International Journal of Medicine and Health Development

ORIGINAL ARTICLE
Year
: 2023  |  Volume : 28  |  Issue : 1  |  Page : 19--24

Assessment of resilience in the second wave of the COVID-19 pandemic: A snapshot of experiences of adolescents secondary school children in southeast Nigeria


Awoere T Chinawa1, Edmund N Ossai2, Ann E Aronu3, Josephat M Chinawa3,  
1 Enugu State University Teaching Hospital, Enugu State, Nigeria
2 Department of Community Medicine, College of Health Sciences, Ebonyi State University, Abakaliki, Nigeria
3 Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus, Enugu State, Nigeria

Correspondence Address:
Josephat M Chinawa
Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus, Enugu State
Nigeria

Abstract

Background: The second wave of the COVID-19 pandemic has created much psychological burden on the adolescent child. Resilience is an intertwine of risk and protective factors that may help the adolescent child in growth and development. Objectives: This study aimed to determine the factors that influence resilience among adolescents attending secondary schools in southeast Nigeria. Materials and Methods: This is a cross-sectional study of 496 adolescent students who attend six secondary schools in Enugu city. Results: The majority of the respondents, 79.4%, feel safe when they are with their families. A high proportion of the respondents, 61.5%, were resilient. A comparable proportions of male (59.9%) and female (62.9%) respondents were resilient. (χ2=0.476, P = 0.490). A significantly higher proportion of respondents who were in junior secondary three class, 70.5%, were resilient when compared with those in senior secondary three class, 59.4% (χ2=4.050, P = 0.044). The highest proportion of respondents who had strong social support, 75.8%, were resilient, whereas those who had poor social support were the least, 36.6%. The observed difference was statistically significant (χ2=39.995, P < 0.001). The respondents who had poor social support were about six times less likely to be resilient when compared with those who had strong social support [adjusted odds ratio (AOR)=0.177, 95% confidence interval (CI): 0.099–0.317]. Also, the respondents who had moderate social support were about three times less likely to be resilient when compared with those who had strong social support (AOR=0.369, 95%CI: 0.261–0.601). Conclusion: Resilience in adolescents is enhanced by education, being in junior secondary class, good family structure, and strong social support.



How to cite this article:
Chinawa AT, Ossai EN, Aronu AE, Chinawa JM. Assessment of resilience in the second wave of the COVID-19 pandemic: A snapshot of experiences of adolescents secondary school children in southeast Nigeria.Int J Med Health Dev 2023;28:19-24


How to cite this URL:
Chinawa AT, Ossai EN, Aronu AE, Chinawa JM. Assessment of resilience in the second wave of the COVID-19 pandemic: A snapshot of experiences of adolescents secondary school children in southeast Nigeria. Int J Med Health Dev [serial online] 2023 [cited 2023 Feb 9 ];28:19-24
Available from: https://www.ijmhdev.com/text.asp?2023/28/1/19/363250


Full Text



 Introduction



The COVID-19 pandemic has afflicted people all over the world, and the adolescent child is not exempted.[1] The adolescent child is encompassed with lots of challenges in their health and education as well as their interaction with their family members and the society at large.[2] The harmful effects of the pandemic could cause stressors and evoke psychological distress among them.[2] Besides, the preventive measures of lockdown and school closures could also negatively affect their well-being and quality of life.[3],[4] Studies on previous pandemics and other traumatic events have shown that higher levels of distress or fear after a traumatic event could cause higher odds of psychological maladjustment.[5] This could also evoke long-term development of resilience among the adolescent child.[6]

Resilience is the ability to adapt to trauma, crisis, or stress positively while remaining in a good state of health.[7] It is a good shield in modulating the harm done by internalizing and externalizing difficulties.[8] Resilience is a very good preventive mechanism for behavioral and emotional stress during this COVID era, in which mortality and morbidity are on the rise.

Adolescents are prone to several psychological, emotional, and behavioral disorders and the pandemic could worsen this. The COVID-19 pandemic is a harbinger of several stressors that could arise from the virus itself and its effects on the adolescent’s social well-being. Several resilience factors could positively enhance the well-being of the adolescent child in the COVID 19 pandemic and could buffer the effects of the numerous life changes and the “new-normal” caused by COVID-19. This study aimed to determine the factors that promote resilience among adolescents attending secondary schools in southeast Nigeria. This is the first time this work has been done in this local. It will go a long way to educate mental health professionals, public health physicians, and adolescent pediatricians on the need to design some services that will focus on adolescents’ mental health and well-being in the COVID-19 era.

