The effectiveness of a transtheoretical model-based smoking cessation intervention for rural smokers: A quasi-experimental longitudinal study.

OBJECTIVE: Cigarette smoking is highly prevalent, despite being a primary preventable cause of disease and mortality. This study examined the effect of a Transtheoretical Model (TTM)-based psychoeducational intervention for smoking cessation (SC) on knowledge, SC-related parameters, and progression through the TTM stages of change among rural smokers. METHODS: This quasi-experimental study recruited 200 smokers from an outpatient clinic. The comparison group was recruited before the experimental group to address possible self-selection bias. Structured questionnaires were administered pre- and post-intervention (three months) and at follow-up (six months). RESULTS: A generalised estimation equation model indicated that the TTM-based intervention significantly increased participants' SC-knowledge and improved progression through TTM stages by the six-month follow-up. No significant group differences were found in self-efficacy and nicotine dependence scores or daily cigarette consumption. CONCLUSIONS: A TTM-based intervention enhances SC-knowledge and fosters progress through change stages. However, it does not directly impact nicotine dependence or cigarette consumption. Outpatient settings may employ TTM-based programmes for SC education and motivation. Detecting anticipated effects may require a longer intervention duration exceeding six months. PRACTICE IMPLICATIONS: Such TTM-based programmes may facilitate SC-knowledge and motivation in outpatient settings. Further research to comprehend patients' context and experiences during the stages of change is required.

Association of urinary incontinence with impaired functional status among older people living in a long-term care setting.

AIM: To examine the association between functional status and urinary incontinence. METHODS: A total of 27 participants with urinary incontinence and 50 participants without urinary incontinence were analyzed at a long-term care setting in Pingtung County, Taiwan, in 2011. The recruitment criteria were age older than 65 years, ability to communicate with the researcher, agreement to participate in the present study and potential ability to complete at least one measurement of functional status. Urinary incontinence was defined as urine leakage at least once a week during the past 4 weeks, whereas functional status was assessed by the body composition (body mass index and waist circumference), upper body strength (grasp test), lower body strength (30-s and 5-times chair stand test), upper body flexibility (back scratch test), lower body flexibility (chair sit-and-reach test) and agility/dynamic balance (8-ft up-and-go test). RESULTS: In univariate analyses, performances on the tests of 5-time chair stand, 30-s chair stand, 8-ft up-and-go, chair sit-and-reach, and grasp were significantly different between the participants with and without urinary incontinence (all P < 0.05). However, after multiple logistical regression adjusting sex, age and chronic illnesses, just two tests, 8-ft up-and-go and chair sit-and-reach, were independent predictors of urinary incontinence. CONCLUSION: Poor performance on the tests of 8-ft up-and-go and chair sit-and-reach were the predominated risk factors of urinary incontinence. Further studies regarding how to improve the functional status, especially focusing on the function of the lower body, might be required in order to enhance continence care.