研究背景與目的：慢性阻塞性肺疾病目前在全世界許多國家，是主要引起殘障與死亡的慢性疾病之ㄧ；隨著人口老化與抽菸人口增加，世界衛生組織預測到2030年，慢性阻塞性肺疾病將成為世界第三大死因。在現今醫療體系提倡以病人為中心的理念下，研究者以Bandura社會認知理論、Bourbeau等人行為改變因果模式為理論架構，目的要了解慢性阻塞性肺疾患日常生活中的疾病自我管理行為，建構慢性阻塞性肺疾患疾病自我管理模式，未來發展疾病自我管理計畫，提昇病人生活品質。
研究方法：本研究採方法三角交叉法，以質性研究了解慢性阻塞性肺疾患日常生活中疾病自我管理行為、影響因素及行為成果，並發展自我效能與自我管理行為量表；以量性研究驗證工具信、效度，建構自我管理模式。質性研究在北台灣某醫學中心之胸腔科病房、門診與呼吸治療室進行，自2004年4月、2006年11月至2007年4月，及2008年8月間，共訪談19位樣本，以Miles和Huberman的交互作用模式分析資料。量性研究在胸腔科門診進行，自2007年10月至2008年7月，共收集212份有效問卷，採用SPSS 15.0進行描述性統計分析、項目分析、探索式因素分析，以AMOS模組進行驗證式因素分析、結構方程式分析。
研究結果：質性研究結果發現，在尋求症狀穩定的過程中，病人會受到外在環境、疾病認知與情緒因素的影響，使用不同且多樣性的自我管理行為處理疾病與緩解症狀；無論疾病嚴重程度如何，樣本自我管理行為共五類，包括：症狀處理、活動和運動執行、環境控制、心理調適、生活保健。量性研究結果顯示，疾病知識與自我管理行為量表之信、效度未能達到滿意水準，自我管理模式之整體模式適配度指標：χ2/df 1.514、RMSEA 0.049，理論模式與資料間的適配度尚可接受，各變項中自我效能對自我管理行為的影響最大，直接影響係數0.641（p＜0.01），自我管理行為對生活品質的直接影響係數0.315（p＜0.01）。
結論與建議：慢性阻塞性肺疾患是自己生活的專家，他們將個人經驗、智慧與醫療人員教導的知識，整合至疾病自我管理行為；同時，藉由自我管理模式的建立，了解影響慢性阻塞性肺疾患自我管理行為與生活品質的因素包括：診斷時間、疾病知識、憂鬱、社會支持與自我效能。研究結果建議，醫療專業人員應發展以實證為基礎之自我管理計畫，並藉由自我管理教育之落實、定期電話追蹤與召開病友討論會，增強病人自我效能。

Background and Purpose: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. The World Health Organization projects that, by 2030, COPD will be the third leading cause of death worldwide. These increases are in response to a longer life expectancy, coupled with an increasing number of individuals who smoke. A patient-centered perspective calls for this study. Based on Bandura’s social cognitive theory and Bourbeau’s et al. causal model of behavior change, the purpose of this study was to explore the self-management behaviors and to construct self-management model as means to develop self-management program and enhance quality of life for patients with COPD.
Methods: This study adopted the methodological triangulation. The qualitative study was to understand the self-management behaviors, antecedent factors, consequences of behaviors, and development scale of self-management behavior. The quantitative study was to verify the reliability and validity of instruments and to construct the self-management model.
A purposive sample of 19 men was invited to participate in the study. To better understand the behaviors of patients under different conditions, participants were drawn from different settings: including a thoracic ward, outpatient department, and the respiratory therapy room in a medical center in Northern Taiwan. Data were collected from April 2004, November 2006 ~ April 2007 to August 2008. Miles and Huberman’s interactive model was used to analyze the data. The quantitative study was conducted in the outpatient department from October 2007 to July 2008. The participants were a purposive sample of 212 participants who had COPD. Data from the questionnaire for each participant were entered into the Statistical Package for the Social Sciences (SPSS), version 15.0, for analysis of descriptive statistics, item analysis, and exploratory factor analysis. The SPSS module of analysis of moment structure (AMOS) used for confirmatory factor analysis and structure equation model (SEM) analysis.
Results: The participants chose the self-management behaviors that suited them to avoid any condition which might induce symptoms and to maintain stable physical functions and daily living conditions. Also, the participants would be affected by environmental factors, disease cognition, and affective factors. No matter what the level of severity, five themes of disease management behaviors were identified: symptom management, activity and exercise implementation, environmental control, emotional adaptation and maintaining a healthy lifestyle.
The results of quantitative study indicate that instruments of disease knowledge, and self-management didn’t demonstrate good internal consistency reliability and construct validity. The overall model fit of self-management was fair fit, χ2/df 1.514, RMSEA 0.049. Self-management behavior was directly influenced by self-efficacy (ß=.641). Quality of life was directly influenced by self-management behavior (ß=.315).
Conclusion and Suggestion: Participants are experts on their lives and, as such, they adopt appropriate disease control behaviors, based on their experience, wisdom, and knowledge that teach by healthcare professionals as well as integrate the illness and its symptoms into their lives. Factors associated with self-management including the average duration of illness, disease knowledge, depression, social support, and self-efficacy. The results suggest that healthcare professionals should develop an evidence-based program for self-management for COPD patients that incorporates strategies to enhance patient’s self-efficacy of self-management behavior.

