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Estudos de Psicologia (Natal)

Print version ISSN 1413-294XOn-line version ISSN 1678-4669

Estud. psicol. (Natal) vol.25 no.3 Natal July/Sept. 2020

http://dx.doi.org/10.22491/1678-4669.20200032 

DOI: 10.22491/1678-4669.20200032

THEMES IN SOCIAL POLICIES: SOCIAL ASSISTANCE AND ASSURANCE SYSTEM OF RIGHTS

 

Repercussions of the COVID-19 pandemic for families with children: implications for mental health practice in the Brazilian context

 

Repercussões da pandemia de COVID-19 em famílias com crianças: implicações para a prática em saúde mental no contexto brasileiro

 

Repercusiones de la pandemia de COVID-19 en familias con niños: implicaciones para práctica en la salud mental en el contexto brasileño

 

 

Angela Helena MarinI; Ana Carolina FonsecaI; Beatriz SchmidtII

IUniversidade Federal do Rio Grande do Sul
IIUniversidade Federal do Rio Grande

 

 


ABSTRACT

The aim of this study was to systematize scientific and technical knowledge, through a critical review of the literature, on repercussions of the new coronavirus pandemic for families with children, considering different family compositions and social realities in the Brazilian context. Given the emerging psychological demands, implications for the professional psychologist's practice with these families were discussed, and socioemotional skills were presented as a protective factor. The lack of empirical evidence on the repercussions of the COVID-19 pandemic for families with children in Brazil was evidenced and the need for production in the field is highlighted. Thus, it would be possible to propose interventions aligned with the particularities of psychological demands of families in the country, which may offer subsidies to face this and other public health crises that might possibly occur in the future.

Keywords: coronavirus infections; infectious diseases; pandemics; family relations; child.


RESUMO

O objetivo do estudo foi sistematizar conhecimentos científicos e técnicos, por meio de uma revisão crítica da literatura, sobre as repercussões da pandemia do novo coronavírus em famílias com crianças, em especial na saúde mental de seus membros. Considerou-se, particularmente, distintas composições familiares e realidades sociais no contexto brasileiro. Tendo em vista as demandas psicológicas emergentes, foram discutidas as implicações para a atuação do profissional psicólogo junto a essas famílias e apresentadas as competências socioemocionais como um fator de proteção. Evidenciou-se a escassez de evidências empíricas sobre as repercussões da pandemia de COVID-19 em famílias com crianças no Brasil, destacando-se a necessidade de produção na área. Dessa forma, entende-se que será possível propor intervenções alinhadas às particularidades das demandas psicológicas das famílias no país, as quais poderão oferecer subsídios para o enfrentamento dessa e de outras crises de saúde pública que eventualmente ocorram no futuro.

Palavras-chave: infecções por coronavírus; doenças infecciosas; pandemias; relações familiares; criança.


RESUMEN

El objetivo del estudio fue sistematizar conocimiento científico y técnico, por medio de una revisión crítica de la literatura, sobre las repercusiones de la pandemia del nuevo coronavirus en las familias con niños, considerando diferentes composiciones familiares y realidades sociales en el contexto brasileño. Dadas las demandas psicológicas emergentes, se discutieron las implicaciones para el trabajo del psicólogo con estas familias y se presentaron las competencias socioemocionales como un factor protector. Se evidenció la falta de evidencia empírica sobre las repercusiones de la pandemia COVID-19 en familias con niños en Brasil, destacando la necesidad de producción en el área. Por lo tanto, se entiende que es posible proponer intervenciones en línea con las particularidades de las demandas psicológicas de las familias en el país, que pueden ofrecer subsidios para enfrentar esta y otras crisis de salud pública que eventualmente se presenten en el futuro.

Palabras clave: infecciones por coronavirus; enfermedades infecciosas; pandemias; relaciones familiares; niño.


 

 

The pandemic of the new coronavirus (COVID-19) represents a serious public health crisis being faced by communities worldwide. The first cases of contamination were reported late December 2019, in China, when residents of Hubei province presented cases of pneumonia, the cause of which was identified as arising from a variation of the coronavirus family, provisionally named new coronavirus 1 (2019-nCoV) or SARS-CoV-2 (C. Wang et al., 2020). Since then, the number of cases of the disease has grown exponentially, spreading to other countries. Due to the high incidence indicators, the World Health Organization declared the COVID-19 outbreak as a public health emergency and defined it as a pandemic on March 11, 2020 (World Health Organization [WHO], 2020a).

