Title

應用跨理論模式探討職場戒菸協助的困難度

Translated Titles

Application of the Transtheoretical Model in the Analysis of the Task for Smoking Cessation in Workplace

Authors

賈台寶(Tai-Pau Chia);邱政元(Jeng-Yuan Chiou);林幸嫻(Hsin-Hsien Lin);黃奕孝(Yih-Shiao Huang);洪瀚濰(Han-Wei Hung);洪敦益(Duen-Yi Hung);余偉綸(Wei-Lung Yu)

Key Words

職場 ; 跨理論模式 ; 吸菸行為 ; 戒菸 ; Workplace ; Transtheoretical model ; Smoking behavior ; Smoking cessation

PublicationName

勞工安全衛生研究季刊

Volume or Term/Year and Month of Publication

21卷4期(2013 / 12 / 01)

Page #

387 - 403

Content Language

繁體中文

Chinese Abstract

職場菸害已導致健康與經濟的嚴重損失,如何有效協助職場員工戒菸,降低職場戒菸率,仍需進一步的努力,本研究透過跨理論模式分析員工吸菸行為,了解協助員工戒菸的困難度,並提出相關實務建議。本研究以中部地區職場共1,872名吸菸員工為調查對象,以跨理論模式量表進行調查,依員工戒菸意圖區分為「無意圖期」、「意圖期」及「準備期」三個改變階段,利用SPSS12.0統計軟體進行統計分析,以敘述性統計、ANOVA及雪費法分析吸菸員工的改變階段與吸菸態度、改變過程的差異性。三期吸菸員工數各為「無意圖期」(n=1,345)、「意圖期」(n=364)及「準備期」(n=163),最不想戒菸的「無意圖期」員工教育程度以高中職者居多、上班時平均吸菸次數最多;決策權衡分析經事後檢定比較發現「無意圖期」與「意圖期」員工作吸菸決定時視利益更為重要;自我效能分析結果為「無意圖期」與「意圖期」員工在三種情境下比「準備期」的員工更想吸菸;三期吸菸員工在改變吸菸行為過程面向具有顯著差異。透過跨理論量表分析可知三期吸菸員工的吸菸狀況與協助需求有顯著不同處,顯示三期吸菸員工的戒菸協助方式須以量身訂作、階段式、多元化、長期追蹤輔導的模式進行,但在經營競爭的壓力下使得協助職場員工戒菸呈現高困難度。佔多數的「無意圖期」員工,建議可先行了解其生活或工作困難與壓力源,再提供後續專業適宜的協助,才能全面顧及吸菸員工真正的需求。在新修訂法規規定加強對勞工健康照護及國內龐大菸害損失的壓力下,期許職場行有餘力時能戮力降低職場吸菸率,亦可避免未來的健康損害與潛在的重大工安災害。

English Abstract

Smoking has resulted in huge health and economic loss in workplace. Great effort should be made to assist employees for smoking cessation and to reduce the smoking prevalence rate. The aim of our study was to analyze the smoking behavior of workers using the Transtheoretical Model. From the model, the difficulties of smoking cessation in workplace were discussed and the practical strategies were proposed as well.One thousand, eight hundred and seventy-two smokers in the factories in central Taiwan were recruited for this survey. Questionnaires of the Transtheoretical Model were used in this study. According to their intention to smoking cessation, the smokers were divided into three ”stages of change”, which were the precontemplation stage, the contemplation stage and the preparation stage. The Statistics Package for Social Science software (SPSS Statistics 12.0) was used for data management and statistical analysis. The differences in the smoking attitude and the process of change among the three stages of change of the smokers were analyzed by using the ANOVA and the Scheffe's method.The number of the smokers in the three stages was 1,345 (precontemplation stage), 364(contemplation stage) and 163(preparation stage), respectively. The ones who had no intention to quit smoking (precontemplation stage) were with lower educational level and higher smoking frequency during the workdays. The results of decision making analysis showed that the smokers in the precontemplation and the contemplation stage considered more benefits or advantages to adopt smoking. In self-efficacy analysis, smokers in the precontemplation and the contemplation stage also showed higher tendency to smoke in the three situational temptations. And there were significant differences in the process of change of smoking cessation among the three stages of smokers.According to the analyses of the Transtheoretical Model, the needs of smoking cessation of the smokers in three stages differed significantly. It showed that the approaches for smoking cessation should be tailored, hierarchy, multi-channeled and long term followed-up. However, comprehensive approaches may face great difficulties in the workplace with tight operation schedule. As most smokers were in precontemplation stage, it is suggested that the stressors and difficulties of smokers should be consulted first and then offer professionals' assistance on the basis of thoroughly caring the smokers' requests. Under the pressure of the recently revised regulations of workers' health care and the great loss attributed by smoking, more effort should be made to prevent health risks and potential disasters in the workplace.