目錄
頁數
謝誌‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥i
中文摘要‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ ii
英文摘要‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ iv
目錄‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥vii
附錄‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ x
圖目錄‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ xi
表目錄‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ xii

第一章 緒論
第一節 研究背景與重要性‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥1
第二節 研究假設‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥6
第三節 研究問題‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥6
第四節 名詞解釋‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥6
第二章 文獻查証
第一節 理論架構‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥9
一、 社會認知理論‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥9
二、 行為改變因果模式‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 12
三、 研究概念架構‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 14
第二節 慢性阻塞性肺部疾病之概念與相關研究‥‥‥‥‥‥‥‥‥‥ 15
第三節 慢性阻塞性肺疾患自我管理定義‥‥‥‥‥‥‥‥‥‥‥‥‥ 19
第四節 慢性阻塞性肺疾患自我管理行為‥‥‥‥‥‥‥‥‥‥‥‥‥ 23
第五節 慢性阻塞性肺疾患自我管理行為的影響因素‥‥‥‥‥‥‥‥ 26
一、 自我效能‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 26
二、 情緒狀態‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 28
三、 社會支持‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 29
四、 疾病認知‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 31
第六節 慢性阻塞性肺疾患自我管理成果與生活品質‥‥‥‥‥‥‥‥ 35
一、 慢性阻塞性肺疾患自我管理成果‥‥‥‥‥‥‥‥‥‥‥‥‥ 35
二、 慢性阻塞性肺疾患生活品質‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 39
第三章 研究方法
第一節 三角交叉研究法‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥42
第二節 質性研究—慢性阻塞性肺疾患疾病自我管理行為‥‥‥‥‥‥‥45
一、 研究目的與問題‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 45
二、 研究方法‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 45
（一） 研究場所與對象‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 45
（二） 研究工具‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 46
（三） 研究工具之信效度‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 48
（四） 研究倫理‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 50
（五） 資料分析‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 50
第三節 量性研究—慢性阻塞性肺疾患自我管理量表發展與模式結構‥‥55
一、研究目的與問題‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 55
二、量性研究概念架構‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 56
三、研究方法‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 57
（一） 研究對象‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 57
（二） 研究步驟‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 58
（三） 量表發展‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 59
（四） 研究工具‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 64
（五） 研究倫理‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 70
（六） 資料分析‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 70
第四章 研究結果
第一節 質性研究--慢性阻塞性肺疾患疾病自我管理行為‥‥‥‥‥‥‥73
一、研究對象之基本資料‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 73
二、慢性阻塞性肺疾患疾病自我管理行為‥‥‥‥‥‥‥‥‥‥‥ 76
三、慢性阻塞性肺疾患自我管理行為影響因素‥‥‥‥‥‥‥‥‥ 97
四、慢性阻塞性肺疾患自我管理成果‥‥‥‥‥‥‥‥‥‥‥‥‥106
第二節 量性研究—慢性阻塞性肺疾患自我管理量表發展與模式建構‥ 109
一、研究對象之基本資料‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥109
二、自我管理行為、自我效能與疾病知識量表之項目分析‥‥‥‥114
（一） 自我管理行為量表‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥115
（二） 自我效能量表‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥115
（三） 疾病知識量表‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥120
三、疾病知識量表之因素分析‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥123
四、自我管理行為、自我效能與疾病知識量表之信度分析結果‥‥126
（一） 自我管理行為量表‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥126
（二） 自我效能量表‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥127
（三） 疾病知識量表‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥127
五、自我管理行為與自我效能量表之建構效度分析結果‥‥‥‥‥128
（一） 自我管理行為量表‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥128
（二） 自我效能量表‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥135
六、研究工具之描述性分析‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥138
（一） 自我管理行為‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥138
（二） 自我效能‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥140
（三） 疾病知識‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥141
（四） 憂鬱‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥143
（五） 社會支持‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥144
（六） 生活品質‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥147
