• Journal of Korean Academy of Nursing
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• v.54 no.2
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• pp.250-265
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• 2024

Purpose: This study aimed to develop an app-based self-management program based on the transtheoretical model (TTM) for breast cancer survivors' exercise practice, as well as to investigate the program's effects on the stage of change for exercise, exercise self-efficacy, exercise decisional balance, exercise amount, and body composition. Methods: This non-randomized controlled study included 52 participants (26 in each of the experimental and control groups, respectively). An app-based self-management program based on the TTM was conducted with the experimental group for a 12-week period. The program comprised three components: individual coaching for each stage of change for exercise based on TTM, amount of exercise and body composition monitoring, and online self-help meetings. Results: Compared with the control group, the experimental group had significantly higher stages of change for exercise (p < .001), exercise self-efficacy (p < .001), exercise decisional balance (p = .002), exercise amount (p < .001), and body composition (body weight [p = .006], body mass index [p = .005], and body fat percentage [p = .010]) immediately and four weeks after the intervention. Conclusion: An app-based self-management program based on the TTM improves exercise behaviors in breast cancer survivors and provides physical benefits.

• Journal of Preventive Medicine and Public Health
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• v.36 no.4
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• pp.377-382
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• 2003

Objectives : The purpose of this study was to investigate the predictor associated transitions with each stage of smoking cessation based on the Transtheoretical Model, and to provide basic data for smoking cessation programs for adolescents. Methods : The participants were 297 current and former smokers, obtained from stratified random sampling of 2nd graders from 127 high schools in B cities. The data were collected between April 6th and 16th 2002, using a structured self-report questionnaire, and analyzed using a multiple logistic regression, with the SPSS program for Windows (Version 10.0). Results : The predictors of transition from precontemplation to contemplation were consciousness raising (OR=1.22, 95% CI:1.07-1.40), coping pros (OR=.84, 95% CI:.70-1.00) and attitude of parents to smoking (OR=2.97,95% Cl: 94-9.24). The predictors of transition from contemplation to preparation were helping relationships (OR=.83, 95% CI:.72-.96), self-liberation (OR=1.15, 95% CI: 99-1.33) and nicotine dependence (OR=.76, 95% CI: 56-1.03). The only predictor of transition from preparation to action was the social pros (OR=.66, 95% CI:.57-.82). The predictors of transition from action to maintenance were self-reevaluation (OR=.81, 95% CI:.71-.92) and negative affective situation (OR=.85, 95% CI:.72-1.00). Conclusion : Adequate examination on the factors for predicting the transitional stages of change for smoking cessation in Koreans are presented in this study. The results of this study will become the pillar of smoking cessation Planning and application programs.

• Research in Community and Public Health Nursing
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• v.15 no.1
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• pp.110-121
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• 2004

Purpose: This study was performed to identify factors associated with drinking behavior using Transtheoretical Model in workers. Method: The study method was a survey of 216 marine shipping metal workers in Koje city from November 11, 2002 to November 30, 2002. Result: The subjects were divided in four stages of drinking behavior: 38.9% in pre contemplation stage, 38.6% in contemplation stage, 17.6% in preparation stage and 7.9% in action & maintenance stage. The amount of drinking was significantly decreased as the workers progressed through each stage. Helping relationships(HR) and Self reevaluation(SR) were identified as the main processes of change in all stages. Self liberation(SEL), Counter conditioning(CC), Helping relationships(HR), Self reevaluation(SR), Dramatic relief (DR) and Social liberation(SL) were used higher than average. The self efficacy score increased as the workers progressed through each stage, but not significantly. The Pros score of decisional balance was the highest in the pre contemplation stage and decreased as the workers progressed through each stage. but not significantly. The Cons score of decisional balance was the highest in the preparation stage, but not significantly in as the workers progressed through each stage. Conclusion: This study can provide the basis of a staged matching alcohol reducing program using TTM for more effective and useful intervention.

