This cross-sectional survey was carried out to assess the decisional balance of Korean women toward mammography screening. A sample of 1, 903 naturally postmenopausal women was selected from the community-based social groups in town or city hall auxiliaries in seven metropolitan areas and six provinces in Korea. The classification of women according to the stage of adoption of mammography was 54.9% in pre-contemplation, 31.9% in contemplation, 7.8% in action, and 5.5% in maintenance. The mean differences of pros, cons, and the decisional balance by the stage of mammography adoption were statistically significant. There were significant mean differences between the stages of adoption according to a woman's experience with and intention for mammography and the pros score, the cons score, and the decisional balance score. Results provide the empirical evidence for the Transtheoretical model. An association between stages of mammography adoption and decisional balance exists.
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.
The purpose of this study was to identify causal relationships among variables of transtheoretical model for exercise in the elderly. A predictivel model explaining the stage of change was constructed based on a transtheoretical model. Empirical data for testing the hypothetical model was collected from 198 old adults over 60 years old in a community setting in Seoul, Korea in April and May,1999. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling (LISREL) 8.0 program was used to find the best fit model which predicts causal relationship of variables. The fit of the hypothetical model to the data was X2=132.85. (df=22, p=.000). GFI=.88, NNFI=.35, NFI=.77, AGFI=.59 which was not favorable but the fit of modified model to the data was X2=46.90. (df=27, p=.01).GFI= .95, NNFI=.91, NFI=.92, AGFI=.87) which was more than moderate. The predictable variables of stage of change for exercise of the Korean elderly were helping relationship, self cognitive determination, conversion of negative condition in process of change and efficacy for exercise . These variables explained 68% of stage of change for exercise of the Korean elderly.
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.
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.
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.
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 precontemplation and contemplation stages, and stress self determination and dramatic relief.