七、慢性阻塞性肺疾患自我管理模式‥‥‥‥‥‥‥‥‥‥‥‥‥148
（一） 樣本資料常態分佈檢驗‥‥‥‥‥‥‥‥‥‥‥‥‥‥148
（二） 社會支持、疾病知識與憂鬱之測量結構評估‥‥‥‥‥151
（三） 自我管理模式之評估‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥161
第五章 討論
第一節 質性研究—慢性阻塞性肺疾患疾病自我管理行為‥‥‥‥‥‥ 165
一、慢性阻塞性肺疾患疾病自我管理行為‥‥‥‥‥‥‥‥‥‥‥165
二、慢性阻塞性肺疾患自我管理的影響因素‥‥‥‥‥‥‥‥‥‥171
第二節 量性研究—慢性阻塞性肺疾患自我管理量表發展與模式建構‥ 174
一、慢性阻塞性肺疾患之自我管理行為‥‥‥‥‥‥‥‥‥‥‥‥174
二、慢性阻塞性肺疾患之自我效能‥‥‥‥‥‥‥‥‥‥‥‥‥‥176
三、慢性阻塞性肺疾患之疾病知識‥‥‥‥‥‥‥‥‥‥‥‥‥‥178
四、慢性阻塞性肺疾患之憂鬱‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥183
五、慢性阻塞性肺疾患之社會支持‥‥‥‥‥‥‥‥‥‥‥‥‥‥185
六、慢性阻塞性肺疾患之生活品質‥‥‥‥‥‥‥‥‥‥‥‥‥‥187
七、慢性阻塞性肺疾患之疾病自我管理模式‥‥‥‥‥‥‥‥‥‥189
第六章 結論
第一節 慢性阻塞性肺疾患疾病自我管理行為‥‥‥‥‥‥‥‥‥‥‥193
第三節 慢性阻塞性肺疾患自我管理量表發展與模式建構‥‥‥‥‥‥194
一、慢性阻塞性肺疾患自我管理行為與量表信、效度‥‥‥‥‥‥194
二、慢性阻塞性肺疾患自我效能與量表信、效度‥‥‥‥‥‥‥‥194
三、慢性阻塞性肺疾患疾病知識與量表信、效度‥‥‥‥‥‥‥‥194
四、慢性阻塞性肺疾患憂鬱‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥195
五、慢性阻塞性肺疾患社會支持‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥195
六、慢性阻塞性肺疾患生活品質‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥195
七、慢性阻塞性肺疾患疾病自我管理模式‥‥‥‥‥‥‥‥‥‥‥195
第七章 研究限制與建議
第一節 限制‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥197
一、研究設計的限制‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥197
二、樣本特性的限制‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥197
三、研究工具的限制‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥198
四、資料品質的限制‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥198
第二節 建議‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥200
一、護理實務的建議‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥200
二、護理研究的建議‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥202
三、護理教育的建議‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥203
四、護理專業的建議‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥204
五、醫療政策的建議‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥204

中文參考資料‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥206
英文參考資料‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥210

中文參考資料
王憲華（1999）‧應用出院準備服務於慢性阻塞性肺疾病之成效探討‧未發表的碩士論文，台北：台北醫學大學護理研究所。
王瑜欣（2000）‧類風濕性關節炎患者生活品質及其相關因素之探討‧長庚護專學報，2，71-95。
內政部戶政司（2008）‧內政統計年報‧2010年1月8日取自http://sowf.moi.gov.tw/stat/year/y02-01.xls
台灣胸腔暨重症加護醫學會（2007，4月15日）‧男爬樓女提籃會喘-慢性肺阻早期徵狀‧2009年4月16日取自http://health.chinatimes.com/contents.aspx?cid=1,11&id=5751
行政院衛生署（2006）‧民國95年全民健康保險醫療統計年報‧2009年10月1日取自http://www.doh.gov.tw/statistic/%C2%E5%C0%F8%B2%CE%ADp%A6~%B3%F8/95.htm
行政院衛生署（2007）‧醫療統計年報‧2009年6月20日取自http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=10352&class_no=440&level_no=3
行政院衛生署（2009）‧ICD-10全國主要死亡原因‧2009年6月20日取自http://www.doh.gov.tw/CHT2006/DisplayStatisticFile.aspx?d=71701&s=1
李良哲（1999）‧維繫婚姻關係重要因素的成人期差異初探‧教育心理研究，22，145-160。
李文宏、顏啟華、李孟智（2005）‧老人周全性評估‧基層醫學，20（9），212-218。
李佳諭、葉莉莉、陳炯睿、林佩宜、薛尊仁、王文玲（2008）‧慢性阻塞性肺疾患者自我管理行為之探討‧護理雜誌，55（5），45-54。
何莉櫻（2005）‧慢性阻塞性肺病的治療‧臨床醫學，55（1），11-17。
何瓊芳、陳綱華（1997）‧胸腔科護士及病患使用定量噴霧劑技術正確性之探討‧長庚護理，8（2），29-41。
吳明隆（2008）‧結構方程式模式AMOS的操作與應用‧台北：五南。
吳明隆、涂金堂（2008）‧SPSS與統計應用分析‧台北:五南。
邱怡玟、蔡素華、李選（1999）‧探討慢性阻塞性肺疾病住院患者知憂鬱狀況與日常生活功能的相關性‧護理研究，7（2），145-155。
邱皓政（2006）‧量性研究與統計分析‧台北：五南。
邱皓政（2008）‧結構方程模式‧台北：雙葉。
林碧莉（2001）‧花蓮地區慢性阻塞性肺疾病患對肺部復健的知識、態度、行為及其相關因素之探討‧美和技術學院學報，19，15-28。
姚開屏（1996）‧從心理計量的觀點看測量工具的發展‧職能治療學會，14（1），6-22。
姚開屏（2000）‧簡介與評論常用的一般性健康相關生活品質量表兼談對未來研究的建議‧中國測驗學會，47（2），111-138。
姚開屏（2002）‧健康相關生活品質概念與測量原理之簡介‧台灣醫學會，6（2），183-192。
高紀惠（1992）‧心臟復健運動對活動耐力進展效應之探討‧護理雜誌，39（3），63-75。
陳夏蓮、吳子卿、李薇莉、梁天麗（2006）‧慢性阻塞性肺疾病患生活品質相關因素‧台灣醫學，10（3），309-317。
許麗齡、尹祚芊（1988）‧慢性阻塞性肺疾病患者生活品質及其相關因素之探討‧護理雜誌，35（3），73-88。
許華雲（2007）‧帕金森氏症病患者疲憊感及生活品質之相關探討‧未發表的碩士論文，桃園：長庚大學護理研究所。
黃貴美（1998）‧邁向廿一世紀的婦女政策--臺灣婦女的權益保障問題‧行政管理學報，1，92-119。
黃文玲（2004）‧公費安養機構老人憂鬱與睡眠品質之探討‧未發表的碩士論文，桃園：長庚大學護理研究所。
黃芳銘（2007）‧結構方程模式：理論與應用‧台北：五南。
葉秀逸（2002）‧慢性阻塞性肺部疾病患者之臨床指標與生活品質之相關性：評值聖喬治呼吸問卷的適用性‧新台北護理，4（2），19-27。
曾淑津、黃秀梨（1997）‧慢性阻塞性肺疾病患者的疾病認知、醫囑遵從行為及心理感受之探討‧護理研究，5（4），308-319。
廖以誠、葉宗烈、柯慧貞、駱重鳴、盧豐華（1995）‧老年憂鬱量表-中譯版之信、效度初步研究‧彰化基督教醫院，1，11-17。
廖以誠、葉宗烈、揚延光、盧豐華、張智仁、柯慧貞、駱重鳴（2004）‧台灣老年憂鬱量表之編製與信、效度研究‧台灣精神醫學，18（1），30-40。
蔡秀鸞（2000）‧影響慢性阻塞性肺疾病患者的憂鬱程度因素之探討‧新台北護理，2（2），69-80。
劉淑娟（1999）‧罹患慢性病老人服藥遵從行為及其相關因素之探討‧護理研究，7（6），581-593。
劉惠瑚、陳玉敏（2004）‧自我照顧之概念分析‧慈濟護理，3（1），8-12。
鄭淑貞（2008）‧自我管理概念分析—探討氣喘兒童的自我管理‧護理雜誌，55（5），73-77。

英文參考資料
Alberto, J. (1993). The reliability and validity of the COPDSC: A tool that measures self-care behavior of persons with chronic obstructive pulmonary disease. Perspectives in Respiratory Nursings, 4(5), 1-4.
