The Impact of the Covid-19 Pandemic on Children's Rights and Psychosocial Status

doi:10.21203/rs.3.rs-4893073/v1

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The Impact of the Covid-19 Pandemic on Children's Rights and Psychosocial Status

https://doi.org/10.21203/rs.3.rs-4893073/v1

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Objective

Children's rights emerged with the recognition of human rights and constitutional fundamental rights for children under eighteen. This study aimed to evaluate the attitudes and behaviors of parents towards children at home during the COVID-19 pandemic in terms of violation of children's rights.

Material and Method

Between December 2022 and June 2023, researchers administered a 38-question questionnaire to 540 parents at the university hospital general pediatrics outpatient clinic and pediatrics service.

Results

Among the participants, 70.4% were mothers, and 29.6% were fathers. The analysis indicated that fathers who took part in the survey engaged in child abuse less frequently than mothers at a statistically significant level. Furthermore, the severity of punishment administered by fathers to their children was statistically significantly lower than that of mothers.

Conclusion

In our study, they reported that verbal or physical violence occurred in the family during the pandemic period. Hence, it was determined that social isolation and disruption of education experienced with COVID-19 increased the rate of childhood exposure to domestic abuse and violence.

Forensic Medicine

COVID-19 Pandemic

Children's Rights

child abuse

child neglect.

The rights of children, which are a part of human rights, are gathered under the title of "Children's Rights" because people between the ages of 0–18 need care and protection in terms of age and maturity. They have needs such as ensuring their development in a healthy way(1). The Convention on the Rights of the Child, which Turkey signed in 1990 and entered into force in 1995, granted children the rights to education and health, aiming to provide them with opportunities for development in social spheres(2). It is emphasized that the awareness and consciousness of parents have increased with the increasing awareness in the world about children's rights; however, they still need to be sufficiently informed about the types, content, and implementation of these rights(3)

With the occurrence of cases in Turkey during the COVID-19 pandemic, many measures were taken to minimize the public risk associated with COVID-19, including the temporary closure of educational institutions, theaters, movie theaters, museums, and sports facilities. In March 2020, schools and kindergartens were closed, and a curfew for those under 20 was introduced on April 3 (4). Children were significantly impacted by these processes, primarily due to both involuntary restrictions and their vulnerable developmental stage (5). It has been reported that children and their mothers are more susceptible to domestic violence due to physical, psychological, and employment problems caused by the Covid-19 process (6). Children's rights are pushed to the background as in every pandemic period (7).

This study aimed to evaluate parents' attitudes and behaviors toward children at home during the COVID-19 pandemic in terms of violation of children's rights.

Between December 2022 and June 2023, researchers administered a 38-question questionnaire to parents at the University Hospital General Pediatrics Outpatient Clinic. This questionnaire was given to parents who brought their children for treatment at the Pediatrics Service and agreed to participate in the study by providing consent. Parents who participated in the survey scored the violent behavior towards their children and the severity of punishment they received, in addition to scoring the severity of the beating they received from their parents and the severity of punishment they received from their parents, ranged from never (1) rarely = 2, sometimes = 3, often = 4, very often = 5, continuous (6). While evaluating the findings obtained in the study, which received ethics committee approval from the university hospital Clinical Research Ethics Committee with the decision dated 15/12/2022, 28/12/2022 and numbered 1459824, 1459865. The research was conducted according to the "Declaration of Helsinki". NCSS (Number Cruncher Statistical System) 2020 Statistical Software (NCSS LLC, Kaysville, Utah, USA) program was used for statistical analysis. While evaluating the study data, quantitative variables were shown with mean, standard deviation, median, min, and max values, and qualitative variables were shown with descriptive statistical methods such as frequency and percentage. Shapiro Wilks test and Box Plot graphs were used to evaluate the conformity of the data to normal distribution. The student's t-test was used for two group evaluations of quantitative variables that showed normal distribution. Mann Whitney U test was used to evaluate variables that did not show normal distribution according to two groups. Chi-Square test and Fisher Exact test were used to compare qualitative data. The results were evaluated at a 95% confidence interval, and significance was assessed at p < 0.05.

