Table 2 Example of charted synthesis across studies and group interviews with stroke service staff

Staff exemplars But ongoing symptoms like feeling tired or feeling weak, I’d probably say that feeling tired well that’s post stroke fatigue, that sort of thing that in the future will hopefully be alleviated with time. I mean there’s not many on there that I personally would say that would be, I’d never even thought of those. 2:17 (124:124)

SPARC physical domain Over 80% of sample reported some problems with ‘feeling weak’ or ‘feeling tired’. Nearly 40% rated these items as most severe.

Patient exemplar It was, I felt really, totally shattered initially… 5:2 (19:19)

The experience of fatigue is significant (in intensity and impact), although not clearly associated with palliative care.

SPARC psychological domain Nearly 70% reported some problem with ‘feeling everything’s an effort’. Over 20% reported this item as most severe

Problems and needs relevant to palliative care are reported by patients and family members, although these tend not to be seen as palliative care when the patient is still being actively treated.

You’re alleviating any problems that they’ve got, like with pain, tiredness or discomfort but you’re not actively rehabilitating them. [2:24]

Memo Other than concerns about loss of independence and disability, these items were the most significant for participants across the SPARC assessment

Memo Lack of awareness about intensity and range of problems within stroke population (as compared with cancer context)