Wang Ruey-Hsia, Cheng Chung-Ping, Chou Fan-Hao
College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Clin Nurs. 2009 Apr;18(7):1010-7. doi: 10.1111/j.1365-2702.2008.02509.x. Epub 2008 Nov 20.
To understand (1) the change of stage of changes, self-efficacy, decisional balance and processes of change for sexual abstinence behaviour across a 15-month interval, (2) relations of baseline stage of changes, self-efficacy, decisional balance and processes of change to follow-up stage of changes for sexual abstinence and (3) the important predictors of follow-up stage of changes and transition of stage of changes for sexual abstinence behaviour.
Examining factors of sexual abstinence behaviour among adolescents can provide useful information in designing sexual abstinence intervention programmes.
This study applied a transtheoretical model and used a longitudinal design.
Anonymous questionnaires were administered to 281 participants at baseline and 15-month follow-up.
In summary, 46.3% (n = 130) of the participants were in the same stage, 30.2% (n = 85) regressed and 23.5% (n = 66) progressed their stage from baseline to follow-up. Baseline self-efficacy, decisional balance and processes of change are related to follow-up stage of changes for sexual abstinence. Participants with higher baseline self-efficacy, lower decrease of self-efficacy from baseline to follow-up and lower decrease of decisional balance from baseline to follow-up were more in the definite group (preparation and action stage) at follow-up. Participants with higher baseline decisional balance, lower decrease of decisional balance from baseline to follow-up and lower decrease of self-efficacy from baseline to follow-up were more in the advancement transition group at follow-up.
Focus of interventions could differ according to intervention purpose. Reducing the decrease of self-efficacy and decisional balance across time is important to enable adolescents to be in or progress to better stages across time.
To make adolescents be in later stages at follow-up, increasing baseline self-efficacy is important. If the purpose is to progress the stages, baseline decisional balance should be emphasised. Health care providers should continually boost the self-efficacy and decisional balance of adolescents across time.
了解(1)在15个月的时间间隔内,性禁欲行为的变化阶段、自我效能感、决策平衡和改变过程的变化情况;(2)性禁欲行为的基线变化阶段、自我效能感、决策平衡和改变过程与随访时变化阶段的关系;(3)性禁欲行为随访时变化阶段和变化阶段转变的重要预测因素。
研究青少年性禁欲行为的相关因素可为设计性禁欲干预项目提供有用信息。
本研究应用了跨理论模型,并采用纵向设计。
在基线和15个月随访时,对281名参与者进行匿名问卷调查。
总体而言,从基线到随访,46.3%(n = 130)的参与者处于相同阶段,30.2%(n = 85)倒退,23.5%(n = 66)进展到更高阶段。基线自我效能感、决策平衡和改变过程与性禁欲行为随访时的变化阶段相关。基线自我效能感较高、从基线到随访自我效能感降低较少以及从基线到随访决策平衡降低较少的参与者,在随访时更倾向于确定组(准备和行动阶段)。基线决策平衡较高、从基线到随访决策平衡降低较少以及从基线到随访自我效能感降低较少的参与者,在随访时更倾向于进展转变组。
干预重点可根据干预目的而有所不同。随着时间推移减少自我效能感和决策平衡的下降,对于使青少年能够处于或进展到更好的阶段很重要。
为使青少年在随访时处于后期阶段,提高基线自我效能感很重要。如果目的是推动阶段进展,则应强调基线决策平衡。医疗保健提供者应随着时间不断增强青少年的自我效能感和决策平衡。