Abstract
In Singapore, preschool children with developmental disabilities receive developmental interventions by multidisciplinary teams of providers across various settings. Cessation of in-person sessions during the early stages of the COVID-19 pandemic necessitated providers to pivot rapidly and use virtual platforms to continue delivering interventions. This cross-sectional study assessed the effects of this challenging experience on providers’ psychological wellbeing, including resilience, depression, stress, and anxiety. Ninety-five providers anonymously completed (i) an online questionnaire which included questions on their perceptions of the provision of virtual services and stress; (ii) the Connor-Davidson Resilience Scale (CD-RISC); and (iii) the Depression, Anxiety and Stress Scale (DASS). Among participants who used virtual platforms to continue providing interventions, 83.3% reported difficulties during sessions. Over half (57.9%; n = 55) reported increased stress compared to pre-COVID-19. The mean CD-RISC score (62.7; range: 36–88) was lower than that of general population samples, indicating reduced resilience. Lack of flexibility to work from home, difficulties providing interventions online, higher self-reported stress, and a non-hospital setting were significantly associated with lower resilience. Prevalence rates of depression, anxiety, and stress were 13.7% (n = 13), 42.1% (n = 40), and 56.8% (n = 54), respectively, with school-based settings significantly associated with a positive screen for depression. The results reveal the often-invisible psychological ill-effects in providers of children with developmental disabilities and underscore the need for targeted support to improve their resilience and overall mental wellbeing so that they can continue to effectively provide the crucial interventions needed by the children under their care.
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References
Aishworiya, R., & Kang, Y. Q. (2021). Including children with Developmental Disabilities in the equation during this COVID-19 pandemic. Journal of autism and developmental disorders, 51(6), 2155–2158. https://doi.org/10.1007/s10803-020-04670-6.
Albott, C. S., Wozniak, J. R., McGlinch, B. P., Wall, M. H., Gold, B. S., & Vinogradov, S. (2020). Battle Buddies: Rapid Deployment of a psychological resilience intervention for Health Care Workers during the COVID-19 pandemic. Anesthesia and analgesia, 131(1), 43–54. https://doi.org/10.1213/ANE.0000000000004912.
Alvarez, C., Sims, H., Grant, K., Walczak, J., Lipman, P. D., Marsteller, J. A., Cooper, L. A., & On Behalf Of Rich Life Project Investigators. (2022). Healthcare Leadership Perspectives on supporting Frontline Workers in Health Center Settings during the pandemic. International journal of environmental research and public health, 19(6), 3310. https://doi.org/10.3390/ijerph19063310.
Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric Properties of the 42-Item and 21-Item versions of the Depression anxiety stress scales (DASS) in clinical groups and a community sample. Psychological Assessment, 10, 176–181. https://doi.org/10.1037/1040-3590.10.2.176.
Baskin, R. G., & Bartlett, R. (2021). Healthcare worker resilience during the COVID-19 pandemic: An integrative review. Journal of nursing management, 29(8), 2329–2342. https://doi.org/10.1111/jonm.13395.
Chen, Y., Allen, A. P., Fallon, M., Mulryan, N., McCallion, P., McCarron, M., & Sheerin, F. (2022). The challenges of mental health of staff working with people with intellectual disabilities during COVID-19–A systematic review. Journal of intellectual disabilities: JOID, 17446295221136231. https://doi.org/10.1177/17446295221136231. Advance online publication.
Chew, N. W. S., Lee, G. K. H., Tan, B. Y. Q., Jing, M., Goh, Y., Ngiam, N. J. H., Yeo, L. L. L., Ahmad, A., Ahmed Khan, F., Napolean Shanmugam, G., Sharma, A. K., Komalkumar, R. N., Meenakshi, P. V., Shah, K., Patel, B., Chan, B. P. L., Sunny, S., Chandra, B., Ong, J. J. Y., Paliwal, P. R., & Sharma, V. K. (2020). A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain behavior and immunity, 88, 559–565. https://doi.org/10.1016/j.bbi.2020.04.049.
Clements, C., Barsamian, J., Burnham, N., Cruz, C., Darcy, A. M. G., Duphiney, L., FitzGerald, J., Holland, S., Joyce, C., & DeSanto-Madeya, S. (2021). Supporting Frontline Staff during the COVID-19 pandemic. The American journal of nursing, 121(9), 46–55. https://doi.org/10.1097/01.NAJ.0000790632.18077.c1.
