Fatigue in men and women who have returned to work after stroke: Assessed with the Fatigue Severity Scale and Mental Fatigue Scale

Abstract

Objective To assess the occurrence of self-reported fatigue among men and women who have returned to work after stroke, and the association between 2 fatigue rating scales. Design A cross-sectional study. Subjects A total of 91 adults (58 men/33 women, mean age 53 years) with mild to moderate disability. Methods: Questionnaires were posted to participants approximately one year after stroke. Fatigue was assessed with the Fatigue Severity Scale (FSS) and the Mental Fatigue Scale (MFS). Results In total, 58% of the women and 33% of the men reported fatigue on the FSS (total score ≥ 4), and 46% of the women and 28% of the men reported mental fatigue on the MFS (total score ≥ 10.5). Being easily fatigued, decreased motivation, mental fatigability and sensitivity to stress were the most reported problems. FSS and MFS were moderately associated (rho 0.517–0.732). Conclusion Fatigue is common among persons who have returned to work after stroke, and interferes with daily life. The long-term consequences of fatigue should be addressed after stroke, especially in women. The FSS and the MFS can be used in combination, as they provide information on different aspects of fatigue. LAY ABSTRACT Fatigue can be a long-lasting and disabling impairment following stroke. There is a need for increased knowledge of how fatigue affects people who have returned to work after stroke, and which fatigue rating scales capture their problems most appropriately. The aim of this study was to assess the occurrence of self-reported fatigue among men and women who have returned to work after stroke, and to determine the association between 2 fatigue rating scales. The study was based on a postal survey and includes 91 participants. Fatigue was found to be common 1 year after stroke, especially in women, and interfered with daily life. The 2 fatigue rating scales could be used in combination, as they provide different information on fatigue. The findings could be used to develop support that enables people with stroke to return to and to stay at work long-term.

Fatigue Experiences in People With Stroke

“…Therefore, it is important to understand why some characteristics respond to physical and occupational therapies and rest/sleep, but others do not. It appears that characteristics of fatigue that did not improve over time have a mental component to them that the others do not (Norlander et al, 2021). To perform a task requires not only physical abilities, but the brain must allow the task to be completed.…”

“…Individuals with stroke struggle with starting and finishing things even after having sleep or rest because, although they may be physically able to move forward, their mental fatigue does not allow them to complete the task (Norlander et al, 2021). This notion is also reflected in our participants’ comments and in the “frustrated to do things I want” characteristic, which initially improved significantly, but that improvement was not sustained over time.…”

“…Nurses in the rehabilitation unit are charged with caring for this population and ensuring that they get proper rest during their day so they can engage in rigorous therapies. The common practice of allowing people with stroke to have naps and sleep in between their therapy is critical in their recovery; however, their mental rest is also paramount (Norlander et al, 2021). Nurses may consider providing a quiet environment, which not only provides physical rest but also may allow the brain to not be distracted by multiple stimuli.…”

Screening Method for Assessment of Work Ability for Patients Suffering From Mental Fatigue

“…Among those employed before the hemorrhage, 55% had not returned to work, 35% on part time and 10% to full time work ( Western et al, 2021 ). Fatigue (FSS, MFS) was a common complaint among people who had returned to work after a stroke where two-thirds of the women and half of the men reported that fatigue interfered with everyday life ( Norlander et al, 2021 ). From a qualitative study, patients who had suffered a stroke and returned to work commonly reported fatigue, concentration and memory problems and personal change as having an impact on work ability ( Balasooriya-Smeekens et al, 2016 ).…”

Factors associated with fatigue among people who have returned to work after stroke: an exploratory study

“…It has also been revealed that many of those who do resume working after stroke struggle with problems related to fatigue, which can negatively affect their ability to remain working in the long term ( 18 , 19 ). We recently showed that the prevalence of fatigue among people who had returned to work within 1 year after stroke was as high as 42%, and that fatigue interfered with work or other responsibilities ( 20 ).…”