Magnitude and Factors Affecting Parental Stress and Effective Stress Management Strategies Among Family Members During COVID-19

Introduction

The COVID-19 epidemic has a devastating influence on people all across the world. It has been regarded as a global public health crisis that poses a threat to all elements of human life.^1–4 The first cases of a novel coronavirus with pneumonia symptoms associated with severe acute respiratory syndrome coronavirus-2, were reported in Wuhan, China.⁴ The virus causes severe respiratory disease in humans when it spreads from an animal source to humans.^5–8 People are infected with the deadly virus on a vast scale throughout the world. Many have perished as a result of their incapacity to fight it. As a result, the world health organization (WHO) declares a global pandemic on March 12th, 2020.^6–11

As of November 23, 2021, WHO had received 257,469,528 confirmed cases of COVID-19 with 5,158,211 fatalities. According to the most recent WHO figures, a total of 7,408,870,760 vaccine doses have been provided as of November 21, 2021.¹² Real-time reverse transcription–polymerase chain reaction assays, examination of upper and lower respiratory tract secretions, endotracheal secretions, and additional body fluid examinations such as blood, urine, and feces, and possible radio diagnostic examinations for the confirmation of viral load are used to diagnose virus-affected patients. All patients in life-threatening situations are admitted to intensive care units for immediate illness management and breathing support to ensure the patient’s survival.⁵

The viral spread is only controlled by isolating virus-infected patients, maintaining strict quarantine, and providing effective vaccination against the COVID-19 or Severe acute respiratory syndrome coronavirus-2 virus to stabilize morbidity and mortality on the occurrence of virus-related deaths. Many countries have successfully created numerous types of immunizations and implemented them, and they are still working hard to manage the COVID-19 pandemic.¹³

The WHO defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”.¹⁴ As per the WHO health definition or statement, people are failed in the maintenance of normal life in all aspects during the COVID-19 pandemic era. A wide range of factors are affecting families around the globe due to the increasing burden of COVID-19. Parents are the primary caregivers of their children and fulfill the day-to-day needs of them concurrently.¹⁵

The global pandemic constraints are bringing big challenges among parents and families by altering the regular activities of work or employment from the home, diminished economic status of the family, especially on maintenance of health, limited fulfilment of basic needs, closing of daycare centers especially who depend on them and burden of unemployment.^3,16 Besides, it has a burden in security jobs along with increased dependent family members, deviation to offline schooling modes through online platforms like whatsApp, Google meet or zoom web applications with minimized internet facility in remote areas, failure to manage or assist the children education from home, parent work load increased with children new educational patterns, diminished health status of the family members with sudden pandemic attacks, and house arrest due to complete or partial lockdowns.⁶ Moreover, fear of pandemic spread among the family members or community, failure of home quarantine due to minimized home environment, minimal or improper usage of personal protective equipment’s financial burdens, restricted personal social communication, diminished physical activity of the children, unusual verbal and physical abuse of the children by their parents, severe hetero aggressions among the families, and loneliness.³ Furthermore, isolation due to virus spread or outside quarantine practices, unfamiliar travel restrictions, minimal recreational activities, severe frustration on ongoing or uncertainty situation of pandemic conditions, failure to meet health demands of the family members by minimizing health resources during pandemic attack, failure to utilize health insurance services, unexpected deviations on mental health of family members by increased fear, anxiety, insomnia, severe stress, depression,⁴ self-blaming or injury, aggressive behavior, unintentional suicidal thoughts or tendencies,^3,6,16 increased alcohol and substance abuse or drug addictions,^3,17 sudden death of loved one in the family, mood disorders,¹⁸ and posttraumatic stress disorder/posttraumatic stress syndrome.^4,6 These all contributing factors are creating a severe pandemic burden among parents in all families since February 2020.^{1,6,10,11,17,19–25}

Magnitude of Parent Stress

The author recorded the magnitude of the parent’s stress in the form of a review of the literature for an easy understanding of each study. Each review is explained on title of the study. The different scales were used to assess parental stress during the studies.

