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

Poststroke fatigue severely affects stroke survivors (SSs) physically and mentally. Although the literature acknowledges the critical role of care partners (CPs) in survivors' fatigue adaptation, this topic remains under-explored. This study, guided by the Adaptive Leadership Framework for Chronic Illness, explored how SSs and CPs managed fatigue collaboratively within 6 months poststroke. This longitudinal qualitative analysis included nine first-time ischemic SSs and their CPs who consented to interviews. Semistructured interviews were conducted during the index hospitalization (or within 10 days postdischarge) and at 1, 3, and 6 months poststroke. Directed content analysis was used to analyze the data. Four themes were identified. First, SSs and CPs engaged in collaborative work by achieving a mutual understanding of fatigue levels but misalignment was found during 3-6 months poststroke. Second, CPs provided emotional and practical support, exercising adaptive leadership to help survivors adapt to fatigue. The support squad, including informal and formal helpers beyond the primary CPs, also undertook adaptive leadership behaviors to facilitate the post-stroke adaptation to fatigue for both SSs and CPs. Third, the day-to-day realities of post-stroke fatigue presented persistent challenges for SSs. Fourth, SSs managed fatigue (adaptive work) by using self-awareness, resting, and pacing activities. Results suggested the need for SSs and CPs to develop a shared understanding of fatigue. Healthcare professionals should treat SSs and CPs as an adaptive unit, ensuring access to support resources at discharge to facilitate post-stroke adaptation to fatigue.