Transtheoretical Model in Smoking Cessation
Introduction
Michael Scott is a 42-year-old employee. He noticed a decline in his regular performance for the last six months while playing social netball with his colleagues and decided to schedule an appointment with his General Practitioner (GP). During the interview, Michael confessed that he smokes approximately ten cigarettes in a day. The GP conducted an assessment on chest auscultation, oxygen saturation, and peak flow assessment. The results indicated that his lung health was worse than the expectation of the GP. The GP recommended Michael to visit a pulmonary specialist for some additional tests. However, he denied the condition by asserting that he had smoked for the entire of his life, and he had never experienced any problem.
Transtheoretical Model
Psychologists formulated practical approaches to help people change their behaviour. Thus, understanding the elements of change, the stage of evolution, and mechanism to work on each step to help individuals achieve their goals. Transtheoretical Model is a biopsychosocial , integrative model which conceptualizes the process of intentional behavioural change. The transtheoretical model (TTM) is the most appropriate in comprehending how people go through a change in behaviour (Hashemzadeh et al., 2019). The time an individual can stay in every stage varies, but the task necessitated to move to the next step remains constant. Noticeably, the process of changes works effectively for every level, reducing resistance, facilitating progress, and preventing relapse. (Owusu et al. 2015) also, assert that only 20% of a population at risk is ready to take action at any given moment. Therefore, action-oriented supervision fails to attend persons in the early stages. TTM training increases involvement in the process of behaviour change since it allures the population instead of the minority committed to taking action (Bakan & Erci, 2018). The behavioural change of Michael on quitting smoking uses TTM that recognizes changes as a progression reveal over time, and has a series of stages for behavioural change to take place. When the stage of evolution occurs in a linear trend, nonlinear progression often occurs as individuals regress to earlier stages from later one.
Case Study Application
Transtheoretical Model suggest that the cessation of unhealthy behaviour and gaining complementary of healthier behaviour advancement through five stages of change. Smoking cessation using TTM involves five steps where each stage could be applied along with the model in behavioural change. In the first stage, contemplation, a person is not thinking of making behavioural change (Luke, 2017). For the case of Michael, he does not think about quitting; neither does he realizes the health impact environmental tobacco has on his heath. Thus, precontemplator is characterized by resistance and unreadiness to get help. The contemplation stage is when an individual thinks about behaviour change though not committed to act (Luke, 2017). Individuals think of quitting smoking yet not quite ready and hope to leave shortly but weigh pros and cons, such as potential health benefits along with the consequences of possible withdrawal symptoms they encounter. The individual tends to change in six months, often featured by behavioural adjournment.
Preparation (ready) is the third stage, where the individual needs to takes a plan of action for the future immediately, usually proposed as the next month (Luke, 2019). At this stage, Michael would have started enrolling in the cessation program and start reading the information on how to quit or even minimize the number of cigarettes he smokes per day. Typically, he would have taken paramount action for the past year. The action plan is to consult a specialist and relies on a self-change approach.
After an individual making overt modifications about their lifestyle, the action stage occurs within the past six months (Luke, 2017). In this stage, Michael needs to make a significant effort when modifying his behaviour, which requires considerable commitment and time. Since the action is observable, the overall TTM gets equated with work. The stage has overt behaviour change, especially when individuals abstain 100% from smoking (Owusu et al., 2017). However, not all modification behaviour sums up as an action in TTM.
The maintenance stage, a final phase of TTM, asserts that when a smoker quits smoking, there is an integration of new behaviour in their daily life (Luke, 2017). Thus, Michael needs to continue maintaining this new healthier behaviour for an unspecified time. Instead, he would make overt modifications of lifestyle and work to prevent relapse. At the maintenance stage, Micheal experiences less temptation on the decline, and he grows and gains confidence as he continues making necessary changes. The researchers estimate that the maintenance stage lasts 6-60 months based on self-efficacy data (Lee, Park & Min, 2015). Therefore, when applying TTM, it is paramount to remember the change of behaviour evolve, and individuals are not ready to actively engage in the traditional program of behavioural change. The intervention needs to support the process of change, directed at each stage of evolution.
Conclusion and Recommendation
TTM is the most appropriate psychological approach that could be advocated for Michael in smoking cessation. The model profoundly highlights insights on how people go through a change in behaviour and entails series of stages that indicate progress. At the pre-contemplation stage, Michael does not even think of making change. Then, the contemplation stage always feels of behaviour change though not committed to act. At the preparation stage, the individual initiates a plan for behaviour change in the future, usually the next months. The action stage follows with an individual in the past six months with apparent reform of lifestyle of smoking cigarettes. The maintenance stage, which is the last stage, and Michael stops smoking and integrates new behaviour in his daily life.
The smoking cessation using TTM should be invigilated by specialists perceived as a role model by society to avoid relapse. The recommended practices would include training provision based on TTM as a course in nursing schools, along with compulsory in-service training in health institutions.
References
Bakan, Ayse Berivan, PhD., R.N., & Erci, B., PhD. (2018). Comparison of the effect of training based on the transtheoretical model and the health belief model on nurses’ smoking cessation. International Journal of Caring Sciences, 11(1), 213-224. Retrieved from https://search.proquest.com/docview/2058267537?accountid=151051
Hashemzadeh, M., Rahimi, A., Zare-Farashbandi, F., Alavi-Naeini, A., & Daei, A. (2019). The transtheoretical model of behavioural health change: A systematic review. Iranian Journal of Nursing and Midwifery Research, 24(2), 83-90. doi:http://dx.doi.org/10.4103/ijnmr.IJNMR_94_17
Lee, J. Y., Park, H., & Min, Y. H. (2015). Transtheoretical model-based nursing intervention on lifestyle change: A review focused on intervention delivery methods. Asian Nursing Research, 9(2), 158-167. doi:http://dx.doi.org/10.1016/j.anr.2015.05.001
Luck, K. E. (2017). A proposed program theory for a smoke-free hospital property. Social Theory & Health, 15(3), 323-345. doi:http://dx.doi.org/10.1057/s41285-017-0031-8
Owusu, D., Quinn, M., Wang, K., Aibangbee, J., & Mamudu, H. M. (2017). Intentions to quit tobacco smoking in 14 low- and middle-income countries based on the transtheoretical model. Drug and Alcohol Dependence, 178, 425. Retrieved from https://search.proquest.com/docview/1952113400?accountid=151051