Poststroke fatigue in subacute and chronic stroke rehabilitation phase: prevalence, associated factors and impact on self-efficacy and functional ability

Background Stroke is a leading cause of death and long-term disability worldwide, with low-income and middle-income countries accounting for about 87% of stroke-related deaths and disability-adjusted life-years. Among poststroke complications, poststroke fatigue is a common but often under-recognised condition characterised by emotional, cognitive and physical exhaustion unrelated to exertion and not relieved by rest. Poststroke fatigue can hinder functional recovery, yet it remains underassessed in the study area. So this study investigates the prevalence, associated factors and impact of poststroke fatigue on self-efficacy and activities of daily living. Methods A hospital-based cross-sectional study was conducted through a systematic random sampling technique on 370 study participants. The Fatigue Severity Scale, Nottingham Extended Activities of Daily Living and Stroke Self-efficacy Questionnaire were used to collect questionnaires related to fatigue and its impact. The data were analysed on SPSS using binary logistic regression to assess associated factors and ordinal logistic regression to assess impacts of fatigue on self-efficacy and activities of daily living. Result Fatigue was reported by 65.4% of participants (95% CI 60.30% to 70.20%) during the subacute and chronic rehabilitation phases. Older age, both overweight and underweight body mass index, National Institutes of Health Stroke Scale ≥12, lacked physiotherapy follow-up and experiencing depression were associated with poststroke fatigue with 95% CI and p<0.05. Moreover, individuals with poststroke fatigue were approximately 5.4 times less likely to report higher functional levels and 3.6 times less likely to demonstrate greater self-efficacy compared with those without fatigue. Conclusions Poststroke fatigue is highly prevalent among stroke survivors and negatively impacts both self-efficacy and functional ability. These findings highlight the need for early identification and targeted management of fatigue to improve rehabilitation outcomes and quality of life in stroke survivors.