Cole, C. L., Waterman, S., Stott, J., et al. (2020). Adapting IAPT services to support frontline NHS staff during the Covid-19 pandemic: The Homerton Covid Psychological support (HCPS) pathway. Cogn Behav Therap, 13, e12. https://doi.org/10.1017/S1754470X20000148.
Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and anxiety, 18(2), 76–82. https://doi.org/10.1002/da.10113.
Cyrulnik, B. (2009). Resilience: How your inner strength can set you free from the past. Penguin UK.
d’Orville, H. (2020). COVID-19 causes unprecedented educational disruption: Is there a road towards a new normal? Prospects (Paris), 1–5. https://doi.org/10.1007/s11125-020-09475-0.
Deldar, K., Froutan, R., Dalvand, S., Gheshlagh, R. G., & Mazloum, S. R. (2018). The relationship between Resiliency and Burnout in Iranian Nurses: A systematic review and Meta-analysis. Open access Macedonian journal of medical sciences, 6(11), 2250–2256. https://doi.org/10.3889/oamjms.2018.428.
Dhiman, S., Sahu, P. K., Reed, W. R., Ganesh, G. S., Goyal, R. K., & Jain, S. (2020). Impact of COVID-19 outbreak on mental health and perceived strain among caregivers tending children with special needs. Research in developmental disabilities, 107, 103790. https://doi.org/10.1016/j.ridd.2020.103790.
Hu, T., Zhang, D., & Wang, J. (2015). A meta-analysis of the trait resilience and mental health. Personality and Individual Differences, 76, 18–27. https://doi.org/10.1016/j.paid.2014.11.039.
Keder, R. D., Mittal, S., Stringer, K., Wallis, K. E., Wallace, J. E., & Soares, N. S. (2022). Society for Developmental & behavioral pediatrics position Statement on Telehealth. Journal of developmental and behavioral pediatrics: JDBP, 43(1), 55–59. https://doi.org/10.1097/DBP.0000000000001046.
Killgore, W. D. S., Taylor, E. C., Cloonan, S. A., & Dailey, N. S. (2020). Psychological resilience during the COVID-19 lockdown. Psychiatry research, 291, 113216. https://doi.org/10.1016/j.psychres.2020.113216.
Landes, S. D., Finan, J. M., & Turk, M. A. (2022). COVID-19 mortality burden and comorbidity patterns among decedents with and without intellectual and developmental disability in the US. Disability and health journal, 15(4), 101376. https://doi.org/10.1016/j.dhjo.2022.101376. Advance online publication.
Lee, S. M., Kang, W. S., Cho, A. R., Kim, T., & Park, J. K. (2018). Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Comprehensive psychiatry, 87, 123–127. https://doi.org/10.1016/j.comppsych.2018.10.003.
Lim, T. S. H., Tan, M. Y., Aishworiya, R., Kang, Y. Q., Koh, M. Y., Shen, L., & Chong, S. C. (2022). Factors contributing to Psychological Ill-Effects and Resilience of Caregivers of children with Developmental Disabilities during a nation-wide Lockdown during the COVID-19 pandemic. Journal of autism and developmental disorders, 52(7), 3015–3025. https://doi.org/10.1007/s10803-021-05180-9.
McAlonan, G. M., Lee, A. M., Cheung, V., Cheung, C., Tsang, K. W., Sham, P. C., Chua, S. E., & Wong, J. G. (2007). Immediate and sustained psychological impact of an emerging infectious disease outbreak on health care workers. Canadian journal of psychiatry Revue canadienne de psychiatrie, 52(4), 241–247. https://doi.org/10.1177/070674370705200406.
McCain, R. S., McKinley, N., Dempster, M., Campbell, W. J., & Kirk, S. J. (2017). A study of the relationship between resilience, burnout and coping strategies in doctors. Postgraduate medical journal, postgradmedj-2016-134683. Advance online publication. https://doi.org/10.1136/postgradmedj-2016-134683.
Ministry of Health, Singapore (2020). News highlights: Circuit breaker to minimise further spread of COVID-19 Ministry of Health. https://www.moh.gov.sg/news-highlights/details/circuit-breaker-to-minimise-further-spread-of-covid-19.
Mulay, K. V., Aishworiya, R., Lim, T. S. H., Tan, M. Y., Kiing, J. S. H., Chong, S. C., & Kang, Y. Q. (2021). Innovations in practice: Adaptation of developmental and behavioral pediatric service in a tertiary center in Singapore during the COVID-19 pandemic. Pediatrics and neonatology, 62(1), 70–79. https://doi.org/10.1016/j.pedneo.2020.09.003.
