Poststroke Fatigue Adaptation Between Stroke Survivors and Care Partners: A Longitudinal Qualitative Analysis

Area of Science:

• Neurology
• Rehabilitation Medicine
• Psychology

Background:

• Poststroke fatigue significantly impacts stroke survivors' (SSs) physical and mental well-being.
• The role of care partners (CPs) in SSs' fatigue adaptation is acknowledged but under-explored.
• Existing literature lacks depth on the collaborative management of fatigue by SSs and CPs.

Purpose of the Study:

• To explore how SSs and CPs collaboratively managed fatigue within six months poststroke.
• To understand the dynamics of fatigue adaptation from the perspective of both stroke survivors and their care partners.
• To apply the Adaptive Leadership Framework for Chronic Illness to poststroke fatigue management.

Main Methods:

• Longitudinal qualitative analysis of interviews with nine first-time ischemic SSs and their CPs.
• Semistructured interviews conducted at multiple time points: hospitalization/discharge, 1, 3, and 6 months poststroke.
• Directed content analysis to identify themes in collaborative fatigue management.

Main Results:

• SSs and CPs initially achieved mutual understanding of fatigue, with some misalignment emerging between 3-6 months poststroke.
• CPs provided essential emotional and practical support, demonstrating adaptive leadership.
• A 'support squad' of informal and formal helpers also exhibited adaptive leadership, aiding adaptation for both SSs and CPs.
• SSs employed self-awareness, rest, and pacing for fatigue management, facing persistent daily challenges.

Conclusions:

• Developing a shared understanding of fatigue between SSs and CPs is essential for effective adaptation.
• Healthcare professionals should view SSs and CPs as an integrated unit for care.
• Ensuring access to support resources at discharge is critical for facilitating poststroke fatigue adaptation.