Stress and Self-Efficacy in Parents/Caregivers and Oral Health of Individuals with Down Syndrome During the COVID-19 Pandemic: A Cross-Sectional Study.

The family of individuals living with Down Syndrome (DS) often demonstrate high levels of stress associated with the demand for care and difficulties experienced in everyday life. The aim of this cross-sectional study was to assess perceived stress by parents/caregivers of individuals with DS and its association with general perceived self-efficacy and dental outcomes, considering the COVID-19 pandemic's impacts on family's daily activities and finances. A sample of 257 parents/caregivers answered a questionnaire with socioeconomic, dental, and behavioral variables and the short version of the Perceived Stress Scale and the General Perceived Self-Efficacy Scale. The sample was divided into three groups based on perceived stress levels. Associated variables were evaluated using multinomial logistic regression (level of significance 5%), adjusting for socioeconomic factors. The mean perceived stress score was 17.84 +/- 5.75 (0-39). Medium stress (second tertile) was associated with finger/nail biting in individuals with DS (OR = 2.05; 95%CI 1.04-4.03; p = 0.038), difficulty in performing oral hygiene (OR = 2.39; 95%CI 1.23-4.65; p = 0.011) and medium and high self-efficacy (OR = 0.12; 95%CI 0.05-0.31; p < 0.001 and OR = 0.38; 95%CI 0.15-0.98; p = 0.046, respectively); high stress (third tertile) was associated with medium and high self-efficacy (OR = 0.25; 95%CI 0.09-0.67; p = 0.006 and OR = 0.05; 95%CI 0.02-0.15; p < 0.001, respectively) and negative impact of COVID-19 in family finances (OR = 3.00; 95%CI 1.39-6.44; p = 0.005). It was concluded that parents/caregivers' perceived stress was averaged and associated with self-efficacy, finger/nail biting, oral hygiene demands, and the financial impact of COVID-19.