The study highlighted immediate psychological responses and associated factors during the beginning phases of COVID-19 among 1210 respondents. The psychological impact of the study was assessed by the event scale-revised (IES-R), and mental health status was assessed by the depression, anxiety, and stress scale 21 (DASS-21). According to this study findings, 53.8% rated the psychological impact of the outbreak as moderate or severe. About 16.5% had moderate to severe depressive symptoms, 28.8% had moderate to severe anxiety symptoms, and 8.1% had moderate to severe stress levels.¹

The study identified substantial changes in parents with an increased level of anxiety and depressive mood. A minimized interpersonal communicative relation may show a burden on child caring and child neglect among family members as well as other dependents of the family members.²⁶ According to a report of a new study, the number of suicides in Canada connected with unemployment is expected to increase from 418 to 2114.⁶ In addition to this, a systematic review and meta-analysis of a mental health impact of COVID-19 depression outcomes across countries was found to be 21.39% of study participants which had clinically significant depressive symptoms.²³

A recent study on perceived stress as a mediator for longitudinal impacts of the COVID-19 lockdown on the well-being of parents and children found a significant change in parental negative feelings and over-reactivity during a COVID-19 pandemic with a total study sample of 106 parents. Parental stress was assessed using the perceived stress scale, which ranges from 0 to 4. Parental stress was found to be between 0 and 2.4 among parents.²⁶

A new study looked at the impact of autism spectrum disorder (ASD) on parents’ stress and emotional well-being during the COVID-19 pandemic using quantitative observations of 150 parents of children with ASD who had a substantial influence on parental stress and emotional well-being. In this study, 94% of parents were found to be stressed, and 78.7% of parents’ mental well-being was impaired during COVID-19.²⁷ Stress and parenting were identified as risk factors for child maltreatment during the global COVID-19 pandemic. The study’s findings revealed a greater level of perceived parental stress of 6.59%.²⁵

During a COVID19 pandemic, a research study found links between parental stress, parent mental health, and prevalence of unfavorable childhood experiences in families. According to the findings of a representative poll of 1024 parents, more than half of the parents feel anxious as a result of social isolation (56.1%), school closures (52.1%), and a shortage of childcare services (52.1%).¹⁵

Research evidence identified on the mediating effects of parental stress on harsh parenting and parent child relationship during COVID-19 pandemic parental stress among 258 members. The recognized mean parental stress was 2.40 with a standard deviation of 0.46 and a range was 2.50.²⁸ A study conducted on Italian parents among 463 members on stress, resilience, and well-being among Italian children and their parents during the COVID-19 pandemic. The study declared with the parents who are living with physical or psychological problems of children was under high parent stress scale scores as mean=42.3, standard error (SE)=1.74 when compared to parents who are living with healthy children with parent stress scale score of mean=36.6, SE=1.14.²⁹ A study conducted in Italy on the effect of COVID-19 lockdown on parents among 1126 parents of children who are suffering from mental or physical disorders are perceived severe stress and parental burden t¹¹²⁴ −2.70, p −0.001.³⁰

The research conducted in Canada on the examination of family mental health during COVID-19 reported that during the first lockdown period in Canada, 44.3% of parents of children below the age of 18 years who are living at home are identified with severe mental illness during the pandemic situation.³¹ The study regarding parental stress before COVID-19 revealed a mean score of 13.09 with SD of 4.61 and when compared to post COVID-19 mean score which was 13.49 with SD of 4.98.³² A study was conducted on parents’ stress and children’s psychological problems in families facing COVID-19 outbreak in Italy. This study was emphasized on parenting stress index mean was 22.01 with SD was 7.65 and also study analyzed regarding parental DASS mean was 29.57 with SD was 10.28.³³

The study was conducted on the parent stress level in facing children studied from home in the early of COVID-19 pandemic in Indonesia among 223 members. The findings of this study explored the stress levels of parents. From this, 75.34% of parents were experienced moderate stress of which, 71.88% of respondents were women who experienced high stress levels.¹⁹ A research study done on the vulnerability and resilience in children during the COVID‑19 pandemic among 29,202 parents of Hong Kong revealed that the identified parental stress mean was 46.74 with SD being 10.35.³⁴ The study identified that the detection rates of depression and anxiety in parents were 6.1% and 4.0%, respectively. The perceived stress levels of parents are higher in families with internal conflicts when compared with normal healthy families.³⁵

A study was reported among Americans, Asians, and Europeans using the chain mediation model to COVID‑19 symptoms and mental health outcomes with a cross-sectional research design among 4612 participants. The study instruments are the IES-R questionnaire and DASS-21. According to the findings, Poland and the Philippines had the highest levels of anxiety, depression, and stress, while Vietnam had the lowest mean scores in these areas. The overall scores with mean and SD were perceived psychological impact of COVID-19: mean ± SD (2.24 ± 1.27); DASS-21 stress: mean ± SD (1.75 ± 1.03); DASS-21 anxiety: mean ± SD (1.90 ± 1.36); DASS-21 depression: mean± SD (1.78 ± 1.21); physical symptoms resembling COVID-19 infection: mean ± SD (1.06 ± 1.43); the need for health information: mean ± SD (7.58 ± 3.42).¹⁰

