Child Care in Times of COVID-19: Predictors of Distress in Dutch Children and Parents When Re-entering Center-Based Child Care After a 2-Month Lockdown

As a consequence of the outbreak of the Coronavirus Disease 2019 (COVID-19) child care facilities all over the world were temporarily closed to minimize the spread of the virus. In Netherlands, the first closure lasted for almost 2 months. The return to the child care center after this significant interruption was expected to be challenging, because earlier studies demonstrated that transitions into child care can be stressful for both children and their parents. The current paper retrospectively examined the distress of Dutch children (aged 0–4) and their parents during the first 2 weeks after the reopening of child care centers, and what factors accounted for individual differences in distress. In total, 694 parents filled out an online questionnaire about stress during closure and distress after the reopening of child care centers. Furthermore, questions regarding several demographic variables and child care characteristics were included, as well as questionnaires measuring child temperament, parental separation anxiety, and parental perception of the child care quality. Results showed that younger children and children with parents scoring higher on separation anxiety experienced more distress after the reopening, as reported by parents. Furthermore, children were more distressed upon return when they attended the child care center for less hours per week after the reopening, experienced less stress during closure, and grew up in a one-parent family. With regard to parental distress after the reopening, we found that parents scoring higher on separation anxiety and fear of COVID-19 experienced more distress. Moreover, parents experiencing less stress during closure and mothers were more distressed when the child returned to the child care center. Finally, concurrent child and parental distress after reopening were positively related. The results of the current study may help professional caregivers to identify which children and parents benefit from extra support when children return to the child care center after an interruption. Especially the role that parental separation anxiety played in predicting both child and parental distress deserves attention. More research is required in order to study the underlying mechanisms of these associations and to design appropriate interventions.

Intranasal midazolam versus intranasal dexmedetomidine as premedication in paediatric patients: A comparative study

: Preanesthetic medication is important among the paediatric patients undergoing surgeries. A good preanesthetic medication reduces the anxiety and the post-operative pain among paediatric patients. A randomised controlled trial was done to compare the two groups of Dexmedetomidine, and Midazolam given as preanesthetic medication intranasally.: Both the groups had comparable baseline values before premedication but there was a significant difference in the vital parameters of heart rate and systolic blood pressure after medication. The mean Parental Separation Anxiety Scale was found to be 1.4 ± 0.85 and 2.5 ± 0.98 among Dexmedetomidine and Midazolam group respectively. This was found to be significant (p < 0.001). Dexmedetomidine when given as preanesthetic medication intranasally significantly controls the vitals within the normal range and produces better parental separation anxiety scores and mask acceptance scores as compared to Midazolam.

Comparison of Intranasal Dexmedetomidine and Oral Midazolam for Premedication in Pediatric Dental Patients under General Anesthesia: A Randomised Clinical Trial

The aim of this study was to compare the effects of preoperative intranasal dexmedetomidine and oral midazolam on preoperative sedation and postoperative agitation in pediatric dentistry. A total of 60 children (ASA grade I, aged 3–6 years) scheduled for elective pediatric dental treatment were randomly divided into the dexmedetomidine (DEX) and midazolam (MID) groups. Ramsay sedation score, parental separation anxiety scale, mask acceptance scale, pediatric anesthesia emergence delirium scale, and hemodynamic parameters were recorded. The Ramsay sedation scale and hemodynamic parameters of the children were observed and recorded immediately before administration and 10, 20, and 30 min after administration. A satisfactory mask acceptance scale rate was 93.33% in both MID and DEX groups, and there was no significant difference between the two groups (p>0.05). The proportions of children that “successfully separated from their parents” were 93.33% (MID) and 96.67% (DEX). No significant difference was found between the two groups (p>0.05). The incidence of agitation was 20% in the MID group and 0% in the DEX group, and the difference was statistically significant (p<0.05). Intranasal dexmedetomidine and oral midazolam provided satisfactory sedation. No significant difference between the two groups was found in terms of parental separation anxiety and mask acceptance (p>0.05). The incidence of postoperative pediatrics emergence delirium was significantly lower in the DEX group (p<0.05).

Development and Testing of a Scale to Measure Separation Anxiety of Parents of Adolescents

Separation anxiety as an experience of parents of adolescents remains underinvestigated. The purpose of this study was to develop an instrument to assess parental separation anxiety of mothers and fathers of adolescent sons and daughters, that is, the Parental Separation Anxiety Scale (PSAS). The Maternal Separation Anxiety Scale was adapted to address this purpose. Three studies were conducted to assess item performance, internal consistency and test–retest reliability, and construct and predictive validity. Internal consistency reliability ranged from 0.91 to 0.93 across samples. Factor analysis indicated four factors with a primary factor (70% of variance) that was consistent with attachment theory. Parental separation anxiety was negatively associated with global relationship quality (r = –0.23, p = .01). Maternal separation anxiety was negatively associated with cognitive autonomy of sons (r = –0.34, p = .05), while paternal separation anxiety was positively associated with cognitive autonomy of daughters (r = 0.20, p = .05). It was concluded that the final 18-item PSAS has good psychometric qualities and is appropriate for use with parents of chronically ill and healthy adolescents.