Researchers administered a questionnaire to 540 parents attending the General Pediatrics Outpatient Clinic with their children and those whose children were hospitalized in the Pediatrics Service. Among the participants, 70.4% (n=380) were mothers, and 29.6% (n=160) were fathers. The study revealed that 46.9% (n=253) of the treated children were female, while 53.1% (n=287) were male. The children's mean age was 95.44±53.29 months. It was determined that 25.7% of the children hadn’t siblings, 42.0% had one sibling, and 32.2% had two or more siblings. Regarding the mothers and fathers' educational background, 41.3% and 35% had education levels below high school, while 58.7% and 65% had completed high school or higher education, respectively. Regarding the mothers, 55.3% were housewifes, while 44.7% were employed. Among the fathers, 69.4% worked as laborers or civil servants, and 30.6% were self-employed. A comparison of parents' answers to questions about COVID-19 disease is shown in Table 1.

Among the parents who participated in the survey, concern about contracting the disease was prevalent, including 74.7% of mothers and 60.0% of fathers. Mothers exhibited significantly higher levels of fear than fathers (p=0.001; p<0.05). Among the parents who participated in the survey, 94.1% expressed concern about their children contracting the disease. Regarding stress levels, 7.6% of mothers and 13.8% of fathers stated they weren’t stressed.

During this period, 24.1% reported incidents of arguments or physical violence within the family. Regarding their relationship with their child during the pandemic, 5.7% described it as harmful.

It was found that 19.1% of parents with school-age children were unable to utilize the distance education system, citing reasons such as system problems and irregular lessons. 73.7% of the children who benefited from the distance education system stated that they needed additional courses because they found distance education insufficient.

During this period, parents stated that 1.7% chose not to vaccinate. Regarding health checks for COVID-19, 21.9% reported that they couldn't take their children for these checks.

When their child/children spent time at home in 3 months during this period: On average, children of appropriate age, 315.9 ± 298.9 hours played internet games, 197.8 ± 198 hours studied and reading books, 170.1± 171 hours preferred watching television.

It was found that 10.7% of the parents considered beating as a tool in child education. It was determined that 90.9% of the parents who participated in the survey were exposed to being punished by their parents during their childhood. The nature of violence that the parents who conducted the study were exposed to by their parents when they were children is shown in Table 2.

It was found that 90.9% and 96.9% of parents were aware of child neglect and abuse, respectively. Among them, 63.1%, 68.5% from the Internet, 49.7%, 52.6% from print media, 20.2%, and 19.3 % from physicians received information about child neglect and abuse, respectively.

The survey revealed that 20.7 % of participating parents didn’t offer privacy training.

It was found that 93.4% of mothers and 86.3% of fathers admitted to emotionally abusing (parents doing any actions such as verbally warning and angering, not speaking, shouting at their children) their children, with mothers significantly more likely to emotionally abuse their children than fathers (p: 0.007, p<0.05).

It was discovered that 50.8% of mothers and 35.0% of fathers resorted to physical abuse when their children didn’t stop crying (parents doing any actions such as lightly touching their cheek, lightly spanking their buttocks, pushing, pulling their ear, pinching, shaking their by holding their shoulders and arms) with mothers significantly more likely than fathers to abuse their children in this scenario physically (p: 0.001, p <0.05). Furthermore, 69.2% of mothers and 65.9% of fathers admitted that they punished their children by physically abusing them. It was revealed that 92% of parents with less than a high school education and 90.8% of parents with a high school education or above emotionally abused their children. A comparison based on Survey Responding Parents is shown in Table 3.

It was determined that 59.6% of parents with less than high school education and 37.3% of parents with high school and above education physically abused their children if their children did not stop crying. Parents with less than high school education physically abused their children if their children did not stop crying at a significant rate (p: 0.000 p < 0.05) compared to parents with high school and above education. Comparison Based on Mother's and Father's Education Level is shown in Table 4.

It was found that 75.1% of the parents with less than high school education and 63.6% of the parents with high school and above education punished their children by physically abusing them. Parents with less than high school education punished their children by physically abusing them at a significant rate compared to parents with high school and above education.

It was found that 82.2% of participants admitted to punishing their children, which included any actions such as slapping, pulling the child's ear, grabbing the child's shoulder or arm and shaking, kicking, beating with a belt, throwing objects, pinching, not speaking, yelling loudly. Moreover, 86.3% of parents acknowledged abusing their child if they didn’t stop crying, which involved any actions like verbally warning and getting angry, lightly touching their cheek, lightly spanking their buttocks, pushing, pulling their ear, pinching, and shaking them by holding their shoulders and arms.

In our study, while the abuse status of the participants by their parents didn't show a statistically significant difference, it was determined that fathers abused their children statistically significantly less than mothers.

Children's rights emerged with the recognition of human rights and constitutional fundamental rights for children under eighteen, including vital development, protection, and participation rights (8). Childhood is a multidimensional, sensitive period involving continuous growth and change. At the same time, it is a process in which special protection and minimization of the effects of bad experiences are needed due to high dependencies (1–9). The gender distribution, number of siblings, and mean age of the 540 parents' children who participated in the survey align with the findings in the literature (10–12).

The fact that both parents and children are psychologically negatively affected by the pandemic process clearly indicates that the pandemic directly affects all individuals (13). Different studies determined that parents had a moderate level of COVID-19 fear during the COVID-19 pandemic, similar to the studies in the literature(14, 15). In our study, mothers exhibited significantly higher levels of anxiety compared to fathers, while 94.1% expressed concern about their children contracting the disease. Although children are less at risk of contracting COVID-19 than adults, initial reports from China indicate that children and adolescents are more vulnerable to the adverse psychological effects of the pandemic. It was reported that children developed behavioral problems during this process (16). In addition, the fact that parents mainly express their stress to each other and their children points to the effect of family members on each other (13). In our study, the stress levels of parents during this period were evaluated. 7.6% of mothers and 13.8% of fathers stated they weren’t stressed, there were incidents of arguments or physical violence in 24.1% of families, and only 5.7% of the parents described their relationships with their children negatively during this period. The difficulties experienced during the pandemic process cause parents to increase their stress levels, so cases of violence and abuse against children increase in such periods (17, 18). Vital rights are the rights that envisage meeting the child's basic needs, such as survival and having appropriate living standards, medical care, nutrition, and shelter. Developmental rights include the right to education, the right to play and rest, the right to information, freedom of religion, conscience, and thought, which are necessary for the child to realize themself at the highest level (8). During this period, children's rights to privacy, healthy living, growth, and development were the most violated (19). Due to the regulations made to prevent contagion by creating social distancing during this period, schools at primary, middle, and high school levels were suspended. As of March 16, 2020, in Turkey, as in many countries, distance education was started on March 23 through the Education Information Tool or online education channels. As of April 3, a curfew was imposed on children under 20 (20). The distance education environment, which is an application aimed at preventing contagion by creating social distance in the field of education, has been accepted in all countries experiencing intense viral distribution and has been preferred by managers and experts in education(21). However, even with this practice, according to the United Nations Educational, Scientific and Cultural Organization, approximately 1.5 billion children and adolescents worldwide couldn’t go to school as a result of the closure of educational institutions to prevent the spread of COVID-19 (17). During this period, school psychological counselors stated that they could not actively reach children through distance education and that not all children have the same Internet access (19). Aydın et al. reported that 53.5% of children had more or less learning problems during the pandemic period (22). In a study in which seven European countries were represented, it was found that home education was of low quality and negatively affected both children and parents. It was determined that stress, anxiety, social isolation, and conflict levels increased within the family (23). In our study, it was determined that 19.1% of parents were unable to utilize the distance education system. 73.7% of the children who benefited from the distance education system stated that they needed to take additional courses because they found distance education insufficient. Considering that the negativities of exposure to digital stimuli increase as children get younger, self-control in children isn’t mature enough, and both children and families need knowledge and skills on digital literacy, it can be said that parents have negative experiences about their children's distance education process (24). Stating that children's rights to private space and leisure time were also interfered with, psychological counselors reported that 28.8% of children didn’t benefit from the right to play (19). It has been shown that children can't leave their homes; however, they start spending time with their families, are sedentary, and spend much time with technological devices (25–27). In our study, it was found that children spent much time using technological devices during this period. In addition, since routine vaccination programs were disrupted due to the COVID-19 pandemic, more than 80 million children worldwide face the risk of contracting diseases such as diphtheria, measles, and polio (28). In our study, 1.7% of children who were due for the vaccination schedule couldn’t get vaccinated due to the pandemic, and 21.9% didn't take their health checks.