In Brazil, an extensive transmission level was formed in June 2020, with a downward trend from September (Fundação Oswaldo Cruz [Fiocruz], 2020a). In November of the same year, Brazil was among the three nations with the highest number of infection cases and deaths from COVID-19, along with the United States and India (WHO, 2020b). In the same period, epidemiological data revealed an increasing trend in the transmission rate. Therefore, prevention remains the main strategy to contain contagion. However, there are still very few educative campaigns about the disease in Brazil, and there is no guarantee of short-term distribution, to the general population, of the vaccines that are being developed and evaluated (Almeida et al., 2020; Fiocruz, 2020a). Thus, measures related to the use of masks, sanitization of hand, objects and surfaces, and social distancing continue to be a priority. Regarding the latter, the closing of schools and universities stands out.

The suspension of in-person classes in Brazilian educational institutions, and in most South American countries, occurred at the end of March (United Nations Educational, Scientific and Cultural Organization [UNESCO], 2020). In Brazil, in-person classes are being resumed and, effectively, some schools are being reopened, especially the private network, based on recommendations to the school community (Fiocruz, 2020b; Ministério da Educação, 2020). However, many are still closed and even those that have reopened in-person classes have made that modality optional, so that students can follow the activities remotely when they have the resources and the necessary structure. According to data from the Brazilian Institute of Geography and Statistics (IBGE, 2020a), in September 2020, 85% of the students enrolled in schools and universities had resumed academic activities, in person or remotely.

As a result of this and other measures taken to prevent the spread of COVID-19 since the beginning of the pandemic, many Brazilian families have had to adapt to a new routine, characterized by an overload of activities related to child care, especially the younger ones, domestic tasks and remote or in-person work, as well as facing financial difficulties. Often, changes in the family environment have been permeated by feelings such as fear and insecurity (Marques, Moraes, Hasselmann, Deslandes, & Reichenheim, 2020), which can impact the mental health of all those involved. For example, among adults, more pronounced levels of depression, anxiety and sleep issues during the pandemic have been reported by women, compared to men, as evidenced by a study in which 45,161 Brazilians participated (Barros et al., 2020). Repercussions for children have also been evidenced in the national literature, such as changes in sleep patterns, increased idleness and screen time (Sá, Pombo, Luz, Rodrigues, & Cordovil, 2020), as well as in international literature, such as excessive parental dependence, inattention and irritability (Jiao et al., 2020).

Another stress factor in the pandemic is how unpredictable the duration of the period of social distancing is, which often arouses feelings such as frustration and boredom in all family members, due to the isolation (Desclaux, Badji, Ndione, & Sow, 2017). Such feelings can lead people to start interacting again, which has been evidenced in the rates of systematic decline in social distancing (IBGE, 2020b) and the imminence of a second wave of infection (Fiocruz, 2020c). The lack of clarity of the information received from public authorities is also pointed out as a stress factor that can lead to questioning of the purpose of social distancing (Desclaux et al., 2017), causing the population to take unnecessary risks by not adhering to protective measures, either by minimizing the severity of the disease or not understanding the need to comply. This situation has been particularly present in Brazil, since state and federal authorities communicated divergent countermeasures (Prado, 2020). Together, such factors can trigger the development of symptoms of post-traumatic stress, mental confusion and anger (Brooks et al., 2020).

Given the above, the objective of this study was to systematize the knowledge on the repercussions of the pandemic of the new coronavirus in families with children, especially in the mental health of its members, considering different family compositions and social realities in the Brazilian context. In view of the emerging psychological demands, the implications for the psychologist's work with these families are addressed. In addition, socio-emotional skills are presented as a protective factor, which may be triggered as coping resources in crisis situations, highlighting how parents or caregivers and children can develop them. Therefore, a critical review of the literature was carried out, with the goal to present a panorama of the current scientific and technical literature. The search for materials was made by consulting with important scientific databases (PubMed, electronic journals of Psychology, Scientific Electronic Library Online, Scopus, Web of Science) and websites of organizations linked to public health and related areas (Fiocruz, United Nations Children's Fund [UNICEF], IBGE, Ministry of Education, Ministry of Health, WHO, UNESCO) during the months of April, May and November of 2020. Because it is a current and dynamic theme, this type of literature review is appropriate to meet the objectives presented.

