Asian Nursing Research
Volume 3, Issue 1 , Pages 15-23, March 2009

Mediating Effects of Self-Efficacy in the Transtheoretical Model Among Adolescent Male Smokers in Korea

  • Ok Kyung Ham, RN, PhD, CHES

      Affiliations

    • Department of Nursing, Inha University, Incheon, Korea
    • Corresponding Author InformationCorrespondence to: Ok Kyung Ham, RN, PhD, CHES, Department of Nursing, Inha University, 253 Yonghyun-dong Nam-gu, Incheon, South Korea 402-751
    • ,
  • Jae Bok Yoo, RN, MS

      Affiliations

    • Life Long & Physical Education Division, Incheon Metropolitan City Office of Education, Incheon, Korea

Received 22 December 2008; received in revised form 12 January 2009; accepted 6 March 2009.

Article Outline

Purpose

This study examined the moderating and mediating effects of self-efficacy on the relationships between predictor variables (decisional balance and processes of change) and the outcome variable (stages of change) using the Transtheoretical Model.

Design

Cross-sectional data were collected from 147 current and former smokers at three vocational technical high schools in Korean metropolitan areas.

Methods

The survey instruments included decisional balance, self-efficacy, processes of change (behavioral and experiential), and stages of change. Regression analyses were used to identify the mediating effects of self-efficacy.

Results

Self-efficacy mediated the relationships of decisional balance and behavioral processes with stages of change, but not that of experiential processes with stages of change.

Conclusions

The study results will provide valuable information regarding how each predictor variable is connected and path through adoption of smoking cessation behavior. By understanding mechanisms of behavior change, health professionals could develop effective smoking cessation interventions with consideration of roles of self-efficacy in the smoking cessation behavior change. [Asian Nursing Research2009;3(1):15–23]

Key Words:  male adolescents , self-efficacy , smoking cessation , transtheoretical model

