Screening Poststroke Fatigue; Feasibility and Validation of an Instrument for the Screening of Poststroke Fatigue throughout the Rehabilitation Process

Objective: Our objective is to investigate the feasibility and validity of a new instrument to screen for determinants of poststroke fatigue during the rehabilitation process. Design and Setting: This prospective cohort study was conducted within the stroke department of a rehabilitation center. Participants: The participants in the study were postacute adult stroke patients. The Detection List Fatigue (DLF) was administered 2 weeks after the start of the rehabilitation program and again 6 weeks later. Main Outcome Measures: To determine the construct validity, the Hospital Anxiety and Depression Scale, the Checklist Individual Strength subscale fatigue, and the Fatigue Severity Scale-7-item version were administered. A fatigue rating scale was used to measure the patients' fatigue experience. Frequency analyses of the number of patients reporting poststroke fatigue determinants according to the DLF were performed. Results: One hundred seven patients (mean age 60 years) without severe communication difficulties were included in the study. The DLF was easy to understand and quick to administer. The DLF showed good internal consistency (Cronbach's alpha: .79 and .87), high convergent validity (r(s) = .85 and r(s) = .79), and good divergent validity (r(s) =.31 and r(s) = .45). The majority of the patients (88.4%-90.2%) experienced at least 2 poststroke fatigue (PSF) determinants, of which "sleeping problem" was most frequently reported. Conclusions: The DLF is a feasible and valid instrument for the screening of PSF determinants throughout the rehabilitation process in stroke patients. Future studies should investigate whether the use of the list in determining a treatment plan prevents the development of PSF.