Experiences of an online version of a group education programme for the management of post-stroke fatigue: A qualitative descriptive focus group study

Post-stroke fatigue (PSF) is a common symptom after stroke, without proven effective treatment. The Fatigue After STroke Educational Recovery (FASTER) randomized control trial evaluated a group-based, educational Fatigue Management Group (FMG) intervention. The current study explored the experiences of stroke patients, informal caregivers, and therapists when the FMG was delivered online (due to the COVID-19 pandemic). Participants included newly recruited adults (<i>n</i> = 6) with clinically significant fatigue (3-24 months post-stroke), their informal caregivers (<i>n</i> = 6), who attended as observers, and three therapists from the FASTER main trial. Separate online focus groups were conducted with each group, recorded, and analysed using inductive thematic analysis. Four key themes emerged: positive experiences of group membership, gaining understanding and strategies, navigating challenges in online setting, and future directions. Participants acknowledged the intervention for its educational value, normalization, cohesion, and emotional support, and appreciated new understanding of PSF. However, they also encountered challenges, including technological issues, difficulties concentrating, and therapists' struggles in addressing diverse participant needs and fatigue levels within time constraints. Suggested improvements to the intervention included extending its duration and including combinations of online and in-person sessions. Findings highlighted the importance of qualitatively examining intervention experiences in future trials for better optimization and effectiveness.