 

Repercussions of the pandemic of the new coronavirus in families with children: impacts on the different Brazilian family compositions and social realities

The instability generated by the COVID-19 pandemic can affect families with children in different ways, depending, for example, on contextual stressors and relational dynamics among their members (Silva et al., 2020). For many parents or caregivers, keeping the child busy and safe at home during the period of social distancing is a major challenge (WHO, 2020c). This is due, for example, to the difficulties in reconciling professional and family demands, which include organizing the domestic routine, taking physical and emotional care of children, accompanying them in remote academic activities and in moments of leisure (Coyne et al., 2020). It is estimated that parents have spent an average of 27 additional hours each week engaged in housework and childcare (Boston Consulting Group, 2020).

It is important to mention that those who experience socioeconomic vulnerability are especially affected by the negative repercussions of the pandemic (Coyne et al., 2020; Rosenthal, UC, Heys, Hayward, & Lakhanpaul, 2020). When the family residence is overcrowded or precarious in terms of access to drinking water and basic sanitation, it becomes complex to perform certain individual and collective cares recommended by health authorities to prevent contagion, such as hand sanitization and at-home isolation of suspected or confirmed cases (Oliveira, Abranches, & Lana, 2020). Additionally, access to health services and professionals is often more difficult for families in situations of social vulnerability (Rosenthal et al., 2020; Santos et al., 2020), which can generate fear and stress on parents or caregivers.

In Brazil, in particular, 42.3% of children and adolescents from zero to 14 years of age lived in conditions considered as below the poverty line in 2018 (IBGE, 2019). Now, it is possible that this proportion is even higher, given that in addition to the economic crisis, that was already underway, the pandemic has had an impact on measures to reduce working hours and wages, or even job loss for formal workers, as well as a decrease in income for informal workers (Oliveira et al., 2020). Statistics show that between May and September 2020, the unemployment rate in the country rose from 10.5% to 14.4% (IBGE, 2020a). In June of the same year, 8.6% of employed people were without pay (IBGE, 2020b). In this sense, difficulties for subsistence may occur or worsen, which include shortage of food, personal hygiene products, medicines and of other supplies necessary on daily life (Brooks et al., 2020).

As a social protection measure to deal with COVID-19 (Lei No. 13.982/2020), in April 2020 a national emergency aid was granted. Although many people have benefited from this measure (until June 2020, 49.5% of the population shared a home with at least one resident who received the aid (IBGE, 2020b), in other countries, in previous pandemics (such as Ebola), benefits for this same purpose were insufficient. This brought negative repercussions to the families, many of which, due to the difficulties for subsistence, began to depend on the support network to ensure access to their basic needs, which was either difficult to accept or generated conflicts (Desclaux et al., 2017).

Another aspect to consider is that, in September 2020, only 10.4% of employed people in Brazil were working remotely (IBGE, 2020c). When parents or caregivers continue working outside the residence, that is, without the possibility of carrying out their activities remotely, there is a higher risk of being infected and infecting other people, including family members (Burdorf, Porru, & Rugulies, 2020). This is especially the case in occupations that involve direct interaction and physical proximity to other people (Burdorf et al., 2020), such as workers in health services, restaurants, markets, home product deliverers and drivers, services considered essential in Brazil during the COVID-19 pandemic (Decreto No. 10.329/2020). Moreover, the quality of interactions between adults and children tends to be impacted in this context because, in addition to returning home after the work day overloaded and worried about professional and domestic demands, parents or caregivers may fear the closest physical contact with their children for fear of eventually contaminating them (Coyne et al., 2020). In these cases, social distancing has imposed the additional challenge of organizing the care of children during the period when the parents or caregivers are at work (Silva et al., 2020).

In Brazil, grandmothers have traditionally been important partners in providing such care (Schmidt, Schoppe-Sullivan, Frizzo, & Piccinini, 2019). However, the pandemic may interfere with support, given that interactions between children and the elderly have been discouraged, to prevent the spread of the virus (Silva et al., 2020; Weaver & Wiener, 2020), especially since the elderly are more prone to complications as a result of COVID-19 (C. Wang et al., 2020).

Considering that many kindergartens and schools have been closed since March 2020, as was previously mentioned, in addition to the interruption of face-to-face academic activities which were not always replaced by remote academic activities, children in situations of poverty or extreme poverty may be disproportionately affected by the lack of access to meals, hygiene practices and recreational programs commonly carried out in educational institutions (UNICEF, 2020). Therefore, aside from the increased risk of infection with the new coronavirus, these children tend to suffer immediate and long-term damage to their health and development (Rosenthal et al., 2020).