• Korean Journal of Adult Nursing
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• v.18 no.3
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• pp.345-356
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• 2006

Purpose: This study was conducted to compare the process of change, decisional balance, and self-efficacy according to the stages of change of exercise on the basis of the Transtheoretical Model in order to investigate factors associated with the change of exercise in adult diabetic patients. Method: Data were collected from January to April 2005. The subjects were 160 patients in the G university hospital and public health center in J city. Results: The entire process of change showed the significant difference depending on the stage of change(F=20.007, p=.000). For each process of change, the Consciousness Raising(F=14.602, p=.000), Dramatic Relief(F=7.751, p=.000), Environmental Re-evaluation(F=11.843, p=.000), Self Re-evaluation(F=16.035, p=.000), Social Liberation(F=10.968, p=.000), Counter-conditioning (F=24.090, p=.000), Helping Relationships(F= 7.625, p=.000), Reinforcement Management(F= 16.693, p=.000), Self Liberation(F=11.990, p= .000) and Stimulus Control(F=4.020, p=.002) demonstrated significant differences depending on the stages of change of exercise. For the decisional balance, the Pros showed the significant difference depending on the stage of change(F=14.121, p=.000). For the self efficacy showed significant difference depending on the stage of change(F=17.137, p=.000). Conclusion: In order to proceed the stage of change of exercise in patients with Diabetes Mellitus, intensive use of a specific process of change, a stage of change matching is needed.

• Journal of Korea Association of Health Promotion
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• v.3 no.2
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• pp.189-198
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• 2005

This study examined the applicability of the transtheoretical model(TTM) to understanding exercise behavior of early adulthood. A cross-sectional study was conducted and data wee collected from 1618 adults aged from 20 to 39 through internet survey. Major conclusions wee as follows: 1. Stage distribution for exercise behavior was 15.6%, 26%, 25%, 19%, 14.4% for precentemplation, contemplation, preparation, action, maintenance stages, respectively. 2. Behavioral processes were more frequently utilized than cognitive processes for action and maintenance stage. 3. Self-reevaluation, social liberation and reinforcement were frequently used in precontemplation, contemplation and preparation stages. Self-reevaluation, reinforcement, self-liberation were frequently used in action and maintenance stages. 4. Pros of exercise behavior began to be higher than cons of exercise behavior from the actions stage and continued to increase to maintenance stage. 5. Self-efficacy was higher in action stage than precontemplation, contemplation and preparation stages and the highest in maintenance stage.

• Journal of Korean Academy of Nursing
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• v.36 no.4
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• pp.587-595
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• 2006

Purpose. The purpose of this study was to differentiate the change in exercise behavior into different stages and to investigate differences in the process of change, self efficacy, decisional balances and depression according to the stages of exercise behavior change among middle aged women in Korea by using the transtheoretical Model. Methods. A convenience sample of 434 middle aged women (40-64 years) completed measures of all transtheoretical model constructs involved in exercise behaviors (stages and processes of exercise behaviors change, self efficacy and decisional balance) and depression. The data were analyzed by using the SPSS 10.0 program including descriptive statistics, and one-way ANOVA. Results. The subjects were distributed in each stage of change in exercise behaviors: pre-contemplation (n = 106; 24.4%), contemplation (n = 126; 29%), preparation (n = 88; 20.3%), action (n = 51; 11.8%), and maintenance (n = 63; 14.5%). The processes of change, pros (advantages of behaviors), self-efficacy and depression were significantly differentiated across the stages of exercise behavior change. Cons(disadvantage of behaviors) was not significantly differentiated across the stages of exercise behavior change. Conclusions. Results of this study suggested that discriminating of processes of change, self-efficacy, decisional balance, and depression could provide positive information to people about the stages of change in exercise behavior. Therefore, in designing interventions, the stage of a client's exercise behaviors change needs to be assessed prior to application of intervention programs in order to increase and maintain exercise behavior in middle aged women.

