Fatigue after stroke: manifestations and strategies

Abstract

Purpose: To describe how fatigue is experienced by stroke survivors, how they understand and deal with fatigue and how fatigue impacts their daily life. Method: A qualitative interview study was carried out as part of a larger longitudinal study investigating the prevalence, characteristics and contributing factors to post-stroke fatigue. Thirty-two participants (15 men and 17 women) were strategically sampled to explore the experiences of fatigue. Participants were interviewed at 6 months, 1 year and 2 years post-stroke. Data were analysed applying a Grounded theory approach. Results: Patients clearly described and differentiated their experience between: (1) tiredness as an ordinary life event and (2) fatigue as a post-stroke life condition. Three fatigue-transforming strategies were identified, being on a mission, settling for less and stalling. Stalling seemed to put the stroke survivors in a particularly vulnerable situation. Over time, some participants moved between these two tiredness/fatigue manifestations and their range of strategies. Conclusions: Post-stroke fatigue is a new life experience different from ordinary tiredness and seems to be a significant problem in the stroke survivors’ struggle to regain a new normalcy. Intervention studies are needed to reduce the impact of post-stroke fatigue on coping and recovery.

Implications for Rehabilitation

• Fatigue is a common experience following stroke that may have major impact on rehabilitation, coping and quality of life.

• The experienced impact of fatigue varies widely.

• Stroke survivors exhibit different coping approaches and strategies to manage the consequences of fatigue. For some, fatigue threatens their ability to cope.

• Tailored educational and support programs are needed to support fatigued stroke survivors at risk.

Keywords::

• Stroke
• fatigue
• stroke recovery
• qualitative method

Acknowledgements

We acknowledge the contribution of the stroke survivors sharing their experiences with us. We also acknowledge the Danish Research Fund, Aarhus University and Aarhus University Hospital for providing funding for the study and the leadership and professionals at Aarhus University hospital for assisting in recruiting participants to the study.

Declaration of interest:This study was founded by the Danish Research Council, Aarhus University and Aarhus University hospital.