Particularly, the impact of closing kindergartens and schools tends to be challenging for single-parent families headed by women (Silva et al., 2020), which represented 56.9% of households with children and adolescents aged 0 to 14 years who lived in conditions considered below the poverty line in Brazil, in 2017 (IBGE, 2018). In addition to the difficulties in organizing alternative care for their children during the pandemic (Silva et al., 2020), many of these women work in the service sector (e.g. cleaning, food and health), in direct contact with other people, which makes them more exposed to contagion by the new coronavirus (Paz, Muller, Boudet, & Gaddis, 2020). In addition, the socioeconomic vulnerability commonly experienced by single-parent families tends to increase the risk of occurrence of mental health problems in mothers (Rosenthal et al., 2020), which also has an impact on the interactions they establish with their children and, therefore, on Child Development.

Even in two-parent families (e.g. with two guardians, the most traditional configuration being composed of mother and father), women tend to be more burdened by household and child care tasks during the pandemic (Marques et al., 2020; Paz et al., 2020), which already occurred traditionally in the country, before this public health emergency (Barros et al., 2020; Schmidt et al., 2019). Additionally, in the current scenario, the elderly who previously carried out their daily activities independently also need support to avoid exposure to contagion (Coyne et al., 2020), which tends to be carried out by women, who often still take responsibility for the care of family members who have been infected (Paz et al., 2020; Silva et al., 2020). In addition to the damage to physical and mental health, for the women who are inserted in the labor market this overload can decrease the time devoted to work activities, restricting possibilities for professional growth and even resulting on the discontinuing of employment (Paz et al., 2020).

As parental overload and stress increase and financial resources decrease, children tend to be exposed to a higher risk of violence in the family environment (Coyne et al., 2020). In this sense, since the beginning of the pandemic, there are reports of an increase in the number of cases of violence against women and children in different countries, such as China, France, the United States and, also, Brazil (Marques et al., 2020). This situation is especially worrying because home confinement with the aggressor makes it difficult to report and, consequently, the action of the systems of the protection network (Paz et al., 2020). With regard to violence against women, it is noted that increased living time with the aggressor, reduced contact with the support network, financial difficulties and travel restrictions can encourage the aggressor to perpetrate violence, giving him more control and power (Marques et al., 2020). In addition, in families where violence against women occurs, the risk for violence against children is usually higher (Campbell, 2020). This situation can be particularly aggravated during social distancing, as children tend to be bored or irritable due to limitations in their mobility and restrictions in playing with peers and friends. Therefore, they can become more disobedient and aggressive, which asserts family conflicts and violence as a way to control children's behaviors (Marques et al., 2020).

Evidently, the different stressors related to the pandemic have repercussions on the relational dynamics between family members, favoring the emergence of conflicts (Coyne et al., 2020; Lebow, 2020). Taking constructive strategies to solve them, such as open communication and the search for solving problems in a cooperative way, is especially important in this period of social distancing, in which adults and children are sharing more time together, as showed in a study with families of 816 children from zero to 12 years, during the first month of social distancing in Brazil (Sá et al., 2020). Therefore, this can be a good opportunity to strengthen family ties and meet children's emotional needs (Silva et al., 2020; G. Wang, Zhang, Zhao, Zhang, & Jiang, 2020).

In this sense, in two-parent families, for example, the importance of positive co-parenting is highlighted, in which parents or caregivers support each other, communicate constructively, seek to establish agreements and satisfactorily divide responsibilities over child care and household chores (Feinberg, 2003). It is understood that these aspects favor collaborative decision-making, especially in the face of unexpected or critical events, such as the COVID-19 pandemic. In addition, when perceiving the collaborative dynamics between parents or caregivers, children may present more adaptive emotional and behavioral reactions to the changes and restrictions of the period. Therefore, positive co-parenting can be a protective factor of the mental health and psychological well-being of adults and children, in this scenario of stress, overload, instability and uncertainties (Silva et al., 2020). Then, if on the one hand, this period seems conducive to strengthening family resilience; on the other, as discussed, family members are vulnerable to experiencing negative psychological repercussions and relational difficulties (Lebow, 2020; Silva et al., 2020). Together, these aspects have implications for the professional work of the psychologist, as will be talked in more depth below.

