title: Psycho-social determinants and motivational phases in smoking behavior of cardiac inpatients.
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.
authors.affiliation: Department of Health Education and Promotion, Maastricht University, 6200 MD, Maastricht, The Netherlands. c.bolman@gvo.unimaas.nl
authors.forename: C
authors.initials: C
authors.lastname: Bolman
authors.forename: H
authors.initials: H
authors.lastname: de Vries
mesh_terms: 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