Nicholas, D. B., Mitchell, W., Ciesielski, J., Khan, A., & Lach, L. (2022). Examining the impacts of the COVID-19 pandemic on Service Providers Working with Children and Youth with Neuro-developmental disabilities and their families: Results of a Focus Group Study. Journal of intellectual disabilities: JOID, 17446295221104623. https://doi.org/10.1177/17446295221104623. Advance online publication.
Nyashanu, M., Pfende, F., & Ekpenyong, M. (2020). Exploring the challenges faced by frontline workers in health and social care amid the COVID-19 pandemic: Experiences of frontline workers in the English Midlands region, UK. Journal of interprofessional care, 34(5), 655–661. https://doi.org/10.1080/13561820.2020.1792425.
Oei, T. P., Sawang, S., Goh, Y. W., & Mukhtar, F. (2013). Using the Depression anxiety stress scale 21 (DASS-21) across cultures. International journal of psychology: Journal international de psychologie, 48(6), 1018–1029. https://doi.org/10.1080/00207594.2012.755535.
Ong, H. L., Vaingankar, J. A., Abdin, E., Sambasivam, R., Fauziana, R., Tan, M. E., Chong, S. A., Goveas, R. R., Chiam, P. C., & Subramaniam, M. (2018). Resilience and burden in caregivers of older adults: Moderating and mediating effects of perceived social support. BMC psychiatry, 18(1), 27. https://doi.org/10.1186/s12888-018-1616-z.
Sun, P., Wang, M., Song, T., Wu, Y., Luo, J., Chen, L., & Yan, L. (2021). The psychological impact of COVID-19 pandemic on Health Care Workers: A systematic review and Meta-analysis. Frontiers in psychology, 12, 626547. https://doi.org/10.3389/fpsyg.2021.626547.
Vitousek, M. N., Taff, C. C., Ryan, T. A., & Zimmer, C. (2019). Stress resilience and the dynamic regulation of glucocorticoids. Integrative and comparative biology, 59(2), 251–263. https://doi.org/10.1093/icb/icz087.
Wu, A. W., Connors, C., & Everly, G. S. Jr. (2020). COVID-19: Peer support and Crisis Communication Strategies to Promote Institutional Resilience. Annals of internal medicine, 172(12), 822–823. https://doi.org/10.7326/M20-1236.
Ying, J., Tan, G. M. Y., & Zhang, M. W. (2022). Intellectual disability and COVID-19: A bibliometric review. Frontiers in psychiatry, 13, 1052929. https://doi.org/10.3389/fpsyt.2022.1052929.
Zhang, S., Hao, Y., Feng, Y., & Lee, N. Y. (2022). COVID-19 pandemic impacts on children with developmental disabilities: Service disruption, transition to Telehealth, and child wellbeing. International journal of environmental research and public health, 19(6), 3259. https://doi.org/10.3390/ijerph19063259.
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Conceptualization: Tammy SH Lim, Ying Qi Kang, Shang Chee Chong.
Methodology: Tammy SH Lim, Ying Qi Kang, Liang Shen.
Data curation: Mae Yue Tan, Tammy SH Lim, Ying Qi Kang, Phyllis PL Lim, Shang Chee Chong, Ramkumar Aishworiya.
Formal analysis: Mae Yue Tan, Phyllis PL Lim, Liang Shen, Ramkumar Aishworiya.
Writing – original draft preparation: Mae Yue Tan, Ramkumar Aishworiya.
Writing – review and editing: Mae Yue Tan, Tammy SH Lim, Ying Qi Kang, Phyllis PL Lim, Liang Shen, Shang Chee Chong, Ramkumar Aishworiya.
Supervision: Shang Chee Chong.
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This study was performed in line with the principles of the Declaration of Helsinki. The study questionnaire and methodology were approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB) – Domain B, Singapore [Reference No.: 2020/00556].
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Participation in the study was voluntary and involved the anonymous completion of an online questionnaire. Submission of the completed questionnaire was thus interpreted as provision of consent to participate in the study (i.e., implied consent).
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Tan, M.Y., Lim, T.S., Kang, Y.Q. et al. Psychological Resilience of Providers of Children with Developmental Disabilities During the COVID-19 Pandemic. J Dev Phys Disabil (2023). https://doi.org/10.1007/s10882-023-09926-4
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DOI: https://doi.org/10.1007/s10882-023-09926-4