• Women's Health Nursing
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• v.6 no.2
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• pp.191-202
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• 2000

This study was carried out to assess the perception of decisional balance of Korean women toward mammography screening. From Dec. 20, 1998 to Apr. 30, 1999, a samples of 1,903 subjects were selected from 7 metropolitan areas and 6 provinces of Korea. Data was collected using Rakowski et al's decisional balance scale to measure the decisional balance regarding a woman's adoption of mammography screening and to assess the woman's current stages of adoption of mammography. The classification of women according to the stage of adoption of mammography was 54.9 % in precontemplation, 31.9 % in contemplation, 7.8 % in action, and 5.5 % in maintenance. The mean difference of pros, cons, and the decisional balance by the stage of mammography adoption were statistically significant. There were significant mean differences between the stages of adoption according to a woman's experience with and intention for mammography and the pros score, the cons score, and the decisional balance score. The behavioral portion of stage of mammography adoption provides a further level of discrimination. Results provide the empirical evidence for the Transtheoretical model.

• Korean Journal of Adult Nursing
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• v.16 no.3
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• pp.493-501
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• 2004

Purpose: The purpose of this study was 1) to classify the stage of adoption 2) to compare the decisional balance and confidence by stage of adoption 3) to identify factors influenced the stage of adoption for breast self exam. Method: A comparative study using a survey method with convenience sample of 143 women was used. Decisional balance and confidence was measured using the CHBMS-K. Stage of adoption for BSE was measured by a single item modified by the researchers based on the Rakowski et al (1992). Result: 1) The number of women in each stage of adoption for BSE was as follows; maintenance phase, 7.7% (n=11), action phase, 49.0% (n=70), contemplation phase, 35.0% (n=50) and pre- contemplation phase, 8.4%(n=12). 2) The mean difference in the decisional balance (F=4.32, p=.006) and confidence (F=13.85, p=.000) according to the stage of BSE adoption was statistically significant. 3) Prevention education and confidence accounted for 32% of variance in BSE. Conclusion: Assessment of decisional balance and stage of adoption for BSE can guide planning for cancer prevention education. We must educate women to have confidence in BSE. Further, it is important to urge women to continually practice BSE.

• Research in Community and Public Health Nursing
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• v.23 no.3
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• pp.316-326
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• 2012

Purpose: This study was to identify the factors associated with stages of exercise behavior change of residents in a community on the basis of the Transtheoretical Model. Methods: Data were collected from 520 residents of a community using a self-report questionnaire. The survey variables comprised the stages of exercise behavior change, the process of change, decisional balance and self efficacy. Results: There were significant differences in the process of change, decisional balance and self efficacy by the stages of exercise behavior change. The factors associated with transition from pre-contemplation to contemplation were consciousness raising and self efficacy; regarding those from contemplation to preparation, cons of the decisional balance and social liberation; regarding those from preparation to action, dramatic relief and counter conditioning; regarding that from action to maintenance, cons of the decisional balance. Conclusion: TTM would be applicable to explain the exercise behavior of some residents in a community, which suggested that the programs for improving exercise behavior of residents in a community need to be developed.

• Journal of Korean Academy of Nursing
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• v.35 no.5
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• pp.904-913
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• 2005

Purpose: The purpose of this study was to investigate smoking cessation behavior of male taxi drivers in Korea on the basis of the Transtheoretical model(TTM), and to validate the usefulness of TTM. Method: Data were collected using a self-reported questionnaire including smoking history and major factors of TTM from 208 subjects who were current smokers or ex-smokers. Data were analyzed by descriptive statistics and ANOVA. Result: Most subjects ($85.1\%$) were current smokers. Stages of change were precontemplation ($44.7\%$) and contemplation ($27.4\%$). Subjects in precontemplation stages had the lowest mean score in processes of change and the highest mean scores in decisional balance(pros) and temptation(positive affective, habitual/craving). According to stages of change, there were statistically significant differences in processes of change, decisional balance, and temptation. Conclusion: This study supported the generalization of TTM. As this study showed that the subjects didn't have motivation in smoking cessation, applying tailored smoking cessation programs for taxi drivers is needed.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1265-1278
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• 2000