Alberto, J., & Joyner, B. (2008). Hope, optimism, and self-care among Better Breathers Support Group members with chronic obstructive pulmonary disease. Applied Nursing Research, 21(4), 212-217.
Almeida, O. P., & Almeida, S. A. (1999).Short versions of the geriatric depression scale: A study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. International Journal of Geriatric Psychiatry, 14(10), 858-865.
American Thoracic Society (2002). AST statement: Guidelines for the six-minutes walk test. American Journal of Respiratory and Critical Care Medicine, 166(1), 111-117.
Anderson, J. M., Tang, S., & Blue, C. (2007). Health care reform and the paradox of efficiency: Writing in culture. International Journal of Health Services, 37(2), 291-320.
Arnold, E., Bruton, A., & Ellis-Hill, C. (2006). Adherence to pulmonary rehabilitation: A qualitative study. Respiratory Medicine, 100(10), 1716-1723.
Bagozzi, R. P., & Yi, Y. (1988). On the evaluation of structural equation models. Journal of the Academy of Marketing Science, 16(1), 74-94.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215.
Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist, 37(2), 122-147.
Bandura, A. (1986). Social foundations of though and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.
Bandura, A. (1991). Social cognitive theory of self- regulation. Organizational behavior and human decision, 50(2), 248-287.
Barnett, M. (2008）. Nursing management of chronic obstructive pulmonary disease. British Journal of Nursing, 17(21), 1314-1318.
Barr, R. G., Celli, B. R., Mannino, D. M., Petty, T., Rennard, S. I., Sciurba, F. C., et al. (2009). Comorbidities, patient knowledge, and disease management in a national sample of patient with COPD. The American Juornal of Medicine, 122(4), 348-355.
Bartholomew, L. K., Parcel, G. S., Swank, P. R., & Czyzewski, D. I. (1993). Measuring self-efficacy expectations for the self-management of cystic fibrosis. Chest, 103(5), 1524-1530.
Bass, D. S., Attix, D. K., Phillips-Bute, B., & Monk, T. G. (2008). An efficient screening tool for preoperative depression: The geriatric depression scale-short form. Ambulatory Anesthesiology, 106(3), 805-809.
Bernier, M. J., & Leonard, B. (2001). Pulmonary rehabilitation after acute COPD exacerbation. Critical Care Nursing Clinics of North America, 13(3), 375-387.
Blackstock, F., & Webster, K. E. (2007). Disease-specific health education for COPD: A systematic review of changes in health outcomes. Health Education Research, 22(2), 703-717.
Bodenheimer, T., Lorig, K., Holman, H., & Grumbach, K. (2002). Patient self-management of chronic disease in primary care. JAMA, 288(19), 2469-2475.
Boot, C., van der Gulden, J., Vercoulen, J., van den Borne, B., Orbon, K., Rooijackers, J., et al. (2005). Knowledge about asthma and COPD: Associations with sick leave, health complains, functional limitations, adaptation, and perceived control. Patient Education and Counseling, 59(1), 103-109.
Bourbeau, J., Julien, M., Maltais, F., Rouleau, M., Beaupre, A., Begin, R., et al. (2003). Reduction of hospital utilization in patients with chronic obstructive pulmonary disease. Archives of Internal Medicine, 163(5), 585-591.
Bourbeau, J. (2003) Disease-specific self-management programes in patients with advanced chronic obstructive pulmonary disease. Disease Management Health Outcomes, 11(5), 311-319.
Bourbeau, J. (2004). Self-management interventions to improve outcomes in patients suffering from COPD. Expert Review of Pharmacoeconomics & Outcomes Research, 4(1), 71-77.
Bourbeau, J., Nault, D., & Dang-Tan, T. (2004). Self-management and behaviour modification in COPD. Patient Education and Counseling, 52(3), 271-277.
Bourbeau, J. (2008). Clinical decision processes and patient engagement in self-management. Disease Management Health Outcomes, 16(5), 327-333.
Bourbeay, J., & Palen, J. V. D. (2009). Promoting effective self-management programmes to improve COPD. European Respiratory Journal, 33(3), 461-463.
Brink, T. L., Yesavage, J. A., Lum, O., Heersema, P. H., Adey, M., & Rose, T. L. (1982). Screening tests for geriatric depression. Clinical Gerontologist, 1(1), 37-43.
Burckhardt, C. S. (2005). Educating patients: Self-management approaches. Disability and Rehabilitation, 27(12), 703-709.
Burke, W. J., Roccaforte, W. H., & Wengel, S. P. (1991). The short form of the geriatric depression scale: A comparison with the 30-item form. Journal of Geriatric Psychiatry and Neurology, 4(3), 173-178.
