• 한국보건간호학회지
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• 제18권2호
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• pp.205-217
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• 2004

This study conducted a survey with the 67 students who are in their 2nd year at 3 vocational high schools. The researcher of this study developed and operated the smoking cessation program based on the Transtheoretical model. To evaluate the effects, experiments were repeatedly done. The data were collected from June 21, 2004 till July 9, 2004. The survey was done based on the questionnaire-interview before and after education. The collected date was computerized by using SPSS-WIN 10.0 program. The results are as follows: Firstly. before education, the smoking cessation stage of change shows precontemplation stage $37.3\%$, preparation stage $37.3\%$, and contemplation stage $25.4\%$ respectively. However, after education it shows preparation stage $44.8\%$, action stage $25.4\%$, contemplation stage $19.4\%$, precontemplation stage $10.4\%$. The positive result was $62.7\%$ and smoking cessation stage of change made a 0.9 step increase. Secondly, process of change rose in all the areas except helping relationship. It also shows statistical improvement in all the fields except the dramatic relief of the experiential process, the helping relationship of behavioral process and stimulus control Thirdly, negative affective situation temptation, positive social situation temptation, and habitual strength temptation's average points decreased but showed statistical differences. Weight control temptation's average points decreased after education but didn't show statistical differences. Self efficiency increased measurably after education. Fourthly, concerning the social pros and coping pros caused by smoking, the average points were low after education and showed statistic decrease. As for the cons due to smoking, the average points increased but didn't show any statistical differences. In conclusion, thanks to the smoking cessation program applied by the Transtheoretical model, the smoking rate of vocational high school students became low and their smoking temptation also dropped considerably. In conclusion, while the pros for smoking were lessened, its corns were heightened through the educational awareness offered by this program.

• 대한간호학회지
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• 제36권6호
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• pp.1023-1032
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• 2006

Purpose: The purpose of this study was to identify nicotine dependence, smoking-related attitude, and subjective norms across the stages of change for smoking cessation among adult smokers in a rural area. Method: The subjects were 276 current smokers (male=243, female=33). There were 3 stages of change for smoking cessation: pre-contemplation, contemplation, and preparation stage. Data was collected by an interview or self-reporting from February 12th to March 5th 2004, and analyzed with frequency, percentage, $X^2-test$, Fisher's exact probability test, ANOVA, and Scheffe test using the SPSS-PC program. Result: According to the stages of change, 114(41.3%) current smokers were in pre-contemplation, 110(39.9%) in contemplation, and 52(18.8%) in the preparation stage. There was a higher percentage of males than females ($X^2-test$=8.99, p=.011) in the preparation stage. The mean score of the smoking-related attitude (F:7.43, p=.001) and subjective norm(F=27.41, p=.001) were both lowest in the pre-contemplation stage and increased positively during the stages of change for smoking cessation. Conclusion: Based on these findings, the authors recommend that community-based smoking cessation programs should be developed by considering the intention or motives of current smokers and should be initiated in the preparation stage and primarily for male groups.

• 대한간호학회지
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• 제30권5호
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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.

• 기본간호학회지
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• 제8권1호
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• pp.69-80
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• 2001

This study was done to investigate the relation of smoking temptation, stage of change in smoking cessation, nicotine dependency and perceived health status in middle aged men. Convenience samples of 176 subjects who were either smoked or used to smoke, aged between 30 to 64, living in Seoul and Kyungi province area in Korea were selected for the study. The data was collected from December 1, 1999 to June 30, 2000. The research instrument were Stage of Change of Smoking Cessation Measure (DiClemente et al. 1991). Smoking Temptation Measure (Velicer, DiClemente, Rossi, Prochaska. 1990), Perceived Health Status Measure (McDowell & Newell, 1996), and Nicotine Dependency Scale (FTQ: Fagerstrom, 1978). The data were analyzed using the SAS Program. The result of the study are as follows : 1. The analysis of variance and multiple comparison showed that according to the stage of change, there were significant mean differences in the three sub-factors of smoking temptation; 'positive affect situation (F=12.64, p=.0001)', 'negative affect situation (F=16.01, p=.0001)', 'habitual craving situation (F=14.43, p=.0001)' and nicotine dependency (F=4.12, p=.0033) The mean score for smoking temptation for the subjects who were in the precontemplation stage outweighed the mean score for smoking temptation for subjects who were in the maintenance stage. 2. Through discriminant analysis, it was found that negative affect situation was the most influential variable of the smoking temptation sub-factors which can be used to discriminate stage of change. 3. The analysis of Pearson correlation coefficients showed that there was a significant positive relation between nicotine dependency and negative affect situation of smoking cessation((r=0.2182, p=0.0045) and a significant negative relation between nicotine dependency and perceived health status(r=-0.2115, p=0.0059).