Topic Category 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
社會科學 > 社會學
Reference
  1. Centers for Disease Control and Prevention. Best practices for comprehensive tobacco control programs: CDC 1999; 1-87..
  2. Armitage, CJ.(2009).Is there utility in the transtheoretical model?.British Journal of Health Psychology,14,195-210.
  3. Callaghan, RC,Thaddeus, AH.(2006).The relation between processes-of-change and stage-transition in smoking behavior: A two-year longitudinal test of the Transtheoretical Model.Addictive Behaviors,31,1331-45.
  4. Carbonari, JP,DiClemente, CC,Sewell, KB.(1999).Stage transitions and the transtheoretical "stages of change" model of smoking cessation.Swiss Journal of Psychology,58,134-44.
  5. Centers for Disease Control and Prevention(2004).Surgeon General's ReportSurgeon General's Report,CDC.
  6. Dement, JM.(2000).Tobacco smoking and workplace hazards: cancer, heart disease and other occupational risks.Work, smoking and health. A NIOSH Scientific workshop,Washington DC: USA:
  7. DiClemente, CC,Prochaska, JO,Fairhurst, SK,Velicer, WF,Velasquez, MM,Rossi, JS.(1991).The process of smoking cessation: an analysis of precontemplation, contemplation and contemplation/ action.Journal of Consulting and Clinical Psychology,59,295-304.
  8. Gunes, G,Ilgar, M,Karaoglu, L.(2007).The effectiveness of an educational program on stages of smoking behavior for workers at a factory in Turkey.Industry Health,45,232-6.
  9. Guo, B,Aveyard, P,Fielding, A,Sutton, S.(2009).Do the transtheoretical model processes of change, decisional balance and temptation predict stage movement? Evidence from smoking cessation in adolescents.Addiction,104,823-38.
  10. Haberstick, BC,Timberlake, D,Ehringer, MA,Lessem, JM,Hopfer, CJ,Smolen, A(2007).Genes, time to first cigarette and nicotine dependence in a general population sample of young adults.Addiction,102,655-65.
  11. Ham, OK,Lee, YJ.(2007).Use of the Transtheoretical Model to predict stages of smoking cessation in Korean adolescents.Journal of School Health,77,319-26.
  12. Heimendinger, J,Feng, Z,Emmons, K,Stoddard, A,Kinne, S,Biener, L(1995).The working well trial: Baseline dietary and smoking behaviors of employees and related worksite characteristics.Preventive Medicine,24,180-93.
  13. Hennrikus, DJ,Jeffery, RW,Lando, HA.(1995).The smoking cessation process: Longitudinal observations in a working population.Preventive Medicine,24,235-44.
  14. Herzog, TA.(2008).Analyzing the Transtheoretical Model Using the Framework of Weinstein, Rothman, and Sutton(1998): The Example of Smoking Cessation.Health Psychology,27,548-56.
  15. Hu, L,Sekine, M,Gaina, A,Narsermoaddeli, A,Kagamimori, S.(2007).Association of smoking behavior and socio-demographic factors, work, lifestyle and mental health of Japanese Civil servants.Journal of Occupational Health,49,443-52.
  16. Iacobelli, N,Gallus, S,Petridou, E,Zuccaro, P,Colombo, P,Pacifici, R(2008).Smoking behaviors and perceived risk of injuries in Italy.Preventive Medicine,47,123-6.
  17. Johnson, JL,Fava, JL,Velicer, WF,Monroe, AD,Emmons, K.(2002).Testing stage effects in an ethnically diverse sample.Addictive Behaviors,27,605-17.
  18. Keller, S,Nigg, CR,Jäkle, C,Baum, E,Basler, HD.(1999).Self-efficacy, decisional balance and the stages of change for smoking cessation in a German sample.Swiss Journal of Psychology,58,101-10.
