Factors Of Post-stroke Fatigue In Acute Stroke Period And The Correlation Between Fatigue And Quality Of Life

Objective:Investigate the prevalence of Post-Stroke Fatigue（PSF）in acute stroke period and analyze the related factors of PSF,identify fatigue associated with the quality of life so as to provide reference for the relevant departments to formulate intervention measures,improve the prognosis and quality of life of the patients.Methods:Three hospitals were selected from third-level medical units by Simple random sampling.296 patients within first 2 weeks after stroke were investigated when they were treated in hospital from January to August 2018.The survey included social demography data,stroke disease information,clinical factors and quality of life for the patients.PSF were measured by fatigue severity scale（FSS）,post-stroke depression（PSD）were measured by self-rating depression scale（SDS）,the quality of life was measured by the short form-36 health survey（SF-36）.The data were entered in Epidata 3.1 and analyzed by SPSS 22.0 software.Results:There were 296 questionnaires issued,with an average age of 61.24±10.81 years old,males accounting for 61.8%and females 38.2%.Fatigue was pres ented in 202 stroke survivors（68.2%）2 weeks after stroke,with FSS score34. Univariate analysis showed that regular exercise,self-care,sleep disorders,pre-stroke fatigue,post-stroke depression,hypertension,gout,lesions in the occipital and centru m ovale were significantly associated with PSF.Multivariate logistic regression anal-ysis showed that 60 to 74 years old（OR=0.228）,more than 74 years old（OR=0.076）,pre-stroke fatigue（OR=4.047）,hypertension（OR=2.002）,mild depression（OR=2.176）,moderat to severe depression（OR=3.982）,completely unable（OR=2.921）were related to PSF.The score of SF-36 in physica（46.89±26.36）,role-physical（40.62±18.37）,role-emotional（53.82±22.30）,general health（44.06±23.94）,vitality（59.03±23.80）,socical function（61.14±30.43）,mental health（69.93±20.71）,body pain（71.57±32.63）of patients which in actue stroke were lower than physica（89.01±15.73）,rol e-physical（81.99±31.65）,role-emotional（77.04±35.45）,general health（66.03±20.87）,vitality（71.15±18.09）,socical function（84.60±18.15）,mental health（75.23±16.09）,body pain（80.40±19.79）of Chinese norm population.Physica,role-physical,role-emotional,general health,socical function,mental health of patients which in actue stroke were lower than physica（80.96±34.00）,role-physical（91.83±12.89）,role-emotional（81.26±33.04）,general health（71.95±20.34）,socical function（83.28±22.69）,mental health（74.74±18.05）of the USA norm popilation.Fatigue patients’all dimensions of SF-36 were lower than non-fatigue group.Pearson correlation analysis showed that FSS was negatively correlated with physica（r=-0.595）,role-physical（r=-0.558）,role-emotional（r=-0.691）,general health（r=-0.366）,vitality（r=-0.708）,socical function（r=-0.457）,mental health（r=-0.416）,body pain（r=-0.270）of SF-36.With physica（Y₁）,role-physical（Y₂）,role-emotional（Y₃）,general health（Y₄）,vitality（Y₅）,socical function（Y₆）,mental health（Y₇）,body pain（Y₈）as the dependent variable,in terms of FSS score（X₁）,age（X₂）,regular exercise（X₃）,sleep disorder（X₄）,pre-stroke fatigue（X₅）,post-stroke depression（X₆）,stroke type（X₇）,sequelae（X₈）,self-care（X₉）,multiple factors were gradually returned to the analysis,regression equation is obtained:Y₁=101.785-5.764X₁+6.444X₃-5.304X₆-4.450X₇-10.280X₉,Y₂=76.359-4.288X₁-3.606X₆-4.876X₉,Y₃=97.146-7.232X₁-6.082X₆,Y₄=92.776-2.612X₁-5.269X₂-13.717X_6,Y₅=112.286-7.040X₁-12.585X₆,Y₆=120.875-4.632X₁-11.407X₆-4.909X₇-6.378X₉,Y₇=107.247-2.087X₁-16.683X_6,Y₈=119.322-3.279X₁-14.193X₄-6.369X₉.Conclusion:Post-stroke fatigue is one of the common complications of stroke in acute stroke period,which has a high incidence.Young and middle-aged patients have a higher risk of fatigue than older patients.In the acute phase,young and middle-aged patients should be given positive stress coping counseling,and combined with the diversified health education of family members to alleviate the negative emotions of patients.Patients combined with pre-stroke fatigue,hypertension,post-stroke depression,and those who are unable to care for themselves have an increased risk of fatigue.Clinicians should identify high-risk groups with risk factors early,use medication-assisted psychological care to reduce fatigue and depressive symptoms,control blood pressure,and improve patient compliance.Post-stroke fatigue has a negative impact on quality of life and is an important predictor of quality of life in patients with acute stroke.