Experiences of poststroke fatigue: qualitative meta-synthesis

Aim To interpret and synthesize stroke survivors' experiences of poststroke fatigue. Background Several studies have found fatigue to be a common and distressing difficulty experienced after stroke. This review has synthesized qualitative findings of stroke survivors' experiences of poststroke fatigue with the aim of guiding practice and further research. Data sources A computer-aided search of the PubMed, CINAHL, PsycINFO, and Embase databases was performed up to April 2012. Design and review methods Interpretive qualitative meta-synthesis. Of 167 papers identified, 12 were included. Findings Three main themes of the experience of poststroke fatigue were identified. First, five characteristics were identified and interpreted as core characteristics of poststroke fatigue. These did not seem to be influenced by the context. Two additional, distressing characteristics were identified. These were interpreted as being more responsive to the context. Second, we found that the acknowledgement of poststroke fatigue by stroke survivors and their significant others were important for the experience of poststroke fatigue. This theme appeared to be consistent across studies and was interpreted as having a major impact on the third theme identified; coping with poststroke fatigue. Two main coping patterns appeared: one taking the fatigue into account and the other struggling to cope. Lack of acknowledgement of poststroke fatigue complicates the coping process and invokes additional emotional distress. Conclusion Poststroke fatigue is a complex phenomenon. Acknowledging its presence and impact is important to cope well with it. Lack of acknowledgement from significant others increases add to the burden. [Correction added after online publication 3 September 2012: Instances of the word statistically' have been removed from the Findings and Conclusion in the abstract section.]