Campbell, T. (1998). Patient-focused care：Primary responsibilities of research nurses. British Journal of Nursing, 7(22), 1405-1409.
Celli, B. R. (1998). Pulmonary rehabilitation for COPD：A practical approach for improving ventilatory conditioning. Postgraduate Medicine, 103(4), 159-176.
Chang, A. T., Haines, T., Jackson, C., Yang, I., Nitz, J., Low Choy, N., et al. (2008). Rationale and design of the PRSM study: Pulmonary rehabilitation or self management for chronic obstructive pulmonary disease (COPD), What is the best approach. Contemporary Clinical Trials, 29(5), 796-800.
Chau, J., Martin, C., Thompson, D. R., Chang, A. M., & Woo, J. (2006). Factor structure of the Chinese version of the geriatric depression scale. Psychology, Health & Medicine, 11(1), 48-59.
Chen, S. Y., & Wang, H. H. (2007). The relationship between physical function, knowledge of disease, social support and self-care behavior in patients with rheumatoid arthritis. Journal of Nursing Research, 15(3), 183-191.
Chen, K. H., Chen, M. L., Lee, S., Cho, H. Y., & Weng, L. C., (2008). Self-management behaviours for patients with chronic obstructive pulmonary disease: A qualitative study. Journal of Advanced Nursing, 64(6), 595-604.
Cheung, H. W. (2008). Validity of the Chinese version of EQ-5D and SF-6D as health related quality of life measure in Chinese older adults in Hong Kong. Unpublished master’s dissertation, The University of Hong Kong, China.
Christenbery, T. L. (2005). Dyspnea self-management strategies: Use and effectiveness as reported by patients with chronic obstructive pulmonary disease. Heart and Lung, 34(6), 406-414.
Cicutto, L. C., Brooks, D., & Henderson, K. (2004). Self-care issues from the perspective of individuals with chronic obstructive pulmonary disease. Patient Education and Counseling, 55(2), 168-176.
Cicutto, L.C., & Brooks, D. (2006). Self-care approaches to managing chronic obstructive pulmonary disease: A provincial survey. Respiratory Medicine, 100(9), 1540-1546.
Clark, N. M., Becker, M. H., Janz, N. K., Lorig, K., Rakowski, W., & Anderson, L. (1991). Self-management of chronic disease by older adults. Journal of Aging and Health, 3(1), 3-27.
Clark, N. M., & Becker, M. H. (1998). Theoretical models and strategies for improving adherence and disease management. In S. A. Shumaker, E. B. Schron, J. K. Ockene, & W. L. McBee (Ed.), The handbook of health behavior change (2nd ed., pp.15-21). New York, NY: Springer.
Clark, N. M., Janz, N. K., Dodge, J. A., & Sharpe, P. A. (1992). Self-regulation of health behavior: The “take PRIDE” program. Health Education Quarterly, 19(3), 341-354.
Clark, N. M., & Zimmerman, B. J. (1990). A social cognitive view of self-regulated learning about health. Health Education Research, 5(3), 371-379.
Cleland, J. A., Lee, A. J., & Hall, S. (2007). Associations of depression and anxiety with gender, age, health-related quality of life and symptoms in primary care COPD patients. Family Practice, 24(3), 217-233.
Coleman, M. T., & Newton, K. S. (2005). Supporting self-management in patients with chronic illness. American Family Physician, 72(8), 1503-1510.
Cresswell, J. W., Clark, V. L., Gutmann, M. L., & Hanson, W. (2003). Advanced mixed methods research designs. In A. Tashakkori & C. Teddie (Eds.), Handbook of Mixed Methods in Social & Behavioral Research. Thousand Oaks, CA: Sage.
Cross, S. (2005). Managing exacerbations of chronic obstructive pulmonary disease. British Journal of Nursing, 14(11), 607-609.
Curry, L. A., Nembhard, I. M., & Bradley, E. H. (2009). Qualitative and mixed methods provide unique contributions to outcomes research. Circulation, 119(10), 1442-1452.
Davis, A. H. T., Carrieri-Kohlman, V., Janson, S. L., Gold, W. M., & Stulbarg, M. S. (2006). Effects of treatment on two types of self-efficacy in people with chronic obstructive pulmonary disease. Journal of Pain Symptom Management, 32(1), 60-70.
Deaton, C. (2000). Outcomes measurement. The Journal of Cardiovascular Nursing, 14(4), 116-118.
DeVellis, R. F. (1991). Scale development: Theory and application. Newbury Park, CA: Sage.
Dolan, P. (1997). Modeling valuation for EuroQol health states. Medical Care, 35(11), 1095-1108.
Dowson, C. A., Kuijer, R. G., & Mulder, R. T. (2004). Anxiety and self-management behaviour in chronic obstructive pulmonary disease: What has been learned. Chronic Respiratory Disease, 1(4), 213-220.
Dowson, C. A., Town, G. I., Frampton, C., & Mulder, R. T. (2004).Psychopathology and illness beliefs influence COPD self-management. Journal of Psychosomatic Research, 56(3), 333-340.
Eastwood, S., Kralik, D., & Koch, T. (2002). Compromising and containing: Self-management strateagies used by men and womenn who live with multiple sclerosis and urinary incontinent. Austrlian Journal of Holistic Nursing, 9(1), 33-43.
Effing, T., Monninkhof, E. E. M., van der Valk, P. P., Zielhuis, G. G.A., Walters, E. H., & van der Palen, J. J. (2009). Self-management education for patients with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2, 1-73.
Efraimsson, E. Ö., Hillervik, C., & Ehrenberg, A. (2008). Effects of COPD self-care management education at a nurse-led primary health care clinic. Scandinavian Journal of Caring Sciences, 22(2), 178-185.
