Dorien Brouwer

50 Chapter 1.2 PART 1 Support by a dietician for changing diet has been mentioned by one male participant in order to get some more guidelines for good cholesterol levels. One participant already had a dietician for, among other things, diet plans. “She finds schedules for me for food, for sports and for weight ... I wanted to lose 10 kilos, because I had gained 10 kilos after that accident. And half of that is now reached, still five kilos .. and she will accompany me for a few months. And she always sends me these things [applications].” (12, M68) Social support has been mentioned in different ways. Some participants currently get emotional support to move more. For example, one patient receives support from his wife when walking and others receive encouragement from their partner to get more exercise. “Yes, I will cycle with her. Yes since now. She likes being with me, because she is not yet completely sure what I can, and cannot do, by the way. She does it more for me, by the way, protecting or controllingme may be too big a word. Yes, I amnot so afraid of that now, but okay, if it makes her feel safer, that’s good. ” (3, M53) Patients also named the importance of support in quitting smoking and in insisting on reducing alcohol consumption. “Nothing. Yes, my daughters and son. They also say: not too much! “ (9, M59) Discussion Patients understand what constitutes a healthy lifestyle, but seem unable to adequately appraise their own health-related behavior. More than half of the patients were satisfied with their lifestyle and had no urgency to change. Self-efficacy was the most important determinant for health-related behavior change. It was mentioned both as barrier and facilitator. The majority of the patients did not need support or already received support in changing their lifestyle. Patients indicated knowledge, guidelines and social support as most needed to change health-related behavior and to preserve a healthy lifestyle. Participants know what a healthy lifestyle consists of, but it was unclear to what extent participants were able to assess their own lifestyle as we did not assess their actual health-related behavior in this study. Earlier studies also showed that risk assessment and knowledge about risk factors is not optimal after ischemic stroke. [16] In our study patients also indicated knowledge and guidelines as facilitating factors for health-related behavior change. Several previous studies showed that many stroke patients express a lack of understanding and desire for further knowledge about all aspects of stroke disease. [24]