Impact of the COVID-19 Pandemic on the Emotional State of School Children

Year 2025, Volume: 15 Issue: 1, 182 - 190, 28.03.2025

Rukiye Çelik , Birgül Erdoğan , Gizem Çakır , Naime Altay , Ebru Kılıçarslan Törüner

https://doi.org/10.33808/clinexphealthsci.1542187

Abstract

Objective: This study was conducted to determine school children’s (8–10 years of age) feelings during the COVID-19 pandemic.
Methods: This study was descriptive. The study was conducted online between March 1 and June 17, 2022, with 49 children and their parents living in Türkiye who met the inclusion criteria and agreed to participate.
Results: Our study found that the anxiety scores of children who were diagnosed themselves or had someone in their families diagnosed were higher than those who were not diagnosed. According to the drawing technique, the rate of insecurity and anger was higher in children with a family member diagnosed with COVID-19 compared to those without a diagnosis. According to the results of the correlation, statistically significant relationships were found between anxiety scores and shyness (p=.031), between impulsivity and insecurity (p=.000), between impulsivity and anger (p=.029), and between insecurity and anger (p=.029).
Conclusions: Nurses should be aware of the social and emotional impact of pandemics on children and be able to use the drawing method, a therapeutic communication technique, to determine children’s perceptions of the pandemic process and how they are affected by it.

