Introduction:
Post-stroke fatigue affects almost half of all stroke survivors, negatively impacting recovery and ongoing quality of life. The FOCUS post-stroke study is a multi-disciplinary designed project that aims to clarify the effect of stress on the association of post-stroke fatigue and quality of life.
Methods:
This multi-centre, longitudinal, observational study recruited ischemic and haemorrhagic stroke survivors between three months and three years post-stroke from Darling Downs and West Moreton Health Services, Queensland. Fatigue, stress and quality of life were self-reported via surveys during a face-to-face interview. Over three months, four interviews were undertaken with stress and fatigue measures being collected monthly, and quality of life at baseline and final interview. The mediation effect of stress on the relationship between fatigue and quality of life was determined using a multiple regression model (SPSS v. 29.0.2.0; PROCESS v. 50).
Results:
Preliminary analysis of 20 male and four female participants (aged 43 - 92, mean 67) demonstrated a direct effect of fatigue on all measures of quality of life (p <0.05). Partial mediation was indicated on measures of quality of life including emotional wellbeing at two time points, (a <0.05, b 0.00, c 0.86) estimated indirect effect of -1.1 (BootSE=0.32, 95% CI [-1.8, -0.55]) and (a <0.05, b 0.00, c <0.05) estimated indirect effect of 0.81(BootSE=0.38, 95% CI [-1.6, -0.23]).
Conclusion:
Preliminary findings suggest that stress has a partial mediating effect on the relationship between fatigue and quality of life post-stroke.
Relevance to clinical practice and patient experience:
The bidirectional relationship between stress and fatigue post-stroke remains insufficiently understood, contributing to a lack of effective, evidence-based interventions, particularly for fatigue. Identifying stress as a mediating factor, offers a promising therapeutic target, enabling the development of strategies that mitigate fatigue through stress reduction. Such approaches have the potential to enhance recovery trajectories and significantly improve the quality of life for stroke survivors.