• Journal of Korean Academy of Nursing
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• v.37 no.7
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• pp.1159-1165
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• 2007

Purpose: The purpose of this study was to investigate the stages of change in smoking cessation after a Coronary Artery Bypass Graft(CABG) and to identify the related factors. Methods: The subjects (n=157) were patients who underwent a CABG in a university hospital from March 1998 to October 2005 and were smokers before the CABG. Data was collected viachart review and a telephone interview, and analyzed with descriptive statistics, $X^2$ test, one-way ANOVA, and Kruskal-Wallis procedure by the SPSS/PC win 12.0 program. Results: The subjects smoked for an average of 34 years (21 cigarettes per day) before surgery. Eleven percent of the subjects were in pre-contemplation, 6.4% in contemplation, 13.5% in preparation, 4.5% in action, and 64.5% in the maintenance stage. Nicotine dependence and self-efficacy were different among the groups with different stages of change in smoking cessation. Nicotine dependence was the lowest (p=0.00) and self-efficacy was the highest (p=0.00) in the maintenance stage. The number of subjects in pre-contemplation and contemplation significantly increased 6 years after surgery(p=0.05). Conclusions: To implement effective smoking cessation interventions for CABG patients, the intervention should be developed to accommodate individual readiness for smoking cessation, especially so for those who had a CABG more than 6 years previously.

• 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.

• Journal of Korean Library and Information Science Society
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• v.52 no.1
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• pp.279-300
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• 2021

The present study aimed to investigate the information needs and information seeking behavior of consumers who attempted to quit or maintain the ceasing of smoking and analyze the effects of the health information obtained at different stages. In particular, we examined how consumers use mobile health applications(health apps) as aids to change unhealthy behaviors and how their use of health apps influence health behavior changes. For 7 months from December 2017 to July 2018, the researchers observed changes in smoking behaviors of college students who use smoking-cessation apps and conducted face-to-face interviews. Regarding the effects of smoking-cessation apps, the participants in the action stage reported that they were encouraged to quit smoking by visualized information such as the number of days of smoking cessation, change of health status, and the saving of money due to smoking cessation. The participants in the maintenance stage highlighted that smoking cessation apps were helpful in recognizing the importance and achievement of smoking cessation by sharing experiences and social support with other attempters in the app community. The study provided theoretical implications in the field of information behavior in that it identified the particular types of information needs and information-seeking behavior of the consumers who were using mobile apps in their behavior modification process. In addition, those findings can contribute to designing the contents of the smoking cessation apps that reflect the information needs of those who attempt to cease smoking and further suggest practical insights to health information services that promote effective information intervention strategies in health behavior change.

• Journal of Korean Academy of Nursing
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• v.33 no.8
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• pp.1101-1110
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• 2003

Purpose. The purpose of this study was to identify the stage of change of smoking cessation behavior and investigate factors associated with the stage of smoking cessation behavior according to the transtheoretical model. Methods. The participants, 297 smokers & quitters were selected by a stratified random sampling from 127 high school sophomore students in B city. Data were collected from April 6th to 16th, in 2002 using the structured self-report questionnaire. Results. The subjects were distributed in each stage of change of smoking cessation behavior: there were 46 subjects (15.5%) in precontemplation, 73 subjects (24.6%) in contemplation, 67 subjects(22.3%) in preparation, 56 subjects (18.5%) in action, 55 subjects (18.5%) in maintenance. Compared to the precontemplation and contemplation, people in preparation tended to smoke daily more and smoked for a shorter time, and as precontemplation progressed to the maintenance, past 1 year smoking cessation frequency increased and friends smoking decreased. Smoking onset age was the earliest in preparation, and the latest in maintenance. Helping relationships and self relationships are used a lot in precontemplation and also in contemplation. In preparation, self liberation and helping relationships are used a lot, in action, self liberation and helping relationships, and in maintenance, self liberation and environmental reevaluation. At each stage, the score of negative affect situation was the highest, but the one of negative affect situation, positive social situation, habitual strength, weight control decreased as precontemplation progressed to the maintenance. While the score of social pros and coping pros decreased with increasing stage, the one of cons tended to increase. Through stepwise discriminant analysis, it was found that social pros, smoking onset age, delf-libration were the most influencing powers among factors associated with the stages of smoking cessation behavior. Conclusions. This study suggested that, in developing an effective smoking cessation intervention for adolescents, all the stage of a client's cessation had to be assessed prior to applying intervention programs. In addition, the results of this study will become a pillar of smoking cessation program planning and application.

• Research in Community and Public Health Nursing
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• v.32 no.3
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• pp.268-280
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• 2021

Purpose: The study is examined the effects of the smoking cessation program of life skills training using flipped learning for male middle school students. Methods: The study was a nonequivalent control group non-synchronized design. The Smoking Cessation Program of life skills training using flipped learning is a Smoking Cessation Program that applied 5 stages of flipped learning such as before class, introductory class, during class, after class, and during work. Participants were 32 male students attending a middle school in D city, with 16 in the control group and 16 in the experiment group. Data collection was conducted from February 26, 2019 to May 14, 2019 for the control group, and from May 28, 2019 to August 19, 2019 for the experiment group. The collected smoking knowledge, smoking attitude, self-efficacy, basic psychological needs, and urine cotinine were analyzed by x² test, independent t-test, two-way repeated measured ANOVA, and Fishers exact test using the SPSS 25.0 program. Results: The experimental group showed higher smoking knowledge, smoking attitude, self-efficacy, basic psychological need, and urine cotinine negative response than the control group, and there were significant differences. Conclusion: These findings indicate that the Smoking Cessation Program of life skill training using flipped learning is an effective intervention for cessation of middle school male students, and it has a positive effect on the increase in urine cotinine, and a physiological indicator of the cessation effect, and is effective in the success of smoking cessation.

