• Journal of Korean Academy of Nursing
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• v.35 no.1
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• pp.27-36
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• 2005

Purpose: The main purpose of this study was to investigate that the stages of change in smoking cessation behavior among coronary artery disease patients for six months progressed following the stages of change suggested by the transtheoretical model. Method: Subjects for this descriptive survey were 59 coronary disease patients who were smoking or who had stopped smoking for less than six months. Result: In the baseline, the distribution of the subjects’ stages of change was as follows: pre-contemplation stage 25.4%, contemplation stage 25.4%, preparation stage 22%, and action stage 27.1%. After six months, more subjects in the contemplation(33.3%) and preparation stages(30.8%) progressed to the action stage than those of the pre-contemplation stage(0%). Eighty-one percent of the subjects in the action stage at baseline progressed to the maintenance stage. The relationship between the numbers of smoking cessation attempts for six months and stages of change at baseline was significant(p=.001). However, the relationships between self-efficacy and nicotine dependence at baseline and progression in stages of change after six months were not significant. Conclusion: Progression in the stages of change for six months among subjects corresponded to the stages of change suggested by the transtheoretical model. Hence, future development and evaluation of intervention programs should be tailored individually considering each patient's stage of change.

• Journal of Korean Public Health Nursing
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• v.26 no.1
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• pp.147-157
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• 2012

Purpose: The purpose of this study was to identify the related factors of change affecting the stages of change for exercise, on the assumption that there are various stages of change in the exercise behavior of women in nursing college. Methods: The subjects were 496 female college students in D city. The research instruments were stages of change for exercise behavior, the process of change, decisional balance, and self-efficacy. The dates were analyzed by descriptive statistics, ANOVA, and stepwise multiple regression using the SPSS 18.0 program. Results: The distribution of the subjects across the stages was: pre-contemplation, 17.7%; contemplation, 58.7%; preparation, 19.0%; action, 2.8%; maintenance, 1.8%. Analysis of variance showed that cognitive process (F=17.26, p<0.01), behavioral process (F=27.05, p<0.01), the pros of decisional-balance (F=7.07, p<0.01), the cons of decision-balance (F=5.82, p<0.01), and self efficacy (F=17.79, p<0.01) were significantly associated with the change of exercise behavior stages. The related factors of change affecting the change of exercise behavior stage were the cons of decision-making, counter conditioning, self re-evaluation, and body mass index, including 28.4% R-square. Conclusion: The transtheoretical model would be applicable to explain the exercise behavior of some women in nursing college. So, this study will be useful information for developing effective exercise behavior programs considering female students' stages of change.

• 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.

• Korean Journal of Health Education and Promotion
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• v.27 no.2
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• pp.79-93
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• 2010

Objectives: This study aims to identify the factors associated with the stages of change in colorectal cancer screening, and develop a model explaining these stages of change by using structural equation modeling analysis. Methods: On the basis of literature review and expert advice, we constructed our hypothetical model that consisted of five theoretical constructs(process of change, pros, cons, self-efficacy, stage of change). In 2009, data was collected from 486 participants aged between 50 and 69. The data were analyzed by SPSS 15.0 and AMOS 6.0. Results: In the case of stage of adoption, the contemplation stage was the most common (37.4%), followed by the action stage (26.5%). In the final model of the stage of change for colorectal cancer screening, there was a direct influence of the process of change ($\gamma$=.562, p<.001), and cons ($\gamma$=.132, p<.01) on the stage of change with the terms of GFI .931, AGFI .904, RMR .038, NFI .930, and NNFI .936. Conclusion: It is necessary to produce and disseminate evidence-based cancer screening information, which can mitigate the negative attitude among the public toward cancer screening. Also, it is essential to provide a safer and more comfortable environment at cancer screening center.

• Korean Journal of Health Education and Promotion
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• v.28 no.3
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• pp.67-82
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• 2011

Objectives: The purpose of this study was to identify the factors influencing the stages of exercise behavior change after adjusting for related covariates. Methods: Participants included 362 of fourth to sixth graders in 3 elementary schools in a metropolitan city in Korea. The data were collected using structured questionnaire included Korean Stages of Change Scale for Exercise. Results: Logistic regression results showed that the motivational factors associated with transition from precontemplation to contemplation were cognitive process of change, self-reevaluation, conscious raising; regarding that from contemplation to preparation, cons of the decisional balance; regarding those from preparation to action, behavioral process, counter-conditioning, stimulus control, which were very similar to the results of previous researches subjected other age groups. But, there was no motivational factors associated with from action to maintenance, and self-efficacy had no influence on forwarding stages of change. Conclusions: TTM would be applicable to explain the exercise behavior of some children in Korea, which suggested that it be useful in developing the programs to improve physical activities of Korean school children.

• 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.

• Korean Journal of Community Nutrition
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• v.5 no.4
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• pp.615-623
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• 2000

Under the assumption that people go through stages in making dietary behavior change, this study was attempted to apply the stages of a change model for fat intake by examining the associations of social psychological variables with stages of change in dietary fat reduction. Derived from social psychological theories, 10 social psychological variables on motivational beliefs(6), social influence(3) and self-efficacy(1) related specifically to selecting every day diets low in fat were constructed. Fat and energy intakes were assessed by a short form semi-quantitative food frequency questionnaire. The associations of stages of change with motivational beliefs, social influence, and self-efficacy variables and energy and fat intakes were assessed in 333 female adults from large cities in Korea. Dietary stage groups differed significantly on most of the social psychological variables in ways predicted by theory. Motivational factors that lead to a psychological state of readiness to take action were important in the early stages of the dietary change process. Social influences were more important in the stages as people decide to take action. Self efficacy and motivational beliefs, particularly, reduction of perceived barriers were important in maintaining fat reduction behavior. The results of our study indicate differences in stages of change in fat reduction behavior in terms of nutrient intakes and social psychological correlates and suggests that adding a time dimension to social psychological models increases our understanding of dietary change, which assist us in designing nutrition education interventions that are more appropriately targeted by stage of change. (Korean J Community Nutrition 5(4) 615∼623, 2000)

• Research in Community and Public Health Nursing
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• v.23 no.2
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• pp.189-200
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• 2012

Purpose: The purpose of this study is to identify factors associated with the stages of change in medication adherence in patients with hypertension. Methods: Participants were 323 patients with hypertension. Sociodemographic/medication-related characteristics, stages of change, processes of change, self efficacy and decisional balance were self-administered. Results: Stages of change were significantly different according to gender, age, job and living arrangement. A multinominal logistic regression analysis has revealed that gender, age, living arrangement, self-liberation, and self-efficacy were significantly associated with the precontemplation stage. Age and self-liberation were significantly associated with the contemplation stage. Gender, age, living arrangement, and self-liberation were significantly associated with the preparation stage. Gender and helping relationship were significantly associated with the action stage. This model explained 52.0% of the stages of change in medication adherence. Conclusion: The tailored intervention strategies based on the stages of change may be needed for improving medication adherence in patients with hypertension.

• 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.