Background In order to prevent SARS-CoV2 diffusion, Italy was the first country to implement a national lockdown. Due to the restrictive measures, the life of millions of Italians suddenly changed and negative consequences in relationships, lifestyles and mental health may have occurred. In a country with a familial culture and where the welfare is based on family support, the reduced help from retired parents to the families during the national lockdown may have resulted in a worsening in households’ mental health. Methods Within the project Lost in Italy (financially supported by the Directorate General for Welfare of the Lombardy Region, in collaboration with the Italian National Institute of Health and the Mario Negri Institute for Pharmacological Research) a web-based cross-sectional study was conducted on a representative sample of Italian adults from April 27 to May 3, 2020 to assess the impact of lockdown, also on psychological aspects. A sample of 3156 subjects aged 18-74 years was recruited and asked to report information on reduced help (in housework and baby-sitting) from retired parents and selected mental health indicators (sleep quality, sleep quantity, depressive symptoms, anxiety symptoms and quality of life), assessed through validated scales, before and during lockdown. Other demographic and socio-economic information were collected, as well. Multiple logistic regression models after adjustment for sex, age group, level of education, geographic area and marital status were used to derive odds ratios (OR), and corresponding 95% confidence intervals, for worsening in mental health outcomes according to the changes in help from parents. Statistical weight was used to ensure representativeness of the Italian sample for age, sex, geographic area and socio-economic status. Results A total of 1484 (47%) and 769 (64%) subjects reported reductions in housework and baby-sitting help from retired parents, respectively. A worsening in sleep quality and quantity was reported in subjects with reduced housework help from parents, compared to subjects reporting unchanged help (sleep quality: OR=1.74, 95% CI:1.49-2.03; sleep quantity: OR=1.50, 95% CI:1.28-1.76). Reducing housework help from relatives was also associated with worsening in depressive and anxiety symptoms (depression: OR=1.32, 95% CI:1.14-1.53; anxiety: OR=1.53, 95% CI:1.32-1.78). Subjects with reduced housework help reported worse quality of life, as well (OR=1.46, 95% CI: 1.25-1.70). Compared to subjects reporting unchanged help, in those who reduced baby-sitting help from retired parents, a worsening in sleep characteristics, depressive and anxiety symptoms was reported (OR= 2.32, 95% CI: 1.76-3.05 for sleep quality; OR=2.32, 95% CI: 1.76-3.05 for sleep quantity; OR= 1.79, 95% CI: 1.39-2.31 for depression; OR= 1.90, 95% CI: 1.48-2.46 for anxiety). A reduced baby-sitting help was also associated with reduced quality of life (OR=1.50, 95% CI: 1.16-1.93). Conclusions National lockdown measures came along with reduced households’ support from parents, which negatively impacted on households members’ mental health. Our findings might inform evidence-based family and welfare policies so as to promote population health within and beyond pandemic times.
Background Al fine di contrastare l’epidemia causata da SARS-CoV2, dal 9 Marzo 2020 in Italia è stato imposto un lockdown nazionale. In conformità alle misure restrittive, sono conseguiti profondi cambiamenti nelle dinamiche sociali dei cittadini. In un Paese caratterizzato da un welfare a trazione prevalentemente familiare, il ridotto aiuto da parte dei genitori pensionati alle famiglie italiane durante il lockdown, può aver impattato negativamente sulla salute mentale dei membri delle famiglie stesse. Materiali e metodi Nel contesto del più ampio progetto Lost in Italy (finanziato dalla Direzione Generale Welfare di Regione Lombardia, in collaborazione con l’Istituto Superiore di Sanità e l’Istituto di Ricerche Farmacologiche Mario Negri), è stato condotto uno studio cross-sectional su un campione rappresentativo di 3156 adulti italiani con età compresa fra i 18 e 74 anni. Tra il 27 Aprile e il 3 Maggio 2020, durante il lockdown, un questionario, basato su scale validate, è stato sottoposto online al campione in studio. Ai partecipanti, in particolare, è stato chiesto di riportare informazioni riguardo al ridotto aiuto da parte dei genitori pensionati (nelle faccende domestiche e nel baby-sitting) e a selezionati indicatori di salute mentale (qualità e quantità di sonno, depressione, ansia e qualità di vita), in riferimento sia al periodo antecedente al lockdown, sia durante lo stesso. Altre caratteristiche demografiche e socio-economiche sono state raccolte. Attraverso modelli logistici multivariati, sono stati stimati gli odds ratios (ORs) e i relativi intervalli di confidenza al 95% per il peggioramento degli indicatori di salute mentale rispetto alla riduzione dell’aiuto dei genitori pensionati. I modelli includevano i seguenti termini di aggiustamento: sesso, classi di età, livello di educazione, area geografica e stato civile. Nelle analisi sono stati utilizzati dei pesi statistici per assicurare la rappresentatività del campione italiano in termini di età, sesso, area geografica e stato socio-economico. Risultati Rispettivamente 