This study was carried out to assess the perception of decisional balance of Korean subjects about 4 health behaviors and to identify the influencing factor of decisional balance for exercise acquisition, smoking cessation, mammography screening and Kegel's exercise acquisition. All are representative health behaviors nurses can intervene in Korea based on the Transtheoretical model. Convenient samples of 2,484 subjects (191; exercise, 169; smoking cessation, 1903; mammography screening and 221; Kegel's exercise) were selected from cities and counties over 9 provinces throughout Korea, and the data was collected from January 1, 1999 to February 29, 2000. The research instrument were the Decisional Balance Measure for Exercise (Marcus & Owen., 1992), Smoking Cessation (Velicer et al., 1985), Mammography Screening (Rakowski et al.,1992) and Kegel Exercise (Lim, 1999) and Stage of Change Measure for Exercise (Marcus et al, 1992), Smoking Cessation (DiClemente et al., 1991), Mammography Screening (Rakowski et al.,1992) and Kegel's Exercise (Lim, 1999). The data was analyzed by the SAS Program. The results are as follows; 1. According to the stage of change measure, 2,484 subjects were distributed in each stage of change for four health behaviors: 1,233 subjects (49.8%), 745 subjects (30.2%), 113 subjects (4.7%), 156 subjects (6.5%), and 216 (8.7%) belonged to the pre- contemplation stage, contemplation stage, preparation stage, action stage and maintenance stage. They were all series of stages of change in their efforts to do health behavior. 2. Factor analysis identified 3 factors (1 of Pros, 2 of Cons) for the exercise, 4 factors for smoking cessation (2 of Pros, 2 of Cons), 2 factors (1 of Pros, 1 of Cons) for the mammogram screening and 2 factors (1 of Pros, 1 of Cons) for Kegel's exercise of decisional balance. 3. The analysis of variance and multiple comparison analysis showed that for all 4 samples, the Cons of changing the problem behaviors outweighed the Pros for subjects who were in the pre- contemplation stage, The opposite was true for subjects in action and maintenance stage. 4. Through the discriminant analysis, it was found that one factor of Pros for exercise, one factor of Cons for smoking cessation, 1 factor of Cons for mammogram screening and one factor of Cons for Kegel's exercise were the more influencing factors, than others in discriminating the stages of change. Results are consistent with the applications of the Transtheoretical model, which have been used to understand how people change health behaviors. This results provide some evidence that subject's report of his/her health behavior corresponds to beliefs about usefulness of related health behaviors. The results of this study have implications for patients' health education and health intervention strategies. The findings of this study give useful information for nursing educators for 4 health behaviors, especially the factors relating to decision making in the different stages of change.

• Korean Journal of Adult Nursing
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• v.12 no.1
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• pp.40-51
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• 2000

Purpose : This study was carried out to identify the factor of decisional balance for exercise. This was composed of a set of variables at the level of decision making when the elderly decide to do exercise. It was used to classify and identify the characteristics of the stages of change for exercise to which the elderly belong, and was used to identify the variables of decisional balance which influence the stage of change for exercise in the elderly. Methods : Convenient samples of 198 subjects over age 60 in Seoul( mean age=70) were selected from community living, mentally competant older adults and the data was collected from April 1, 1999 to May 31, 1999. The research instrument was the Decisional Balance Measure for Exercise(Marcus & Owen., 1992), Stage of Change Measure(Marcus et al,1992). The data was analyzed by SAS Program. Results: 1. According to stage of change measure, without missing data,191 subjects were distributed in each stage of change for exercise : 50 subjects(26.1%), 7 subjects (3.6%), 52 subjects(27.2%), 4 subjects(2%), and 78(40.8%) belonged to the precontemplation stage, contemplation stage, preparation stage, action stage and maintenace stage. 2. Factor analysis identified 3 factors of decisional balance as appropriate factors for exercise of the elderly and named by researchers; 1)'Perceived Physical-psychological benefit', 2)'Perceived Physical-psychological burden', and 3)'Perceived time burden'. 3. The analysis of variance showed that the two components Perceived Physical - psychological benefit(F=45.95, P=.0001), and Perceived Physical-psychological burden (F=26.52, P=.0001) were significantly associated with stage of change. 4. Through the discriminant analysis, it was found that both 'Self Perceived Physical - Psychological benefit' and 'Perceived Physical-Psychological burden' were the influential variables in discriminating the three stages of change(pre-contemplation, preparation, and maintenance). Conclusion : Results are consistent with the application of the Transtheoretical model, which has been used to understand how people change health behaviors. Even though this study is a cross-sectional, not a longitudinal study, the findings of this study give useful information for exercise intervention about especially the factors relating to decision making for exercise of the elderly in the different stages of change of exercise.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.164-176
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• 2000

Purpose : This study was done to identify the factors of decisional balance for smoking cessation among middle aged men in Korea. This was composed of a set of variables at the level of decision making when middle aged men decide to stop smoking. It was used to classify and identify the characteristics of the stages of change for smoking cessation to which the middle aged men belong, and was used to identify the variables of decisional balance which influenced the stages of change for smoking cessation in middle aged men. Methods : A convenience sample of 169 men who had smoked and were smoking, were between age 30 and 60 and lived in Seoul(mean age=44), were selected from the community. The data was collected from December 10, 1999 to February 28, 2000. The research instrument was the Decisional Balance Measure for Smoking Cessation (Velicer et al., 1985). and Stage of Change Measure(DiClemente et al., 1991). The data were analyzed using the SAS Program. Results : 1. According to stage of change measure, the 169 subjects were distributed in each stage of change for smoking cessation: in the pre-contemplation stage 63 subjects(32.7%), contemplation stage 60 subjects (35.5%), preparation stage 17 subjects(10.1%), and maintenance stage 29 subjects(17.2%). 2. Factor analysis identified 4 factors of decisional balance as appropriate factors for smoking cessation of middle aged men. There were named by the researchers; 1)'Perceived Burden to Self', 2)'Perceived Benefit to Others' 3)'Perceived Approval to Others', and 4)'Perceived Disapproval to Self'. 3. Analysis of variance showed that the three components, 1)'Perceived Burden to Self(F=8.50, P=.0001)', 2)'Perceived Benefit to Others(F=3.19, P=.025)' and 3)'Perceived DisApproval to Self(F=2.87, P=.038)were significantly associated with stage of change. 4. Through discriminant analysis, it was found that 'Perceived Burden to self' was the most influential variable in discriminating the four stages of change(pre-contemplation, contemplation, preparation, and maintenance). Conclusion : The results are consistent with the application of the Transtheoretical model, which has been used to understand how people change health behavior. Even though this study is a cross-sectional, not a longitudinal study, the findings of this study give useful information for smoking cessation intervention for the middle aged men.

