Factors associated with post-stroke fatigue among stroke survivors: a cross-sectional study

Post-stroke fatigue (PSF) is a common complication experienced by stroke survivors. These individuals often confront psychological challenges such as depression and anxiety, along with significant obstacles like reduced quality of life (QoL) and limitations in activities of daily living (ADLs). Such challenges can profoundly affect their overall recovery and well-being. Despite its prevalence, the associated factors contributing to PSF remain poorly understood. This study aims to primarily investigate these associated factors, while also examining the interrelationships among PSF, depression level, QoL, and ADLs, highlighting the need for a better understanding of these complex interactions.

This cross-sectional study involved 271 stroke survivors and was conducted at the Department of Neurology, Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, China, from September 2023 to January 2024. Participants independently completed the Fatigue Severity Scale (FSS), Patient Health Questionnaire-9 (PHQ-9), and the Short Version of the Stroke-Specific Quality of Life Scale (SV-SS-QoL) as part of a convenience sampling method, while medical professionals assessed the Barthel Index (BI) using the same sampling framework. Multivariable linear regression analyses were employed to determine the factors associated with the persistence of PSF.

The mean FSS score was 35.04 ± 11.60, while the average score for the SV-SS-QoL was 34.28 ± 9.51, and the BI score averaged 77.79 ± 25.90. Approximately 45.8% of participants (n = 124) experienced PSF. The mean score on the PHQ-9 was 7.63 ± 6.13. A significant negative correlation was identified between fatigue and both QoL and ADLs (P < 0.01). Furthermore, multiple linear regression analyses revealed that age, gender, income level, depression level, QoL, and ADLs were associated factors of fatigue severity among stroke survivors, all showing statistically significant differences (P < 0.01).

This study emphasizes the critical factors associated with PSF and highlights the necessity of developing targeted interventions, such as depression management, QoL enhancement, and ADLs restoration, to alleviate fatigue in stroke survivors. Future research should focus on evaluating the effectiveness of these interventions to optimize rehabilitation outcomes and improve survivors' overall recovery and well-being.