• 대한간호학회지
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• 제33권8호
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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.

• 보건교육건강증진학회지
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• 제22권2호
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• pp.97-110
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• 2005

Objectives: Recent studies have shown that tailored messages for cancer screening to the beliefs and stage of cancer screening behavior of individual women increases the take-up probability. Many studies on cancer screening have used the Transtheoretical Model (TTM) to identify variables associated with cancer screening behavior. This study was carried out to identify the cognitive-behavioral factors associated with stomach cancer screening among women aged 40 years and over, and to develop and evaluate a tailored educational program for stomach cancer screening by stages of change. Methods: Building on the TTM constructs, we conducted a quasi-experimental study(N=283) to test the effectiveness of a tailored educational program for endoscopic stomach cancer screening. We carried out pre and post tests in the experimental group(N=162) and the control group(N=121), and the experimental group was subdivided into an on-line group(N=81) and an off-line group(N=81) by educational methodology using e-mail and the postal service. We used the chi-square test, trend test, and paired t-test to test the effectiveness of the program for stomach cancer using a tailored stage-matched messages. Results: To examine the effectiveness of the program for stomach cancer screening by the tailored stage-matched messages, the stage-matched materials were offered to the experimental group(N=162) four times for 4 weeks. The stage-matched materials consisted of the four types for stomach cancer. The tailored message was effective in changing the cognitive-behavioral factors, such as experience process, behavior process, con opinion for stomach cancer, self-efficacy, and the behavioral stages for stomach cancer screening. The stomach cancer screening adherence was higher for the stage-matched materials using postal mail than for those using e-mail. Conclusion: To improve the stomach cancer screening rate, the use of tailored messages for stomach cancer screening will be generated using an expert system. Therefore the implementation of tailored educational program will be supported a partnership between public and private health organizations and increasing awareness of the necessity of community-based interventions.

• 한국보건간호학회지
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• 제30권1호
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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.

• 보건교육건강증진학회지
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• 제22권1호
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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.

• 성인간호학회지
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• 제18권3호
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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.

• 성인간호학회지
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• 제25권2호
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• pp.136-147
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• 2013

Purpose: This study developed a program to facilitate evidence-based practice (EBP) in one nursing organization, and identifies the effects of the program on the nurses' EBP facilitators. Methods: The program was based on the Transtheoretical Model of stages of organizational change, a literature review, the cases of hospitals overseas, and a prior study. To identify the effects of the program, a one-group pretest-posttest study was conducted with 45 nurses who participated in the EBP implementation. Results: The program consisted of EBP educational sessions, consultations with academic nursing faculty and clinical EBP mentors, and support from the administration and relevant departments. After the EBP program, there was a statistically significant difference in belief in the value of EBP between the pretest and the posttest (t=2.31, p=.026). However, no significant differences were found between the pretest and the posttest for organizational support to develop EBP (t=0.62, p=.537), skills in locating and evaluating research reports (s=-1.00, p=.987), knowledge of research language and skills (s=-1.00, p=.986), and time to devote to EBP (s=-23.00, p=.711). Conclusion: The findings provide important data that can be used to develop and implement strategies for enhancing EBP in clinical settings in Korea.

• 대한간호학회지
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• 제34권2호
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• pp.362-371
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• 2004

Purpose: The study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of exercise behavior change based on a Transtheoretical Model in middle aged women. Method: The subjects consisted of 317 women by convenience sampling residing in city B. The collected data were analyzed using one-way ANOVA, Scheffe test, and Discriminant analysis by SPSS/WIN program. Result: The subjects were distributed in each stage of change of exercise behaviors: 53 subjects (16.7%) in the precontemplation stage, 86 subjects (27.1%) in the contemplation stage, 88 subjects (27.8%) in the preparation stage, 51 subjects (16.1%) in the action stage and 39 subjects(12.3%) in the maintenance stage. Analysis of variance showed that consciousness raising (F=24.96, p=.00), environmental reevaluation (F=7.l3, p=.00), self reevaluation (F=19.47, p=.00), dramatic relief (F=15.22, p=.00), social liberation (F=4.26, p=.00), counter conditioning (F=26.44, p=.00), a helping relationship (F=13.l7, p=.00), reinforcement management (F=21.25, p=.00), self liberation (F=27.70, p=.00), stimulus control (F=13.49, p=.00), pros (F=14.40, p=.00) and self-efficacy (F=39.9l, p=.00) were significantly associated with the stages of change of exercise behaviors. Through discriminant analysis, it was found that ‘stimulus control’ was the most influential variable in discriminating the five stages of change. Conclusion: This study can provide the basis of a staged matching exercise program using TTM for more effective and useful intervention.

• 대한간호학회지
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• 제35권7호
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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.

• 한국직업건강간호학회지
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• 제23권4호
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• pp.262-268
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• 2014

Purpose: This study was conducted to identify the differences by the stages of change in exercise behaviors of caregivers based on Transtheoretical Model. Methods: The subjects were consisted of randomly chosen 105 caregivers working in a nursing home. The collected data were analyzed with descriptive statistics, chi-square test, ANOVA and Duncan test using IBM SPSS Statistics 19. Results: The results showed that in the stages of exercise behaviors, there were most participants in contemplation stage with 24.7%, followed by 22.8% in preparation, 21.9% maintenance, 19.0% action and 11.4% pre-contemplation. As for the process of change by the stages of change in exercise behaviors, it showed statistically significant differences in behavioral strategies (F=7.64, p<.001). In decisional balance, pros (F=3.75, p=.007) showed statistical significance, with higher pros in all stages except pre-contemplation. Self-efficacy was also statistically significant (F=6.25, p<.001), especially in the maintenance stage. Conclusion: This study suggested that in order to encourage caregivers to exercise, a strategic intervention to reinforce the process of change, recognition of positive decision-making and promotion of self-efficacy in exercise behaviors should be developed.

• 지역사회간호학회지
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• 제18권4호
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• pp.611-623
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• 2007

Purpose: To evaluate a reducing alcohol intervention program for workers. Method: The intervention program employed one-group pretest-post-test design with repeated measuring by quasi-experimental study. The program was developed from literature review based on the Transtheoretical Model, and evaluated from April 6 to June 22, 2006. Sixteen white collar male workers participated. At the beginning, the subjects were at the pre-contemplation stage (50%) and contemplation stage (50%). The intervention was applied personally or in group twice a week for 9 weeks. Results: The scores of each stage of change in the post-test increased significantly compared with those in the pretest. The scores of process (cognitive and behavioral) of change in the post-test increased significantly compared with those in the pretest. The score of self-efficacy of change in the post-test increased significantly compared with that in the pretest. The score of pros-cons for drinking in the post-test decreased significantly compared with that in the pretest. The consumption of alcohol a week and a day in the post-test decreased significantly compared with that in the pretest. The levels in ALT, AST, GGT, total cholesterol, triglyceride, B.P. and BMI in the post-test did not decrease significantly compared with those in the pretest, but the level of FBS decreased significantly compared with that in the pretest. Conclusion: The above result informs us that a stage-based reducing alcohol intervention program for workers has the effect of increasing the stages of change, the process of change (cognitive and behavioral) and self-efficacy, and decreasing pros-cons for drinking alcohol consumption and FBS, and it also has a value as an effective means of nursing for workers.