• Women's Health Nursing
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• v.10 no.3
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• pp.218-225
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• 2004

Purpose: The study was performed to identify exercise self-efficacy, depression, and stress by the stage of change in exercise behavior in middle aged women. Method: The subjects consisted of 317 women residing in B city by convenience sampling. The collected data was analyzed by the SPSS/WIN program. Result: The subjects were distributed in each stage of exercise behavior change: There were 53 subjects in the pre-contemplation stage, 86 subjects in the contemplation stage, 88 subjects in the preparation stage, 51 subjects in the action stage and 39 subjects in the maintenance stage. Analysis of variance showed that exercise self-efficacy (F=39.9, p<.001), depression (F=5.58, p<.001), and stress (F=6.33, p<.001) were significantly associated with the stages of exercise behavior change. There was a significant negative correlation between the stage of change and depression, and the stage of change and stress, but a significant positive correlation between the stage of change and self- efficacy, depression and stress. Conclusion: This study identified that exercise self-efficacy, depression and stress were significant variables to explain a possible relationship with exercise stages of middle aged women. This study provides new information to influence the development of better health promotion and exercise intervention for middle aged women in the community.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.10 no.2
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• pp.138-144
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• 2003

Purpose: The purpose of this study was to identify the change processes for exercise behaviors in each stage. Method: Participants for this study were randomly selected from adults between the ages of 20-44. Data were collected using questionnaires over a 2 week period at the end of May, 2003. The instrument, Stages of exercise behavior change developed by Marcus et al. (1992b), and the instrument, Changing phases of exercise behaviors developed by Nigg et al. (1999) and translated by Kwon (2002) were used to investigate the behaviors. Result: 1. Related to stage of exercise behavior change of participants, it was found that 55.2% of participants exercised regularly. 2. Among the change processes according to stage of change showed that dramatic relief was the most frequently used process for all stages. Environmental reevaluation and social liberation were used most in the contemplation stage, while environmental reevaluation and stimulus control were used most in the preparation stage. In addition, scores for stimulus control and environmental reevaluation were high in the action stage. In the maintenance stage, social liberation and counter-conditioning were used most frequently. 3. The process of exercise behavior change which differentiates the stages of exercise behavior change were shown to be counter-conditioning, which was an influential factor that differentiates the contemplation stage and maintenance stage. Conclusion: The results suggest that change process management should be the focus to enhance the stage of change for exercise in this group.

• Korean Journal of Adult Nursing
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• v.18 no.4
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• pp.573-581
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• 2006

Purpose: This study was to predict the stage of exercise behavior change in undergraduate students and to identify the factors affecting exercise behavior change by using the trans theoretical Model. Method: The subjects were 193 undergraduate students at K and D university in D city. Data were collected by questionnaire surveys using convenience sampling and analyzed by SPSS 12.0 program. Results: 77.7% of 193 nursing students do not exercise or they exercise irregularly. Exercise self-efficacy score and exercise benefits score were decreased with advancing exercise stage, on the other hand exercise barriers score and the process of exercise behavior change score were increased. In addition to this, the results revealed that stage of exercise behavior was significantly correlated with the process of exercise behavior change, exercise benefits, exercise barriers and exercise self-efficacy. Conclusion: These results suggested that the process of exercise behavior change, exercise decisional balance and exercise self-efficacy can be potential affecting factors for the stages of behavior change in university students. Therefore, these findings give useful information for educating nurse to construct nursing service programs focused on the stage of behavior change.