 

Emerging psychological demands and their implications for the psychologist's work with families with children in the context of the pandemic

Evidence shows that in outbreaks of infectious diseases, such as the COVID-19 pandemic, high levels of stress and mental distress are expected in families with children and in the general population (Brooks et al., 2020). For example, children who already faced clinical pictures of anxiety, depression or behavioral difficulties may experience an increase in the severity of symptoms. Parents, in turn, may have their well-being affected due to financial concerns (Oliveira et al., 2020) and the need to reconcile personal, professional and family attributions (American Psychological Association [APA], 2020; Coyne et al., 2020). Together, these aspects tend to favor the emergence or just intensification of family conflicts (Lebow, 2020; Marques et al., 2020). Given this scenario, we highlight the importance of providing psychological support to families with children during this period (Coyne et al., 2020). In Brazil, particularly, the Federal Council of Psychology (CFP) regulated the offering of psychological services through information and communication technology during the pandemic (Resolução No. 04/2020). Thus, the moment can be seen as an opportunity to introduce innovations in mental health care, despite the difficulties associated with performing remote interventions with families with children (Lebow, 2020), or children, exclusively (APA, 2020a).

For family therapists, for example, this can be a challenging work due to the scarcity of studies on technical and ethical issues in remote interventions aimed at this population (Lebow, 2020). In addition, this type of care for families living in a context of greater vulnerability is often even more laborious due to the difficulty of access and the digital interaction they present. The scarcity of digital resources is related to socioeconomic difficulties and should be considered in the proposition of mental health care practices, so as not to accentuate existing disparities (Rajkumar, 2020). Therefore, the understanding that this type of psychological support is not feasible for all social groups shows the demand for more democratic therapeutic strategies, especially in countries experiencing severe economic crises and largely affected by the effects of the pandemic (Beaunoyera, Dupéré, & Guittonac, 2020), such as Brazil.

In general, family therapists may feel unprepared or uncomfortable to transpose face-to-face interventions to the remote format in a short time (Lebow, 2020). Among the suggestions for clinical care to families with children by videoconference, it is emphasized the importance of the professional to ensure privacy and confidentiality; ensure the adequacy of sound, luminosity and visual contact with each of the family members; and requesting verbal feedback (Wrape & McGinn, 2019). With regard to the children, when assessing the feasibility of conducting remote interventions, the psychologist should communicate, in an understandable way to the patient's age group, the need to change the format of the meetings (Dyk, Kroll, Martinez, Emerson, & Bursch, 2020). In addition, they must ensure that the children have a safe and confidential space at home, as well as adequate electronic equipment (Wrape & McGinn, 2019). Some recommendations include minimizing the possibilities of distraction on site and the use of interactive virtual features, such as displaying images and stories through the camera and sharing the screen for the creation of drawings together. The psychologist can also ask the child to share their favorite objects of the house and propose games that explore body movements (APA, 2020).

Beyond the clinical context, practices aimed at expanded health care are an alternative to meet the demands of families living in circumstances of greater social vulnerability. Regarding the format of these actions, given the recommendation that face-to-face interventions be restricted to the minimum possible in the current scenario, psychoeducational support, such as booklets and other informative materials which are available free of charge in audio and video, are useful tools. To ensure the effectiveness of these proposals, it is important that their contents are aligned with the cultural characteristics and demands of the target audience, being presented in accessible language and in a visually appealing way (G. Wang et al., 2020).

Moreover, psychological listening services to parents or caregivers can also be offered on online care platforms or by phone call (G. Wang et al., 2020). With regard to content, it is very relevant that interventions for prevention and promotion of mental health are developed, based on socio-emotional learning (Weaver & Wiener, 2020). Even if it is a challenge to prepare emotionally for the occurrence of critical events, due to their unpredictability, the evidence points to the socio-emotional skills as a protective factor for a satisfactory resolution of adversities (Suhaimi, Marzuki, & Mustaffa, 2014).

