Author: Ho, Yuen Wah
Title: Fatigue among Hong Kong people with stroke
Advisors: Ng, Shamay (RS)
Lai, Claudia (SN)
Degree: DHSc
Year: 2020
Subject: Fatigue
Cerebrovascular disease -- China -- Hong Kong
Cerebrovascular disease -- Patients -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Faculty of Health and Social Sciences
Pages: xvii, 292 pages
Language: English
Abstract: Background: Although fatigue is a common complaint among people with stroke, its level has not been clearly specified in a Chinese population. A number of factors have been found to be associated with fatigue after a stroke but their strength of correlation has not been clearly quantified. Evidence shows that promoting sleep quality may improve fatigue in people with stroke but its predictive power to fatigue is not clear. More evidence is thus needed to support the development of fatigue interventions targeting sleep quality. Aims: This study aimed to determine the level of fatigue experienced by Chinese community-dwelling people with stroke and compare it with that felt by healthy older people; quantify the strength of any correlation between fatigue and physical, social, and demographic factors; and quantify the contribution of sleep quality to fatigue following a stroke. Methods: This study was in three phases. In Phase 1, the psychometric properties of the Chinese (Cantonese) version of the Fatigue Assessment Scale (C-FAS) and Chinese (Cantonese) version of the Life-Space Assessment (C-LSA) were tested. Both scales were found to be reliable and valid in assessing Hong Kong people with stroke and suitable for used in the study's subsequent phases. In Phase 2, the levels of fatigue in people with stroke were determined and compared with those reported by healthy older people. The C-FAS and the Chinese version of the Geriatric Depression Scale were used to collect the data. Descriptive statistics and Mann-Whitney tests were used in the data analyses. In Phase 3, the contribution of sleep quality to fatigue was quantified. The C-FAS, the Cantonese version of the Pittsburgh Sleep Quality Index (C-PSQI), a visual analogue scale - pain (VAS-Pain), the Fugl-Meyer Assessment (FMA), the 5 Times Sit-To-Stand (FTSTS) test, the Chinese version of the Epworth Sleepiness Scale (C-ESS), the Chinese version of the Frenchay Activities Index (C-FAI), the C-LSA, the Cantonese version of the Community Integration Measure (CIM-C), and the Chinese version of the Multidimensional Scale of Perceived Social Support (MSPSS-C) were used to collect data. Descriptive statistics, correlation coefficients, and multiple linear regression modeling (the forced entry method) were employed in the statistical analyses. Results: Fatigue was reported by 53.57% of 112 people with stroke. The mean C-FAS score was 22.63±6.06. The median C-FAS physical score was 12.00 which was significantly higher than the mental score of 10.00 (p<0.001). The median C-FAS scores of 66 people with stroke were significantly higher than those of 65 healthy older people (sum: 22.00 vs 18.00, p=0.001; physical: 12.00 vs 9.00, p=0.001; mental: 10.00 vs 9.00, p=0.005). Stroke survivors with depressive symptoms had significantly higher C-FAS scores than those without. Poor sleep quality was reported by 64.29% of 112 people with stroke. The mean C-PSQI score was 7.51. After controlling for FTSTS time and C-ESS score, significant partial correlations were found between the C-FAS scores and C-PSQI (r=0.27, p=0.005), C-FAI (r=-0.25, p=0.008), CIM-C (r=-0.22, p=0.023), and MSPSS-C scores (r=-0.23, p=0.016). The C-PSQI score independently accounted for 5.91% of the variance of in the C-FAS scores. Conclusions: The proportion of stroke survivors reporting fatigue and that reporting poor sleep quality were high. The level of fatigue of stroke survivors is generally higher than in similar healthy older people. Feeling fatigued correlates with sleep quality, participation in daily activities, community integration, and social support. Sleep quality can independently predict fatigue following stroke.
Rights: All rights reserved
Access: restricted access

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