• Korean Journal of Adult Nursing
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• v.15 no.2
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• pp.236-246
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• 2003

Purpose: The purpose of this study was to examine the differences of the process of change, decision making, self-efficacy and perception of subjective health according to the stages of exercise behaviors suggested by transtheoretical models among older adults. Method: The subjects consisted of 291 older adults. Trained research assistants interviewed the older adults using structured questionnaires. ANOVA analyses with post hoc test were used to examine the mean differences for each stage of exercise behavior using SPSS for windows. Result: The subjects were divided into five stages of exercise behavior: 24.4% precontemplation, 12.4% contemplation, 17.9% preparation, 12.4% action, 33.0% maintenance stage. There were significant differences in process of change, decision making, self-efficacy and subjective health perception according to the exercise stage of change. 'Self-liberation' and 'stimulus control' were important strategies for intention of exercise, while 'reinforcing management' for the actual practice of exercise. 'Self-efficacy' was an effective strategy to change older adults from pre-contemplation to preparation stage. Conclusion: For exercise intervention, older adults should be classified into groups according to their stages of exercise behaviors and provided effective individualized intervention depending on their stage.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.13 no.3
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• pp.409-418
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• 2006

Purpose: This study was done to identify the process of change, decisional balance and self-efficacy corresponding to stage of exercise behavior based on the Transtheoretical model in patients with chronic arthritis. Method: The participants were 151 patients with chronic arthritis using an out-patient pain clinic and hospital in C city. The collected data were analyzed using ANOVA, Sheffe test and discriminant analysis with SPSS/WIN. Results: The patients were distributed as follows for each stage of exercise behavior 21.8% in the precontemplation stage, 26.5% in the contemplation stage, 25.2% in the preparation stage, 7.3% in the action stage, and 19.2% in the maintenance stage. Significant effects for stage of change were found for nine of the 10 processes of change and Pros, Cons, self-efficacy. Scores on these variables were found to increase across the stage of exercise behaviors from precontemplation to maintenance. Discriminant analysis revealed that self-efficacy and stimulus control, and reinforcement management were the major correlates of the stage of exercise behaviors. Conclusion: The findings of this study give useful information for exercise intervention, by using strategies of exercise for chronic arthritis patients in different stages of exercise behavior.

• 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.

• 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 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.

• Korean Journal of Adult Nursing
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• v.16 no.2
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• pp.191-201
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• 2004

Purpose: Many studies have shown that regular exercise produces positive effects on health. The purpose of this study was to examine the differences of health-related quality of life by stage of exercise and the interaction effect of age, sex and stage of exercise. Method: A total of 1266 participants were interviewed with structured questionnaire. Stage of exercise was assessed with a single item and respondents were classified with respect to exercise intention and behavior. Health-related quality of life was measured with SF-36 Health Survey Questionnaire. Result: Health-related QOL were found to be different by stage of exercise. The subjects who were reached maintenance stage showed significantly higher scores on physical functioning, bodily pain, general health perception, mental health, role limitation due to emotional problems, social functioning, and vitality than those in preparation, contemplation, and precontemplation stage. In addition a significant interaction effect between stage of exercise and age was found on physical functioning, bodily pain, general health perception, mental health, and vitality. Conclusion: Perceived health-related QOL varies with stage of exercise. This finding suggests that health is related to both intention and behavior of exercise. Therefore it is important to consider cognitive-motivational and behavioral stage of change for developing exercise programs.

• Journal of muscle and joint health
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• v.21 no.1
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• pp.46-54
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• 2014

Purpose: This study was designed to explore the stage distribution of subjects according to stages of change for exercise and to identify factors that could discriminate subjects in various stages. Methods: The sample consisted of 182 subjects who had metabolic syndrome. The instruments used in this study were the stage placement instrument for exercise, the metabolic syndrome knowledge and metabolic syndrome health belief scale, and the metabolic syndrome exercise self efficacy scale. Data were analyzed using chi-square, ANOVA, and discriminant analysis by using the SPSS 19.0 program. Results: For exercise stages, exercise efficacy, occupation, and exercise benefit showed high standardized canonical discriminant function coefficients. Subjects in precontemplation/contemplation stage for exercise were more likely to have occupations, had less exercise efficacy and exercise benefit than those in other stage. Conclusion: This study implies that the level of exercise efficacy and exercise benefit of subjects in precontemplation/contemplation stage need to be enhanced in developing exercise program incorporating the stage of change for metabolic syndrome patients.