Elsevier

Preventive Medicine

Volume 27, Issue 5, September 1998, Pages 738-747
Preventive Medicine

Regular Article
Psycho-social Determinants and Motivational Phases in Smoking Behavior of Cardiac Inpatients,☆☆

https://doi.org/10.1006/pmed.1998.0352Get rights and content

Abstract

Background.To explore possibilities for health education, this study analyzed the differences in motives regarding smoking cessation of cardiac inpatients in various motivational phases. The Attitude—Social influence—Efficacy Model (ASE model) was used to assess motives, while motivational phases were measured with concepts from the Transtheoretical Model.

Methods.Data on smoking behavior, attitudes, social influences, self-efficacy expectations, and motivational phases were collected from a sample of 532 cardiac inpatients. A revised typology of the Transtheoretical Model was used for measuring motivational phases and resulted in four groups: smokers in precontemplation, smokers in contemplation, externally motivated actors, and internally motivated actors. Analysis of variance with Tukey's multiple comparison test was used to study differences in psycho-social determinants between these four groups.

Results.As hypothesized, externally motivated actors differed from internally motivated actors in having less positive attitudes, less social support, and lower self-efficacy expectations. Attitudes and social support were most positive among smokers in contemplation and internally motivated actors. Self-efficacy expectations were lowest among subjects in precontemplation and contemplation.

Conclusions.Subjects in different motivational phases differed in their psycho-social determinants. Therefore, it is recommended that stage-tailored education be developed. Finally, externally motivated actors have to be approached in a different way than internally motivated actors.

References (45)

  • JW Deckers et al.

    Quitting smoking in patients with recently established coronary artery disease reduces mortality by over 40%: results of a meta-analysis

    Eur Heart J

    (1994)
  • R Mulcahy

    Influence of cigarette smoking on morbidity and mortality after myocardial infarction

    Br Heart J

    (1983)
  • U.S. Department of Health & Human Services, The health benefits of smoking cessation,...
  • J Ockene et al.

    Smoking cessation and severity of disease: the coronary artery smoking intervention study

    Health Psychol

    (1992)
  • CB Taylor et al.

    Smoking cessation after acute myocardial infarction: effect of a nurse managed intervention

    Ann Intern Med

    (1990)
  • G Rose et al.

    Randomized control trail of anti-smoking advice: final (20 years) results

    J Epidemiol Comm Health

    (1992)
  • CT Orleans et al.

    A hospital quit-smoking consult service: clinical report and intervention quidelines

    Prev Med

    (1990)
  • LW Green et al.

    Health promotion planning: an educational and environmental approach

    (1991)
  • H De Vries et al.

    Self-efficacy: the third factor besides attitude and subjective norms as a predictor of behavioral intentions

    Health Educ Res

    (1988)
  • GJ Kok et al.

    Planned health education and the role of self-efficacy: Dutch research

    Health Educ Res

    (1991)
  • AN Mudde et al.

    Self-efficacy as a predictor for the cessation of smoking: methodological issues and implications for smoking cessation programs

    Psychol Health

    (1995)
  • M Fishbein et al.

    Belief, attitude, intention and behavior: an introduction to theory and research

    (1975)
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    This study was supported by grants from The Netherlands Heart Foundation and The Foundation on Public Health and Smoking.

    ☆☆

    Hersen, MEisler, R, MMiller, P, M

    2

    Address correspondence and reprint requests to Catherine Bolman, Department of Health Education and Promotion, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. Fax: 31(0)43-3671032. E-mail:[email protected].

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