Effects of a self-management program for poststroke fatigue: A feasibility study targeting patients with early fatigue

Objective: To examine the effects of a self-management program for poststroke fatigue (PSF). Methods: The study participants included were 30 patients with early fatigue within 3 months after a stroke. During hospitalization, a 2-week-long self-management program for PSF was provided, consisting of components on problem-solving support, self-monitoring support, and education. The outcomes included fatigue (Multidimensional Fatigue Inventory [MFI]), motivation (Apathy Evaluation Scale [AES]), and self-management skills (correct answer rate on a knowledge evaluation questionnaire), with higher MFI and AES scores indicating more severe fatigue and reduced motivation. We then performed pre- and post-intervention comparisons to obtain the effect sizes. The ethics review committee approved this study. Results: A total of 25 participants completed the program (five dropouts). Regarding the pre- and post-intervention comparisons, MFI scores decreased significantly after the intervention (p = .00, Cohen's d = 1.48), with the proportion of those who exceeded the cutoff decreasing from 60.0% to 36.0%. AES scores also decreased significantly after the intervention (p = .03, Cohen's d = 0.45), with the proportion of those who exceeded the cutoff decreasing from 44.0% to 28.0%. Knowledge also increased significantly (p = .00, r = 0.86), suggesting the acquisition of self-management skills. Conclusions: After the intervention, fatigue and motivation improved, and self-management skills were acquired. Although we cannot deny the possibility that fatigue improved naturally, the program was likely effective to some extent. Further studies on the program are necessary, and a randomized controlled trial with an adequate sample size is warranted to examine its effects. Trial registration: UMIN Clinical Trials Registry (UMIN000048681)