EuroQol Group (2009). User guide: Basic information on how to use EQ-5D.
Ferrans, C. E., & Powers, M. J. (1992). Psychometric assessment of the quality of life index. Research in Nursing & Health, 15(1), 29-38.
Ferraro, F. R., & Chelminski, I. (1996). Preliminary normative data on the geriatric depression scale-short form (GDS-SF) in a young adult sample. Journal of Clinical Psychology, 52(4), 443-7.
Fraser, D. D., Kee, C. C., & Minick, P. (2006). Living with chronic obstructive pulmonary disease: Insiders’ perspectives. Journal of Advanced Nursing, 55(5), 550-558.
Froggatt, K., & Walford, C. (2005). Developing advanced clinical skills in the management of breathlessness: Evaluation of an educational intervention. European Journal of Oncology Nursing, 9(3), 269-279.
Fu, D., Ding, Y., McGowan, P., & Fu, H. (2006). Qualitative evaluation of chronic disease self management program (CDSMP) in Shanghai. Patient Education and Counseling, 61(3), 389-396.
Funnell, M. M., & Anderson, R. M. (2004). Empowerment and self-management of diabetes. Clinical Diabetes, 22(3), 123-127.
Gadoury, M. A., Schwartzman, K., Rouleau, M., Maltais, F., Julien, M., Beaupre, A., et al. (2005). Self-management reduces both short- and long-term hospitalisation in COPD. European Respiratory Journal, 26(5), 853-857.
Gallefoss, F. (2004). The effects of patient education in COPD in a 1-year follow-up randomized, controlled trial. Patient Education and Counseling, 52(3), 259-266.
Garson, G. D. (2009). Factor Analysis. 2009年10月1日取自http://faculty.chass.ncsu.edu/garson/PA765/factor.htm
Glasgow, R. E., Strycker, L. A., Toobert, D. J., & Eakin, E. (2000). A social-ecologic approach to assessing support for disease self-management: The chronic illness resources survey. Journal of Behavior Medicine, 23(6), 559-583.
Glasgow, R. E., Davis, C. L., Funnell, M. M., & Beck, A. (2003). Implementing practical interventions to support chronic illness self-management. Joint Commission Journal on Quality and Safety, 29(11), 563-574.
GOLD Executive Committee (2008). Global strategy for diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2009年6月30日取自 http://www.goldcopd.com/Guidelineitem.asp?l1=2&l2=1&intId=2003
Gonzalez-Moro, J. M. R., Ramos, P. de L., Alonso, J. L. I., Ballesteros, B. L., Díaz, E. A., Ribera, X., et al. (2009). Impact of COPD severity on physical disability and daily living activities: EDIP-EPOC Ⅰ and EDIP-EPOC Ⅱ studies. The International Journal of Clinical Practice, 63(5), 742-750.
Gosselink, R. (2003). Controlled breathing and dyspnea in patients with chronic obstructive pulmonary disease (COPD). Journal of Rehabilitation Research and Development, 40(5), 25-34.
Gourley, G. A., Portner, T. S., Gourley, D. R., Rigolosi, E. L., Holt, J. M., Solomon, D. K., et al. (1998). Part 3: Humanistic outcomes in the hypertension and COPD arms of a multicenter outcomes study. Journal of The American Pharmaceutical Association, 38(5), 586-597.
Gronkiewicz, C., & Borkgren-Okonek, M. (2004). Acute exacerbation of COPD: Nursing application of evidence-based guidelines. Critical Care Nursing of Quarterly, 27(4), 336-352.
Grosbois, J. M., Lamblin, C., Lemaire, B., Chekroud, H., Dernis, J. M., Douay, B., et al. (1999). Long-Term benefits of exercise maintenance after outpatient rehabilitation program in patients with chronic obstructive pulmonary disease. Journal of Cardiopulmonary Rehabilitation and Prevention, 19(4), 216-225.
Güell, R., Casan, P., Belda, J., Sangenis, M., Morante, F., Guyatt, G. H., et al. (2000). Long-term effects of outpatient rehabilitation of COPD. Chest, 117(4), 976-983.
Guyatt, G. H., Feeny, D. H, & Patrick, D. L. (1993). Measuring health-related quality of life. Annals of International Medicine, 118(8), 622-629.
Hair, J. F., Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis (5th ed.) (pp.605). Upper Saddle River, NJ: Prentice-Hall.
Harper, R., Brazier, J. E., Waterhouse, J. C., Walters, S. J., Jones, N. M. B., & Howard, P. (1997). Comparison of outcome measures for patients with chronic obstructive pulmonary disease (COPD) in an outpatient setting.Thorax, 52(10), 879-887.
Hill, K., Geist, R., Goldstein, R. S., & Lacasse, Y. (2008). Anxiety and depression end-stage COPD. European Respiratory Juornal, 31(3), 204-212.
Holman, H., & Lorig, K. L. (2004). Patient self-management: A key to effectiveness and efficiency in care of chronic disease. Public Health Reports, 119(3), 239-243.
Hopp, J. W., Lee, J. W., & Hills, R. (1989). Development and validation of a pulmonary rehabilitation knowlwdge test. Journal of Cardiopulmonary Rehabilitation, 9(7), 273-278.
Jeng, C., Yang, H. C., Wai, P. M., Tsai, J. C., Wei, L. L., & Chen S. R. (2002). Investigation of the difference between treadmill self efficacy and actual performance in Taiwanese patients with chronic obstructive pulmonary disease. Heart & lung, 31(2), 150-156.
Jerant, A. F., von Friederichs-Fitzwater, M. M., & Moore, M. (2005). Patients’ perceived barriers to active self-management of chronic conditions. Patient Education and Counseling, 57(3), 300-307.