Keywords

Child, COVID-19, drawing, anxiety, nurse

References

• Umakanthan S, Chauhan A, Gupta, MM, Sahu PK, Bukelo MM, Chattu VK. COVID-19 pandemic containment in the Caribbean Region: A review of case-management and public health strategies. AIMS Public Health. 2021;8(4):665. https://doi.org/10.3934/publichealth.2021053
• Kaur R, Boobna T, Kallingal P Effect of Covid-19 lock down on indian children with autism. Research in Developmental Disabilities. 2022;125:104230. https://doi.org/10.1016/j.ridd.2022.104230
• Serlachius A, Badawy SM, Thabrew H. Psychosocial challenges and opportunities for youth with chronic health conditions during the COVID-19 pandemic. JMIR Pediatrics and Parenting. 2020;3(2):e23057. https://doi.org/10.2196/23057
• Richter SA, Ferraz‐Rodrigues C, Schilling LB, Camargo NF, Nunes ML. Effects of the COVID‐19 pandemic on sleep quality in children and adolescents: A systematic review and meta‐analysis. Journal of sleep research. 2023;32(1):e13720. https://doi.org/10.1111/jsr.13720
• Buheji M, Hassani A, Ebrahim A, da Costa Cunha K, Jahrami H, Baloshi M, Hubail S. Children and coping during COVID-19: A scoping review of bio-psycho-social factors. International Journal of Applied Psychology. 2020;10(1):8-15. https://doi.org/10.5923/j.ijap.20201001.02
• Christakis DA School reopening—the pandemic issue that is not getting its due. JAMA pediatrics. 2020;174(10):928-928. DOI:10.1001/jamapediatrics.2020.2068
• Anand P, Patil RS, Puri P, Patil S. The psychosocial effects of lockdown due to the COVID-19 Pandemic on children in 2021. Cureus, 2024;16(2): e53614. https://doi.org/10.7759/cureus.53614
• UNICEF. Psychosocial Support for Children during COVID-19. A Manual for Parents and Caregivers. 2024. https://www.unicef.org/india/media/3401/file/PSS-COVID19-Manual-ChildLine.pdf
• TC Sağlık Bakanlığı. Covid Bilgilendirme Platformu. 2024. https://covid19.saglik.gov.tr/TR-66158/81-il-psikososyal-destek-hat-bilgileri.html
• Becker SP, Gregory AM. Editorial Perspective: Perils and promise for child and adolescent sleep and associated psychopathology during the COVID‐19 pandemic. Journal of Child Psychology and Psychiatry. 2020;61(7):757-759. https://doi.org/10.1111/jcpp.13278
• Jefsen OH, Rohde C, Nørremark B, Østergaard SD. Editorial Perspective: COVID-19 pandemic-related psychopathology in children and adolescents with mental illness. Journal of Child Psychology and Psychiatry. 2020;62:798–800. https://doi.org/10.1111/jcpp.13292
• Phelps C, Sperry LL. Children and the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy. 2020. https://doi.org/10.1037/tra0000861
• Ravens-Sieberer U, Kaman A, Erhart M, Devine J, Schlack R, Otto C. Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. Eur Child Adolesc Psychiatry. 2021;31(6):879-889. https://doi.org/10.1007/s00787-021-01726-5
• Courtney D, Watson P, Battaglia M, Mulsant BH, Szatmari P. COVID-19 impacts on child and youth anxiety and depression: challenges and opportunities. The Canadian Journal of Psychiatry. 2020;65(10):688-691. https://doi.org/10.1177/0706743720935646
• Liu JJ, Bao Y, Huang X, Shi J, Lu L Mental health considerations for children quarantined because of COVID-19. The Lancet Child & Adolescent Health. 2020;4(5):347-349. https://doi.org/10.1016/S2352-4642(20)30096-1
• Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S. Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a meta-analysis. JAMA Pediatrics. 2021;175(11):1142-1150. https://doi.org/10.1001/jamapediatrics.2021.2482
• Şahbudak B, Emiroğlu Nİ. COVID-19 pandemic and mood disorders in children and adolescents. Turk J Child Adolesc Ment Health. 2020;27(2):59-63. (Turkish)
• Wang G, Zhang Y, Zhao J, Zhang J, Jiang F. Mitigate the effects of home confinement on children during the COVID-19 outbreak. The Lancet. 2020;395(10228):945-947. https://doi.org/10.1016/S0140-6736(20)30547-X
• Voltmer K, von Salisch M. Longitudinal prediction of primary school children’s COVID-related future anxiety in the second year of the pandemic in Germany. Plos one. 2024;19(5):e0302065. https://doi.org/10.1371/journal.pone.0302065
• The American Academy of Pediatrics COVID-19 guidance for safe schools and promotion of ın-person learning. The American Academy of Pediatrics. 2023. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools
