Rehabilitation services lockdown during the COVID-19 emergency: the mental health response of caregivers of children with neurodevelopmental disabilities

The present study investigated the impact of the COVID-19-related rehabilitation services lockdown on the mental health of caregivers of children with neurodevelopmental disabilities. Between 26 March and 11 May 2020, 84 caregivers filled out ad-hoc and standardized questionnaires through an online survey in order to measure their psychological response to the emergency and lockdown as well as their levels of parenting stress, anxiety and depression. Worries about COVID-19 contagion and concerns for the child left without rehabilitation programs were the greatest sources of mental health burden for caregivers. Nonetheless, only the concerns for the child were significantly associated with caregivers’ reports of stress, depressive and anxious symptoms. These findings highlight the burden faced by caregivers of children with neurodevelopmental disabilities during the COVID-19 emergency in Italy. These families should be considered as a high-risk population that requires dedicated healthcare attention, such as promoting continuity of care by investing in tele-rehabilitation programs.Implications for rehabilitationCaregivers of children with disability reported symptoms of anxiety and depression during COVID-19 emergency.Major concerns regarded COVID-19 contagion risk and child development during rehabilitation lockdown.Caregivers' psychological symptoms were associated with concerns for child development during the lockdown.Parents of children with disability may face relevant stress during and after COVID-19 psychological burden.During COVID-19 recovery, policy-makers and clinicians should dedicate specific care actions for families of children with disability. Caregivers of children with disability reported symptoms of anxiety and depression during COVID-19 emergency. Major concerns regarded COVID-19 contagion risk and child development during rehabilitation lockdown. Caregivers' psychological symptoms were associated with concerns for child development during the lockdown. Parents of children with disability may face relevant stress during and after COVID-19 psychological burden. During COVID-19 recovery, policy-makers and clinicians should dedicate specific care actions for families of children with disability.

本研究探讨了新冠相关康复服务停摆对神经发育障碍儿童（children with neurodevelopmental disabilities）照护者（caregivers）心理健康的影响。2020年3月26日至5月11日期间，84名照护者通过在线调查填写了临时定制（ad-hoc）问卷与标准化问卷，以评估其对此次紧急状态与封控措施的心理反应，以及育儿压力、焦虑与抑郁水平。对新冠病毒感染的担忧，以及对孩子因康复项目停摆而无法接受治疗的担忧，是照护者心理健康负担的最主要来源。然而，仅有对孩子的担忧与照护者报告的压力、抑郁及焦虑症状存在显著关联。上述研究结果凸显了意大利新冠紧急状态期间，神经发育障碍儿童照护者所承受的负担。此类家庭应被视为需要专属医疗照护的高风险群体，例如通过投入远程康复（tele-rehabilitation）项目来保障照护的连续性。

康复领域实践启示
残疾儿童照护者在新冠紧急状态期间出现了焦虑与抑郁症状。
主要担忧集中于新冠感染风险，以及康复服务停摆期间的儿童发育状况。
照护者的心理症状与封控期间对儿童发育的担忧存在关联。
残疾儿童的父母在新冠疫情期间及之后可能承受显著的心理压力负担。
在新冠疫情复苏阶段，政策制定者与临床医师应为残疾儿童家庭提供针对性的照护措施。
残疾儿童照护者在新冠紧急状态期间出现了焦虑与抑郁症状。
主要担忧集中于新冠感染风险，以及康复服务停摆期间的儿童发育状况。
照护者的心理症状与封控期间对儿童发育的担忧存在关联。
残疾儿童的父母在新冠疫情期间及之后可能承受显著的心理压力负担。
在新冠疫情复苏阶段，政策制定者与临床医师应为残疾儿童家庭提供针对性的照护措施。