  19. McClave, AK,Dube, SR,Strine, TW,Mokdad, AH.(2009).Associations between health-related quality of life and smoking status among a large sample of U.S. adults.Preventive Medicine,48,173-9.
  20. Nakata, A,Takahashi, M,Ikeda, T,Hojou, M,Nigam, JA,Swanson, NG.(2008).Active and passive smoking and depression among Japanese workers.Preventive Medicine,46,451-6.
  21. National Institute for Occupational Safety and Health(2000).Work, Smoking and Health. A NIOSH Scientific Workshop,Washington DC, USA:
  22. Nishiura, C,Narai, N,Ohguri, T,Fanahashi, A,Yarita, K,Hashimoto, H.(2009).The effect of smoking prevalence at worksite on individual cessation behavior.Journal of Occupational Health,51,48-56.
  23. Parrott, S,Godfrey, C,Raw, M.(2000).Costs of employee smoking in the workplace in Scotland.Tob Control,9,187-92.
  24. Prochaska, JO,DiClemente, CC.(1983).Stages and processes of self-change of smoking: Toward an integrative model of change.Journal of Consulting and Clinical Psychology,51,390-5.
  25. Prochaska, JO,DiClemente, CC,Norcross, JC.(1992).In search of how people change. Applications to addictive behaviors.The American Psychologist,47,1102-14.
  26. Prochaska, JO,Norcross, JC.(1992).Attendance and Outcome in a worksite weight control program: Process and stages of change as process and predictor variables.Addictive Behaviors,17,35-45.
  27. Prochaska, JO,Wright, JA,Velicer, WF.(2008).Evaluating theories of health behavior change: A hierarchy of criteria applied to the Transtheoretical Model. An International review.Applied Psychology,57,561-88.
  28. Rossi, SR,Greene, GW,Rossi, JS,Plummer, BA,Benisovich, SV,Keeler, S(2001).Validation of decisional balance and situational temptations measures for dietary fat reduction in a large school-based population of adolescents.Eating Behaviors,2,1-18.
  29. Sargent, R,Shepard, R,Glantz, S.(2004).Reduced incidence of admissions for myocardial infarction associated with public smoking ban before and after study.BMJ,328,977-80.
  30. Skee, M,Cheng, DM,Rigotti, NA,Siegel, M.(2005).Secondhand smoke exposure in the workplace.American Journal of preventive Medicine,28,2103-9.
  31. Sorensen, G.(2001).Worksite tobacco control programs: the role of occupational health.Respiration Physiology,128,89-102.
  32. Tsai, SP,Wen, CP,Hu, SC,Cheng, TY,Huang, SJ.(2005).Workplace smoking related absenteeism and productivity costs in Taiwan.Tob Control,14,i33-7.
  33. Velicer, WF,Prochaska, JO,Fava, JL,Norman, GJ,Redding, CA.(1998).Smoking cessation and stress management: applications of the transtheoretical model of behavior change.Homeostasis in Health and Disease,38,216-33.
  34. Yamada, Y,Noborisaka, Y,Ishizaki, M,Honda, R,Tsuritani, I,Ymada, S.(2004).Association between cigarette consumption and proteinuria in healthy Japanese men and women from an occupational population.Journal of Occupational Health,46,365-73.
  35. 中區職場健康促進與菸害防制中心(2003)。,行政院衛生署國民健康局。
  36. 北區菸害防制中心(2008)。,行政院衛生署國民健康局。
  37. 賈台寶、王櫻芳、黃奕孝、余偉綸、姜豊弦、邱政元(2005)。職場菸害防制推動模式。第13屆海峽兩岸職業安全健康研討會論文集
  38. 賈台寶、林幸嫻、黃奕孝、曾民璟(2006)。職場菸害防制推動必要性探討。環境工程學會2006公安衛,防災研討會
  39. 賈台寶、黃奕孝、邱政元、黃舒平、王櫻芳(2004)。推動職場菸害防制關鍵點探討。安全系統與管理研討會論文集
Times Cited
  1. 王美惠(Mei-Hui Wang);李維玲(Wei-Ling Lee);賴宜萍(Yi-Ping Lai)(2015)。運用跨理論模式協助一位高學歷個案戒菸之照護經驗。護理雜誌。62(1)。98-102。