• World Health Organization. Considering the impact of COVID-19 on children. World Health Organization. 2023. https://www.who.int/europe/activities/considering-the-impact-of-covid-19-on-children
• Wolf K, Schmitz J. Scoping review: longitudinal effects of the COVID-19 pandemic on child and adolescent mental health. Eur Child Adolesc Psychiatry. 2023;33(5):1257–1312. https://doi.org/10.1007/s00787-023-02206-8
• Lyon P. Using drawing in visual research: materializing the invisible. In The SAGE Handbook of Visual Research Methods ( Second ed., pp. 297-308). SAGE Publications, Inc., 2020. https://doi.org/10.4135/9781526417015
• Volans A, Brown E. Children expressing themselves. Oxford Textbook of Palliative Care for Children, 2021;95.
• Brechet C, D'Audigier L, Audras-Torrent L. The use of drawing as an emotion regulation technique with children. Psychology of Aesthetics, Creativity, and the Arts. 2022;16(2):221–232. https://doi.org/10.1037/aca0000314
• Mondragon IN, Munitis EA, Sancho BN, Etxebarria ON. Drawing the COVID-19 pandemic: how do children incorporate the health crisis and its consequences into their everyday thinking? Psychology & Health. 2022. https://doi.org/10.1080/08870446.2022.2066103
• Farley L, Mishra Tarc A. Drawing trauma: The therapeutic potential of witnessing the child’s visual testimony of war. Journal of the American Psychoanalytic Association. 2014;62(5):835-854. https://doi.org/10.1177/0003065114554419
• Schmidt SJ, Barblan LP, Lory I, Landolt MA. Age-related effects of the COVID-19 pandemic on mental health of children and adolescents. Eur J Psychotraumatol. 2021;12(1):1901407. https://doi.org/10.1080/20008198.2021.1901407
• Zengin M, Yayan EH, Vicnelioğlu E. The effects of the COVID‐19 pandemic on children's lifestyles and anxiety levels. Journal of Child and Adolescent Psychiatric Nursing. 2021;34(3):236-242. https://doi.org/10.1111/jcap.12316
• Ozusta HS. Çocuklar için durumluk-sürekli kaygı envanteri uyarlama, geçerlik ve güvenirlik çalışması [Adaptation, validity and reliability study of state-trait anxiety inventory for children]. Turkish Journal of Psychology. 1995;10(34):32-44. (Turkish)
• Koppitz EM. Psychological evaluation of children’s human figure drawings. NewYork: Grune&Stratton. 1968.
• Koppitz, EM. Psychological evaluation of human figure drawings by middle school pupils. London: Grune&Stratton. 1984.
• Abdulah DM, Abdulla BMO, Liamputtong P. Psychological response of children to home confinement during COVID-19: A qualitative arts-based research. International Journal of Social Psychiatry. 2021;67(6):761-769. https://doi.org/10.1177/0020764020972439
• Moitra M, Rahman M, Collins PY et al. Mental health consequences for healthcare workers during the COVID-19 pandemic: A scoping review to draw lessons for LMICs. Frontiers in psychiatry. 2021;12:602-614. https://doi.org/10.3389/fpsyt.2021.602614
• Cornaggia A, Bianco F, Gilli G, Marchetti A, Massaro D, Castelli I. Children’s representations of the COVID-19 lockdown and pandemic through drawings. Frontiers in Psychology. 2022;13:960893. https://doi.org/10.3389/fpsyg.2022.960893
• Idoiaga Mondragon N, Eiguren Munitis A, Berasategi Sancho N, Ozamiz Etxebarria N. Drawing the COVID19 pandemic: how do children incorporate the health crisis and its consequences into their everyday thinking? Psychology & Health. 2022a;19:1-20. https://doi.org/10.1080/08870446.2022.2066103
• Le Vu MN, Do AL, Boyer L, et al. A review of the effectiveness, feasibility, and acceptability of art therapy for children and adolescents during the COVID-19 pandemic. International Journal of Environmental Research And Public Health. 2022;19(18):11612. https://doi.org/10.3390/ijerph191811612
• Zhang L, Zhang D, Fang J, Wan Y, Tao F, Sun Y. Assessment of mental health of Chinese primary school students before and after school closing and opening during the COVID-19 pandemic. JAMA Network Open 3. 2020:e2021482. https://doi.org/10.1001/jamanetworkopen.2020.21482
• Qi M, Zhou SJ, Guo, ZC, Zhang LG, Min HJ, Li XM, Chen JX. The effect of social support on mental health in chinese adolescents during the outbreak of COVID-19. The Journal of Adolescent Health. 2020a;67:514–518. https://doi.org/10.1016/j.jadohealth.2020.07.001
• Yeasmin S, Banik R, Hossain S, Hossain MN, Mahumud R, Salma N, Hossain MM. Impact of COVID-19 pandemic on the mental health of children in Bangladesh: A cross-sectional study. Children and Youth Services Review. 2020;117:105277. https://doi.org/10.1016/j.childyouth.2020.105277
