COVID-19: how it is affecting children and what nurses can do to help
Children may be anxious during the crisis, particularly when attending hospital with long-term conditions
COVID-19 has disrupted our daily lives on a scale never seen before.
It has led to the closure of schools, crèches, childcare centres, after-school clubs, playgrounds, workplaces, cinemas and shops. Families are advised to stay at home and only go out for food, exercise and urgent necessities.
The impact of the virus can be mild or severe requiring ventilatory support in intensive care, and it can be fatal. The unpredictable consequences of COVID-19 are causing anticipatory anxiety and dread for many children and families.
Children may be prone to misconceptions and will pick up on parental anxiety
Losing a daily routine, contact with friends or extended family, restricted activities coupled with parental anxiety can be distressing. The situation is worse for children with anxiety disorders or special needs, and the loss of physical contact can be difficult to understand.
The experience for young children is undoubtedly worse since they have active imaginations, are prone to misconceptions and are more sensitive to parents’ anxieties. Many children are fearful that someone they know will die.
Four-year-old Alice* said: ‘The people who have the virus are getting very sick so they are dying. All the schools are closed so that's why we are staying at home. The people who spread the virus were eating bad food. I am washing my hands very carefully with soap.’
Children with long-term conditions may worry that their healthcare will be disrupted
Young people with chronic conditions, such as cystic fibrosis, asthma and diabetes, are likely to be fearful about doctors and nurses being able to continue to meet their ongoing treatment needs or worrying about the consequences of contracting the virus.
Ashley*, aged 16, said: ‘COVID-19 has affected me in different ways but most common has been with my blood glucose levels. My readings have been quite high the last couple of days as I only am allowed out for an hour of exercise.’
Parents and children may be fearful of being admitted to hospital and whether this will leave them open to contracting COVID-19. Although parents may be aware that the virus mainly affects adults, there have been cases of babies and children becoming ill with it so they will be worried about their child in hospital and siblings at home.
Tips on how you can help children and parents during the COVID-19 pandemic
- Be aware that children may be unduly distressed when being admitted to hospital
- Help them to voice their concerns, feelings and any worries
- Ask them what they know about the coronavirus and what they understand
- Treat their responses with respect and correct any misconceptions
- Make time for them to ask questions and provide simple, calm responses
- Use creative means such as stories, games, drawings and toys to help explain information in a simple and engaging way
- Think of the child’s age and tailor your responses to their developmental understanding
- For children who are very anxious, ask them to write their worries on paper as naming their fears will help reduce the emotional impact
- For children who are anxious, let them talk about their feelings and help them to reframe their concerns to a more helpful way of thinking
- Advise parents to acknowledge their child’s fears and be open to discussing them rather than denying the feelings
- Advise parents on how they can explain the virus and reassure their child
- Provide support for parents as they may be worried about their own health and their wider family, particularly those who have underlying medical conditions
- Be strong advocates and alert all members of the multidisciplinary team that children may be feeling acute anxiety due to the virus
- Children cope better when they know what to expect so careful preparation is essential before procedures
- Try not to express your concerns in front of children or parents
Further support for parents: Coronavirus Q&As: Answers to 7 questions your kids may have about the pandemic
* The quotes from children in this article were given with individual and parental consent
Imelda Coyne is professor in children’s nursing, Trinity College Dublin, and a member of the editorial advisory board of Nursing Children and Young People