title: Exploring the experience of post-stroke fatigue in community dwelling stroke survivors: a prospective qualitative study.
abstract: OBJECTIVE
  To explore the experience of post-stroke fatigue in community-dwelling stroke survivors with and without post-stroke mood disturbance within one year of stroke.
  
  
  METHODS
  This was a prospective qualitative cohort study including semistructured interviews undertaken at baseline (stroke onset), 3, 6, 9 and 12 months in 23 stroke survivors; eight single interviews were held with "supplementary" participants. Qualitative data analysis involved an inductive thematic approach using a process of constant comparison.
  
  
  RESULTS
  Thirty-one participants (17 men, 14 women; age range 37-94 years) took part in 122 interviews. The majority of participants was independent and experienced few major depressive symptoms. Three trajectories emerged regarding the participants' experiences of fatigue including experience of fatigue, coping strategies and knowledge.
  
  
  CONCLUSIONS
  The results of this study suggest that in spite of reasonable objective physical recovery post-stroke, fatigue in community-dwelling stroke survivors may be disabling. The use of qualitative methodology was sensitive in identifying the factors that play a role in the experience of fatigue. The essential role of health professionals in this context is to provide support and education regarding fatigue and to promote participation after stroke in therapy programs. Routine practice for stroke services should include fatigue advice prior to discharge.
authors.affiliation: Hunter New England Area Health Service, Hunter Region Mail Centre, Newcaste, Australia. jennifer.white@hnehealth.nsw.gov.au
authors.forename: Jennifer Helen
authors.initials: JH
authors.lastname: White
authors.forename: Kimberley R
authors.initials: KR
authors.lastname: Gray
authors.forename: Parker
authors.initials: P
authors.lastname: Magin
authors.forename: John
authors.initials: J
authors.lastname: Attia
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sturm
authors.forename: Gregory
authors.initials: G
authors.lastname: Carter
authors.forename: Michael
authors.initials: M
authors.lastname: Pollack
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000209:etiology* / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology / Q000523:psychology*; D011446:Prospective Studies; D036301:Qualitative Research; D012111:Residence Characteristics; D012944:Social Support; D020521:Stroke / Q000150:complications* / Q000523:psychology*; D000071939:Stroke Rehabilitation; D017741:Survivors / Q000523:psychology*