채영란1,김은경2, 추진아*3

강원대학교 간호학과1, 수원과학대학 간호과2, 고려대학교 간호대학3

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.
Korean J Health Promot 2010;10(1):22-30 Key Words: Smoking cessation, coronary heart disease, self-efficacy, stress, social support