INTRODUCTION:

The COVID-19 pandemic declared as a public health emergency of international concern by World Health Organization [WHO] on January 30, 2020 and later declared it as a pandemic in March 2020 is said to be truly one of the greatest collective health crises in the history which had altered the life and living of people across the globe irrespective of the nature and level of development of a country

The infection prevention and control guidelines issued by WHO such as mass quarantine, multiple lock-downs, home confinement, frequent hand-washing, social distancing to reduce the risk of transmission of the disease coupled with changing life style, long-term unemployment, economic challenges, closure of educational, religious, cultural, recreational activities, severe travel restrictions and limitations, uncertainty about the future had led many millions to a desperate state. ⁷

Reports till date indicate that the COVID-19 pandemic has negatively impacted mental health in the general population, while it has also been widely demonstrated that there are positive associations of mental resilience and well-being. ⁵ Upon examining 24 studies to review the psychological impact of quarantine, found that the negative effects of quarantine is wide-ranging, significant and long lasting. It was also found that it has not been easy for people to adapt with the ongoing post pandemic realities and warrants for further examination in the context of pandemic fatigue. ¹

NEED FOR THE STUDY:

The COVID-19 pandemic has played havoc on the healthy functioning of families. Numerous publications reveal that families suffered more negative consequences of the pandemic than the few positive impacts viz., cordial family relations and strengthening of family structure. Families were filled with the challenges of overcoming the ill effects of the pandemic collectively. Family members across all age groups were running the risk of contracting infection and faced challenges of their own disrupting the routine family functioning. The mitigation measures such as lockdown, closure of schools and public places, loss of freedom of movement, lack of employment and loss of income affected the family’s ability to endure, cope and bounce back.

It has been observed that when families face adversity, there is a deficit in the mental health of the family that skews their attention owing to the problem-saturated life-situation making it difficult for the family to identify and build on their resources and strengths.⁶

AIM OF THE STUDY:

A comparative cross-sectional study was done to assess and compare the levels of resilience among families faced with and without COVID-19 infection during the pandemic in selected rural areas of Tamil Nadu, South India.

MATERIALS AND METHODS:

The study was carried out in a selected rural area of a block in March 2024. The study employed a cross-sectional study design with systematic random sampling and studied a total of 17 families [7 families faced with and 10 families faced without COVID-19 infection] as a pilot testing. Families with loss of one or member were excluded from the study for ethical reasons. The data was collected by way of structured interview using Family Resilience Scale Short Form [FRS-16] to measure the level of resilience. The scale consisted of 16 items categorized under three elements - Family Communication and Connectedness, Positive Framing and External Resources/Support. Each item on the Likert Scale was scored on a four point grade ranging from Strongly Disagree, Disagree, Agree to Strongly Agree with scores of 1, 2, 3 and 4 respectively. The score ranged from 16-64. The higher the score indicates higher the levels of family resilience.

RESULTS

Table 1: Distribution of families faced with and without COVID-19 infection during the pandemic according to their socio-demographic variables. N = 17

Socio-demographic Variables

Number

Percentage

No. of families with Adults:

≥ 4

< 4

47.05

52.95

No. of families with Children:

≥ 2

< 2

Nil

11.76

47.05

41.19

Type of Family:

Nuclear

Joint

Extended

Nil

64.70

35.30

---

Religion:

Hindu

Muslim

Christian

Nil

100

---

Number of educated adult members in the family: [n=59]

Illiterate

Pre-graduation

Under-graduation

Post-graduation

25.42

38.98

30.52

5.08

Number of earning members in the family:

> 2

≤ 2

29.41

70.59

Socio-economic Status:

Upper Class

Upper-Middle Class

Middle Class

Lower-Middle Class

Lower Class

11.76

29.41

35.30

17.65

5.88

Table 1 shows that most (64.70%), (70.59%) families lived in nuclear and had ≤ 2 earning members respectively. All 100.0%) of them belonged to Hindu religion. About less than half the families (38.98%), (35.30%) had adult members with education at pre-graduation and belonged to middle class socio-economic group respectively.

