Fatigue after stroke: frequency and effect on daily life

Abstract

Purpose: An audit was conducted to assess the frequency of fatigue after stroke, to determine the impact on daily life, and whether it was discussed with clinicians. Method: Patients were recruited from Nottingham University Hospitals NHS Trust stroke service. Patients were interviewed about their fatigue, and the Fatigue Severity Subscale (FSS-FAI), Brief Assessment Schedule for Depression Cards (BASDEC), Barthel Index and Nottingham Extended Activities of Daily Living (EADL) Scale were administered. Results: 64 patients were recruited, with a mean age 73.5 years (SD 14.0, range 37–94 years), 37 (58%) as in-patients and 27 (42%) as outpatients. There were 41 (64%) who reported significant levels of fatigue and 31 (48%) with significant fatigue on the Fatigue Severity Scale. Demographic and clinical variables were not significantly related to fatigue (p > 0.05), apart from gender, with women reporting significantly more fatigue than men (p = 0.006). There was a moderate correlation between the BASDEC and FSS (r_s = 0.41, p = 0.002). Of the 41 participants who reported fatigue, 33 (81%) had not discussed this with their clinician. Conclusions: Fatigue was a common problem after stroke. There was a lack of awareness in both patients and clinicians and little advice being given to patients with fatigue.

Implications for Rehabilitation

• Fatigue was reported to be a common problem in a group of patients recruited through a stroke service.

• Despite this, few patients had discussed fatigue with clinical team members, suggesting it is under-recognised.

• Rehabilitation staff need to be aware that patients may suffer from significant levels of fatigue which could affect their progress.

Keywords::

• Fatigue
• stroke
• depression
• risk

Acknowledgements

We would like to acknowledge the help of the staff on the stroke wards at the Nottingham University Hospitals NHS Trust.

Declaration of interest: The authors report no conflicts of interest.