• Korean Journal of Adult Nursing
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• v.14 no.1
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• pp.83-92
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• 2002

Purpose: This study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of exercise behavior using Transtheoretical Model in patients with type 2 diabetes mellitus. Method: The study method was a survey in 100 type 2 DM patients at out-patients clinic of Y medical center from March 19, 2000 to October 30, 2000. Result: The results were as follows: The subjects were divided into five stages of exercise behavior ; 15.0% in pre-contemplation stage, 33.0% in contemplation stage, 17.0% in preparation stage, 16.0% in action stage and 19.0% in maintenance stage. The subjects in pre-contemplation stage used all processes of change in the least. "Dramatic relief(DR)", "Environmental reevaluation(ER)" and "Self reevaluation(SR)" were identified as main processes of change in contemplation stage. "Consciousness raising(CR)", "DR" were used higher than average in preparation stage. Helping relationships(HR)", "CR", "ER", "SR", "Social liberation(SL)", "Counter conditioning (CC)", "Reinforcement management(RM)", "Self iberation(SEL)" and "Stimulus control(SC)" were used higher than average in action stage. The subjects in maintenance stage used all process of change the highest except "DR"and "HR". "Cons" score of decisional balance was the highest in pre-contemplation stage, "Pros" score was the highest in action stage and "Self-efficacy" score was the highest in maintenance stage. Conclusion: This study can provide the basis of staged matching exercise program using TTM for more effective and useful intervention.

• Korean Journal of Health Education and Promotion
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• v.23 no.2
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• pp.11-27
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• 2006

Objectives: This study was conducted to evaluate the effects of a tailored program based on the Transtheoretical Model to smoking cessation in high school girls. Methods: A quasi-experimental research design was used in this study. The participants were 35 industrial high school girls who have been smoking. The girls were allocated to an experimental group(18) and a control group(17) by randomization. For intervention, the experimental group received the group smoking cessation program and individual program which tailored according to the stage of change. A common group smoking cessation program was given to the control group. Data were collected before the program, immediately after and 4 weeks after the program was completed and were analyzed with repeated measure ANOVA. Result: In the experimental group, the daily smoking amount, nicotine dependency and decisional balance(Pros) score were significantly decreased and the self-efficacy score were significantly increased at one month after the intervention in comparison with before and immediately after it. The decisional balance(Cons) and processes of change score of the experimental group were significantly increased at immediately after the intervention and one month after it in comparison with before it, and at one month after it in comparison with immediately after it. A significant difference in the daily smoking amount, urine cotinine, nicotine dependency, decisional balance(Pros, Cons) and processes of change score between the both groups was found after one month of intervention. Conclusions: The tailored smoking cessation program was more effective, compared to the common smoking cessation program on smoking behavior, self-efficacy, decisional balance, processes of change. This program can be used for favorable changes in high school girl's smoking behavior.

• Korean Journal of Adult Nursing
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• v.15 no.3
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• pp.483-492
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• 2003

Purpose: The study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of smoking cessation behavior based on Transtheoretical Model in industrial workers. Method: A convenience sample of 146 industrial workers except for the never smokers, were recruited at a H industry in Ulsan. Data were collected from February 1 to 28, 2002. The research instruments were Stages of Change of Smoking Cessation Measure(DiClemente et al, 1991), Process of change(Prochaska, 1988), Smoking Abstinence Self Efficacy (SASE: DiClemente et al, 1985) and Decisional balance(SDB; Kim, 1999). Result: The results of this study were as follows; 1. The subjects were distributed in each stage of smoking cessation change: There were 64 subjects (43.0%) in the precontemplation stage, 35 subjects(23.5%) in the contemplation stage, 28 subjects(18.8%) in the preparation stage, 14 subjects(10.1%) in the action stage and 7 subjects(4.7%) in the maintenance stage. 2. Analysis of variance showed that experiental process(F=2.808, p=.042), behavioral process (F=4.567, p=.004) self-efficacy(F=9.809, p=.000), pros(F=11.107, p=.000), cons(F=6.686, p=.000), pros- cons(F=3.446, p=.018) were significantly associated with the stages of smoking cessation change. 3. Through discriminant analysis, it was found that 'PROS' was the most influential variable in discriminating the four stages of change. Conclusion: This study can provide the basis of staged matching smoking cessation program using TTM for more effective and useful intervention.