• 성인간호학회지
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• 제21권4호
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• pp.391-402
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• 2009

Purpose: This study was conducted to identify predictors of the stage of change for smoking cessation of male university students on the basis of the Transtheoretical model (TTM). Methods: The 388 current smokers or exsmokers who agreed to participate were recruited from three areas in Korea from August 2 to September 5, 2006. Data was analyzed using a SPSS program for descriptive statistics, ANOVA, and multiple logistic regression. Results: Most subjects (76.8%) were current smokers. According to stages of change, there were statistically significant differences in self efficacy, smoking temptation, decisional balance (cons, pros), and processes of change. The predictors of transition from contemplation to preparation were behavioral and experiential processes. The predictors of transition from preparation to action were pros of smoking and experiential process. The predictors of transition from action to maintenance were cons of smoking and behavioral process. Conclusion: Specific nursing interventions based on stages of change need to be developed for smoking cessation of male university students.

• 지역사회간호학회지
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• 제16권4호
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• pp.517-526
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• 2005

Purpose: The purpose of this study is to find taxi drivers' smoking behavior, self-efficacy and expectation level of success in smoking cessation. It will provide useful information for developing nursing interventions in health promotion programs. Method: The subjects of this study were 271 taxi drivers in Seoul and its metropolitan area. Data were collected using a self-reported questionnaire asking smoking history, smoking behaviors, health problem, stages of change for smoking cessation, self-efficacy and the expectation level of success in smoking cessation. Data were analyzed through descriptive statistics. Pearson's correlation, Mann-Whitney U test, Kruskal-Wallis test and Cronbach's a. Results: Of the taxi drivers, 83.8% were current smokers. Stages of change were as follows: 45.8% were in the precontemplation stage, 26.2% in the contemplation stage, 13.7% in the maintenance stage, 12.2% in the preparation stage and 1.5% in the action stage. In addition. 20.3% of the subjects reported health problems such as hypertension, heart disease, diabetes mellitus and respiratory disease. The expectation level of success in smoking cessation was positively related with self-efficacy. There were statistically significant differences in the expectation level of success in smoking cessation according to the number of cigarettes per day and nicotine dependency. In addition. there were statistically significant differences in self-efficacy according to the number of cigarettes per day, duration of smoking (years) and nicotine dependency. Conclusion: The results of this study suggest that taxi drivers' health problems and smoking rate were serious. Therefore more systematic health promotion programs for smoking cessation should be developed and executed by health care specialists at individual taxi companies.

• 한국간호교육학회지
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• 제19권4호
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• pp.640-647
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• 2013

Purpose: The purpose of this study was to identify the effectiveness of smoking cessation education using the transtheoretical model on the process of change, smoking temptation, decisional balance and stage change transition. Methods: A nonequivalent control group non-synchronized design was used for this study. The study population was 44 male college students in the experimental group and 66 students in the control group. Smoking cessation education was administered to the experimental group at one university. Descriptive analysis, t-test, and ANCOVA were used with the SPSS 19.0 program to analyze the data. Results: After providing a smoking cessation program, the experimental group showed significantly higher scores for self-efficacy for smoking cessation, process of change, and a lower score in decisional balance for pros of smoking and nicotine dependancy compared to the control group two weeks after the pre-test. However, no significant differences were found at four weeks after the pre-test. Conclusion: The findings indicate that this program could have a positive effect on process of change, decisional balance and stage transition for college student smokers.

