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Available online 29 July 2022
Health-related quality of life in preadolescents before and during the lockdown
Calidad de vida relacionada con la salud en preadolescentes antes y durante el confinamiento
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Joaquín González-Cabreraa, Jessica Ortega-Baróna, Irene Montiela, Juan Manuel Machimbarrenab,
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a Facultad de Educación, Universidad Internacional de la Rioja (UNIR), Logroño, La Rioja, Spain
b Facultad de Psicología, Universidad del País Vasco (UPV/EHU), Donostia, País Vasco, Spain
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Dear Editor:

The state of alarm declared in Spain due to the coronavirus disease 2019 (COVID-19) pandemic lasted for 98 days, during which the Spanish population was under strict home confinement.

Health-related quality of life (HRQoL) is a widely studied construct in the literature that refers to a state of physical, mental, and social well-being.1 The objective of our study was to compare HRQoL in preadolescents in Spain before and during the COVID-19 lockdown.

We conducted a 2-wave longitudinal study (wave 1, December 2019; wave 2, lockdown period, at least 62 days after it began). The participants were 165 students (38.2% male) from year 6 of primary education to year 2 of compulsory secondary education (ESO in Spanish) enrolled in 5 schools in the regions of Aragón, Asturias and Castilla y León in Spain.

We used the KIDSCREEN-27.2 This version assesses 5 dimensions with 27 items. The reliability indicators were adequate.

We obtained consent for participation of the students, and the study was approved by the schools and the research ethics committee.

We found significant differences in physical well-being, with a substantial decrease during the lockdown (P < .001) during the lockdown. In contrast, scores for the autonomy and parents dimension increased during the lockdown (P < .001) (Table 1). We did not found significant differences based on sex or educational stage.

Table 1.

Repeated-measures ANOVA (before and during the lockdown) of HRQoL by sex and educational stage.

GroupTimeMean (SD)Effects
Time F2Group F2Interaction F2
Physical well-beingSexMaleBefore  52.45 (11.55)  23.51*** (0.14)1.37 (0.01)0.45 (0.00)
During  47.75 (6.81) 
FemaleBefore  50.30 (11.27) 
During  46.74 (7.34) 
StagePrimaryBefore  50.12 (11.68)  15.10*** (0.10)0.73 (0.01)0.36 (0.00)
During  47.37 (6.52) 
ESOBefore  51.48 (11.31) 
During  47.03 (7.38) 
Psychological well-beingSexMaleBefore  52.79 (13.85)  0.11 (0.00)2.86 (0.02)0.88 (0.01)
During  54.25 (12.81) 
FemaleBefore  50.72 (13.63) 
During  50.01 (12.15) 
StagePrimaryBefore  53.11 (12.71)  0.39 (0.00)0.94 (0.00)2.44 (0.02)
During  50.37 (11.49) 
ESOBefore  50.91 (14.06) 
During  52.07 (12.91) 
Autonomy and parentsSexMaleBefore  49.63 (11.54)  25.77*** (0.15)0.19 (0.01)1.46 (0.01)
During  53.80 (12.35) 
FemaleBefore  49.08 (11.50) 
During  55.85 (11.76) 
StagePrimaryBefore  51.01 (13.69)  18.78*** (0.11)0.64 (0.00)0.21 (0.01)
During  54.63 (11.68) 
ESOBefore  48.66 (10.55) 
During  55.09 (11.98) 
Peers and social supportSexMaleBefore  49.52 (12.95)  0.62 (0.00)0.19 (0.00)2.53 (0.02)
During  50.45 (11.88) 
FemaleBefore  52.06 (10.00) 
During  49.30 (12.76) 
StagePrimaryBefore  50.42 (13.47)  1.29 (0.01)0.53 (0.00)0.02 (0.00)
During  51.35 (10.33) 
ESOBefore  48.78 (13.76) 
During  50.09 (11.91) 
School EnvironmentSexMaleBefore  51.27 (11.37)  0.06 (0.00)2.47 (0.02)0.53 (0.00)
During  52.27 (12.00) 
FemaleBefore  54.52 (10.95) 
During  54.02 (11.08) 
StagePrimaryBefore  51.82 (11.99)  0.07 (0.00)0.77 (0.00)0.20 (0.00)
During  52.61 (13.74) 
ESOBefore  53.85 (10.85) 
During  53.63 (10.50) 

ESO, Spanish compulsory secondary education; SD, standard deviation.

***

P < .001.

The significant decrease in physical well-being could be expected given the restrictions to free movement and suspension of face-to-face classes and activities. This situation affecting a large portion of European children and adolescents was a major source of concern3 and should be taken into account in case of future total or partial lockdown situations.

When it comes to the significant increase in the autonomy and parents score, there are several possible explanations: 1) an adaptation to the pandemic through coping strategies4 that buffered the potential negative impact on HRQoL; 2) the time available to legal guardians and devoted to the children, which may have increased due to the confinement. According to the attachment and the self-expansion theories, when parents and children spend more time together, their mutual understanding and psychological well-being increase.

There are limitations to our study, including collection of data with a self-reporting instrument and the size of the sample, and therefore it should be considered merely exploratory. Nevertheless, the results show that in the case of future confinement, it would be important to provide access to outdoor recreational areas with implementation of COVID-19 prevention protocols (use of mask, implementation of staggered schedules and use of vaccination certificates, as applicable) to ensure physical well-being.

Funding

This study was funded by the Spanish Ministry of Economy, Industry and Competitiveness (project RTI2018-094212-B-I00, CIBER-AACC) and the International University of La Rioja (Cyberpsychology project, 2017-2020 and 2020-2022 trienniums).

Ethical considerations

The study was approved by the Research Ethics Committee of the International University of la Rioja (research project 004/2019).

References
[1]
J.L. Wallander, H.M. Koot.
Quality of life in children: a critical examination of concepts, approaches, issues, and future directions.
Clin Psychol Rev., 45 (2016), pp. 131-143
[2]
The Kidscreen Group Europe.
The Kidscreen questionnaires: quality of life questionnaires for children and adolescents: handbook.
3rd edition, Pabst Science Publishers, (2006), pp. 231
[3]
U. Ravens-Sieberer, A. Kaman, C. Otto, M. Erhart, J. Devine, R. Schlack.
Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents.
Eur Child Adolesc Psychiatry., (2021), pp. 1-23
[4]
J.H. Lee, M. Seo, M. Lee, S.Y. Park, J.H. Lee, S.M. Lee.
Profiles of coping strategies in resilient adolescents.
Psychol Rep., 120 (2017), pp. 49-69

Please cite this article as: González-Cabrera J, Ortega-Barón J, Montiel I, Machimbarrena JM. Calidad de vida relacionada con la salud en preadolescentes antes y durante el confinamiento. An Pediatr (Barc). 2022. https://doi.org/10.1016/j.anpedi.2022.01.003

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