Results:

The final survey comprised 13 items based on the Transtheoretical Model. The Transtheoretical Model describes 5 stages of change or readiness to change: precontemplation, contemplation, preparation, action, and maintenance. Because this survey focused on the first 3 months after cardiac surgery, only the first 4 stages were addressed (the maintenance stage relates to >6 months of sustained change). The study cohort included 533 subjects recruited from 7 hospitals in 4 geographic regions of Thailand. Most subjects (72%) were within 2 weeks of surgery at the time of participation. Women represented slightly less than half the cohort (42%). Eighty percent of the cohort had elementary or high school education. The subjects had undergone heart valve surgery (54%), coronary artery bypass graft surgery (35%), and a small number of septal defect closure and other procedures. The main focus of the study was the development and validation of the survey tool. The authors provided appropriate statistical support for the validity and reliability of the survey. Although the authors cited other studies reporting that almost half of subjects were in either the precontemplation or contemplation stages, meaning they were not yet ready to change their behavior, the authors did not provide these data from their own study.