• Korean Journal of Adult Nursing
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• v.12 no.1
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• pp.40-51
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• 2000

Purpose : This study was carried out to identify the factor of decisional balance for exercise. This was composed of a set of variables at the level of decision making when the elderly decide to do exercise. It was used to classify and identify the characteristics of the stages of change for exercise to which the elderly belong, and was used to identify the variables of decisional balance which influence the stage of change for exercise in the elderly. Methods : Convenient samples of 198 subjects over age 60 in Seoul( mean age=70) were selected from community living, mentally competant older adults and the data was collected from April 1, 1999 to May 31, 1999. The research instrument was the Decisional Balance Measure for Exercise(Marcus & Owen., 1992), Stage of Change Measure(Marcus et al,1992). The data was analyzed by SAS Program. Results: 1. According to stage of change measure, without missing data,191 subjects were distributed in each stage of change for exercise : 50 subjects(26.1%), 7 subjects (3.6%), 52 subjects(27.2%), 4 subjects(2%), and 78(40.8%) belonged to the precontemplation stage, contemplation stage, preparation stage, action stage and maintenace stage. 2. Factor analysis identified 3 factors of decisional balance as appropriate factors for exercise of the elderly and named by researchers; 1)'Perceived Physical-psychological benefit', 2)'Perceived Physical-psychological burden', and 3)'Perceived time burden'. 3. The analysis of variance showed that the two components Perceived Physical - psychological benefit(F=45.95, P=.0001), and Perceived Physical-psychological burden (F=26.52, P=.0001) were significantly associated with stage of change. 4. Through the discriminant analysis, it was found that both 'Self Perceived Physical - Psychological benefit' and 'Perceived Physical-Psychological burden' were the influential variables in discriminating the three stages of change(pre-contemplation, preparation, and maintenance). Conclusion : Results are consistent with the application of the Transtheoretical model, which has been used to understand how people change health behaviors. Even though this study is a cross-sectional, not a longitudinal study, the findings of this study give useful information for exercise intervention about especially the factors relating to decision making for exercise of the elderly in the different stages of change of exercise.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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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.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.164-176
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• 2000

Purpose : This study was done to identify the factors of decisional balance for smoking cessation among middle aged men in Korea. This was composed of a set of variables at the level of decision making when middle aged men decide to stop smoking. It was used to classify and identify the characteristics of the stages of change for smoking cessation to which the middle aged men belong, and was used to identify the variables of decisional balance which influenced the stages of change for smoking cessation in middle aged men. Methods : A convenience sample of 169 men who had smoked and were smoking, were between age 30 and 60 and lived in Seoul(mean age=44), were selected from the community. The data was collected from December 10, 1999 to February 28, 2000. The research instrument was the Decisional Balance Measure for Smoking Cessation (Velicer et al., 1985). and Stage of Change Measure(DiClemente et al., 1991). The data were analyzed using the SAS Program. Results : 1. According to stage of change measure, the 169 subjects were distributed in each stage of change for smoking cessation: in the pre-contemplation stage 63 subjects(32.7%), contemplation stage 60 subjects (35.5%), preparation stage 17 subjects(10.1%), and maintenance stage 29 subjects(17.2%). 2. Factor analysis identified 4 factors of decisional balance as appropriate factors for smoking cessation of middle aged men. There were named by the researchers; 1)'Perceived Burden to Self', 2)'Perceived Benefit to Others' 3)'Perceived Approval to Others', and 4)'Perceived Disapproval to Self'. 3. Analysis of variance showed that the three components, 1)'Perceived Burden to Self(F=8.50, P=.0001)', 2)'Perceived Benefit to Others(F=3.19, P=.025)' and 3)'Perceived DisApproval to Self(F=2.87, P=.038)were significantly associated with stage of change. 4. Through discriminant analysis, it was found that 'Perceived Burden to self' was the most influential variable in discriminating the four stages of change(pre-contemplation, contemplation, preparation, and maintenance). Conclusion : The results are consistent with the application of the Transtheoretical model, which has been used to understand how people change health behavior. Even though this study is a cross-sectional, not a longitudinal study, the findings of this study give useful information for smoking cessation intervention for the middle aged men.

• 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.

• Korean Parent-Child Health Journal
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• v.11 no.1
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• pp.61-72
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• 2008

This study is a descriptive research attempted to examine the exercise practice of junior high school students and figure out their changing process, decision-making balance, and self-efficacy according to the exercise practice so that they can be utilized as fundamental data for developing exercise intervention programs for junior high school students. The study subjects were students from five junior high schools in B City. Total 600 questionnaires were distributed, and 554 responded ones were analyzed. The collected data were analyzed using SPSS/Win 10.0. According to the results of analyzing the subjects with the exercise changing stage tool, exercise non-practice group including the precontemplation stage, contemplation stage, and preparation stage occupies 57.6% while the exercise practice group including the action stage and maintenance stage consists of 42.4%. And according to the results of discriminating analysis setting total 10 factors of transtheoretical model variables as predictive factors to predict each group based on whether they practice exercise or not, it was found out that the subordinate factors of the changing process, consciousness-raising (F=33.98, p=.000), self-cognitive decision (F=21.55, p=.000), contrary condition provision (F=84.67, p=.000), helping relationship (F=28.52, p=.000), reinforced thinking (F=14.15, p=.000), and stimulus control (F=54.64, p=.000), and the subordinate factors of the decision-making balance, beneficial factors (F=15.65, p= .000) and hindering factors (F=8.58, p=.004), and self-efficacy (F=78.60. p=.000) were significant predictive factors and discriminating variables. Based on the research findings above, it will be necessary to develop exercise intervention programs sufficiently reflecting the changing process, decision-making balance, and self-efficacy suitably for the subjects and make strategies to encourage their active participation and exercise maintenance, through verifying transtheoretical model variables according to whether the junior high school students practice exercise or not.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.15 no.1
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• pp.60-70
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• 2008

