Publication: Post stroke fatigue and its associated factors among stroke survivors in the second affiliated hospital of Guizhou University of traditional Chinese Medicine, China
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Date
2025-03
Authors
Yuan, Dong
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Abstract
Post stroke fatigue (PSF) is a common and debilitating condition among stroke
survivors, significantly affecting their quality of life (QoL), activities of daily living
(ADLs), and recovery outcomes. Despite its clinical importance, the proportion and
associated factors of PSF remain underexplored, particularly in young and middleaged
stroke survivors. This cross-sectional study aimed to assess the proportion of PSF
and its associated factors among 271 stroke survivors at the Second Affiliated Hospital
of Guizhou University of Traditional Chinese Medicine, conducted from September
2023 to January 2024, using a convenient sampling method. Participants were included
if they were aged 18 to less than 60 years, not bedridden, and had experienced a stroke
within 3 months, while those with severe cognitive dysfunction or life-threatening
comorbidities were excluded. Data were collected using validated instruments,
including a sociodemographic characteristics questionnaire, the Fatigue Severity Scale
(FSS), Short Version of the Stroke-Specific Quality of Life Scale (SV-SS-QoL),
Patient Health Questionnaire-9 (PHQ-9), and Barthel Index (BI), and analyzed using
SPSS version 29.0. The proportion of PSF among stroke survivors was 45.8%.
Univariate analysis identified significant factors associated with PSF, including age,
gender, income, education level, occupational status, living situation, depression, QoL,
and ADLs. Multivariate logistic regression confirmed that age, gender, income,
occupational status, depression, QoL, and ADLs were key factors. Middle-aged survivors (36–59 years) were 12.94 times more likely to experience fatigue compared
to younger survivors (18–35 years) (OR 12.94, 95% CI: 1.91–87.83), and female
survivors faced a 3.54 times higher risk of PSF compared to males (OR 3.54, 95% CI:
1.45–8.64). Depression significantly increased the likelihood of fatigue by 23% per
unit increase in the depression score (OR 1.23, 95% CI: 1.13–1.34), while protective
factors included higher income (OR 0.14, 95% CI: 0.04–0.53), stable occupational
status (OR 0.09, 95% CI: 0.02–0.44), better QoL (OR 0.81, 95% CI: 0.75–0.86), and
improved ADLs (OR 0.97, 95% CI: 0.95–0.98). The model demonstrated good
calibration (Hosmer-Lemeshow test, χ² = 3.85, P = 0.87) and an accuracy of 85.2%.
This study highlights the high proportion of PSF and its multifactorial associations in
young and middle-aged stroke survivors. Identifying high-risk groups, such as middleaged
individuals, females, and those with depression, is essential. Nurses can address
PSF by providing psychological support, enhancing QoL and ADLs, and promoting
income and occupational stability. These findings offer insights for developing
personalized rehabilitation programs to alleviate PSF and improve recovery outcomes.