The goal of this observational study is to better understand fatigue after stroke. Many people feel ongoing tiredness months or years after a stroke. This fatigue may affect daily activities, work, and social life. It does not always improve with rest. This study aims to answer these questions: How do participants describe their fatigue? How strong and how often does it occur? How does it affect daily life and quality of life? What strategies do participants use to manage it? About 20 to 30 adults living in French-speaking Switzerland who have had a stroke will take part. Participants will: Complete one anonymous questionnaire online or on paper. Answer questions about their fatigue and daily life. Share their experience in their own words. The questionnaire takes about 15 to 20 minutes. There are no medical tests, treatments, or follow-up visits. Participation is voluntary. Participants may stop at any time. No names or identifying information are collected. The results may help health professionals better understand post-stroke fatigue and improve rehabilitation care.
Post-stroke fatigue is a common and long-lasting symptom experienced by many people after a stroke. It is described as persistent physical, cognitive, or emotional exhaustion that is not proportional to effort and does not consistently improve with rest. Although fatigue can strongly affect participation, autonomy, and quality of life, it remains insufficiently understood and often under-recognized in rehabilitation practice. The ReFast study (Recovery and Fatigue Study) is a non-interventional, cross-sectional observational study conducted in French-speaking Switzerland. The aim is to explore the subjective experience of post-stroke fatigue in adults living at home in the chronic phase after stroke. The study focuses on understanding how participants perceive their fatigue, how it affects daily life, and which coping strategies they use. Data will be collected through a single anonymous questionnaire that combines structured questions (including rating scales and multiple-choice items) with open-ended questions. This mixed-methods approach allows both quantitative description and qualitative exploration of participants' experiences. Primary outcomes relate to the presence, intensity, frequency, and functional impact of fatigue. Secondary outcomes include perceived quality of life, coping strategies, perceived social or professional support, and contextual factors such as age and time since stroke. Open-ended responses will be analyzed using inductive thematic analysis to identify recurring themes and patterns. The study does not involve any medical intervention, clinical examination, or follow-up visit. Participation consists of completing one questionnaire session. All data are collected anonymously, and no identifying information is recorded. The overall risk is minimal and limited to possible mild emotional discomfort when reflecting on personal experiences. By integrating quantitative and qualitative perspectives, this study seeks to generate clinically relevant insights into post-stroke fatigue. The findings may support the development of more patient-centered rehabilitation approaches and inform future research in neurological rehabilitation.
Study Type
OBSERVATIONAL
Enrollment
30
Haute école de santé de Genève (HEdS - HES-SO)
Carouge, Canton of Geneva, Switzerland
RECRUITINGFatigue Severity Scale (FSS) Total Score
Fatigue severity will be assessed using the Fatigue Severity Scale (FSS), a validated 9-item questionnaire measuring subjective fatigue and its functional impact. Each item is rated on a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). The total score is calculated as the mean of the 9 items and ranges from 1 to 7. Higher scores indicate greater fatigue severity.
Time frame: Assessed once at enrollment (single study visit, Day 0)
Presence of Self-Reported Post-Stroke Fatigue
Presence of post-stroke fatigue will be assessed using a study-specific Post-Stroke Fatigue Questionnaire developed for this cross-sectional study. Participants respond "Yes" or "No" to a binary item assessing whether they have experienced unusual fatigue since their stroke. This is a categorical variable (Yes/No). The proportion of participants reporting "Yes" will be calculated. Higher frequency of "Yes" responses indicates greater prevalence of self-reported post-stroke fatigue.
Time frame: Assessed once at enrollment (single study visit, Day 0)
Self-Reported Fatigue Intensity
Fatigue intensity will be assessed using the study-specific Post-Stroke Fatigue Questionnaire. The Fatigue Intensity Score is calculated as the mean of multiple items rated on a 5-point Likert scale ranging from 1 (low fatigue) to 5 (very high fatigue). The score ranges from 1 to 5. Higher scores indicate greater perceived fatigue intensity.
Time frame: Assessed once at enrollment (single study visit, Day 0)
Self-Reported Functional Impact of Fatigue on Daily Activities
Functional impact of fatigue on daily activities (e.g., household tasks, work, leisure, rehabilitation) will be assessed using multiple structured items from the study-specific questionnaire. Each item is rated on a 5-point Likert scale ranging from 1 (no impact) to 5 (very high impact). The Functional Impact Score is calculated as the mean of these items and ranges from 1 to 5. Higher scores indicate greater functional limitation related to fatigue.
Time frame: Assessed once at enrollment (single study visit, Day 0)
Self-Reported Frequency of Post-Stroke Fatigue
Frequency of fatigue will be assessed using a structured categorical item in the study-specific questionnaire with predefined response options (e.g., daily, several times per week, occasionally, rarely). This is an ordinal categorical variable. Higher frequency categories reflect more frequent fatigue episodes.
Time frame: Assessed once at enrollment (single study visit, Day 0)
Self-Reported Quality of Life Related to Fatigue
Quality of life related to fatigue will be assessed using multiple Likert-scale items from the study-specific questionnaire. Each item is rated from 1 (very poor quality of life) to 5 (very good quality of life). The Quality of Life Score is calculated as the mean of these items, ranging from 1 to 5. Higher scores indicate better perceived quality of life.
Time frame: Assessed once at enrollment (single study visit, Day 0)
Self-Reported Coping Strategies for Managing Fatigue
Coping strategies used to manage fatigue (e.g., rest breaks, activity planning, physical activity) will be assessed using predefined multiple-choice items and optional open-ended responses in the study-specific questionnaire. Results will be summarized descriptively as counts and percentages.
Time frame: Assessed once at enrollment (single study visit, Day 0)
Perceived Social and Professional Support
Perceived social and professional support will be assessed using multiple Likert-scale items from the study-specific questionnaire. Each item is rated on a 5-point Likert scale ranging from 1 (no perceived support) to 5 (very strong perceived support). The Support Score is calculated as the mean of these items, ranging from 1 to 5. Higher scores indicate greater perceived support.
Time frame: Assessed once at enrollment (single study visit, Day 0)
Qualitative Description of Subjective Fatigue Experience
Open-ended responses describing the subjective experience of fatigue, including emotional, cognitive, and functional aspects, will be collected. Responses will undergo inductive thematic analysis.
Time frame: Assessed once at enrollment (single study visit, Day 0)
Sociodemographic and Clinical Contextual Variables
Sociodemographic and clinical characteristics including age, sex, time since stroke, employment status, level of autonomy, and comorbidities will be collected for descriptive and stratification purposes. These are descriptive variables.
Time frame: Assessed once at enrollment (single study visit, Day 0)
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