Protection rights are the rights that ensure the protection of the child against all kinds of neglect, abuse, and exploitation (8). In our study, 96.9% and 90.9% of the parents had previous knowledge of child abuse and child neglect, respectively; no statistically significant difference was observed between the mothers and fathers in their understanding of physical, emotional, and sexual abuse acts and studies in the literature reported that 10-96.3% of the parents knew about child abuse or neglect (11, 29).

Similar to the studies in the literature, it was found that the most common sources from which parents received prior information about child neglect and abuse were the Internet visual and written media, and they also obtained information from physicians (29, 30). In our study, although parents had a high awareness of children's rights, 24.1% of them reported incidents of arguments or physical violence within the family during the pandemic. A recent study highlights that the pandemic period worsens mood in families. The same study points out that 27% of children and adolescents and 37% of parents have increased frequency of arguments at home (31). While it is estimated that domestic violence in China has tripled the normal rate, this rate is estimated to have increased by 30% in France and 40–50% in Brazil; data are showing that domestic violence has also increased in countries that have felt the pandemic deeply, such as Italy and Spain (32).

In our study, it was found that 75.2% of the parents who participated in the survey were exposed to beating by their parents during their childhood. In addition, 90.9% were punished by their parents, and 10.7% still defined beating as a tool in child education. In South Korea, 45% of families beat or kick their children with an object (33). In a study, it was observed that 37% of the participants’ children were beaten and punished with belts by their parents (34). While the participants' abuse from their parents didn't show a statistically significant difference, it was determined that fathers were beaten and punished by their parents statistically significantly more than mothers. Studies have reported that parents who were exposed to neglect and abuse during childhood engage in neglect and abuse towards their children. It was found that parents were five times more likely to report that they exhibited similar parenting behaviors towards their children (35, 36).

Physical and psychological abuse of children and deprivation of their rights to education and health are among the most frequently violated rights in our country (37). Compared to the pre-pandemic period, it is known that the risk of abuse against children and the rate of physiological aggression increased in the world during the pandemic period, and it has also been shown that domestic violence increased (38, 39).

In our study, parents' knowledge about the pandemic and child abuse during the pandemic period and their awareness and attitudes toward the practical application of this information were revealed. In light of the data in our study, it was determined that social isolation and disruption of education experienced with COVID-19 increased the rate of childhood exposure to domestic abuse and violence. We showed that parents, rather than physicians, could access general information about the pandemic mostly through social media and television. We were able to show that parents accessed information about abuse similarly through the Internet and that their attitudes towards their children worsened during the pandemic period. Beyond general information, social awareness raising and adapting the measures to be taken during the isolation period to the conditions of the period may support the return of such violence and abuse case rates to the normal period and the decrease in the difference between parents and parents.

Financing

For this study, financial support hasn't been received any financing institutions in the public, commercial or not-for-profit sectors.

Conflict of Interest Statement

There is no conflict of interest.

Ethics Committee Approval

For the study, Istanbul University Istanbul Faculty of Medicine Clinical Research Ethics Committee with the decision dated 15/12/2022, 28/12/2022 and numbered 1459824, 1459865. The research was conducted according to the "Declaration of Helsinki".

Informed Consent

Informed consent was obtained from all individuals in the study. Consent and written permission for publication of the data were obtained.

Accessibility of Data

Data may only be requested from authors due to confidentiality or other restrictions.

Author Contributions

Conceptualization: CDC, AHD; MAM, MO, AK; Methodology: CDC, AHD; MAM, MO, AK, Formal analysis and investigation: CDC, AHD; Writing - original draft preparation: CDC, AHD; Writing - review and editing: CDC, MAM, MO, AK; Resources: CDC, AHD; MAM, AK; Supervision: CDC, AHD; MAM, MO, AK

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Tables 1 to 4 are available in the Supplementary Files section

The authors declare no competing interests.

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THE IMPACT OF THE COVID-19 PANDEMIC ON CHILDREN'S RIGHTS AND PSYCHOSOCIAL STATUS

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The Impact of the Covid-19 Pandemic on Children's Rights and Psychosocial Status

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Abstract

INTRODUCTION

MATERIAL AND METHOD

RESULTS

DISCUSSION

Declarations

References

Tables

Additional Declarations

Supplementary Files

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