Jöreskog, K. G., & Goldberger, A. S. (1975). Estimation of a model with multiple indicators and multiple causes of a single latent variable. Journal of the American Statistical Association, 70(351), 631-639.
Kara, M., & Mirici, A. (2004). Loneliness, depression, and social support of Turkish patients with chronic obstructive pulmonary disease and their spouses. Journal of Nursing Scholarship, 36(4), 36-34.
Kara, M., & ASTI, T. (2004). Effect of education on self-efficacy of Turkish patients with chronic obstructive pulmonary disease. Patient Education and Counseling, 55(1), 114-120.
Kasikçi, M. K., & Alberto, J. (2007). Family support, perceived self-efficacy and self-care behaviour of Turkish patients with chronic obstructive pulmonary disease. Journal of Clinical Nursing, 16(8), 1468-1478.
Koch, T., & Kralik, D. (2001). Chronic illness: Reflection on a community-based action research programme. Journal of Advanced Nursing, 36(1), 23-31.
Lesher, E. L., & Berryhill, J. S. (1994). Validation of the geriatric depression scale--short form among inpatients. Journal of Clinical Psychology, 50(2), 256-260.
Lewis, S. M., Heitkemper, M. M., & Dirksen, S. R. (2004). Medical-surgical nursing: Assessment and management of clinical problems (6th ed.). St. Louis, MO: Mosby.
Lincon, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage.
Linnell, K. (2005). Chronis disease self-management: One successful program. Nursing Economics, 23(4), 189-198.
Liu W. T., Wang, C. H., Lin, H. C., Lin, S. M., Lee, K. Y., Lo, Y. L., et al. (2008). Efficacy of a cell phone-based exercise programme for COPD. European Respiratory Journal, 32(3), 651-659.
Lobo, M. L. (2005). Research in PhD in nursing programs. Nursing Science Quarterly, 18(1), 16-17.
Lorig, K. L., Holman, H., Sobel, D., Laurent, D., González, V., & Minor, M. (2000). Living a healthy life with chronic conditions: Self-management of heart disease, arthritis, diabetes, asthma, bronchitis, emphysema & others (2nd ed.). Boulder, CO: Bull.
Lorig, K. R., & Holman, H. R. (2003). Self-management education: History, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26(1), 1-7.
Lorig, K. L., Ritter, P., Stewart A. L., Sobel, D. S., Brown, Jr., B. W., Bandura, A., et al. (2001). Chronic disease self-managemant program 2-year health status and health care utilization outcomes. Medical Care, 39(11), 1217-1223.
Lorig, K. R., Sobel, D. S., Stewart, A. L., Brown, B. W., Bandura, A., Ritter, P., et al. (1999). Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization. Medical Care, 37(1), 5-14.
Lorig, K., Stewart, A., Ritter, P., Gonzalez, V., Laurent, D., & Lynch, J. (1996). Outcome measures for health education amd other health care interventions. Thousand Oaks, CA: Sage.
Maher, D., & Hemming, L. (2005). Palliative care for breathless patients in the community. British Journal of Community Nursing, 10(9), 414-418.
Malakouti, S. K., Fatollahi, P., Mirabzadeh, A., Salavati, M., & Zandi, T. (2006). Reliability, validity and factor structure of the GDS-15 in Iranian elderly. International Journal of Geriatric Psychiatry, 21(6), 588-593.
Marino, P., Sirey, J. A., Raue, P. J., & Alexopoulos, G. S. (2008). Impact of social support and self-efficacy on functioning in depressed older adults with chronic obstructive pulmonary disease. International Journal of COPD, 3(4), 713-718.
McCathie, H. C. F., Spence, S. H., & Tate, R. L. (2002). Adjustment to chronic obstructive pulmonary disease: The importance of psychological factors. European Respiratory Journal, 19(1), 47-53.
McGeoch, G. R. B., Willsman, K. J., Dowson, C. A., Town G. I., Frampton, C. M., McCartin, F. J., et al. (2006). Self-management plans in the primary care of patients with chronic obstructive pulmanory disease. Respirology, 11(5), 611-618.
Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook. Thousand Oaks, CA: Sage.
Monninkhof, E. M., van der Valk, P. D. L. P. M., van der Palen, J., van Herwaarden, C. L. A., Partridge, M. R., Walters, E. H., et al. (2003). Self-management education for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2, 1-27.
Monninkhof, E., van der Valk, P., van der Palen, J., van Herwaarden, C., & Zielhuis, G. (2003). Effects of a comprehensive self-management programme in patients with chronic obstructive pulmonary disease. European Respiratory Journal, 22(5), 815-820.
Monninkhaf, E., van der Aa, M., van der Valk, P., van der Palen, J., Zielhuis, G., Koning, K., et al. (2004). A qualitative evaluation of a comprehensive self-management programme for COPD patients: Effectiveness from the patients’ perspective. Patient Education and Counseling, 55(2), 177-184.
Monninkhaf, E., van der Valk, P., Schermer, T., van der Palen, J., van Herwaarden, C., Partridge, M. R., et al. (2004). Economic evaluation of a comprehensive self-management programme in patients with moderate to severe chronic obstructive pulmonary disease. Chronic Respiratory Disease, 1(7), 7-16.
Murphy, N., Bell, C., & Costello, R. W. (2005). Extending a home from hospital care programme for COPD exacerbations to include pulmonary rehabilitation. Respiratory Medicine, 99(10), 1297-1302.
National Heart Lung and Blood Institute (2007). The Morbidity & Mortality: 2007 Chart Book on Cardiovascular, Lung, and Blood Diseases. 2009年6月20日取自http://www.nhlbi.nih.gov/resources/docs/07-chtbk.pdf
Neuman, W. L. (2006). Social research methods: Qualitative and quantitative approaches (6th ed). Boston, MA: Pearson.