Table 2: Distribution according to the clinical variables of families faced with COVID-19 infection during the pandemic N = 7

Clinical Variables	Number	Percentage
No. of family members affected with COVID-19 [n = 11]: Adults Children	11 Nil	100 ---
No. of family members quarantined at home [n = 11]	7	63.64
No. of family members admitted in hospital [n = 11]	2	18.18
No. of family members quarantined at home and admitted in hospital [n = 11]	2	18.18
Place of Diagnosis of COVID-19: Government Hospital [n = 11] Private Hospital Primary Health Centre	5 3 3	45.46 27.27 27.27
Place of Admission for COVID-19: Government Hospital [n = 4] Private Hospital Any Other	1 3 Nil	25.00 75.00 ----

Table 2 shows that 11 members in 7 families were affected with COVID-19 infection and all 11(100.0%) of them were adults. About less than half were diagnosed 5 (45.46%) in Government Hospital and an equal number 3 (27.27%) were diagnosed in Private Hospital and Primary Health Centre. Among those infected with COVID-19 infection, most of them 7(63.64%) were quarantined at home while an equal number 2 (18.18%) were quarantined and hospitalized and only hospitalized. Among those hospitalized, most of them 3(75.0%) were admitted in private hospital.

Table 3: Comparison of Mean and Standard Deviation related to different domains of Resilience of families faced with and without COVID-19 infection during the pandemic N = 17

Variable	Families faced with COVID-19 - infection		Families COVID-19 faced without infection		p-value
	Mean	Std. Deviation	Mean	Std. Deviation
Family Communication and Connectedness	29.14	2.27	26.4	3.03	0.06
Positive Framing	11.43	5.26	14.2	1.81	0.14
External Resources/Support	4.86	1.57	6.4	3.24	0.27

Table 3 reveals that there is no statistically significant difference in the various domains of Resilience between the families faced with and without COVID-19 infection

Figure 1: Overall Resilience of Families

Figure 1 shows that little more than half the 9 (53%) families had moderate resilience and 8 (47%) had high resilience. None of the families had low resilience.

DISCUSSION:

The purpose of this study was to assess and compare the level of resilience between families faced with and without COVID-19 infection during the pandemic. Within the different domains of family resilience, the study has brought out the findings that the mean of family communication and connectedness in families faced with COVID-19 (29.14) is slightly higher than the families faced without COVID-19. On the contrary, the mean of positive framing and external resources/ support is higher (14.2), (6.4) in families faced without COVID-19 infection as compared to the families faced with COVID-19 (11.43), (8.6) respectively ⁴. However, there has been no significant statistical difference in the mean between the families faced with and without COVID-19 infection. There have not been studies that have compared families but a study done in Arabic countries has revealed that the family communication has a partial effect on family resilience ³. A cross-sectional study done at a Medical College Hospital in Chennai, Tamil Nadu, South India portrays that a substantial percentage of women 138 (36.9%) and single individuals 124 (33.8%) exhibited significantly lower levels of resilience in comparison to men 77 (21.04%) and married individuals 91 (24.4%) (χ2 = 25.260, p < 0.001; χ2 = 14.027, p = 0.001) respectively ².

CONCLUSION:

The importance of health promotion in all dimensions of health, across life-span following COVID-19 pandemic has become imperative for health care professionals. Therefore, there is an underlying need for developing newer strategies in enhancing resilience among families thus empowering them for effective adaptation to adverse events.

LIMITATION:

The study was carried out on a small population; hence the findings could not be generalized.

ETHICS AND CONSENT:

Ethical clearance was obtained from the Institutional Review Board before the conduct of the study. A well-informed written consent was got from each participant before their participation. Pseudonyms were used to ensure anonymity and confidentiality. Adequate privacy was ensured while collecting information. Families requiring external support were referred for counseling services by a trained clinical social worker.

ACKNOWLEDGEMENTS:

We thank the Institutional Review Board for their approval and appreciate the enthusiastic participation of the participants for the successful completion of this study.

CONFLICT OF INTEREST:

There is no conflict of interest on the publication of this research paper.

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Received on 26.06.2024 Modified on 17.07.2024

Asian J. Nursing Education and Research. 2024;14(3):231-234.

DOI: 10.52711/2349-2996.2024.00046