Trends in changes of family functioning during different phases of the pandemic - findings across four population-based surveys between 2020 to 2023 in Germany.

Background: The COVID-19 pandemic and the associated measures have had a significant impact on millions of individuals and families worldwide. Although cross-sectional studies have demonstrated the considerable burden placed on families during the pandemic, trends over different phases of the pandemic including later stages and using population-based samples is scarce.

Objective: In this study, we aimed to assess trends in family functioning across four population-based surveys between December 2020 and March 2023 using a repeated cross-sectional design. The surveys were conducted using a similar sampling strategy and measures. We included individuals residing in a household with at least one minor below the age of 16.

Results: The most notable changes across surveys over time were related to quality of life. While 54.3% of respondents reported a decline in quality of life during the winter of 20/21 compared to pre-pandemic levels, this was observed in only 22.6% of participants during the spring of 23. The proportion of respondents who indicated a deterioration in their relations with their children also decreased during the pandemic. While 9.9% of respondents reported a deterioration in their relationship with their children during the winter of 20/21 in comparison to the initial phase of the pandemic, this was reported by only 5.2% in the spring 23. The relationship with one's partner and health status exhibited minimal fluctuations. Mental health problems were associated with a decline in quality of life, health status and relationships with children and partners compared to pre-pandemic levels at all time points. Moreover, lower income levels were associated with poorer relationship quality with the partner in the most recent wave.

Conclusions: Our findings demonstrate significant improvements in family functioning since the onset of the pandemic, indicating that individuals and families in our sample were generally adapting well. However, a subgroup of the population still reports suboptimal family functioning compared to before the pandemic. Psychosocial care and social policy support for families are needed.