Dorien Brouwer

46 Chapter 1.2 PART 1 Mood and cognitive problems were also experienced as a mental barrier for health-related behavior change in four patients. “When I ama bit depressed, yes I smoke a bit more, but well then, then I think something like ten cigarettes a day.” (004, V66) Physical complaints, such as pain and fatigue were remarked as most experienced barrier for physical activity. “I do something and then I am tired and then I sit down again, I am tired very quickly, that is the difference. I am tired very quickly. Since I’ve had this, yes.” (005, V55) Also environmental barriers were mentioned. Bad weather (cold or rain) was mentioned as a barrier for physical activity. “Oh, I can’t stand the cold. Because of the blood pressure and vessels. So I stay at home.” (04, V66) One patient found it hard to eat healthy because of bad eating habits of her partner. Response efficacy Response efficacy was mentioned in relation with all types of health-related behavior change. Patients experienced response efficacy mostly as facilitating factor for behavior change. “If I can keep up with that …, then my chances of getting another stroke are just as high as any other.” (8, M66) Response efficacy was especially mentioned in relation with changing eating habits and alcohol use. “That’s because of the cholesterol, it was too high inmy opinion. Because of junk food. So I ate less of that.” (12, M68) “Before this time I drank one or two glasses of beer, not much and not in one time, but really one or two glasses. But that’s not good for this (points at his belly). It increases your blood pressure and thickens your blood.” (8, M66)