• 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 Community Nutrition
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• v.7 no.1
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• pp.8-20
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• 2005

The study purpose was to examine which factors including health perceptions & behaviors, psychosocial factors, dietary intakes were different by stages of change to reduce fast food consumption among university students. Survey data(n = 341) were analyzed using X$^2$ test or analysis of variance. With respect to stages of change, $17\%$ were in the precontemplation ; $21.4\%$ for contemplation, $19.7\%$ for preparation, 11.7% for action, and $30.2\%$ for the maintenance stage. Frequency of fast food consumption (p < 0.001), health status, interest toward health, and exercising behavior (p < 0.05) differed significantly by stages of change. Demographics and nutrient intakes, however, had no association with stages of change. Those in precontemplation through preparation stages felt more strongly on the advantages such as taste, satiety, cleanness of restaurants (p < 0.001), and diverse menus (p < 0.05). Compared to maintainers or actors, pre-contemplators agreed less to the disadvantages of eating fast foods, including sanitary problems (p < 0.001), overeating, indigestion, decreased vegetable intakes (p < 0.01) and loss of freshness (p < 0.05). Influence of significant others (e.g., friends, siblings, parents) significantly differed by stages of change. Compared with maintainers, those in preaction stages felt less control over facilitators or situations for fast food consumption. These included 'others like fast foods', 'providing standard meals', 'when I don't have foods for meals'(p < 0.001), availability, advertisement, 'socially popular', 'when I feel hungry'(p < 0.01), and 'when I don't like to prepare meals' (p < 0.05). These results suggested that nutrition education be planned considering one's stages of change for fast food consumption. For those in preaction stages, it is desirable to use motivational strategies to increase benefits and remove barriers of change, and help to develop skills to deal with situations or factors for fast food consumption. The support from friends or families is also needed to move to further stages.

• 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)

• 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.33 no.8
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• pp.1171-1177
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• 2003

Purpose. Despite many smoking cessation programs, many patients with CAD continue to smoke or re-smoke. The processes of change and self-change for smoking cessation is emphasized. The purpose of present study was to investigate decisional balances and processes of change according to stages of change for smoking cessation in the patients with CAD. Methods. This descriptive study was performed using the self-reported questionnaires from 157 male patients with CAD who have smoking experiences. The questionnaires consisted of decisional balances toward smoking (pros/cons) and processes of change including 7 factors. Results. 45.2% of the subjects had myocardial infarction and 54.8% for angina pectoris. Major stages of change were maintenance, contemplation, and precontemplation in 62%, 14%, and 18% respectively. The mean score of pros smoking was 31.07 and cons smoking was 32.52. The mean scores of processes of change were high in all 7 factors, especially in self determination. The pros smoking in precontemplation stage was significantly higher than those in other stages. Between contemplation and precontemplation stages, processes of change showed significant differences in stimulus control, self determination, information management, and dramatic relief. Conclusion. This study suggests that decisional balances and processes of change are stage-specific. As this study, smoking cessation program in the patients with CAD must put priority on the patients group in pre-contemplation and contemplation stages, and stress self determination and dramatic relief.

• 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.

• 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.

• 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.

• Nutrition Research and Practice
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• v.4 no.6
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• pp.535-540
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• 2010

In this study, 342 grade 4-6 elementary school students in Gyeonggi-do were recruited to determine their readiness to change food safety behavior and to compare their food safety knowledge and practices by the stages of change. The subjects were divided into three stages of change; the percentage of stage 1 (precontemplation) was 10.1%, the percentage of stage 2 (contemplation and preparation) was 62.4%, and that of stage 3 (action and maintenance) was 27.5%. Food safety knowledge scores in stage 3 (4.55) or stage 2 (4.50) children were significantly higher than those in stage 1 children (4.17) (P < 0.05). The two food safety behavior items "hand washing practice" and "avoidance of harmful food" were significantly different among the three groups (P < 0.05). Stages of change were significantly and positively correlated with food safety knowledge and practice. Age was significantly and negatively correlated with the total food safety behavior score (r = -0.142, P < 0.05). The most influential factor on the stage of change was a mother's instruction about food safety (P < 0.01).