Exploring post-stroke fatigue from the perspective of stroke survivors: what strategies help? A qualitative study.

Abstract

Post-stroke fatigue is a research priority for stroke survivors and health professionals but there is limited evidence to guide management. We aimed to explore (1) the experience of post-stroke fatigue from the perspective of stroke survivors and their caregivers and (2) fatigue management strategies that are used. This was a qualitative study using semi-structured interviews. People with self-reported post-stroke fatigue and caregivers were recruited using maximum variation sampling. Analysis was done via the framework approach. We recruited 17 stroke survivors, nine male (53%), most under 65 years (<i>n</i> = 12, 76%), and greater than 1-year post-stroke (<i>n</i> = 16, 94%, range 10-months to 22-years). One-third of participants self-reported having aphasia (<i>n</i> = 5, 36%). We also recruited eight caregivers, most of whom were female (<i>n</i> = 7, 88%). We identified four themes: (1) <i>fatigue is unexpected after stroke and symptoms vary</i>; (2) <i>the individual experience of fatigue is complex, influenced by multifactorial and biopsychosocial factors</i>; (3) <i>learning to adapt and accept fatigue</i>; and (4) <i>Strategies to manage fatigue and personal approaches to rest</i>. Post-stroke fatigue experience varies presenting cognitively, physically, and psychologically according to a complex interplay of biopsychosocial factors and personal triggers. Self-management strategies are individualised and include organisation, medications, lifestyle modifications, and peer support.