The impact of the COVID-19 pandemic on Asians’ physical and mental health was investigated in a study among the 4479 respondents. A study was conducted on seven Asian middle-income countries. To assess mental health, the IES-R and DASS-21 were used. The respondents filled out a questionnaire with demographic information, physical symptoms, and healthcare utilization, contact history, knowledge, and concerns, and precautionary measures, as well as completing the IES-R and DASS-21 to rate their mental health. Protective and risk factors linked with mental health indicators were identified using descriptive statistics, one-way analysis of variance and linear regression. Between 7 middle income countries, there were significant differences in IES-R and DASS-21 scores (p < 0.05). Thailand received the highest IES-R and DASS-21 stress, anxiety, and depression levels while Vietnam received the lowest.²²

Factors Affecting Parental Stress

Many contributing factors are directly or indirectly causing increased parental stress during COVID-19 pandemic. There are different factors which were identified from the literature by addressing parental stress.

Parental Negative Feelings

The majority of the parents are identified with exhibiting negative feelings or psychological disturbances like depression, anxiety, frustration, confusion, over or hyper-reactivity, interpersonal sensitivity, irritability, and disturbed sleep.^4,15,25,26

Hetero Aggressions or Domestic Violence

A stressful environment of the family, increased family or domestic violence in the family during the pandemic crisis for various reasons such as failure to meet the demands of the dependent family members, unable to manage home-related activities with added work during the pandemic as homeschooling with work from home, complete house arrest of the children, unable to meet the primary needs of the children in time, misunderstandings among parents, siblings complications, home quarantine or isolation of infected people with limited home spacing’s are identified factors for the domestic violence during the pandemic era.^15,26,34,36

The Burden of Physically Challenged People

Several studies reported that parents are overburdened while caring for physically challenged people, especially autism spectrum disorder (ASD), and experience deficient emotional well-being with fluctuation of regular activities of the family, frustrations with child behaviors, unable to meet the demands of the children, intolerance with aggressive behavior of the children, more burden with single parenting child, minimized social supports during the pandemic.^27,30,35

Child Care Neglect or Maltreatment

During a pandemic, parents are exposed to internal and external stressing factors. In some families, it showed a contributing impact on child maltreatment and child neglect or abuse and harsh parenting.^25,36 Child maltreatment may be due to parental low education, single parenthood, economical problems causing poor parenting behavior towards child care and child maltreatment is identified more in families who are directly fighting with the deadly virus.^32,37

Increased Economic Burden

For human survival, financial support will play a crucial role in the day-to-day life of every family. Increased demand of economic burden in families was due to COVID-19 health risk, failure to meet free health care services during a pandemic, unable to obtain health insurance services from the health insurance agencies due to demand of the health burden to the population at the time, economic crisis to receive private organizational services due to high-cost medical services and with limited family economic supports, and failure to grab the job opportunity in this critical times.^{2,20,25,30,32}

Pandemic Related Stress

Pandemic related stress were due to sudden loss of family members, friends, relatives and colleagues, neighbors or family members identified with positive of the COVID-19 virus, stress with social distancing and limited social supports, home or hospital quarantine with social isolation, minimized social relations or communication, exposure to posttraumatic stress disorder during the critical times.^{4,15,33,38,39}

Loss of Employment

Many families lose their jobs during the pandemic era or receive of half-pay scale from the employer due to decreased financial sources from the institutions of the working agencies, which are additional added financial stress among the families. Moreover, job opportunities were minimized for the newly graduated students in the family. This led to a failure to meet the demands of the families as necessary needs of the day-to-day life of people in a society.^4,15,30,33

Altered Children Education

Sudden changes happened such as school closings and changes in the educational pattern of the children such as online mode delivery of the education system. Children are unable to cope with the changes in the educational pattern and sometimes unable to grasp the subject learning systems. Changes and difficulties in the pattern of public examination systems among children and adolescents, fear of viral contamination through school reopening, and final examination of children were the leading contributing factors for parental stress.^{1,2,4,30,33,40}

Minimized Education of Parents

With less educational level of the parents are unable to assist their children during the online class timing. Some parents are unable to understand the medium of the language which is delivered by the school teachers. This inability to complete school homework is found to be the additional burden of home-related work.^19,20,30