• Journal of Korean Academy of Nursing
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• v.31 no.5
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• pp.818-834
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• 2001

This study aims at confirming exercise effects on obesity, mobility, self-efficacy, process of change, and decisional component by stage based exercise motivational intervention program for the elderly. The stage based exercise intervention program was constructed based on Transtheoretical Model. Methods: The design of this study is nonequivalent control group with repeated measuring by quasi-experimental study. The subjects of this study, composing of experimental group of 32 and control group of 28 were selected at one institution for the aged in Seoul. Results: 1) The body fat (weight, BMI and circumference of waist), of the intervention group was significantly decreased than the control group. 2) The mobility of the intervention group was not significantly increased than control group. 3) The self-efficacy, Pros, Process of Change for exercise of the intervention group was not significantly increased than the control group. 4) The Cons for exercise of intervention group was not significantly decreased than the control group. Conclusion: The above result have informed us that a stage-based exercise motivational intervention program for the elderly has the effect of decreasing old persons' body fat and has value as an effective means of nursing for the elderly.

• Research in Community and Public Health Nursing
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• v.18 no.3
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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.

• Korean Journal of Health Education and Promotion
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• v.22 no.1
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• pp.103-115
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• 2005

The Purpose of this study was to identify the process of change, decisional balance and self-efficacy corresponding to the stages of change in exercise behavior based on the Transtheoretical Model(TTM) in obese adolescents. A random sample of 517 obese adolescents was recruited in Pusan. The data were collected from June 15 to 30, 2004. The research instruments were Stages of Change for Exercise Behavior, Process of Change, Decisional Balance, and Self-Efficacy. The data were analyzed by descriptive statistics and ANOVA using SPSS WIN 10.0 program. The results of this study were as follows 1. The subjects were distributed in each stage of exercise behavior: There were 255 subjects($49.3\%$) in the contemplation stage, 131 subjects($25.3\%$) in the preparation stage, 52 subjects($10.1\%$) in the maintenance stage, 41 subjects($7.9\%$) in the action stage, and 38 subjects($7.4\%$) in the precontemplation stage. 2. Analysis of variance showed that cognitive process (F=13.57, p=.000), behavioral process(F=17.23, p=.000), decisional balance pros(F=11.95, p=.000), and self efficacy(F=12.52, p=.000) were significantly associated with the stages of exercise behavior change, but decisional balance cons(F=2.87, p=.023) was not significantly associated with the stages of exercise behavior change. This study can provide useful information for developing effective exercise behavior program considering obese adolescents' stages of change according t'.t the TTM.

• Journal of Korean Public Health Nursing
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• v.30 no.1
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• pp.105-121
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• 2016

Purpose: This study examined the influencing factors from the Transtheoretical Model on the stage of change in the self-management behaviors, i.e. regular physical activity and diet, among community-residing adults with hypertension in a rural area. Methods: With a cross-sectional descriptive design, 134 adults who had registered and received a prescription for hypertension medication from a public health center in W city were recruited using convenient sampling. The instrument was an interviewer-administered questionnaire on the stage of change, process of change, self-efficacy, and decisional balance of physical activity and diet. The data were analyzed using descriptive statistics, 2-sample t-test, ${\chi}^2$ test, and logistic regression. Results: The results revealed significant differences in the process of change, self-efficacy, and decisional balance of physical activity and diet between those who were in the pre-execution stage (precontemplation, contemplation, preparation) and those who were in the execution stage (action and maintenance). Logistic regression showed that consciousness raising and self-efficacy were significant predictors of the execution stage in physical activity, and self-reevaluation, social liberation and self-efficacy were significant predictors in the diet. Conclusion: The relevant processes of change, differentiated according to the stage of change, along with self-efficacy, should be addressed to enhance the execution of self-management behaviors among hypertensive adults residing in the community.