 Materials and Methods



Study area/study design

This study was undertaken in six secondary schools drawn in Enugu city. This was a cross-sectional study among adolescent students who attended secondary schools in Enugu city.

Study population

This consists of the consecutive enrollment of 496 adolescents who attended 6 secondary schools in Enugu.

Inclusion criteria

Adolescents who gave consent were enrolled in the study.

Exclusion criteria

Adolescents who had a suspected history of any psychiatric illness were excluded from the study.

Ethics approval and consent to participate

Approval was obtained from the Ethics and Research Committee, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria (UNTH/NHREC/ 05/01/2008B-FWA00002458-1RB00002323). Written informed consent was obtained from each of the research participants.

Sample size estimation

To achieve 5% precision at a 95% confidence interval (CI) for a population of >100,000, a minimum sample size of 400 was determined from Glenn’s table of sample sizes necessary for given combinations of precision, confidence level, and variability for different population sizes. However, a sample size of 496 was used to make the study more robust and fill in the gaps where adolescents did not fill the questionnaire properly or opted out.

Data analysis

Data entry and analysis were done using IBM Statistical Package for Social Sciences (SPSS) version 25. Categorical variables were summarized using frequencies and proportions, whereas continuous variables were summarized using mean and standard deviation. A χ2 test of statistical significance and multivariate analysis using binary logistic regression were used in the analysis. A P-value of less than 0.05 determined the level of statistical significance. In determining the predictors of resilience among the respondents, variables with a P-value of less than 0.2 on the bivariate analysis were included in the logistic regression model. The logistic regression analysis results were reported using an adjusted odds ratio (AOR) and 95% CI, and the level of statistical significance was determined by a P-value of less than 0.05.

The resilience of respondents was assessed using the Child and Youth Resilience Measure (CYRM-12) (12 items).[8] This consists of 12 variables with a 5-point Likert scale that included 1=Not at all, 2=A little, 3=Sometimes, 4=Quite a bit, and 5=A lot. The total score of each respondent to 12 variables was calculated, and the entire respondents’ mean score was obtained. (The mean score was 51.6 ± 6.7.) Respondents who scored above the mean score were regarded as being resilient, whereas those who scored the mean score and below were classified as not resilient.

The socio-economic class of the parents of the respondents was determined by Oyedeji.[9]

 Results



The mean age of the respondents was 16.5 ± 1.9 years and a majority of the respondents, 78.6%, were in the age group of 15–19 years. Majority, 52.2%, were females. A higher proportion, 80.8%, were in senior secondary three class.

[Table 1] shows responses to the respondents’ CYRM-12. The majority of the respondents, 85.3%, consider education as being of a lot of importance to them. A higher proportion of the respondents, 71.8%, were of the opinion that their families stand by them during difficult times. Also, majority of the respondents, 79.4%, feel safe when they are with their families.{Table 1}

[Table 2] shows the prevalence of resilience among the respondents. The mean resilience score for the respondents was 51.6 ± 6.7. A higher proportion of the respondents, 61.5%, were resilient, whereas 38.5% were not resilient.{Table 2}

[Table 3] shows the factors associated with resilience among the respondents. A comparable proportion of respondents who were males, 59.9%, were resilient when compared with females, 62.9% (χ2=0.476, P = 0.490). A significantly higher proportion of respondents who were in junior secondary three class, 70.5%, were resilient when compared with those in senior secondary three class, 59.4% (χ2=4.050, P = 0.044). The highest proportion of respondents who had strong social support, 75.8%, were resilient, whereas those who had poor social support were the least, 36.6%, and the difference in proportions was found to be statistically significant (χ2=39.995, P < 0.001).{Table 3}

[Table 4] shows the predictors of resilience among the respondents. The respondents who had poor social support were about six times less likely to be resilient when compared with those who had strong social support (AOR=0.177, 95% CI: 0.099–0.317). Also, the respondents who had moderate social support were about three times less likely to be resilient when compared with those who had strong social support (AOR=0.369, 95% CI: 0.261–0.601).{Table 4}

 Discussion



This work sought to determine factors that promote resilience against the COVID-19 pandemic among adolescents attending secondary schools in southeast Nigeria. A higher proportion of the adolescents, 61.5%, had resilience against the COVID-19 pandemic. This finding was higher than that seen in the study of Morales-Rodríguez[10] who noted a lower prevalence among Spanish university students. Their study was conducted at the peak of the COVID-19 pandemic, which could explain the difference in prevalence rates.

