Post-stroke Fatigue and Its Correlation With Family Functioning in Patients With First-episode Stroke

Sleep Disturbances

时间窗: Day 5 of hospitalization

The Athens Insomnia Scale (AIS) is used to measure the sleep quality of patients during the study period. AIS is an internationally recognized self-assessment scale for sleep quality, consisting of 8 items. The scale is a 4-point Likert scale, scored 0, 1, 2, or 3, with 0 representing "not at all" and 3 representing a "severe" impact. The total score is 24 points. Scores ranging from 0-4 indicate no sleep disturbances, 4-6 suggest possible insomnia, and scores above 6 represent insomnia. The higher the score, the poorer the sleep quality and the more severe the sleep problems. The Cronbach's alpha coefficient for this scale is 0.875.

Post-stroke fatigue

时间窗: Day 5 of hospitalization

Post-stroke fatigue was scored using the Fatigue Severity Scale, which is mainly designed to assess the severity of physical and mental fatigue felt by patients as a result of the disease. When assessing stroke patients using the FSS, some scholars have diagnosed a score of ≥36 points as indicative of PSF. The FSS is comprised of a total of nine entries, each of which is scored on a 7-point Likert scale ranging from 1 to 7. A score of 1 indicates a 'strongly disagree' response to the corresponding entry, and a score of 7 represents a 'strongly agree' response to the corresponding entry. The final FSS score for the patient was obtained by summing the total score of the nine entries. The higher the score is, the more severe the patient's fatigue。

activities of daily living

时间窗: Before hospitalization

modified Barthel index (MBI) is a tool most commonly used to assess the ability of stroke patients to perform activities of daily living. The measurement consists of 10 items, namely feeding, bed-to-wheelchair transfer, personal hygiene, toileting, bathing, walking, walking up and down stairs, dressing and bowel control, with a total score of 100. The lower the MBI score is, the more severe the dysfunction and the greater the dependence. The degree of dependence was categorised into four grades, with ≤40 points categorised as severe dependence (all items required care from others - poor), 41-60 points categorised as moderate dependence (most items required care from others - fair) and 61-90 points and 90-100 points, categorised as mild or no dependence, respectively (few or no items required care from others - good).

family adaptation, partnership, growth, affection and resolve (APGAR) score

时间窗: First day after hospitalization

assess patients' satisfaction with family functioning. It was developed to measure the five dimensions of adaptation, partnership, growth, affection and resolve in five separate questions. Each question was assigned a score of 0-2, with a total score of 0-10 points. The degree of family dysfunction was divided based on the total score, with 7-10 points defined as good family function, 4-6 points as moderate family dysfunction and 0-3 points as severe family dysfunction, with a Cronbach's α coefficient of 0.94

Anxiety and Depression

时间窗: Day 5 of hospitalization

The Hospital Anxiety and Depression Scale (HADS) is composed of 14 items divided into two subscales: the depression subscale (7 items) and the anxiety subscale (7 items). Scores from 0 to 7 indicate no symptoms, 8 to 10 suggest possible symptoms, and 11 to 21 indicate definite symptoms. The overall Cronbach's alpha coefficient for the scale, as well as those of the anxiety and depression subscales, are 0.88 and 0.81, respectively.