• 대한간호학회지
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• 제39권4호
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• pp.469-479
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• 2009

Purpose: The purpose of this study was to identify the effectiveness of public health center smoking cessation counseling program using the transtheoretical model on the process of change, smoking temptation, decisional balance and stage change transition. Methods: A nonequivalent control group non-synchronized design was used for this study. The study population was 115 adult smokers. The counseling program was administered to the experimental group and a smoking cessation program from the Korean Ministry of Health & Welfare was administered to the control group. Descriptive analysis, $\chi^2-test$, t-test, and ANCOVA were used with the SPSS 12.0 program to analyze the data. Results: After treatment with this program, the experimental group showed significantly higher scores for process of change (t=4.148, p<.001), smoking temptation (t=-2.988, p=.003), and stage change transition ($\chi^2=5.871$, p=.031) compared to the control group. Experimental group members also showed significantly lower score for Pros of smoking (t=-3.151, p=.002). Conclusion: The findings indicate that this program could have positive effect on process of change, smoking temptation, decisional balance and stage transition for adult smokers. Based on these findings, the authors suggest additional counseling program focusing on smokers in specific stages.

• 지역사회간호학회지
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• 제18권3호
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• pp.431-440
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• 2007

Purpose: The purpose of this study was to describe stage distribution of current and former smokers and to analyze significant variables that used by adolescents at each stage using the Transtheoretical Model. Methods: A cross-sectional study was performed with 145 students attended to five high schools in one rural area. The survey instruments included stages and processes of change. decisional balance, self-efficacy, and knowledge related to smoking. Results: Among the participants, 47.6% were in the precontemplation and contemplation stages, 20.7% were in the preparation stage, and the other 31.7% were in the action and maintenance stages. Analysis of variance tests revealed that behavioral processes, pros and cons of smoking, and self-efficacy were significantly associated with the stages of smoking cessation, while among 10 processes of change, self-reevaluation, self-liberation, and reinforcement management were significantly different by the stages. Conclusions: The study results suggest that smoking cessation programs should emphasize behavioral strategies, self-efficacy, and decisional balance to help students adopt and maintain smoking cessation.

• 대한간호학회지
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• 제26권4호
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• pp.820-832
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• 1996

The average smoking rate for Adults' in our country is 40.6% : It is 74.2% for men and 5.0% for women. Particularly, the smoking rate for men is reported higher than that of men in U.S.A. or Japan. Since the first report on the association between smoking and cancer appeared, 370 thousand smokers have succeeded in smoking cessation and over 90% of them have responded that they depended on a self-help smoking cessation approach. Despite this positive evidence about self- help approaches for smoking cessation, most studies on smoking cessation have focused on evaluation of formal treatment programs that are provided by clinics. Reports on the smoking cessation process used by smokers in our country could not be found. However, it is believed that the situation in our country would be quite similar to that in U.S.A. as far as approaches to successful smoking cessation are concerned. This study was conducted to classify the smoking stage to which they smoker belong and which changing mechanisms could be included at each changing stage (precontemplation stage, comtemplation stage, action stage) with a sample of 155 college students between 20 and 29 years old. And it also identified which variables related both to smoking pattern and to health, which ones were significantly discriminating in the changing stages. From the results of the data analysis it was found that Self-Determination is the most influential variable as one of the changning mechanisms which can discriminate three changing stages. And as the next significant mechanisms were Reinforcement, Dramatic Relief, Cognitive Restructuring, Helping Relationship, and Information Management in that order. Among variables related to the smoking pattern, years of regular smoking, whether smoking is continued or not even when they are sick, the number of attempts to stop smoking, number of cigarettes smoked per day, and whether they have smoked over 100 cigarettes up to now, but not the time of the first cigarette after waking-up, were the significant factors to descriminate changing stages. It was confirmed that among variables related to health that, perceived control for health, confidence of health maintence ability, and self confidence in smoking cessation, were significant variables in determinating changing stages. The most influential variables among them was self-confidence in smoking cessation. Conclusively, it was shown that smoking cessation is the process of attempting to change smoking habits through the various changing processes. Also it can be shown that a few factors smoking habit, self-confidence of smoking cessation, and belief in self control of his /her health, were influential in discriminating the changing stages of the smoking habit.