Physical impairment, depressive symptoms and pre-stroke fatigue are related to fatigue in the acute phase after stroke

Abstract

Purpose. The aim of this study was to describe prevalence of fatigue and its relationship with demographic and clinical variables during the first 2 weeks (acute phase) following a stroke.

Method. Data were collected in a cross-sectional correlational study from face-to-face interviews using structured questionnaires and patient's medical records. The sample consists of 115 patients with first-ever stroke admitted to two hospitals in Norway in 2007 and 2008. Post-stroke fatigue was measured with the Fatigue Severity Scale (FSS). The FSS measure was applied in the analysis as a continuous variable, and also used to categorise patients into three groups of fatigue intensity: no fatigue (mean FSS-score <4), moderate fatigue (mean FSS-score = 4–4.9) and severe fatigue (mean FSS-score ≥5). Patients who reported fatigue lasting longer than 3 months before the stroke were defined as having prestroke fatigue.

Results. Pre-stroke fatigue was reported by 34 patients (30%). After stroke, 24% had severe fatigue, and fatigue was more common for women (57%). Controlling for sex and prestroke fatigue, the multivariate analysis showed that prestroke fatigue, lower physical function and depressive symptoms were related to post-stroke fatigue.

Conclusion. Pre-stroke fatigue and fatigue during the acute phase needs to be assessed in relation to physical functioning and depression during recovery and the rehabilitation process.

Keywords:

• Fatigue
• quality of life
• stroke
• physical impairment
• depression
• activity of daily living

Declaration of interest: The Research Council of Norway (Grant: 176503) and Buskerud University College, Drammen, Norway has funded this research. This paper is a product stemming from the research project: Post-stroke Fatigue for which Dr. Hesook Suzie Kim is the project director and Drs. Grethe Eilertsen, Anners Lerdal, and Heidi Ormstad are the principal researchers. This project is funded by the Research Council of Norway (RCN) and Buskerud University College for 2006 to 2010. We acknowledge the support and assistance provided by Research Assistant Gunn Pedersen and various staff members of Buskerud Hospital Trust in Drammen and Oslo University Hospital – Aker in Oslo, Norway in carrying out this research project. AL has received funding from the RCN (Grant no. 19256), the Norwegian Nurses Organisation and the U.S.–Norway Fulbright Foundation.