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Ajzen I , Fishbein M . Understanding attitudes and predicting social behavior . Englewood Cliffs, NJ: Prentice Hall; 1980;
  2. Bandura A . Self-efficacy: Toward a unifying theory of behavioral change . Psychological Review . 1977;84:191–215
  3. Baron RM , Kenny DA . The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations . Journal of Personality and Social Psychology . 1986;51:1173–1182
  4. Beech BM , Rice R , Myers L , Johnson C , Nicklas TA . Knowledge, attitudes, and practices related to fruit and vegetable consumption of high school students . Journal of Adolescent Health . 1999;24:244–250
  5. Bennett JA . Mediator and moderator variables in nursing research: Conceptual and statistical differences . Research in Nursing & Health . 2000;23:415–420
  6. Borrelli B , Mermelstein R . Goal setting and behavior change in a smoking cessation program . Cognitive Therapy and Research . 1994;18:69–83
  7. Carson LE , Taenzer P , Koopmans J , Casebeer A . Predictive value of aspects of the Transtheoretical Model on smoking cessation in a community-based, large-group cognitive behavioral program . Addictive Behaviors . 2003;28:725–740
  8. Centers for Disease Control & Prevention  . Preventing tobacco use among young people: A report of the Surgeon General (executive summary) . http://Retrieved March 6, 2009, from http://www.cdc.gov/mmwr/preview/mmwrhtml/00030927.htm 1994;
  9. Chan SSC , Sarna L , Wong DCN , Lam TH . Nurses' tobacco-related knowledge, attitudes, and practice in four major cities in China . Journal of Nursing Scholarship . 2007;39:46–53
  10. Chang SO , Kim EJ , Kil SY , Seomun GA , Lee SJ . Influential variables on intention and action to quit smoking between adolescent smokers and adult smokers: Based on the Transtheoretical Model . Journal of Korean Academy of Nursing . 2005;35:1410–1419
  11. De Vries H , Mudde AN , Dijkstra A , Willemsen MC . Differential beliefs, perceived social influences, and self-efficacy expectations among smokers in various motivational phases . Preventive Medicine . 1998;27:681–689
  12. DiClemente CC , Schludnt D , Gemmell L . Readiness and stage of change in addiction treatment . The American Journal of Addictions . 2004;13:103–119
  13. Dozois DJA , Westra HA , Collins KA , Fung TS , Garry JKF . Stages of change in anxiety: Psychometric properties of the University of Rhode Island Change Assessment (URICA) scale . Behaviour Research and Therapy . 2004;42:711–729
  14. Fahrenwald NL , Walker SN . Application of the Transtheoretical Model of behavior change to the physical activity behavior of WIC mothers . Public Health Nursing . 2003;20:307–317
  15. Heuts PH , de Bie RA , Dijkstra A , Aretz K , Vlaeyen JW , Schouten HJ , et al.   Assessment of readiness to change in patients with osteoarthritis. Development and application of a new questionnaire . Clinical Rehabilitation . 2005;19:290–299
  16. Jung YS . Adolescents' smoking status and effectiveness of smoking cessation education in Chonan area . Journal of the Korean Academy of Family Medicine . 2003;24:150–157
  17. Kim, K.S., (2001). The effects of smoking cessation program on self-efficacy, smoking behavior, knowledge, and attitude. Unpublished master's thesis, Kyungpook National University, Daegu, Korea.
  18. Kim SY , Kim SI , Chun YJ , Lee PS , Lee SJ , Park ES , et al.   A prediction model for stages of change of exercise in the Korean elderly: Based on the Transtheoretical Model . Journal of Korean Academy of Nursing . 2000;30:366–379
  19. King TK , Marcus BH , Pinto BM , Emmons KM , Abrams DB . Cognitive behavioral mediators of changing multiple behaviors: Smoking and a sedentary lifestyle . Preventive Medicine . 1996;25:684–691
  20. Korean Association of Smoking & Health  . Survey on smoking prevalence among Korean students . Retrieved February 16, 2009, from http://www.kash.or.kr/user/main.asp 2008;
  21. Lazarus RS , Folkman S . Stress, appraisal, and coping . New York: Springer; 1984;
  22. Lee JH , Kang ES , Lee MH , Lee YE . The effects of self-efficacy promotion smoking cessation program for middle school students . Journal of Korean Community Nursing . 2001;12:716–731
  23. Lindberg CE . Knowledge, self-efficacy, coping, and condom use among urban women . Journal of the Association of Nurses in AIDS Care . 2000;11:80–90
  24. National Cancer Center  . Death statistics based on vital registration . Retrieved February 17, 2008, from http://www.ncc.re.kr/ 2006;
  25. Prochaska JO . A stage paradigm for integrating clinical and public health approaches to smoking cessation . Addictive Behaviors . 1996;21:721–732
  26. Prochaska JO , DiClemente CC . Stages and processes of self-change of smoking: Toward an integrative model of change . Journal of Consulting and Clinical Psychology . 1983;51:390–395
  27. Prochaska JO , Velicer WF , DiClemente CC , Fava J . Measuring processes of change: Applications to the cessation of smoking . Journal of Consulting and Clinical Psychology . 1988;56:520–528
  28. Rakowski W , Clark MA , Pearlman DN , Ehrich B , Rimer BK , Goldstein MG , et al.   Integrating pros and cons for mammography and Pap testing: Extending the construct of decisional balance to two behaviors . Preventive Medicine . 1997;26:664–673
  29. Rohsenow DJ , Abrams DB , Monti PM , Colby SM , Martin R , Niaura RS . The Smoking Effects Questionnaire for adult populations. Development and psychometric properties . Addictive Behaviors . 2003;28:1257–1270
  30. Son HM . Differences in processes of change, decisional balance, and temptation across the stages of change for smoking cessation . Journal of Korean Academy of Nursing . 2005;35:904–913
  31. Wagner EF , Myers MG , McIninch JL . Stress-coping and temptation-coping as predictors of adolescent substance use . Addictive Behaviors . 1999;24:769–779
  32. Wagner J , Burg M , Sirois B . Social support and the Transtheoretical Model: Relationship of social support to smoking cessation stage, decisional balance, process use, and temptation . Addictive Behaviors . 2004;29:1039–1043
  33. Willis TA , Hirky AE . Coping and substance abuse: A theoretical model and review of the evidence . In:  Zeichnec M ,  Eudler NS editor. Handbook of coping: Theory, research, and applications . New York: Wiley; 1996;p. 279–302

PII: S1976-1317(09)60012-8

doi:10.1016/S1976-1317(09)60012-8

Asian Nursing Research
Volume 3, Issue 1 , Pages 15-23, March 2009

Article Tools