Prevalence,Influencing Factors Of Post Stroke Fatigue And Impact On Quality Of Life In Patients With Ischemic Stroke

ObjectivesWe conducted a cross-sectional study to investigate the post-stroke fatigue and quality of life in patients with ischemic stroke;We aimed to analyze the influencing factors of post-stroke fatigue from the aspects of demography,disease characteristics,accompanying symptoms,psychological and social factors;to explore the effect of post-stroke fatigue on quality of life,and to provide empirical basis for further understanding and management of this symptom,so as to improve the quality of life of stroke patients by reducing fatigue level.MethodsWe recruited 454 patients with ischemic stroke admitted to neurosurgery department of two tertiary hospitals from May 2018 to November 2018 in Jinan,Shandong Province.Post-stroke fatigue was assessed with the Fatigue Severity Scale(FSS),Barthel Index(BI),Pittsburgh Sleep Quality Index(PSQI),Patient Health Questionnaire(PHQ-9),Chronic Disease Self-Efficacy Scale(CDSES),Medical Outc01omes Study Social Support Survey(MOS-SSS)and Stroke Specific Quality of Life Scale(SSQOL).Other information included demographic and clinical characteristics.Data were analyzed using SPSS21.0(1)Mean,standard deviation and composition ratio were used for statistical description;(2)t-test and chi-square test were used for univariate analysis of post-stroke fatigue;(3)Logistic regression was used to analyze the risk factors of post-stroke fatigue,and multiple linear regression was used to analyze the impact of post-stroke fatigue on quality of life.Results1.Among the 454 ischemic stroke patients,193 patients developed post-stroke fatigue,with the incidence reaching 42.5%.2.Univariate analysis of post-stroke fatigue found that there were statistically significant differences in the incidence of fatigue in patients with ischemic stroke,including age,education,payment method,medical complications(yes/no),history of cerebral infarction,self-care ability,depression level,self-efficacy and social support(P<0.05).3.Multivariate logistic regression found that age,payment method,medical complications(yes/no),self-care ability and depression level were risk factors of post-stroke fatigue.With the group aged less than 60 as the reference,patients aged 60～80 had 3.935 times risk to develop fatigue(OR=3.935,95%CI 2.365-6.547)and 3.957 times among patients over 80 years old(OR=3.957,95%CI 1.623-9.646);With medical insurance as the reference,patients who are completely self-funded had 2.442 times risk to develop fatigue(OR=2.442,95%CI 1.454-4.099);With no comorbidity as the reference,patients with comorbidity had 26.769 times risk to develop fatigue(OR=26.769,95%CI 3.344-214.320);With normal self-care ability as the reference,patients with mild dependence had 1.814 times rnsk to develop fatigue(OR=1.814,95%CI 1.079-3.052)and 6.261 times for moderately dependent patients(OR=6.261,95%CI 2.827-13.864);With no depression as the reference,patients with mild depression had 1.753 times risk to develop fatigue(OR=1.753,95%CI 1.070-2.872)and 4.281 times for patients with moderate depression(OR=4.281,95%CI 1.090-16.812)Self-efficacy was a protective factor of post-stroke fatigue(OR=0.768,95%CI 0.658-0.895),indicating that the higher the patient’s self-efficacy,the less likely to develop post-stroke fatigue;At the same time,social support was also the protective factor of post-stroke fatigue(OR=0.200,95%CI 0.109-0.368),that was,the higher the social support,the less likely to develop post-stroke fatigue.4.The effect of post-stroke fatigue on quality of life among ischemic stroke patients:taking quality of life as dependent variable,controlling age,marriage,education,income,post-stroke functional status,self-care ability,sleep status,depression status,self-efficacy and social support,multiple linear regression results showed that the fatigue symptoms can independently explain the 20.2%variation of the quality of life of stroke patients.Conclusions1.Post-stroke fatigue is a common concomitant symptom among ischemic stroke patients.It is not only limited to physical fatigue,but also includes fatigue in terms of cognition,vitality and motivation.It is a multidimensional symptom.Therefore,nurses should pay attention to the assessment and screening of fatigue symptoms in stroke patients.2.Age,payment method,medical complications(yes/no),self-care ability and depression level are risk factors of post-stroke fatigue,while self-efficacy and social support are protective factors of post-stroke fatigue.3.Post-stroke fatigue has great impact on the quality of life of ischemic stroke patients,and can independently explain the 20.20%variation of the quality of life of stroke patients.Therefore,clinical nurses can improve the quality of life of patients by identifying and managing the symptom,and provide a new basis for the future development of intervention programmes to improve the quality of life in the target population.