• Zhou SJ, Wang LL, Yang R, Yang XJ, Zhang LG, Guo ZC, et al. Sleep problems among Chinese adolescents and young adults during the coronavirus-2019 pandemic. Sleep Medicine. 2020a;74:39–47. https://doi.org/10.1016/j.sleep.2020.06.001
• Cao Y, Huang L, Si T, Wang NQ, Qu M, Zhang XY. The role of only-child status in the psychological impact of COVID-19 on mental health of Chinese adolescents. Journal of Affective Disorders. 2021;282:316–321. https://doi.org/10.1016/j.jad.2020.12.113
• Tang S, Xiang M, Cheung T, Xiang YT. Mental health and its correlates among children and adolescents during COVID-19 school closure: The importance of parentchild discussion. Journal of Affective Disorders. 2021;279:353–360. https://doi.org/10.1016/j.jad.2020.10.016
• Miao, R., Liu, C., Zhang, J., & Jin, H. Impact of the COVID-19 pandemic on the mental health of children and adolescents: a systematic review and meta-analysis of longitudinal studies. Journal of Affective Disorders. 2023;340:914-922. https://doi.org/10.1016/j.jad.2023.08.070
• Carter C, Barley R, Omar A. ‘I wish that COVID would disappear, and we'd all be together’: Maintaining Children's friendships during the Covid‐19 pandemic. Children & Society. 2023. https://doi.org/10.1111/chso.12693
• Idoiaga Mondragon N, Eiguren Munitis A, Berasategi Sancho N, Picaza Gorrotxategi M, Dosil Santamaria M. How are children coping with COVID-19 health crisis? Analysing their representations of lockdown through drawings. Childhood. 2022b;29(4):545-560. https://doi.org/10.1177/09075682221101199
• Ellis WE, Dumas TM, Forbes LM. Physically isolated but socially connected: Psychological adjustment and stress among adolescents during the initial COVID-19 crisis. Canadian Journal of Behavioural Science/Revue Canadienne Des Sciences Du Comportement. 2020;52:177–187. https://doi.org/10.1037/cbs0000215
• O’Sullivan K, Clark S, McGrane A et al. A qualitative study of child and adolescent mental health during the COVID-19 pandemic in Ireland. International Journal of Environmental Research and Public Health. 2021;18(3):1062. https://doi.org/10.3390/ijerph18031062
• Abawi O, Welling MS, van den Eynde E et al. COVID-19 related anxiety in children and adolescents with severe obesity: A mixed-methods study. Clinical Obesity. 2020;10:e12412. https://doi.org/10.1111/cob.12412
• Evans S, Mikocka-Walus A, Klas A, Olive L, Sciberras E, Karantzas G, Westrupp EM. From “It has stopped our lives” to “spending more time together has strengthened bonds”: The varied experiences of Australian families during COVID-19. Frontiers in Psychology. 2020;11:588-667. https://doi.org/10.3389/fpsyg.2020.588667
• Jones K, Hughes B. Children's Experiences of Death Anxiety and Responses to the Covid-19 Pandemic. Illness, Crisis & Loss. 2022;31(3):1-18. https://doi.org/10.1177/10541373221100899
• Jiao WY, Wang LN, Liu J, Fang SF, Jiao FY, Pettoello-Mantovani M, Somekh E. Behavioral and emotional disorders in children during the COVID-19 epidemic. The Journal of Pediatrics. 2020;221:264–266.e1. https://doi.org/10.1016/j.jpeds.2020.03.013
• Xue Q, Xie X, Liu Q et al. Knowledge, attitudes, and practices towards COVID- 19 among primary school students in Hubei Province, China. Children and Youth Services Review. 2021;120:105735. https://doi.org/10.1016/j.childyouth.2020.105735
• Qi H, Liu R, Chen X, Yuan XF, Li YQ, Huang HH, et al. Prevalence of anxiety and associated factors for Chinese adolescents during the COVID-19 outbreak. Psychiatry and Clinical Neurosciences. 2020b;74:555–557. https://doi.org/10.1111/pcn.13102
• Zhou SJ, Zhang LG, Wang LL, Guo ZC, Wang JQ, Chen JC, et al. Prevalence and sociodemographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19. European Child and Adolescent Psychiatry. 2020b;29:749–758. https://doi.org/10.1007/s00787-020-01541-4
• Idoiaga MN, Eiguren MA, Berasategi SN, Ozamiz EN. Drawing the COVID-19 pandemic: How do children incorporate the health crisis and its consequences into their everyday thinking?. Psychology & Health. 2024;39(3):379-398. https://doi.org/10.1080/08870446.2022.2066103
• Drake JE. How children can use drawing to regulate their emotions. Theory Into Practice. 2023;62(2):181-192. https://doi.org/10.1080/00405841.2023.2202132