• 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 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.

• Journal of Korean Academy of Nursing
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• v.42 no.3
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• pp.322-332
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• 2012

Purpose: This study was conducted to examine effects of a small group-based cardiocerebrovascular disease (CVD) prevention education program on knowledge, stage of change and health behavior among male bus drivers with CVD risk factors. Methods: A non-equivalent control group pretest-posttest design was used. Participants were 68 male bus drivers recruited from two urban bus companies. Participants from the two groups were selected by matching age, education and risk factors. Experimental group (n=34) received a small group-based CVD prevention education program 8 times over 6 weeks and 3 times through telephone interviews at 2-week intervals. Data were collected between December, 2010 and March, 2011, and were analyzed using chi-square test, t-test, and repeated measure analysis of variance with SPSS/Win18.0. Results: Experimental group showed significantly higher scores in CVD prevention knowledge (p<.001) and health behavior (p<.001) at 6 and 12 weeks after intervention. Participants in pre-contemplation and contemplation stages made progress to contemplation and action. This was significantly better at 6 and 12 weeks after intervention (p<.001). Conclusion: Results suggest that small group-based education programs for CVD prevention are effective in increasing knowledge, stage of change, and health behavior to prevent CVD among male bus drivers with CVD risk.

• Journal of Korean Academy of Nursing
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• v.37 no.7
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• pp.1159-1165
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• 2007

Purpose: The purpose of this study was to investigate the stages of change in smoking cessation after a Coronary Artery Bypass Graft(CABG) and to identify the related factors. Methods: The subjects (n=157) were patients who underwent a CABG in a university hospital from March 1998 to October 2005 and were smokers before the CABG. Data was collected viachart review and a telephone interview, and analyzed with descriptive statistics, $X^2$ test, one-way ANOVA, and Kruskal-Wallis procedure by the SPSS/PC win 12.0 program. Results: The subjects smoked for an average of 34 years (21 cigarettes per day) before surgery. Eleven percent of the subjects were in pre-contemplation, 6.4% in contemplation, 13.5% in preparation, 4.5% in action, and 64.5% in the maintenance stage. Nicotine dependence and self-efficacy were different among the groups with different stages of change in smoking cessation. Nicotine dependence was the lowest (p=0.00) and self-efficacy was the highest (p=0.00) in the maintenance stage. The number of subjects in pre-contemplation and contemplation significantly increased 6 years after surgery(p=0.05). Conclusions: To implement effective smoking cessation interventions for CABG patients, the intervention should be developed to accommodate individual readiness for smoking cessation, especially so for those who had a CABG more than 6 years previously.

• 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 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.

• Korean journal of food and cookery science
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• v.30 no.6
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• pp.687-694
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• 2014

The purpose of this study was to investigate the salt-related dietary behaviors according to the stage of change model in middle school students from the Gyeongsangbuk-do area. Data were collected from, a total of 253 male and 210 female middle school students through. Self-reporting questionnaire. By stage of salt-related dietary behaviors, the 'Pre-contemplation stage' was comprised of 57.3%, the 'Contemplation stage' of 12.2%, the 'Preparation stage' of 7.4% and the 'Action stage' of 23.2% of students. There were significant differences in the stage of change according to the experience with salt-related nutrition education (p<0.05), wherein differences according to gender and parent's education were not observed. In the salt-related dietary behaviors, there were significant differences according to gender (p<0.05), pocket money (p<0.01), and the stage of change (p<0.001). Males had higher salt-related dietary behavior scores than females, while students who had more pocket money also had higher scores, and the action group had lower scores than the other groups. Among the 10 items of salt-related dietary behaviors, only 4 showed above the average score (2.92/5.00), including behaviors of liking kimchi, completely consuming snacks and instant foods, and drinking the broth of soups. The salt-related dietary score of males was higher than females, while the action group's score was lower than the other stages.

