The impact on the mental health and well-being of unpaid carers affected by social distancing, self-isolation and shielding during the COVID 19 pandemic in England - a systematic review

ObjectiveThis study explores the impact of the COVID 19 lockdown measures on the mental health and well-being of unpaid carers, who make up the largest number of the carer population in England. Study designA systematic review research protocol was designed and used to conduct the review along with the Enhancing Transparency in Reporting the synthesis of Qualitative Research - ENTREQ statement [43]. Pre-determined inclusion and exclusion criteria were used. EndNote X9 reference management was used and the search process was represented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram [76]. Appraisal of the included research was carried out using the Critical Appraisal Skills Programme (CASP) [57]. Line by line coding was done using inductive thematic synthesis and EPPI Reviewer 4 software [60]. ResultsFour themes emerged; immediate worries or fears, adapting to change, post pandemic fears and use of technology. ConclusionThe measures put in place during the first lockdown period have had detrimental impacts on unpaid carers, putting them at greater risk of burnout. However, use of digital platforms could have a positive impact on well-being. Recommendations for further research are provided. What is new?O_ST_ABSKey findings?C_ST_ABSO_LIDiscontinued or reduced access to activities and services during the first lockdown during the pandemic has had a negative impact on both people who require care and their carers. C_LIO_LICarers prioritise the mental health and wellbeing needs of the people they care for over their own. C_LIO_LIFurther qualitative research from different groups of carers would be useful to gain a deeper understanding of the impact of the COVID 19 pandemic measures on unpaid carers. C_LIO_LIUse of digital technology and digital platforms may be useful tools for carers both during the pandemic and after. C_LI What this adds to what is known?O_LIThere have been very few qualitative studies on the impact of the COVID 19 pandemic on the mental health and wellbeing of unpaid carers, this review has synthesised their findings and will contribute to future research. C_LIO_LIUnpaid carers are known to be at risk of poor mental health and wellbeing outcomes, this review demonstrates that they are even more at risk due to the increased reliance on them during the pandemic. C_LI What is this implication and what should change?O_LIThere is limited qualitative data available from a range of different groups of carers for example, spouse carers, parent carers, carers of people who have specific needs or conditions. Therefore, purposeful sample research to determine the needs of groups of carers during the COVID 19 pandemic could be valuable. C_LIO_LIUnpaid carers who do not have appropriate support are more at risk of poor mental health and wellbeing outcomes. During the pandemic services have had to adapt to the various rules implemented. Digital adaptations to the provision of support to both carers and the people they care for could be beneficial both during and after the pandemic. C_LI