Exploring the experience of post-stroke fatigue in community dwelling stroke survivors: a prospective qualitative study

Abstract

Purpose: To explore the experience of post-stroke fatigue in community-dwelling stroke survivors with and without post-stroke mood disturbance within one year of stroke. Methods: This was a prospective qualitative cohort study including semistructured interviews undertaken at baseline (stroke onset), 3, 6, 9 and 12 months in 23 stroke survivors; eight single interviews were held with “supplementary” participants. Qualitative data analysis involved an inductive thematic approach using a process of constant comparison. Results: Thirty-one participants (17 men, 14 women; age range 37–94 years) took part in 122 interviews. The majority of participants was independent and experienced few major depressive symptoms. Three trajectories emerged regarding the participants’ experiences of fatigue including experience of fatigue, coping strategies and knowledge. Conclusions: The results of this study suggest that in spite of reasonable objective physical recovery post-stroke, fatigue in community-dwelling stroke survivors may be disabling. The use of qualitative methodology was sensitive in identifying the factors that play a role in the experience of fatigue. The essential role of health professionals in this context is to provide support and education regarding fatigue and to promote participation after stroke in therapy programs. Routine practice for stroke services should include fatigue advice prior to discharge.

Implications for Rehabilitation

• Issues regarding fatigue are of major importance to stroke survivors.

• Allied health can play a significant role in providing training regarding management of fatigue symptoms to assist maintain community participation.

• Allied health professions have an important role in assisting stroke survivors to transition through feelings of loss and in providing education concerning new skills to assist manage symptoms of fatigue post-stroke.

Keywords::

• Fatigue
• qualitative
• rehabilitation
• stroke
• stroke outcomes

Acknowledgments

This work was supported by grants from the John Hunter Hospital Charitable Trust. J.W. was the recipient of the Barker Scholarship. We thank all the participants in the study and the Hunter Stroke Service and the University of Newcastle who also supported the study.

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

Declaration of Interest: The authors report no conflict of interest.