 

Socio-emotional skills: resources for families with children to face crisis situations

Socio-emotional competencies comprise constructs of different categories, such as attitudes, beliefs, emotional and social qualities, and personality traits (Lipnevich & Roberts, 2012). The organization of the north american Collaborative for Academic, Social-Learning (CASEL) has proposed that they be addressed in the five core aspects (CASEL, 2017): 1) self-awareness (understanding your emotions, thoughts, and values as they influence behavior in various contexts); 2) self-control (controlling thoughts, emotions, and behaviors toward a goal, self-discipline, and persistence aspects); 3) social awareness (to have empathy, care about one another, respecting differences); 4) the ability of the relationship (the ability to communicate with clarity, listen actively, cooperate, and work collaboratively to solve problems and negotiate conflicts in a constructive manner); 5) responsible decision making (solving problems in ethics, to make choices, constructive behavior, and the social interactions in a variety of situations). Therefore, the development of these skills enables perception and understanding of emotions in oneself and others, emotional adaptation to the context in which one is inserted and the functional management of one's own emotions, as well as the establishment of relationships based on mutual help and solidarity, aspects that can help to face stress situations.

In Brazil, socio-emotional competencies have been approached in the area of education due to the rapid adaptations that were necessary, such as mediation of Information and Communication Technologies in the relationship between teachers, students and the school community (Morgado, Sousa, & Pacheco, 2020). However, it is also necessary to address this with the families, since coping with the COVID-19 pandemic involves both individual and family efforts to regulate the emotional state which was mobilized, in addition to attention to measures to contain transmission, as already noted. In this sense, the relevance of the ability to recognize one's own emotions and deal with them is highlighted, which favors the development of communication between family members, especially with children, with lower levels of impulsivity and aggressiveness. Thus, some strategies related to emotional regulation, the management of the intensity and duration of emotions, can help them cope with all the routine changes that stem from the pandemic which were previously highlighted. Weaver and Wiener (2020) suggest that parents or caregivers help children in recognizing emotions and naming them, encouraging them to accept all of them, even anger and sadness, as they are equally important. For this, it is essential that adults are also able to observe their own feelings, so that they can welcome those of the children.

Jiao et al. (2020) stressed to parents and family members the importance of communicating with children to help them face their fears and concerns, as well as recommended that they engage in collaborative play and games to alleviate loneliness, encouraging activities that promote physical activity and singing to reduce child worry and stress during the COVID-19 pandemic. According to the authors, these are strategies that strengthen resilience and promote the development of skills that help children manage their emotions and adequately overcome a condition of distress, aiming towards emotional and physiological stabilization. These indications were made since, often, instead of developing activities that engage family members, parents used to resort to entertainment in the media as a way to alleviate the suffering of their children and resolve their concerns about the moment of crisis they were facing.

In addition to connecting with themselves and the family, thinking collectively about opportunities to help others by fostering feelings such as hope or optimism has also been indicated as a stress coping strategy (Weaver & Wiener, 2020). Something to be learned from this period of public health crisis, fundamental to the development of children, is the mutual care between people and those in the environment in which they live. Finally, the search for information from reliable and secure sources consists of a resource to alleviate fear in the face of an unknown phenomenon such as that of the current pandemic, since it allows the identification of problems and reflecting on the situation (WHO, 2020d). And so, one should not be afraid to share with the children news about what is happening. They have already heard about the virus and it is possible to explain the situation in an understandable way for each age group, guide on prevention and care measures, clarify doubts and allow them to express their concerns. Above all, it is important that parents are available to listen and validate the emotions of children in this moment.

Several materials have been developed in order to support and clarify the repercussions of the pandemic on families. Texts were also produced that provide subsidies for the psychologist's exercise in online care of children and adolescents, in order to mitigate negative impacts on mental health and interactions at family and community level due to COVID-19. In addition, there are documents for health professionals, educators, public managers and the general population on the importance of psychosocial care for children in the pandemic. In order to systematize the information on the topic, Table 1 presents some materials, bringing a brief description of the proposal, the priority target audience and how to access them.

Final considerations

In view of the above, we understand that the public health crisis triggered by COVID-19 created an unprecedented need to offer psychological support to families with children in Brazil, due to the emotional adversities caused by the pandemic. Due to the emerging psychological demands and limitations for face-to-face consultations, psychologists working with them face difficulties, since both content and format of the consultations have undergone transformations. Such a scenario becomes even more challenging due to the interaction of socioeconomic factors with mental and physical morbidities, which can exacerbate the effects of COVID-19 infection, a characteristic that has been defined as a syndemia (Horton, 2020). Therefore, despite the benefits of remote interventions, attention should be paid to the setbacks associated with this type of follow-up in a country such as Brazil, with many different family settings, in terms of compositions and social realities.

