Clinical and psychological correlates of poststroke fatigue. Preliminary results

BACKGROUND AND PURPOSE: Although poststroke fatigue concerns almost 60% of patients, still little is known about its pathogenesis and contributing factors. Therefore, the purpose of this study was to evaluate the severity of fatigue in terms of its impact on physical, psychological and social functioning as well as to determine the relation between fatigue and clinical, demographic and psychological factors. MATERIAL AND METHODS: Patients (n = 50) with acute first-ever stroke admitted to the neurological department were interviewed at 3 months after discharge. Poststroke fatigue was assessed using the Polish version of the Fatigue Impact Scale. Neurological status was examined with the Scandinavian Stroke Scale, functional status with the Barthel Index, and emotional status with the Beck Depression Inventory. Styles of coping with stress were identified using the Coping Inventory for Stressful Situations. Sex, age, type of stroke and lesion location were documented as well. RESULTS: Ninety percent of patients demonstrated high level of fatigue in physical functioning, 16% in the psychological domain, and 18% in the social domain. In the univariate analyses, impact of fatigue on patients functioning significantly correlated with age, lower mood, neurological and functional status, as well as with styles of coping. Emotion-oriented coping was associated with lower level of fatigue, whereas the reverse was found regarding task-oriented coping. In the multivariate analyses the emotion-oriented style of coping was the most important correlate of fatigue. CONCLUSIONS: The causes of poststroke fatigue appear to be multifactorial. Psychological factors, especially coping strategies, might be an important area for future interventions.