Table 2 Codes and categories mapped to TDF domains

Awareness of risk factors;

Awareness of risk of recurrence, cardiovascular events or death; Consciousness of unhealthy behaviours;

Lack of understanding about the stroke;

Information provided; Understanding stroke risk; Recognising warning signs

Knowing/not knowing

(awareness/understanding of stroke)

“I never thought I’d have a stroke…”

1. Knowledge (awareness of the existence of something)

A lot of information to absorb; Barriers to accessing information; Being invisible;

Needing to know why and how to; Readiness for information; Reinforcement of the information; Unexplained orders

Information needs/unmet information needs

(need for active and passive information, importance, lack of guidance)

“what I found was nobody told us how!”

A lot of information to absorb; Cognitive function;

Fatigue

Cognitive overload

(difficulties experienced due to information overload or mental fatigue)

“She got a lot of information, but she couldn’t… It went over her head.”

Memory and cognition;

Need to be heard;

Stroke consequences

Thought processing and sense making

(remembering, retaining, thinking or comprehending)

“I was getting a lot of information in the hospital and I couldn’t process it…”

2. Skills (ability or proficiency acquired through practice)

Consciousness of healthy behaviours associated with roles;

Identity

Self-identity

(social role and established habits)

“I was a postman for 38 years and I always had a sort of a routine”

3. Social/Professional role & identity (a coherent set of behaviours and displayed qualities of an individual in a social or work setting)

Identity

Different person

(impact of loss of role identity)

“I just miss the old me.”

Confidence and ability; Determination;

Independence;

Motivation

Confidence/lack of confidence

(ability to adopt healthy habits and sustain behaviours)

“I think the more you can do something for yourself, the more confidence it gives you”

4. Beliefs about capabilities (acceptance of truth, reality, validity of ability, talent, can put to constructive use)

Persistence;

Responsibility for self-care;

Routine

Perceived control

(established habits and discipline)

“… was up to me to make sure we have a healthy diet.”

Barriers to adopting healthy habits; Dealing with addiction/s;

Fatigue

Barriers to change

(dealing with addictions and physical limitations)

“I could walk but to go for a walk. I just started very slowly”

5. Optimism (confidence things will happen for the best, desired goals attained)

Alternative health beliefs;

Feeling lucky;

Safety concerns;

Uncertainty

Personal health beliefs

(acceptance and denial of the outcome of behaviours)

“The more active you are, in my opinion, the longer chance you have of living.”

6. Beliefs about consequences (acceptance of truth, reality, validity of outcomes of behaviour)

Being healthy is hard;

Consciousness of healthy behaviours;

Sustaining healthy lifestyle

Expected outcomes

(staying healthy is not easy)

“I did cut back now eventually I did now, but uh… I found that, uh, a struggle, now trying to cut back on the sweet things”

Comparison with others post-stroke; Life after stroke;

Life as before;

Positive mindset

Anticipated impact of stroke

(comparing with others and staying positive)

“I do tell myself this will prevent you from ever going through what you went through again”

Additional supports;

Incentives;

Reinforce the information

Enabling change

(external factors supporting behaviour change)

“… reminders to keep reminding us about these things,”

7. Reinforcement (increasing probability of response by arranging dependent relationship, or contingency, between response/stimulus)

Do’s and don’ts

Sanctions

(the do’s and don’ts or rules to observe)

“you have to follow the rules… you can’t ignore it”

8. Intentions (conscious decision to perform behaviour/resolve act)

Goals and intentions

Goal setting

(identifying targets to work towards and planning to achieve)

“It was like [getting back to golf]… a goal that I I could look forward to”

9. Goals (end states individual wants to achieve)

Memory and cognition;

Need to be heard;

Stroke consequences

Thought processing and sense making

(remembering, retaining, thinking or comprehending)

“I don’t even remember going home”

10. Memory, Attention, Decision Process (retain information, focus, choose between alternatives)

A lot of information to absorb; Cognitive function;

Fatigue

Cognitive overload

(difficulties experienced due to information overload or mental fatigue)

“there’s so much happening around you, plus the fact I think that the sheer shock of having the stroke, the realisation,”

11. Environmental context and Resources (discourages/ encourages development of skills/abilities, independence, social competence, adaptive behaviour)

Familial support;

Peer-support

Support from family, friends, peers

(having the support of others)

“My sister brings me now…… and takes me shopping”

12. Social influences (interpersonal processes that cause change of thoughts, feelings, behaviours)

Community support resources; Social support;

Unsustained social support

Community support

(structured supports and resources in the community)

“And the interaction with people with the same condition in the past,”

Carer responsibility;

Family dynamics

Potential conflicts

(struggles or conflict when caring and receiving care from family)

“… and sometimes it could be a little bit tetchy”

Emotional reactions;

How to manage emotional aspects; Loneliness;

Religion and spirituality;

Uncertainty

Emotional reactions

(acknowledging and attempting to deal with emotions)

“It took me a long time to accept it and I’d be really angry”

13. Emotion (complex reactions, experiential, behavioural, physiological, in attempting to deal with personally significant event)

Emotional self-management skills; Positive mindset;

Religion and spirituality

Mood management

(enabling self-regulation of emotions and minding their mental health)

“I had a tape that just for eh to calm me down, used to listen to that”

Goals and intentions;

Routine;

Strategies to be healthy

Strategies

(action planning to perform healthy behaviour)

“when I wake up in the morning, get up and get dressed and get out for a walk”

14. Behavioural regulation (aimed at managing/changing actions– objectively observed/measured)

Monitoring risk factors and behaviours;

Regulating behaviours

Self-monitoring

(establishing a method to monitor and record performance)

“I make sure to get me 10,000 steps in everyday”