1484 (47%) e 769 (64%) soggetti hanno riportato un ridotto aiuto nelle faccende domestiche e nel baby-sitting da parte dei genitori pensionati durante il lockdown. I soggetti che hanno ricevuto un ridotto aiuto nelle faccende domestiche hanno riportato un peggioramento di qualità e quantità del sonno rispetto a coloro che hanno riferito un aiuto invariato da parte dei genitori pensionati (qualità di sonno: OR=1.74, 95% CI:1.49-2.03; quantità di sonno: OR=1.50, 95% CI:1.28-1.76). Il ridotto aiuto nei lavori domestici durante il lockdown, è stato anche associato ad un peggioramento dei sintomi di depressione e ansia, rispetto a coloro che hanno mantenuto costante il supporto da parte dei genitori (depressione: OR=1.32, 95% CI:1.14-1.53; ansia: OR=1.53, 95% CI:1.32-1.78). Inoltre, chi ha ridotto l’aiuto nelle mansioni domestiche ha anche riportato una peggiore qualità di vita (OR=1.46, 95% CI: 1.25-1.70). Considerando l’aiuto dei genitori pensionati per il baby-sitting, coloro che hanno ridotto il supporto durante il lockdown hanno riportato un peggioramento di qualità e quantità del sonno (OR= 2.32, 95% CI: 1.76-3.05 e OR=2.32, 95% CI: 1.76-3.05, rispettivamente), depressione (OR= 1.79, 95% CI: 1.39-2.31) e ansia (OR= 1.90, 95% CI: 1.48-2.46). Inoltre, il ridotto aiuto nel baby-sitting da parte dei genitori pensionati è stato anche associato ad una peggior qualità di vita (OR=1.50, 95% CI: 1.16-1.93). Conclusioni Il lockdown nazionale ha impattato negativamente sul supporto che i genitori pensionati offrono quotidianamente alle famiglie italiane, con forti ripercussioni sulla salute mentale delle stesse. La delineazione di interventi di contrasto basati sulle evidenze nel contesto di politiche familiari e di welfare sarebbe opportuna al fine di promuovere e garantire la salute della popolazione generale, durante e dopo la pandemia.
COVID-19 lockdown impact on familial relationships and mental health in a large representative sample of Italian adults
ZEDURI, MARGHERITA
2020/2021
Abstract
Background In order to prevent SARS-CoV2 diffusion, Italy was the first country to implement a national lockdown. Due to the restrictive measures, the life of millions of Italians suddenly changed and negative consequences in relationships, lifestyles and mental health may have occurred. In a country with a familial culture and where the welfare is based on family support, the reduced help from retired parents to the families during the national lockdown may have resulted in a worsening in households’ mental health. Methods Within the project Lost in Italy (financially supported by the Directorate General for Welfare of the Lombardy Region, in collaboration with the Italian National Institute of Health and the Mario Negri Institute for Pharmacological Research) a web-based cross-sectional study was conducted on a representative sample of Italian adults from April 27 to May 3, 2020 to assess the impact of lockdown, also on psychological aspects. A sample of 3156 subjects aged 18-74 years was recruited and asked to report information on reduced help (in housework and baby-sitting) from retired parents and selected mental health indicators (sleep quality, sleep quantity, depressive symptoms, anxiety symptoms and quality of life), assessed through validated scales, before and during lockdown. Other demographic and socio-economic information were collected, as well. Multiple logistic regression models after adjustment for sex, age group, level of education, geographic area and marital status were used to derive odds ratios (OR), and corresponding 95% confidence intervals, for worsening in mental health outcomes according to the changes in help from parents. Statistical weight was used to ensure representativeness of the Italian sample for age, sex, geographic area and socio-economic status. Results A total of 1484 (47%) and 769 (64%) subjects reported reductions in housework and baby-sitting help from retired parents, respectively. A worsening in sleep quality and quantity was reported in subjects with reduced housework help from parents, compared to subjects reporting unchanged help (sleep quality: OR=1.74, 95% CI:1.49-2.03; sleep quantity: OR=1.50, 95% CI:1.28-1.76). Reducing housework help from relatives was also associated with worsening in depressive and anxiety symptoms (depression: OR=1.32, 95% CI:1.14-1.53; anxiety: OR=1.53, 95% CI:1.32-1.78). Subjects with reduced housework help reported worse quality of life, as well (OR=1.46, 95% CI: 1.25-1.70). Compared to subjects reporting unchanged help, in those who reduced baby-sitting help from retired parents, a worsening in sleep characteristics, depressive and anxiety symptoms was reported (OR= 2.32, 95% CI: 1.76-3.05 for sleep quality; OR=2.32, 95% CI: 1.76-3.05 for sleep quantity; OR= 1.79, 95% CI: 1.39-2.31 for depression; OR= 1.90, 95% CI: 1.48-2.46 for anxiety). A reduced baby-sitting help was also associated with reduced quality of life (OR=1.50, 95% CI: 1.16-1.93). Conclusions National lockdown measures came along with reduced households’ support from parents, which negatively impacted on households members’ mental health. Our findings might inform evidence-based family and welfare policies so as to promote population health within and beyond pandemic times.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/13012