Cellular or Smartphone Addiction of the Children

Currently, all children are using smart mobile phones because of the online lecture deliveries. Sometimes children are misleaded towards online gaming, listening to songs from YouTube or watching videos, and engaging in whatsApp chatting with friends. Prolonging these activities may harm education concentration, which is a factor for parental stress.^34,36

Poor Parental Control of the Children

Some parents are burdened by increased home-related responsibilities and are unable to regulate their children’s activities, which can lead to misinformed behavior and full distraction from social connections with friends and other leisure activities. When children are suddenly exposed to the pandemic virus, some families are unable to care for them.^19,29,41

Diminished Psychological Well-Being

Suddenly, people have come across phobia with pandemic exposure. Social deviations among the population, minimized communication with familiar people, reduced recreational activities, pandemic isolation, loneliness, frustration with regular usage of face masks, or unable to manage the face mask with respiratory suffocations, moisture covering with a face mask if a person has eyeglasses, finance burden with continuous usage of personal protective equipment by low-income family members, and decreased quality of life of the people especially in vulnerable groups during pandemics are may be distractive factors for the low psychological well-being or mental health disturbances among the people.^{2,30,31,35,42,43}

Closing of Schools and Child Care Centers

For complete lockdown reasons, complete closure of children’s school and the primary child care centers are under complete resting position. By this, some parents are unable to manage their children at home with behavioral changes among the children, inability to manage conflicts between siblings, and difficulty to continue their official work from the home environments.^2,4,30,32

Health Crisis

The pandemic situation strongly affects the mental health of the people. Once in a family, anybody is affected by the virus and the health condition impacts the whole family. If the person is hospitalized in a family, it leads to an altered family process and all regular activities of the family are disturbed.³⁰ Some parents are addicted to substance abuse, increasing thoughts towards suicidal tendencies, and self-harming or self-abusing themselves because of the increased psychological burden on them.^4,31

Failure to Meet Coping Strategies

During pandemic lockdowns, all family members are sticking to home environments with limited home space, limited social communication, unable to meet relatives and friends, and failure to visit recreational areas such as shopping malls, visiting parks, movie theatres, and long driving with belongings.³⁶

Parental Separation from Children

Parents are separated from their children if the parents are infected with the virus. For prevention of cross-infection from parent to child, parents are under the control of self-isolation or in the quarantine process.^33,36

Increased Burden of Single Parenthood

Parents who are separated or divorced or living alone with children due to any circumstances are identified with more severe stress due to increased burden with domestic work, offline schooling, job-related work from home, and with minimized social supports, problems with siblings, and unable to compromise them, minimized financial burden, dependence of increased number of children’s, and handling of any situation alone by the single parents are undergoing severe stress during the pandemic conditions.^4,34

Emotional Disturbances

Emotional instability due to loneliness, inability to meet familiar coping mechanism skills of family members, and increased mental and physical health causes during the pandemics.^4,19,36

Deviation from Normal Life

Some parents depend on alcohol substances or drug addiction, especially by men. The increased suicidal thoughts or self-harm and self-abusing among people were due to the inability to control the terrific situations of the pandemic crisis.^4,31

Failure to Meet Health Emergencies

Vulnerable groups like children, aging people, and especially pregnant women were unable to receive emergency care immediately due to a lack of health care personnel and services, which may lead to decreased quality of people and may progress to high-risk cases during the pandemic era.⁴³

Stress Management Strategies

COVID-19 still influences some countries by different variants and dramatically influences health, economic, and social distractions. Due to the influence of this pandemic, people are frustrated around the world, especially highly influencing the increased burden on the parents by various contributing factors. Regular follow or maintenance of stress management strategies are keeping away of parents and other family members stress-free during pandemic vulnerability and sustained towards the healthy well-being.

Family Adherence to Positive Coping Skills

All family members should adopt to the inculcation of positive coping strategies and maintenance of supportive family environments, especially during the pandemic critical situation to prevent extreme stress among the family members.^25,36

Maintenance of Parent-Child Bonding

Parents should understand the current situation of the pandemic and should maintain positive parent-child bonds towards their beloved children and try to fulfill the primary needs of their children.^35,36

Expanding Communications

Following effective communication with peer groups while maintaining social distancing, people may relax and be free from pandemic stress and by sharing proper health information on COVID-19 preventive protocols.⁴⁴

Adequate Sleeping

Adequate sleeping practices induce physical and mental relaxation in this present situation. Maintenance of adequate sleeping practices among the family members will help to forget the fear of COVID-19 pandemic situation.^19,39