Purpose: This study was done to identify types of smoking decision making-temptation in adolescents and characteristics related to type among student smokers. Method: Data collection was done from March to July. 2006. A survey was administered to 275 students in 13 high schools and 15 middle schools in Seoul, South Korea. To identify types and characteristics smoking decision making-temptation in adolescents, cluster analysis using the K-mean method was employed. Characteristics of the influential variables according to the identified types of adolescent smokers were evaluated using ANOVA. Results: Four types of smoking pattern in adolescents were identified: habitual craving (17.7%), nicotine dependence (35.8%), feeblemindedness (28.4%), and self control (18.1%). The score for nicotine dependency was higher in the habitual craving type than any other type (F=11.79, p=.001), while the score for self efficacy for smoking abstinence was higher in the self control type (F=23.06, p=.000). Conclusions: Findings from this study suggest that effective interventions for smoking cessation in adolescents require not only active implementation of nicotine replacement therapy but also development of individualized approaches for each person targeting change in the social environment that may lead to positive smoking decisional balance.

• Korean Journal of Health Education and Promotion
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• v.23 no.1
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• pp.63-75
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• 2006

Objective: This study was performed to identify the related factors of change affecting the stage of change, on the assumption that there are various stages of change in the exercise behavior of workers. Method: The subjects of the study consisted of 138 workers of 10 workplaces located in Daejeon City, and data collected by using questionnaires were analyzed with SPSS/WIN 11.5 program. Results: The subjects were distributed in the stage of exercise behavior change as follows: precontemplation stage(10.9%), contemplation stage(22.5%), preparation stage(41.3%), action stage(8.7%), and maintenance stage(16.7%). Of the process of change depending on the stage of exercise behavior change, the consciousness raising(F=11.50, p=.00), dramatic relief(F=2.82, p=.02) showed significant difference in the cognitive process, and the counter conditioning(F=4.56, p=.00), reinforcement management(F=4.64, p=.00), self-liberation(F=9.46, p=.00), and stimulus control(F=13.28, p=.00) showed significant difference in the behavioral process. For decision-making depending on the stage of exercise behavior change, both the pros of decision-making(F=9.23, p=.00) and the cons of decision-making(F=2.45, p=.04) showed significant difference. Self-efficacy depending on the stage of exercise behavior change showed significant difference as F=11.50, p=.00. The related factors of change affecting the stage of exercise behavior change were the pros of decision-making, the cons of decision-making, and self-efficacy including 34.1% R-square. Conclusion: In order to change the exercise behavior of workers positively, they need to be stimulated to use the cognitive and behavioral process in the process of change properly, and to be induced to make a decision positively. And also exercise programs suitable to various characteristics of each worker as well as those of workplaces to enhance self-efficacy need to be applied after being devised. Through the further longitudinal research, it is necessary to analyze the various aspects, such as groups to select, to maintain, to stop or give up the exercise, and to avoid the change, and to study how the related factors of change affect diversity like the above.

• Korean Journal of Occupational Health Nursing
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• v.23 no.4
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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.

• Journal of Nutrition and Health
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• v.43 no.6
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• pp.597-606
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• 2010

This study investigates the change of level of psychosocial factors of decisional balance, processes of change, and self-efficacy after nutrition education on vegetable and fruit intake of children in pre-action stages. Forty-seven 5th grade elementary school children in Yeongi-Gun, Chungnam-Do were categorized into pre-action stages from a total of 71 children by four-stage questions, and then finally into two stages of precontemplation and contemplation & preparation. After 6 weeks nutrition education, recognition of both of pros and cons of vegetable intake were improved in the two groups of precontemplation and contemplation & preparation. In fruits intake, however, recognition of pros was not changed after nutrition education in either stage, but recognition of cons was improved only in the precontemplation stage. However, no difference in any psychosocial variables was found between precontemplation stage and contemplation & preparation stage. After the nutrition education, the score of consciousness raising of vegetable intake belonging to cognitive process of change increased in the subjects of the precontemplation stage, wheres the scores of dramatic relief, self-reevaluation, environment reevaluation and social liberation increased in the group of contemplation & preparation. In fruit intake, however, no change was found except in the environment reevaluation in the precontemplation group. The behavioral process of change of vegetable and fruit intake did not show any change in either group after nutrition education. Self-efficacy scores of vegetable intake of keeping the foods at hand, eating the recommended number of servings and making time to eat increased in the precontemplation group, while in the contemplation & preparation group, self efficacy scores of shopping for a variety of vegetables, instead of keeping the foods at hands, as well as the scores of the rest two items of eating the recommended number of servings and making time to eat increased after nutrition education. However, in case of fruits intake, no difference was shown in the precontemplation stage except an item of keeping the foods at hand. The results indicated that the stage of change was progressed in the pre-action stage after nutrition education and the scores of many psychosocial factors increased in both pre-action stages. It is suggested that the recognition of cons as well as the cognitive process of change and self-efficacy could be best used as indicators of the assessment of nutrition education program for vegetable intake.