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Stroke is the leading neurological cause of
adult long-term disability in Europe. Even though functional
consequences directly related to neurological impairment
are well studied, post-stroke trajectories of functional
health according to the International Classification of
Functioning, Disability and Health are poorly understood.
Particularly, no study investigated the relationship between
post-stroke trajectories of activities of daily living (ADL)
and self-rated health (SRH). However, such knowledge
is of major importance to identify patients at risk of
unfavourable courses. This prospective observational
study aims to investigate trajectories of ADL and SRH, and
their modifying factors in the course of the first year after
stroke.
Methods and analysis The study will consecutively enrol
300 patients admitted to a tertiary care hospital with acute
ischaemic stroke or transient ischaemic attack (TIA; Age,
Blood Pressure, Clinical Features, Duration of symptoms,
Diabetes score ≥3). Patient inclusion is planned from May
2021 to September 2022. All participants will complete
an interview assessing ADL, SRH, mental health, views
on ageing and resilience-related concepts. Participants
will be interviewed face-to-face 1–5 days post-stroke/
TIA in the hospital; and will be followed up after 6 weeks,
3 months, 6 months and 12 months via telephone. The
12-month follow-up will also include a neurological
assessment. Primary endpoints are ADL operationalised
by modified Rankin Scale scores and SRH. Secondary
outcomes are further measures of ADL, functional health,
physical activity, falls and fatigue. Views on ageing, social
support, resilience-related concepts, affect, frailty, illness
perceptions and loneliness will be examined as modifying
factors. Analyses will investigate the bidirectional
relationship between SRH and ADL using bivariate latent
change score models.
Ethics and dissemination The study has been approved
by the institutional review board of the University
Medicine Greifswald (Ref. BB 237/20). The results
will be disseminated through scientific publications,
conferences and media. Moreover, study results and
potential implications will be discussed with patient
representatives.
The COVID-19 pandemic is one of the most serious health and economic crises of the 21st century. From a psychological point of view, the COVID-19 pandemic and its consequences can be conceptualized as a multidimensional and potentially toxic stressor for mental health in the general population. This selective literature review provides an overview of longitudinal studies published until June 2021 that have investigated the impact of the COVID-19 pandemic on mental health in the European population. Risk and protective factors identified in the studies are summarized. Forty-two studies that met inclusion and search criteria (COVID-19, mental health, longitudinal, and Europe) in PubMed, PsycInfo, and Web of Science databases indicate differential effects of the pandemic on mental distress, depression, and anxiety, depending on samples and methods used. Age-specific (e.g., young age), social (e.g., female, ethnical minority, loneliness), as well as physical and mental health-related factors (e.g., pre-pandemic illness) were identified as risk factors for poor mental health. The studies point to several protective factors such as social support, higher cognitive ability, resilience, and self-efficacy. Increasing evidence supports the assumption of the pandemic being a multidimensional stressor on mental health, with some populations appearing more vulnerable than others, although inconsistencies arise. Whether the pandemic will lead to an increase in the prevalence of mental disorders is an open question. Further high-quality longitudinal and multi-national studies and meta-analyses are needed to draw the complete picture of the consequences of the pandemic on mental health.