Document Type

Dissertation

Degree

Doctor of Philosophy

Major

Nursing

Date of Defense

8-23-2006

Graduate Advisor

Anne F. Fish, PhD, RN

Committee

Jean Bachman, D.S.N., RN

Gary Burger, Ph.D.

Kuei-Hsiang Hsueh, Ph.D., RN

Abstract

Nurses have a key role in promoting healthy lifestyles to reduce incidence of disease in adults. Since the 1980¿s, researchers have recognized readiness as a key component of adopting healthy lifestyle change. Prochaska¿s transtheoretical model, which contains readiness, or stage of change, served as the theoretical framework for the current study. The purpose of this study was to test an exercise behavior model, and in so doing: (a) compare the concurrence rates of exercise stage of change classifications obtained from the four selected exercise stage of change self-report measures; and (b) determine the relative strength of the predictive factors of exercise stage of change and of exercise performance, in healthy adults in a work setting. This correlational study used a one-group design. Ninety-five subjects, aged 19 to 62, completed six questionnaires and two structured interviews about healthy lifestyles. The first stage of change, precontemplation, was not used in data analysis due to few subjects classified in this stage. Agreement of stage classification by four measures of exercise stage of change was determined, with most agreement found between five answer choice and ladder (k = 0.82, p < .01), and between ladder and the structured interview (k = 0.86, p < .01). Using multinomial logistic regression, exercise self-efficacy (p = .003) and behavioral processes of change (p = .005) were significant predictors of stage classification. Differences in mean exercise performance across the stages were found, with exercise performance significantly (p < .05) lower in contemplation than in maintenance. Using multiple regression, exercise self-efficacy was the strongest positive predictor of exercise performance (β = .39, p < .01), followed by behavioral processes of change (β = .30, p = .021). Decisional balance pros was a significant negative predictor of exercise performance (β = -.22, p = .031). The results from this study may help to identify accurate measures which enable more correct classification of an individual¿s exercise stage of change. Revisions to enhance clarity of wording and directions and further testing of selected instruments are recommended.

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Nursing Commons

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