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KMID : 0928320100100010022
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Korean Journal of Health Promotion and Disease Prevention
2010 Volume.10 No. 1 p.22 ~ p.30
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Stress, Self-efficacy, and Social Support By the Stages of Change in Smoking Cessation in Patients With Coronary Heart Disease
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Chae Young-Ran
Kim Eun-Kyoung
Choo Jin-A
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Abstract
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Background: Smoking cessation is one of the most important health behaviors to be acquired after a diagnosis
of coronary heart disease (CHD). The behavior may go through several stages of change up to the maintenance
of smoking cessation. We aimed to investigate CHD patients by stages of change in smoking cessation and to
identify psychological factors associated with these stages.
Methods: Subjects included 178 male CHD patients from two hospitals in Seoul and its metropolitan city, who
were smokers when diagnosed with CHD. We performed the multinomial logistic regression to examine if there
were any significant and independent associations with stress, self-efficacy, and social support with each
stage- precontemplation, comtemplation/preparation, and action/maintenance stages, after adjusting for age
and duration of illness.
Results: 73.6% of participants were ex-smokers. 7.9% were at pre-contemplation stage; 9.0% at contemplation;
9.6% at preparation; 12.9% at action; and 60.7% at maintenance stage. A higher level of positive
social support was significantly and independently associated with contemplation/preparation stages compared
to precontemplation stage (odds ratio=1.20, 95% CI [1.02, 1.41], p=.026). A higher level of positive social
support and a lower level of stress were significantly and independently associated with action/maintenance
stages compared to precontemplation stage (odds ratio=1.1×10-7, 95% CI [8.5×10-12-0.002]).
Conclusions: Higher positive social support and lower stress were significant factors associated with shifts in
stages from precontemplation to contemplation/preparation or to action/maintenance. These factors should be
considered in developing stage-tailored interventions for smoking cessation in CHD patients.
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KEYWORD
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Smoking cessation, coronary heart disease, self-efficacy, stress, social support
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