StyleA.L. van Tilburg, Miranda, Emily Edlynn, Marina Maddaloni, Klaas van Kempen, Maria Díaz-González de Ferris, and Jody Thomas. 2020. "High Levels of Stress Due to the SARS-CoV-2 Pandemic among Parents of Children with and without Chronic Conditions across the USA" Children 7, no. 10: 193. https://doi.org/10.3390/children7100193