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Increased Anxiety and Depression Symptoms in Post-Acute Care Patients with Stroke during the COVID-19 Pandemic

Hsiang‐Yun Chou, Yu‐Chun Lo, Ya-Wen Tsai, Chia-Li Shih, Chieh-Ting Yeh

2021International Journal of Environmental Research and Public Health14 citationsDOIOpen Access PDF

Abstract

This study aimed to explore the quality and stability of post-acute care for patients with stroke, including their functional outcomes, mental health and medical care in Taiwan during the COVID-19 pandemic. In this retrospective case–control study—based on propensity score matching—we assessed 11 patients admitted during the pandemic period (in 2021) and 11 patients admitted during the non-pandemic period (in 2020). Functional outcomes, including the scores of the modified Rankin Scale, Barthel Index, EuroQoL-5 Dimension, Lawton–Brody instrumental activities of daily living, Berg Balance Scale, 5-metre walking speed and 6-min walking distance, were determined. Data on the length of acute care, length of post-acute care, destination after discharge and 14-days readmission were used to evaluate the quality of medical care. The Wilcoxon signed-rank test was used to compare functional performance before and after rehabilitation. The pandemic group showed no significant improvement in the scores of EuroQoL-5 Dimension, a self-reported health status assessment (p = 0.13), with the anxiety or depression dimension showing a negative effect (r = 0.21). Post-acute care programmes can efficiently improve the functional performance of patients with stroke during the COVID-19 pandemic in Taiwan. Mental health should therefore be simultaneously maintained while rehabilitating physical function.

Topics & Concepts

MedicinePandemicAnxietyDepression (economics)Quality of life (healthcare)Hospital Anxiety and Depression ScaleModified Rankin ScalePropensity score matchingActivities of daily livingPhysical therapyRehabilitationStroke (engine)Mental healthEmergency medicineCoronavirus disease 2019 (COVID-19)PsychiatryInternal medicineDiseaseNursingEconomicsMechanical engineeringInfectious disease (medical specialty)Ischemic strokeIschemiaEngineeringMacroeconomicsStroke Rehabilitation and RecoveryLong-Term Effects of COVID-19COVID-19 and healthcare impacts