Thus, we highlight the importance of integrating health surveillance to prevention, diagnosis, treatment and rehabilitation actions, which requires the expansion of investments in the Unified Health System (Sistema Único de Saúde - SUS), which most of the Brazilian population uses, as well as strengthening of social protection measures (Fiocruz, 2020a). This is because socioeconomic and psychosocial impacts have been observed as a consequence of the containment measures adopted to control the accelerated spread of the virus, such as the isolation of confirmed or suspected cases, and social distancing, factors that are related to the decline in economic activity in the country (Almeida et al., 2020)

It should also be emphasized that, although personal resources are important mechanisms for coping with the crisis and the emotional mobilizations that come from it, such as the strengthening of socio-emotional skills, which can be considered a factor of protection to the mental health of parents or caregivers and children in the face of the repercussions of COVID-19, it is essential that the government take on measures to reduce the vulnerabilities arising from a public calamity which are based on scientific knowledge. Faced with the unpredictability of this moment, the support of science is fundamental to subsidize the decisions to be made. Bearing in mind that the purpose of this study was a critical review of the literature, and the materials were predominantly produced internationally, due to the shortage of national publications on the topic, we emphasize the importance of empirical studies that investigate the impact of the pandemic of the new coronavirus in families with children.

Diagnoses of the Brazilian reality in the current situation, with a view to proposing actions and public policies which are aligned with the particularities of the psychological demands of the country's families, may offer subsidies for the contextualized understanding of the phenomenon and for coping with this and other public health crises that may occur in the future. The new coronavirus is not the first pathogen to threaten humanity and will not be the last. Therefore, evidence-based prevention and health promotion strategies must be used to strengthen families, providing a protected and caring future for children around the world.

 

References

Alliance for Child Protection in Humanitarian Action (2020b). Nota técnica: Proteção da criança durante a pandemia do coronavírus. Retrieved from https://www.unicef.org/brazil/media/7561/file        [ Links ]

Almeida, A. C. G., Cordeiro, A. J. A., Scorza, F. A., Moret, M. A., Rocha Filho, T. M., & Ramalho, W. M. (2020). Nota Técnica – Situação da pandemia de COVID-19 no Brasil. Retrieved from https://coronavidas.net/wp-content/uploads/2020/11/SITUACAO-PANDEMIA-22_11_2020.pdf        [ Links ]

American Psychological Association (2020, April 2). Connecting with children and adolescents via telehealth during COVID-19. Advice for child and adolescent psychologists. American Psychological Association. Retrieved from https://www.apa.org/topics/covid-19/telehealth-children         [ Links ]

Barros, M. B. A., Lima, M. G., Malta, D. C., Szwarcwald, C. L, Azevedo, R. C. S., Romero, D., & Gracie, R. (2020). Relato de tristeza/depressão, nervosismo/ansiedade e problemas de sono na população adulta brasileira durante a pandemia de COVID-19. Epidemiologia e Serviços de Saúde, 29(4), e2020427. doi: 10.1590/s1679-49742020000400018        [ Links ]

Bhatia, R. (2020, December 3). How to talk to your anxious child or teen about coronavirus. Anxiety and Depression Association of America. Retrieved from https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/how-talk-your-anxious-child-or-teen-about        [ Links ]

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Received in 26.may.20
Revised in 04.dec.20
Accepted in 31.dec.20

 

 

Angela Helena Marin, Doutora pelo Programa de Pós-Graduação em Psicologia da Universidade Federal do Rio Grande do Sul (UFRGS), é Professora da Universidade Federal do Rio Grande do Sul (UFRGS). Endereço para correspondência: Rua Ramiro Barcelos, 2600 – sala 221. Porto Alegre  RS. CEP: 90.035-003. Email: marin.angelah@gmail.com
Ana Carolina Fonseca, Graduação em Psicologia pela Universidade Federal do Rio Grande (FURG), Mestranda na Universidade Federal do Rio Grande do Sul (UFRGS). Email: carolina.ana243@gmail.com
Beatriz Schmidt, Doutora pelo Programa de Pós-Graduação em Psicologia da Universidade Federal do Rio Grande do Sul (UFRGS), Pós-doutora pela Universidade Federal do Rio Grande do Sul (UFRGS), é Professora da Universidade Federal do Rio Grande (FURG). Email: psi.beatriz@gmail.com

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