Brazilian children’s quality of life during the COVID-19 pandemic: analysis of contextual factors and dimensions

Mélo, Tainá Ribas; de Araujo, Luize Bueno; Signorelli, Marcos Claudio; Guimarães, Paulo Ricardo Bittencourt; Israel, Vera Lúcia

doi:10.1590/1984-0462/2025/43/2023175

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Brasil

Revista Paulista de Pediatria

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Original Article • Rev. paul. pediatr. 43 • 2025 • https://doi.org/10.1590/1984-0462/2025/43/2023175 copy

Brazilian children’s quality of life during the COVID-19 pandemic: analysis of contextual factors and dimensions

Qualidade de vida de crianças brasileiras durante a pandemia de COVID-19: análise de fatores e dimensões contextuais

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

The aim of this study was to investigate the contextual factors associated with the quality of life (QOL) of Brazilian children aged 0–12 years during the strict period of social isolation.

Methods:

This observational cross-sectional study was conducted between July and September 2020 using an online questionnaire on QOL-related family factors and the Pediatric Quality of Life Inventory (PedsQL™). Results were analyzed by multinomial logistic regression analysis.

Results:

The sample had 849 children, mostly from the South Region of Brazil (75%), white (83%), with typical development (79%), sedentary (68%), using screen (85%) for >3 h/day (44%). Their mothers were their main caregivers (90%). The following variables were significantly associated with high scores of QOL: typical health status (OR 2.38; 95%CI 1.60–3.55; screen time ≤2 h/day (OR 1.62; 95%CI 1.17–2.24); social distancing considered as “easy” (OR 1.67; 95%CI 1.20–2.32), and stimulation of the child by the family (OR 1.93; 95%CI 1.08–3.45).

Conclusions:

This study indicates that the family context can influence children’s QOL, especially during the COVID-19 pandemic and home environment reorganization.

Keywords:
Quality of life; Risk factors; Pandemics; COVID-19; Brazil; Children

	Age group (months/years)
	0–12 months	13–23 months	2–4 years	5–7 years	8–12 years	0–12 years
n	139	85	266	180	179	849
	n (%)
Media use	42 (30.2)	63 (64.1)	258 (97.0)	180 (100)	177 (98.9)	184 (59.9)
Type of screen^* *Percentages calculated based on the number of children who used media/were physically active;
Mobile phone	15 (35.7)	29 (46.0)	169 (65.5)	153 (85.0)	158 (89.3)	90 (48.9)
Tablet	4 (9.5)	10 (15.8)	88 (34.1)	71 (39.4)	57 (32.2)	27 (14.7)
Computer	0 (0.0)	6 (9.5)	31 (12.0)	66 (36.7)	124 (70.0)	13 (7.1)
Television	38 (90.5)	62 (98.4)	238 (92.3)	176 (97.8)	158 (89.3)	169 (91.8)
Videogame	0 (0.0)	0 (0.0)	17 (6.6)	48 (26.7)	75 (42.4)	1 (0.5)
Screen time^* *Percentages calculated based on the number of children who used media/were physically active; ,^† †Significant variables to the regression model.
Up to 30 minutes	14 (33.3)	5 (7.9)	8 (3.1)	3 (1.7)	2 (1.1)	22 (12.0)
Up to 1 hour/day	18 (28.6)	19 (30.2)	35 (13.6)	18 (10.0)	5 (2.8)	41 (22.3)
Up to 2 hour/day	11 (26.2)	13 (20.6)	53 (20.6)	25 (13.9)	21 (11.9)	44 (23.9)
Up to 3 hour/day	4 (9.5)	16 (25.4)	75 (29.1)	45 (25.0)	20 (11.3)	43 (23.4)
>3 hour/day	1 (2.4)	10 (15.9)	87 (33.7)	89 (49.4)	129 (72.9)	34 (18.5)
Stimulation-play^† †Significant variables to the regression model.	137 (98.6)	84 (98.8)	257 (96.6)	168 (93.3)	145 (81.0)	303 (98.7)
Paternal absence^† †Significant variables to the regression model.	18 (13.0)	10 (11.8)	26 (9.8)	31 (17.2)	36 (20.1)	121 (14.3)
Time fathers spent with the children (hour/day)	4±3	4±4	4±3	4±4	4±4	4±4
Attended daycare/school^† †Significant variables to the regression model. before the pandemic	6 (4.3)	39 (45.9)	227 (85.3)	179 (99.5)	175 (97.8)	626 (73.7)
Typical health status^† †Significant variables to the regression model.	125 (89.9)	71 (83.5)	216 (81.2)	134 (74.4)	125 (69.8)	669 (78.8)
Social distancing-easy^† †Significant variables to the regression model.	31 (22.3)	15 (17.7)	56 (21.1)	42 (23.3)	50 (27.9)	194 (22.9)

