Psycho-social determinants and motivational phases in smoking behavior of cardiac inpatients.
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.
Bolman
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Department of Health Education and Promotion, Maastricht University, 6200 MD, Maastricht, The Netherlands. c.bolman@gvo.unimaas.nl
de Vries
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D000704:Analysis of Variance; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000523:psychology*; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007389:Internal-External Control; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D010353:Patient Education as Topic; D020377:Self Efficacy; D016540:Smoking Cessation / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires