Challenges for primary caregivers during the COVID-19 pandemic in accessing health care of children with chronic diseases under periodic follow-up at a tertiary care hospital in South India

Ramya Rajamanickam, Rajesh Jayanandan, Aparna Jayaraman, S. Sivathanu
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Abstract

Introduction: Challenges faced by the primary caregivers during the COVID-19 pandemic help to identify their needs and health seeking behavior during pandemic. Objectives: (1) To describe the factors associated with periodic follow-up at the hospital which posed as difficulties to their primary caregivers during the COVID-19 pandemic. (2) To identify the measures adopted by these primary caregivers to overcome those difficulties. Materials and Methods: This hospital-based cross-sectional observational study was conducted from May to August 2021 among 57 primary caregivers of children with chronic diseases registered before March 1, 2020, who were under periodic follow-up in our pediatrics department. Data were collected by direct or telephonic interview using a predesigned semi-structured questionnaire and analyzed using descriptive and inferential statistics like mean, standard deviation, proportions and paired "t"-test using Epi info and IBM SPSS trial version 28.0. Results: Frequency of hospital visits of 14 (24.6%) subjects were reduced during the COVID pandemic compared to the prepandemic period. During the COVID pandemic, 42 (73.7%) subjects had faced transportation difficulties, 23 (40.3%) had faced financial difficulties, 22 (38.6%) had skipped their scheduled follow-up visits and around 31.6% of them have feared of contracting COVID. None had availed telemedicine consultation for their children either before or during the pandemic. Conclusions: Difficulties faced in transportation, fear of contracting COVID, financial difficulties, and lack of awareness of teleconsultation services were identified as their major obstacles.
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在2019冠状病毒病大流行期间,初级护理人员在印度南部一家三级保健医院定期随访的慢性病儿童获得卫生保健方面面临的挑战
导言:COVID-19大流行期间初级护理人员面临的挑战有助于确定其需求和大流行期间的就医行为。目的:(1)描述在COVID-19大流行期间与医院定期随访相关的因素,这些因素对其主要护理人员构成困难。(2)确定这些主要照顾者为克服这些困难所采取的措施。材料与方法:本研究于2021年5月至8月在我院儿科定期随访的2020年3月1日前登记的57例慢性病患儿的主要护理人员中开展以医院为基础的横断面观察性研究。采用预先设计的半结构化问卷,采用直接或电话访谈的方式收集数据,并采用Epi info和IBM SPSS试用版28.0进行描述性和推断性统计,如均值、标准差、比例和配对“t”检验。结果:与疫情前相比,疫情期间14例(24.6%)受试者的住院次数有所减少。在新冠肺炎大流行期间,42人(73.7%)遭遇交通困难,23人(40.3%)遭遇经济困难,22人(38.6%)没有按计划随访,约31.6%的人担心感染新冠肺炎。在大流行之前或期间,没有人为子女进行过远程医疗咨询。结论:交通困难、害怕感染新冠病毒、经济困难和缺乏远程咨询服务意识是他们面临的主要障碍。
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