PhD defence D. (Dorien) Brouwer-Goossensen

This thesis focuses on health-related behavior change (smoking cessation, healthy diet and exercise) after a TIA or a minor stroke to prevent another stroke. It shows that patients with a TIA or ischemic stroke do not feel an urgency to change health-related behavior and experience barriers such as fatigue, pain, mood, and physical problems. Patients understand what constitutes a healthy lifestyle, but seemed unable to adequately appraise their own lifestyle-behavior. Self-efficacy (confidence in your own abilities), response effectiveness (belief that change is effective) and fear were found to be the most important influencing factors of intention to change health-related behavior. Guidance for health- related behavior changes after a stroke or TIA should therefore focus on these factors. Self-efficacy appears to be lower in elderly, inactive or anxious patients and patients with overweight, depressive complaints or patients with previous vascular problems. These patients would therefore deserve extra attention in health- related behavior change. Patients identify knowledge and social support as important factors for behavioral change. However in addition to knowledge, the right attitude, motivation and capacity are also required to change behavior. The best time to start interventions to support health related behavior change is probably as soon as possible after the TIA or stroke. Nurse practitioners should play a key role in these interventions. These findings can help develop and evaluate targeted and effective programs to support patients in lifestyle changes to prevent new strokes and improve quality of life after TIA or ischemic stroke.

Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall or in the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.