Parental Hesitancy and Concerns around Accessing Paediatric Unscheduled Healthcare during COVID-19: A Cross-Sectional Survey

Nicholson, Emma; McDonnell, Thérèse; Conlon, Catherine; Barrett, Michael J.; Cummins, Fergal; Hensey, Conor; McAuliffe, Éilish

doi:10.3390/ijerph17249264

Cited by 41 publications

(58 citation statements)

References 27 publications

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“…The cases of delayed presentations outlined by clinicians supports the findings of previous studies [5,7,8] and this study provides further insight into this phenomenon, highlighting the impact of parental hesitancy to attend the ED due to COVID-19 [9]. Public health messaging clearly impacted parents faced with making decisions around seeking care for children, thus clear and uncomplicated communication is essential [9]. The positive reaction to infection control measures displayed by parents suggests that a public communication strategy, clearly outlining the measures in place at the ED, can help to combat fears and reassure parents to continue to present [7].…”

Section: Discussionsupporting

confidence: 85%

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The impact of the COVID-19 pandemic on child health and the provision of Care in Paediatric Emergency Departments: a qualitative study of frontline emergency care staff

Conlon

McDonnell

Barrett

et al. 2021

BMC Health Serv Res

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Background The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system. Methods Fifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n = 6), social workers (n = 2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes. Results The pandemic and public health restrictions have had an adverse impact on children’s health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care. Conclusions The spread of COVID-19 and subsequent policies to address the pandemic has had wide-reaching implications for children’s health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.

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Section: Discussionsupporting

confidence: 85%

“…Lower attendance rates have been attributed to reduced infectious diseases and injuries due to public health measures implemented. Furthermore, parental hesitancy to attend hospitals due to fear of COVID-19 and a misinterpretation of public health messaging may have also contributed to reduced presentations [9].…”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on child health and the provision of Care in Paediatric Emergency Departments: a qualitative study of frontline emergency care staff

Conlon

McDonnell

Barrett

et al. 2021

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

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“…Parental anxieties surrounding hospital attendance during the pandemic are documented, [24] which could contribute to reduced attendances/admissions. However, a UK-based prospective study found only 3.8% of ED presentations during were delayed due to the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Using ICD-10 Diagnostic Codes to Identify ‘Missing’ Paediatric Patients During Nationwide COVID-19 Lockdown in Oxfordshire, UK

Charlesworth

Bold

Pal

2021

Preprint

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Objective: To identify diagnoses which were ‘missing’ amongst paediatric inpatients during the UK’s first national lockdown, compared with the same period over the past five years.Study design: A retrospective observational cohort study of all children (0-15 years) attending for urgent care across Oxfordshire, during the first UK lockdown in 2020, compared to matched dates in 2015-2019. This covers two paediatric hospitals providing secondary care, one with tertiary services. Main outcomes: Changes in numbers of patients attending and inpatient diagnoses (using ICD-10 classification) during the first 2020 lockdown, compared with the previous five years.Results: Total ED attendances (n=4030) and hospital admissions (n=1416) during the first UK lockdown were reduced by 56.8% and 59.4%, respectively, compared to attendances/admissions in 2015-2019 (5-year mean n=7446.8 and n=2491.6, respectively). Proportions of patients admitted from ED and length of stay were similar in lockdown to 2015-2019. Significantly greater numbers of neoplasms were diagnosed during lockdown than the same period in 2015-2019 (p= 0.0123). 80% of diagnoses ‘missing’ during lockdown were categorised as infectious diseases or their sequelae, whilst 20% were non-specific pains/aches/malaise and accidental injury/poisonings. Conclusions: Using standardised ICD-10 codes as a measure of diagnostic activity between years; ‘missing’ diagnoses can be identified. Our findings may suggest parents are supervising infectious illness at home or had anxieties about hospital attendance, with self-limited low-morbidity disease. Prospective studies should establish if parents/carers are adequately supported in caring for their children at home, and that access and referral pathways are appropriate where children have concerning clinical features.

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“…Clinicians explained that parents were unaware of the infection control measures put in place in hospitals, such as streaming and triaging for COVID-19, and reacted positively and felt reassured when observing the measures implemented: "I think most of them were very reassured when they came in because they were told no, we had a separate COVID streaming area." [9] 2.2 Stay Home, Stay Safe: Public Health Messaging As cases of COVID-19 rst began to increase in Ireland, authorities introduced restrictions on movement and issued public health advice, instructing people to stay at home. The initial drop in ED attendances coincided with this messaging and a number of clinicians felt it may have led some parents to believe they should not attend hospitals, particularly for issues that parents perceived to be not absolutely urgent:…”

Section: Fear Of Covid-19mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Child Health and Well-Being: Are Children “Slipping through the Net”? A Qualitative Study of Frontline Emergency Care Staff

Conlon

McDonnell

Barrett

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

BackgroundThe COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system. MethodsFifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n=6), social workers (n=2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes. ResultsThe pandemic and public health restrictions have had an adverse impact on children’s health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care.Conclusions The spread of COVID-19 and subsequent polices to address the pandemic has had wide-reaching implications for children’s health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.

show abstract

Parental Hesitancy and Concerns around Accessing Paediatric Unscheduled Healthcare during COVID-19: A Cross-Sectional Survey

Cited by 41 publications

References 27 publications

The impact of the COVID-19 pandemic on child health and the provision of Care in Paediatric Emergency Departments: a qualitative study of frontline emergency care staff

The impact of the COVID-19 pandemic on child health and the provision of Care in Paediatric Emergency Departments: a qualitative study of frontline emergency care staff

Using ICD-10 Diagnostic Codes to Identify ‘Missing’ Paediatric Patients During Nationwide COVID-19 Lockdown in Oxfordshire, UK

The Impact of the COVID-19 Pandemic on Child Health and Well-Being: Are Children “Slipping through the Net”? A Qualitative Study of Frontline Emergency Care Staff

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