• Journal of Korean Academy of Nursing
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• v.27 no.1
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• pp.71-82
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• 1997

In this paper, the study model, which presents the patterns of how the changing mechanisms are adopted to the changing stages of smoking cessation, was developed by modifying the integrative model of Prochaska et al. (1983) with including seven changing mechanisms which were identified by Oh and Kim(1996). Then the developed study model was exploratively tested with 155 University student between 20 and 29 years of age as subjects. According to the study results. among the five mechanisms. which are significant in explaining the differences between stages. DUNCAN post-comparison showed that the least applied ones were Stimulus Control, Self Determinism, Cognitive Restructuring in the precomplation stage, and Reinforcement and Dramatic Relief. in the relapsed stage. In the comtemplation stage. it was observed that Dramatic Relief is used most frequently and that the other two mechanisms, Information Management and Cognitive Restructuring, showed different results from those inferred in the study hypothesis. In the case of Information Management, it was excluded from the analysis it was not included in explaining significant difference among changing stages, but Cognitive Reconstruction turns out to be a more frequently used mechanism in the action stage rather than in the comtemplation stage. Helping Relationship was also excluded in the post-comparison analysis since it was not included in explaining significant difference among changing stages and Reinforcement was a more frequently used mechanisms in the comtemplation stage. Stimulus Control turns out to be the connecting mechanism which was most frequently used in both the contemplation and action stages. Self Determination was most frequently used in the action stage rather than in both the comtemplation stage and action stage, differing from the presumption of the model. Lastly, subjects in the relapsed stage were utilizing Stimulus Control and Self Determination at the same level as subjects in the precontemplation stage. and the utilization of both Reinformcement and Dramatic Relief was lower than that of the precomtemplation stage, that is, at the lowest level. Only Cognitive Restructuring was used of the same level as the comtemplation stage. The relapsed stage in this study did not represent the preparation for action stage as presumed in the model of Prochaska et. al. (1983) but did show a pattern similar to the initial stage of smoking cessation. However, since this interpretation about the relapser was based on only a small number of relapsers(n=5), this conclusion may not be reliable.

• 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 Health Education and Promotion
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• v.28 no.4
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• pp.79-94
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• 2011

Objectives: The aim of this study was to evaluate the effectiveness of smoking cessation clinics for soldiers in the Korean armed forces. In so doing it attempted to identify the predictors of smoking cessation and positive transition of stages of change. Methods: In a single-group pre-post test study design, 5,362 smokers from Korean armed forces participated in the smoking cessation clinic programs based on both the Transtheoretical model and life skills approaches. Changes in stages of change and related variables were measured before the intervention and at 3-month follow-up after the intervention. Results: The cessation rates was 66.0% at 3-month follow-up. With the positive transition to action/maintain stage, proportion of participants in action/maintain stage increased more than 5 times after the intervention. Cons of smoking, self-efficacy, processes of change, and life skills increased, and pros of smoking decreased after the intervention. Predictors of smoking cessation included nicotine dependency, pros of smoking, high levels of self-efficacy, processes of change and life skills. Positive stage transition was predicted by pros of smoking and high self-efficacy. Conclusions: Application of the Transtheoretical model and life skills approaches provided useful strategies for a smoking cessation program in armed forces.

• Korean Journal of Adult Nursing
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• v.22 no.6
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• pp.582-593
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• 2010

Purpose: Health care professionals represent an immediately available resource to promote smoking cessation. However, the content in smoking cessation intervention courses in most institutions is insufficiently covered due to the limited number of class hours. The purpose of this study was to develop a comprehensive tobacco cessation-web-based, multimedia, educational program for a range of medical professionals. Methods: Based on Jung's Teaching and Learning Structure Plan Model, a development process was proposed comprising four stages: (1) analysis, (2) planning, (3) production, and (4) operation/evaluation. The effectiveness of the program was tested using quasi-experimental design, and the participants in experimental group were required to complete the program. Changes in the level of knowledge and attitude were measured. Results: The educational program developed includes nine topics and 26 sub-topics. A total of 180 storyboards, 15 videos, and 27 pictures were made. After the education, the level of knowledge was significantly increased in the experimental group. Conclusion: This web-based program can be recommended as a potential medium for health care professionals to use in counseling smoking cessation. The study findings also indicated that the program may be either offered as a teaching aid or utilized concurrently with lectures for students studying health care-related topics.

• Journal of Korean Academy of Nursing
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• v.35 no.7
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• pp.1285-1294
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• 2005

Purpose: This study was done to evaluate the predictive value of aspects of the Transtheoretical model (TTM) of behavior change as applied to smoking cessation in a rural population. Method: A convenience sample was recruited from a public health center in a community. A total of 484 participants were recruited, including 319 smokers, 116 ex-smokers and 49 non-smokers. A cross-sectional and descriptive design was used in this study. Data was analyzed using descriptive statistics, frequency statistics, ANOVA and Logistic regression. Result: The major findings were 1) The participants were assessed at baseline for their current Stage of Change resulting in a distribution with $42.1\%$ in Precontemplation, $24.1\%$ in Contemplation, $9.7\%$ in Preparation, $6.2\%$ in Active, and $17.9\%$ in the Maintenance stage. 2) There were statistically significant differences of processes of change, decisional balance and situational temptation across the stages of change. 3) The main factors that affect smoking cessation were age, number of years smoking, age when began smoking, self-liberation and negative/affective situations, which combined explained $33.2\%$ of the smoking cessation. Conclusion: TTM variables measured prior to a smoking cessation program added little predictive value for cessation outcome beyond that explained by demographic and smoking history variables.