	Age group (months/years)
	0–12 months	13–23 months	2–4 years	5–7 years	8–12 years	0–12 years
n	139	85	266	180	179	849
	n (%)
Physically active	5 (3.6)	10 (11.8)	76 (28.6)	89 (49.4)	87 (48.6)	30 (9.8)
Frequency of PA^* *Percentages calculated based on the number of children who used media/were physically active. (x/week)
1	8 (80.0)	1 (10.0)	15 (19.7)	10 (11.2)	8 (9.2)	10 (33.3)
2	1 (20.0)	1 (10.0)	17 (22.4)	27 (30.3)	33 (37.9)	6 (20.0)
3	0 (0.0)	2 (20.0)	12 (15.8)	22 (24.7)	26 (29.9)	2 (6.7)
>3	0 (0.0)	6 (60.0)	31 (42.1)	30 (33.7)	20 (23.0)	12 (40.0)
Duration of PA^b
30 minutes	5 (100)	6 (60.0)	44 (57.9)	45 (50.6)	36 (41.4)	20 (66.7)
1 hours	0 (0.0)	3 (30.0)	14 (18.4)	34 (38.2)	33 (37.9)	6 (20.0)
>1 hours	0 (0.0)	1 (10.0)	18 (23.7)	10 (11.2)	18 (20.7)	4 (13.0)

Age group	Associated variables	Effect level	PedsQL™ score response level	Estimate	Standard error	Wald	p	OR	LL	UL
0–12 years	Paternal absence	No	High	0.44	0.22	3.92	0.05	1.56	1.00	2.42
	Health condition	Typical	High	0.87	0.20	18.11	<0.01	2.38	1.60	3.55
	Screen time	≤2 h/day	High	0.48	0.16	8.59	<0.01	1.62	1.17	2.24
	Stimulation at home	Yes	High	0.66	0.30	4.96	0.03	1.93	1.08	3.45
	Social distancing	Easy	High	0.51	0.17	9.26	<0.01	1.67	1.20	2.32
	Time fathers spent with the children	<3±3 h/day	Medium	-0.33	0.12	7.39	0.01	0.72	0.57	0.91
	Paternal absence	No	Medium	0.34	0.15	5.19	0.02	1.41	1.05	1.89
	Health condition	Typical	Medium	0.38	0.12	10.68	<0.01	1.46	1.16	1.84
	Stimulation at home	Yes	Medium	0.52	0.17	9.44	<0.01	1.68	1.21	2.34

Age group	Associated variables	Effect level	PedsQL™ score response level	Estimate	Standard error	Wald	p	OR	LL	UL
0–12 m	Attended daycare/school	No	High	–8.11	0.49	275.61	<0.01	0.0003	0.0001	0.0008
0–12 m	Screen time	≤2 h/day	High	–7.72	0.60	167.46	<0.01	0.0004	0.0001	0.0014
13–23 m	Householder	Father	High	1.76	0.34	26.78	<0.01	5.80	2.98	11.30
	Paternal age	>37±8 years	High	–10.71	0.48	490.74	<0.01	0.00002	0.00001	0.00006
	Time fathers spent with the children	<3±3 h/day	High	1.37	0.35	14.86	<0.01	3.92	1.96	7.86
	Maternal age	<37±7 years	High	–9.82	0.48	425.35	<0.01	0.00005	0.00002	0.00014
	Paternal absence	No	High	6.06	0.74	66.32	<0.01	430.31	99.97	1852.11
	Health condition	Typical	High	5.64	0.58	94.65	<0.01	282.41	90.60	880.32
	Attended daycare	No	High	3.96	0.32	150.72	<0.01	52.52	27.90	98.85
	Social distancing	Easy	High	1.99	0.48	16.92	<0.01	7.30	2.83	18.83
	Stimulation at home	Yes	Medium	2.15	837.19	0.00	<0.01	8.60	0.00	-
2–4 y	Health condition	Typical	High	1.09	0.41	6.90	0.01	2.97	1.32	6.69
	Screen time	≤2 h/day	High	7.34	0.49	220.48	<0.01	1534.77	582.77	4041.90
	Time fathers spent with the children	<3±3 h/day	Medium	–0.78	0.35	4.92	0.03	0.46	0.23	0.91
	Stimulation at home	Yes	Medium	1.09	0.49	5.05	0.02	2.98	1.15	7.72
5–7 y	Screen time	≤2 h/day	High	0.89	0.41	4.61	0.03	2.43	1.08	5.47
	Social distancing	Easy	High	0.91	0.39	5.28	0.02	2.47	1.14	5.35
	Health condition	Typical	Medium	0.46	0.22	4.30	0.04	1.58	1.03	2.43
8–12 y	Health condition	Typical	High	1.58	0.82	3.74	0.05	4.86	0.98	24.08
	Attended daycare/school	No	High	1.75	0.90	3.78	0.05	5.76	0.98	33.69
	Social distancing	Easy	Medium	0.55	0.26	4.60	0.03	1.73	1.05	2.85

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[1] *Corresponding author: E-mail: ribasmelo@ufpr.br (T. R. Mélo)