Follow-Up Regular Exercises

The performance of regular exercises will improve the physical and mental strength of the people. Regular performance of physical activity or exercise by family members during COVID-19 will provide positive energy and healthy lifestyle during the pandemic time.⁴⁵

Increasing Self-Care Practices

Self-care practices are essential to maintain the positive health of each individual in a family. Following and guiding self-care practices among family members during the pandemic time will help to maintain the body fitness of the people and away from the illness.³⁹

Increasing Quality of Life

Day by day, increasing the quality of life by focusing positive thoughts, self-reading, listening to music, spending time with family members, storytelling to the children, spending time with spirituality, and maintenance of physical fitness will progress towards the maintenance of the quality of people life during the pandemic era.^19,39

Minimizing Conflicts

By minimizing day-to-day life stress, anxiety, depression, and other negative feelings, people can maintain positive mental well-being. Minimizing interpersonal conflicts and trying to maintain healthy relations among people will improve the positive strength among people.²⁵

Obtaining Possible Social Support

During a partial or complete lockdown due to a pandemic, there is a gap between the maintenance of social communication. People can maintain social support from family members, friends, and neighbors by extending telecommunication, audio, or video calls, can share their feelings and droughts, and adjust with social supports as much as available during this time till the recovery period.³⁶

Equal Work Delegation

Adjusting the timing of home activities, managing domestic work among family members and professional work burden, and maintaining a good professional connectedness with family members, friends, and co-workers may minimize pandemic-related stress.³⁹

Increasing of Self-Awareness

Increasing self-awareness towards the pandemic situation, knowing the present family members’ health conditions, and may increase the effective communication with family as well as connect surrounding people to the know present pandemic awareness and follow preventive measures towards the deadly virus.³⁹

Obtaining Counseling Services

In a family, if any special needs exist, they should undergo counseling services to increase the optimal health and minimize confusion and choose a better possible option from the counseling services and increase the wellness of the family.¹⁹

Follow-Up Health Care Services

Pandemics brought health crisis among the world. Following health care services, if the need identifies or to support a dependent families, peoples will reduce the health burden during critical times.⁴⁶

Fulfilling the Basic Needs of the Family

Primarily understand the dependent family member’s conditions and their needs. Fulfilling the basic needs of the family members will improve the family’s well-being during pandemics.³¹

Performing Stress Reducing Activities

Following possible stress-reducing activities by all family members such as storytelling to the children’s, encouraging play activities by the children’s, engaging with subject matter, performance of dance activities, maintaining good time with the family, following yoga and meditation, and obtaining spiritual assistance among the family members, if possible watching television and knowing the situation of the pandemics by updating the current health information, and following laughing therapies by watching comedies could be the stress reducing activities.^36,47

Managing Financial Status of the Family

Effective managing of financial family needs by reducing unnecessary spending on shopping, identifying the available budget in a month and planning monthly spending, and identifying the financial burdens in the family and trying to adjust the family economic status are strategies to manage the financial status of the family.³¹

Utilizing Health Care Facilities

Health problems can be solved only by approaching the health care sector or undergoing proper health care services. Utilizing free health-related facilities if the need persists among families may assist the physical and financial burden during critical times.²⁵

Adopting a Positive Work Environment

This includes maintenance of a positive work environment at the working area as well as home environments, schedule work and minimize workload and focus on the comprehensive life among everyone, adapting resting hours by minimizing severe workload and stress, and seeking continuous health care support if the emergency persists.⁴⁸

Increasing Self-Confidence

Good progress will occur by increasing self-confidence in all activities, day by day improving adaptive coping and cognitive skills, adjusting for problem-solving behaviors, following strategies for improving family members’ health, and improving job satisfaction.³⁹

Assisting with the Peer Group

Sometimes peer support will help to reduce mental stress during a pandemic. Assist with peer support to remove the extreme barriers in all aspects of physical, mental, and social well-being of family members by sharing or exchanging ideas during pandemic phobia time.²⁵

Boosting Immunity Towards COVID-19

Utilizing the vaccination facilities to boost up the immunity and by following benefiting healthy tips like good nutrition support, vitamin-c supplements, drinking of hot water and minimizing respiratory infections, following isolation practices, support for medical emergencies, following individual relaxation techniques to minimize perceived stress, attending COVID-19 awareness programs, increasing of self-efficacy skills towards the prevention of the COVID-19, and ready for the self towards the upcoming problems.^31,32