• Journal of Korean Public Health Nursing
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• v.18 no.2
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• pp.205-217
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• 2004

This study conducted a survey with the 67 students who are in their 2nd year at 3 vocational high schools. The researcher of this study developed and operated the smoking cessation program based on the Transtheoretical model. To evaluate the effects, experiments were repeatedly done. The data were collected from June 21, 2004 till July 9, 2004. The survey was done based on the questionnaire-interview before and after education. The collected date was computerized by using SPSS-WIN 10.0 program. The results are as follows: Firstly. before education, the smoking cessation stage of change shows precontemplation stage $37.3\%$, preparation stage $37.3\%$, and contemplation stage $25.4\%$ respectively. However, after education it shows preparation stage $44.8\%$, action stage $25.4\%$, contemplation stage $19.4\%$, precontemplation stage $10.4\%$. The positive result was $62.7\%$ and smoking cessation stage of change made a 0.9 step increase. Secondly, process of change rose in all the areas except helping relationship. It also shows statistical improvement in all the fields except the dramatic relief of the experiential process, the helping relationship of behavioral process and stimulus control Thirdly, negative affective situation temptation, positive social situation temptation, and habitual strength temptation's average points decreased but showed statistical differences. Weight control temptation's average points decreased after education but didn't show statistical differences. Self efficiency increased measurably after education. Fourthly, concerning the social pros and coping pros caused by smoking, the average points were low after education and showed statistic decrease. As for the cons due to smoking, the average points increased but didn't show any statistical differences. In conclusion, thanks to the smoking cessation program applied by the Transtheoretical model, the smoking rate of vocational high school students became low and their smoking temptation also dropped considerably. In conclusion, while the pros for smoking were lessened, its corns were heightened through the educational awareness offered by this program.

• Korean Journal of Health Education and Promotion
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• v.20 no.3
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• pp.171-188
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• 2003

This study, based on stages of behavioral change, was aimed at suggesting strategies for the adoption of moderate drinking habits for community-based health education designed to help rural people. An interview survey was conducted during the period from March 4 to April 5, 2002 by sampling 467 rural people living in 6 villages covered by a public healthcare clinic. The results of this study can be summarized as follows； 1. The perceived non-moderate drinkers were less prepared for behavioral change. 2. The heavier drinking habits were ‘drinking alone’, ‘meals accompanied by drinking’ and ‘drinking twice or more at a time’. The agricultural off-season and the custom of brewing liquor at home were negative environmental factors for moderate drinking. 3. The predisposing factors affecting moderate drinking were recognition of health, expectation of the drinking effect, etiquette encouraging overdrinking and control of drinking. The reinforcing factors were stress from ordinary life and perception of being loved. The enabling factor was accessibility to the public healthcare clinic. 4. Rural residents are less motivated to participate in health education for moderate drinking. Based on the above findings, health education strategies for each stage can be suggested as follows： 1) Pre-contemplation stage： improvement of perception, motivation, sharing of experiences, and reawakening. 2) Contemplation/preparation stag e： measurement of value, departure from the inertia against a change, formation of a habit, and reinforcement of the behavior. 3) Action/maintenance stage： creation of a social atmosphere, encouragement of participation, change of life style, and improvement of environment.

• The Journal of Korean Academic Society of Nursing Education
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• v.21 no.1
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• pp.65-74
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• 2015

Purpose: This study was carried outto compare dietary self-efficacy, obesity stress, and obesity-related quality of life (OQOL) according to BMI and stages of change in vegetable consumption. Methods: A convenience sample of 326 nursing students agreed to complete a questionnaire. Data were collected from October 7 to October 18, 2013. Results: Obesity stress and obesity-related quality of life were significantly different according to BMI. Dietary self-efficacy showed a significant difference between the pre-contemplation/contemplation stage, preparation stage, and action/maintenance stage (F=50.18, p<.001). With obesity stress, there was a significant difference between the PC/C, P, and A/M stages (F=17.63, p<.001). Dietary self-efficacy had a positive correlation with OQOL (r=.11, p<.001) and a negative correlation with obesity stress (r=-.14, p=.012). And obesity stress had a negative correlation with OQOL (r=-.45, p<.001). Conclusion: These findings emphasize that nutritional-intervention programs for changes in behavior during the PC/C and P stages of change in vegetable consumption need to develop strategies to enhance dietary self-efficacy for nursing students.