Experiences and Perceptions of Post-Stroke Fatigue Among Stroke Survivors in Saudi Arabia: A Qualitative Interview Study

Abstract

Wafa Saeed Alahmari,1,2 Kholood Matouq Shalabi,1 Reem M Basuodan,1 Ahmed Saad Alhowimel,3 Mazyad Alotaibi3 1Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; 2Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK; 3Physical Therapy and Rehabilitation Department, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi ArabiaCorrespondence: Kholood Matouq Shalabi, Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, PO Box 84428, Riyadh, Saudi Arabia, Email [email protected]: Post-stroke fatigue (PSF) is a debilitating condition that negatively impacts the quality of life of stroke survivors. The rehabilitation of stroke survivors is important for their quality of life, and rehabilitation programs that cater to the needs of these patients are required. However, there is very little published information on their needs, especially in the Middle East. Therefore, this study aimed to explore stroke survivors’ perceptions and experiences of PSF and its causes, its impact on their daily life, their coping strategies, and support from physicians and caregivers in the context of Saudi Arabia.Patients and Methods: This qualitative interview study was conducted with eight post-stroke survivors from two tertiary stroke centers in Saudi Arabia.Results: The responses in the interviews showed high heterogeneity. From the responses, five main themes and several subthemes were generated: (1) description of PSF as both a physical and psychological experience; (2) perceived causes of PSF (physical causes, psychological causes, and stroke-related causes); (3) impact of PSF on daily life (activities of daily living and social interactions); (4) coping strategies for PSF (pacing, self-motivation, and social participation); and (5) perspectives about support from caregivers and healthcare practitioners (lack of support, provision of information about PSF and its management, physiotherapy interventions, encouragement, and overprotectiveness).Conclusion: Stroke survivors have variable physical and psychological experiences of PSF and variable perceptions of its causes and impact. High heterogeneity was also noted in the perception of support provided by healthcare providers and families or caregivers—ranging from lack of support to overprotection. Similarly, patients’ perceptions of the role of physiotherapy and their attitude towards physiotherapy were also variable. Despite this, the findings do highlight the need for more individualized understanding of PSF and the development of treatment strategies that consider biological, psychological, and social factors.Keywords: cerebrovascular stroke, fatigue, inductive thematic analysis, patient perspective, Saudi Arabia, semi-structured interview

Keywords

• cerebrovascular stroke
• fatigue
• inductive thematic analysis
• patient perspective
• saudi arabia
• semi-structured interview