Increasing Emotional Stability During a Pandemic

Increasing emotional stability towards uncertain events or upcoming challenges, increasing psychological well-being among sick people, and reducing anxiety levels with spiritual encouragement.⁴⁵

Assisting of Dependent Family Members

Family is very essential in the community. Some family members are dependent on a family for various reasons such as children with less age or adults with increased age and some dependent on health deviation situations. Physical aiding of dependent family members in fulfilling their needs, improving decision-making skills in any situation will progress a positive and healthy family in any difficult situation.³⁹

Adopting Independent Decision-Making Skills

Parents should be independent in any situation for proper handling of any critical situation such as physical, financial, and social problems. They should be ready enough to take a competent decision towards their family members during the tough times to save their family members during emergency lifesaving conditions.³⁰

Following COVID-19 Protocols

Without our negligence following the COVID-19 protocol, minimizing traveling activities to reduce the spread of infection and help to prevent health threats of pandemics, control or minimizing internal and external stressing factors, ready to engage in routine activities of day to day life for the better enhancement of life, following social distancing, avoidance of the mass gatherings, and following preventive measures towards the pandemic prevention.^19,45

Adopting Healthy Behaviors

Avoidance of harmful activities by people to support family members as alcohol dependency, cigarette smoking, and any ill-health behaviors.⁵¹

Ability to Manage the Child Behaviors

Childhood is a precious time for growing children. Assisting children’s routine activities as well as educational needs and minimizing the burden of digital technologies on children. During a pandemic, children are encouraged towards play and art activities along with education to prevent the burden and increase the interest of children towards the positive enhancement towards the surroundings of the children’s.^19,36

Away from the Illness Behaviors

Away from health illness behaviors such as alcohol consumption or drug addiction, self-harm, and self-abusing and prevent neglecting behavior towards family and friends and prevent health-related complications towards family members. Measures to take for the maintenance of physical health and prevention of the disease and improve the good health of the family members.⁵¹

Understanding Loss and Grief

Understand and cope and adjust to the loss of being loving or family members adopting to the optimist towards the upcoming life.⁵²

Focusing on the Future

Increasing the concentration towards present activities and not criticizing the present situation or to the people, increasing coping with upcoming challenges in the future, acquiring competent skills for the handling of current situations, and positive hope for the future, and focusing on overcoming life-threatening barriers.⁵¹

Following the Plan of Action

Create a plan of action for upcoming uncertain situations and effectively implement the plan of activities as well as maintain social distance from the onset of upcoming illness or health threats. The attempt to connect people through social networking and managing effective communication for the preservation of healthy human relations, raising awareness among family members about the spread of a deadly virus, and engaging in problem-solving strategies would best as an action plan.^51,53

Exposure to Frequent Recreational Activities

Listening to music for recreational activities, focusing on essential work, caring for being loving’s, and engaging in outdoor activities as gardening may be away from pandemic stress.^45,54

Focusing or Follow-Up Psychological Interventions

During a pandemic, many people undergo severe psychological burdens as fear, anxiety, depression, and suicidal thoughts. These groups are advised to undergo psychological interventions as mind-body relaxation techniques, psycho-education, psychological counseling, or the need to provide psychotherapies like cognitive behavior therapy and mindfulness-based cognitive therapy to overcome the mental health changes which are occurring during the pandemic. The cognitive behavior therapy services may be obtained through online platforms during difficult times also. These techniques may help people to combat the mental health conditions of people during pandemics.^11,55,56

Conclusion

Since the beginning of the year 2020 and until now, worldwide people are exposed to the unfamiliarity situation as not to wish to expose in the forthcoming years. The impact of COVID-19 drastically destroyed parental well-being through creating various stressing factors. The pandemic crisis explored the negative impact on the parents and their family members by deviating all normal day activities of family, community, society, etc. Till now, many countries are unable to fight the pandemic critically and parents are undergoing many intolerable situations, especially by low and middle-income family people. In these critical times, the governments of each country need to understand the parental stress and try to minimize the parental stress by assisting or implementing different parental needy activities. This could include providing financial assistance, extending facilities towards availability of free corporate health services on an emergency basis, and increasing pandemic awareness and preventing protocols among people. Parents and family members essentially know the stress management techniques during the pandemic, to be away from highly stressful conditions and may undergo psychological interventions, and to be competent to tackle any tough time effectively by minimizing stressors and increasing hope towards the upcoming future and trying to inculcate to build healthy families, communities, etc.