Although many adolescents may experience different degrees of mental health outcomes when exposed to a traumatic event, resilience is seen as an important factor that determines such difference. Resilience is a dynamic process that confers a positive adaptation in the wake of significant adversity.[11] Studies on meta-analysis have shown that resilience protects mental health, improves recovery, and cushions the negative effects of a disaster such as the COVID-19 pandemic.[10],[11],[12] This assertion was buttressed by Tugade et al.[13] and Patel and Goodman,[14] whose reportage on the concept of resilience in the wake of the pandemic was noted as a pill that preserves mental health in the face of adversity.[15],[16]

The majority of the college adolescents in this study consider education an important promoter of resilience. Closure of schools was one of the measures to prevent the spread of COVID-19 among adolescents in secondary schools.[17] Nevertheless, prolonged closure of schools will be deleterious to the students.[17] School closures have the potential to diminish the opportunities for students to be educated on issues concerning COVID-19. Education is a potent weapon that makes the adolescent child uniquely positioned to build capacity and enact systemic resilience. In times of adversity, education showcases high public value, informs populations at large, and has the potential to strengthen the adolescents.[17]

Furthermore, a higher proportion of the adolescents believed that their families stand by them during difficult times, which also enhances resilience against the COVID-19 pandemic. Also, the majority of the adolescents noted that their resilience is enhanced when they are with their families.

Social support from friends promote resilience among the adolescent child. Besides, several studies have corroborated the findings above, not only in COVID-19 pandemic but also in various traumatic circumstances.[18],[19],[20]

Family functioning is a protective factor against mental health disorders and is associated with lower stress and better feelings of meaning in life. In the wake of the COVID-19 pandemic, family functioning is very crucial as many families spend time together due to preventative policies like social distancing.[21],[22],[23],[24],[25]

Male adolescents were more resilient than their female counterparts, though this was not statistically significant. Furthermore, a significantly higher proportion of adolescents in junior secondary three class were resilient compared with those in senior secondary three class. The highest proportion of respondents who had strong social support were resilient, whereas those with poor social support were the least.

Broderick and Constance[26] noted that female students were more resilient than their male folks. The female students were also noted to report more positive bonding with their parents, peers, and community than male students. It is important to note that girls have a positive level of social and emotional development and a higher level of caring from parents and relations.[27] Female adolescents also tend to enjoy mutually empathetic relationships with their parents more than their male counterparts.[27]

The fact that junior adolescent children were more resilient than their secondary folks indicate that younger adolescent school students had protective factors. For instance, a study has shown that students in junior secondary school had a significant level of communication, school support, and empathy than their secondary school folk.[28] Younger adolescent students’ coping strategies develop in the early years of primary school and decrease as they progress to secondary school.[28] In developing resilience during early adolescence, it is important to note that adolescence involves the transition of bodily changes (puberty), mental abilities, and social relationships.[29] Besides, early adolescence is a period in which introspection takes preeminence. Thus, there are changes in the evaluation of self and other areas of social experiences.[30],[31],[32],[33]

The study showed that the adolescent child who had poor social support were about six times less likely to be resilient when compared to those who had strong social support. Besides, the adolescent child who had moderate social support were about three times less likely to be resilient when compared to those who had strong social support. Studies have shown that positive social support enhances resilience to stress and protects against trauma-related psychological distress and reduces medical morbidity and mortality.[34],[35]

Literature has shown that social support especially from the family can significantly improve the resilience and well-being of college students.[34],[35] Fletcher and Sarkar[15] also noted that people with a high level of social support compensate for the low levels of resilience in mental health during the COVID-19 pandemic.

 Conclusion



A good number of adolescents were resilient and this was enhanced by education, being in junior secondary class, good family structure, and strong social support.

Recommendation

Identification of factors associated with resilience among secondary school adolescents is very important in developing mental health programs in adolescents.

Limitation

A study on this topic across various states would improve the outcome of this study.

Acknowledgement

We acknowledge Clara for helping in data management.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Authors’ contributions

ATA and JMC, AEA and ENO conceived and designed this study, while ENO helped in critical revision and data analysis/interpretation. All authors have read and approved the manuscript.

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