Exploring The Views Of Stroke Survivors Around Post Stroke Fatigue In Saudi Arabia: A Qualitative Interview Study

Abstract

Background/Aims Among stroke survivors, post-stroke fatigue is highly prevalent, ranging from 25% to 85% and has a significant impact on their quality of life. The available literature on post-stroke fatigue is still rudimentary, especially from middle-eastern countries such as Saudi Arabia, which is a country with a complex health care system and diverse population. The aim of this study is to explore the post-stroke survivors' experiences and perceptions of their post-stroke fatigue. To our knowledge, this is the first attempt to understand post-stroke fatigue among stroke survivors living in Saudi Arabia. Methods This was a qualitative study where semi-structured interviews were conducted with stroke survivors who were diagnosed to have fatigue based on the Fatigue Severity Scale. A total of eight participants were recruited using a purposive sampling technique for the study. Interviews with the participants were recorded, transcribed verbatim and analysed using inductive thematic analysis. Validity was ensured through data triangulation with participants. Results The 8 participants (male=4; female=4), aged between 27 and 65 years (mean 52, standard deviation 14), were interviewed. Their scores on the Fatigue Severity Scale ranged from 4.5 to 6 (mean 5.3, standard deviation 0.5). On analysing the interview transcripts, 8 over-arching themes were generated: fatigue after stroke; symptomatology of post-stroke fatigue; pre-stroke fatigue levels and lifestyle; stroke survivors' perspectives of post-stroke fatigue; post-stroke fatigue's impact on daily living; coping with post-stroke fatigue; post-stroke fatigue patients' perception on physiotherapy; type of support from family and health care professional. Conclusions The results from this study highlights the lack of awareness about fatigue after stroke among stroke survivors. Also, the themes indicate that there is a need to educate stroke patients and their caregivers about post-stroke fatigue and how they should manage it. Based on patients ‘experiences’, physiotherapy seems to be helpful in reducing fatigue symptoms after stroke, but sill there is a need to design specific physiotherapy interventions with suitable frequency and intensity to target fatigue after stroke. In summary, post-stroke fatigue has a significant impact on their quality of life concerning social participation and their daily life. Stroke survivors did not receive enough support from health care professionals with respect to post-stroke fatigue, and it is highly essential to train health care practitioners to identify and acknowledge post-stroke fatigue appropriately.