An investigation of post-stroke fatigue levels and influencing factors in young and middle-aged stroke patients: a cross-sectional study

Abstract

There are few reported studies on post-stroke fatigue (PSF) in young and middle-aged stroke patients, however, PSF plays a key role in the patient's disease regression. Exploring the level of PSF and the influencing factors in young and middle-aged stroke patients is crucial for determining how to reduce the level of PSF and improve the patients' motivation for rehabilitation treatment. Therefore, this study investigated the level of PSF in young and middle-aged stroke patients and analyzed the factors influencing PSF to provide a reference or basis for healthcare professionals to develop effective and targeted PSF intervention programs. The purpose of this study was to investigate the incidence of fatigue and its related influencing factors in young and middle-aged stroke patients. A total of 300 young and middle-aged stroke patients hospitalized in the Neurology Department of a tertiary hospital in Xi'an, China, from June 13 to December 31, 2024 were consecutively recruited by convenience sampling method. According to the Fatigue Severity scale (FSS), the patients were divided into a fatigue group (FSS ≥ 36 points, 187 cases) and a non-fatigue group (FSS < 36 points, 113 cases). The general situation questionnaire, Modified Rankin Scale (mRS), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI) and Stroke Specific Quality of Life Scale (SS-QOL), Chronic Disease Self-efficacy Scale (CDSES) were used to investigate and study them. A logistic regression model was established and stratified analysis was conducted to explore the factors influencing PSF in young and middle-aged patients. The incidence of PSF among 300 young and middle-aged stroke patients was 62.3%, Univariate analysis showed that Pre-Stroke Fatigue (PrSF), mRS score, SAS score, SDS score, PSQI score, SS-QOL score, CDSES score, marital status and occupation were related to PSF (P < 0.05). Multivariate regression analysis revealed that marital status (OR = 8.908, 95%CI 1.776-44.674), PrSF( OR = 2.909, 95%CI 1.555-5.443), SDS score (OR = 1.099, 95%CI 1.046-1.154) and SS-QOL score (OR = 0.985, 95%CI 0.972-0.998) were associated with the occurrence of PSF. Stratified analysis showed that in the group of patients with PrSF, Be married (OR = 0.438, 95%CI 0.046-4.203), SDS score (OR = 1.052, 95%CI 0.965-1.146), SS-QOL score (OR = 0.960, 95%CI 0.937-0.984), among which the SS-QOL score was associated with the risk of PSF (P < 0.001); In the group of patients without PrSF, SDS score (OR = 1.086, 95%CI 1.033-1.142) was associated with a high risk of PSF (P < 0.001), Be married (OR = 0.060, 95% CI 0.007-0.490) and SS-QOL score (OR = 0.984, 95% CI 0.974-0.995) were associated with a low risk of PSF (P < 0.05). The fatigue status of young and middle-aged stroke patients is more serious. Clinically, we should strengthen the protection of high-risk patients with the above risk factors, and corresponding intervention programs should be formulated in time to reduce the incidence of PSF, alleviate the fatigue symptoms of patients, and enhance their quality of life.Trial registration: Registration number of China Clinical Trials Registration Center ChiCTR2500099037.

Keywords: Influencing factors; Post-stroke fatigue; Stroke; Young and middle-aged.

Fig. 1

Description of the participant screening process.