Nield, M. (2000). Dyspnea self-management in African Americans with chronic lung disease. Heart & Lung, 29(1), 50-55.
O’Neill, E. S. (2002).Illness representation and coping of women with chronic obstructive pulmonary disease: A pilot study. Heart & Lung, 31(4), 295-302.
O’Reilly, J. F., William, . E., & Rice, L. (2007). Health status impairment and costs associated with COPD exacerbation managed in hospital. The International Journal of Clinical Practice, 61(7), 1112-1120.
Palen, J. V. D., Klein, J. J., Zielhuis, G. A., Herwaarden, C. L. A. V., & Seydel, E. R. (2001). Behavioural effect of self-treatment guidelines in a self-management program for adults with asthma. Patient Education and Counseling, 43(2), 161-169.
Partridge, M. R. (1997). Introduction: Self-management in adults with asthma. Patient Education and Counseling, 32(supp 1), S1-S4.
Pickard, A. S., Wilke, C., J. E., Patel, S., Stavem, K., & Lee, T. A., (2008). Use of preference-base measure of health (EQ-5D) in COPD and asthma. Respiratory Medicine, 102(4), 519-536.
Prigmore, S. (2005). Assessment and nursing care of the patient with dyspnoea. Nursing Times, 101(14), 50-53.
Pryor, J., & Jannings, W. (2004). Preparing patients to self-manage faecal continence following spinal cord injury. International Journal of Therapy and Rehabilitation, 11(2), 79-82.
Punekar, Y. S., Rodriguez-Roisin, R., Sculpher, M., Jones, P., & Spencer, P. (2007). Implications of chronic obstructive pulmonary disease (COPD) on patients’ health status: A western view. Respiratory Medicine, 101(3), 661-669.
Riegel, B., Carlson, B., & Glaser, D. (2000). Development and testing of a clinical tool measuring self-management of heart failure. Heart & Lung, 29(1), 4-15.
Ringbaek, T., Brøndum, E., Martinez, G., & Lange, P. (2008). EuroQoL in assessment of the effect of pulmonary rehabilitation COPD patients. Respiratory Medicine, 102(11), 1563-1567.
Roche, N., Dalmay, F., Perez, C., Vergnenegre, A., Neukirch, F., Glordanella, J. P., et al. (2008). Impact of chronic airflow obstruction in a working population. European Respiratory Journal, 31(6), 1227-1233.
Rutten-van Mölken, M. P. M. H., Oostenbrink, J. B., Tashkin, D. P., Burkhart, D., & Monz, B. U. (2006). Does quality of life of COPD patients as measuered by the generic EuroQol five-dimension questionnaire differentiate between COPD severity stages. Chest Journal, 130(4), 1117-1128.
Scala, D., Cozzolino, S., Amato, G. D., Cocco, C., Sena, A., Martucci, P., et al. (2008). Sharing knowledge is the key to success in a patient-physician relationship: How to produce a patient information leaflet on COPD. Monaldi Archive for Chest Disease, 69(2), 50-54.
Schilling, L. S., Grey, M., & Knafl, K. A. (2002). The concept of self-management of type 1 diabetes in children and adolescents: An evolutionary concept analysis. Journal of Advanced Nursing, 37(1), 87-99.
Seamark, D. A., Blake, S. D., Seamark, C. J., & Halpin, D. M. G. (2004). Living with severe chronic obstructive pulmonary disease (COPD): Perceptions of patients and their carers. Palliative Medicine, 18(7), 619-625.
Sim, J., & Sharp, K. (1998). A critical appraisal of the role of triangulation in nursing research. International Journal of Nursing Studies, 35(1-2), 23-31.
Smeltzer, S. C., & Bare, B. G. (2000). Brunner & Suddarth’s textbook of medical-surgical nursing (9th ed.). Philadelphia, PA: Lippincott.
Spruit, M. A., Troosters, T., Trappenburg, J. C. A., Decramer, M., & Gosselink, R. (2004). Exercise training during rehabilitation of patients with COPD: A current perspective. Patient Education and Counseling, 52(3), 243-248.
Ståhl, E., Jansson, S. A., Jonsson, A. C., Svensson, K., Lundbäck, B., & Andersson, F. (2003). Health-related quality of life, utility, and productivity outcomes instruments: Ease of completion by subjects with COPD. Health and Quality of Life Outcomes, 1(18), doi: 10.1186/1477-7525-1-18 (e-Journal)
Steuten, L., Vrijhoef, B., Van Merode, F., Wesseling, G. J., & Spreeuwenberg, C. (2006). Evaluation of a regional disease management programme for patients with asthma or chronic obstructive pulmonary disease. International Journal for Quality in Health Care, 18(6), 429-436.
Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Grounded theory procedures and techniques. Thousand Oaks, CA: Sage.
Stuifbergen, A. K., Seraphine, A., & Roberts, G. (2000). An explanatory model of health promotion and quality of life in chronic disabling conditions. Nursing Research, 49(3), 122-129.
Swerissen, H., Belfrage, J. Weeks, A., Jordan, L., Walker, C., Furler, J., et al. (2006). A randomised control trial of a self-management program for people with a chronic illness from Vietnamese, Chinese, Italian and Greek backgrounds. Patient Education and Counseling, 64(1-3), 360-368.
Taylor, R., Dawson, S., Roberts, N., & Sridhar, M. (2007). Why do patients decline to take part in a research project involving pulmonary rehabilitation. Respiratory Medicine, 101(9), 1942-1946.
Tsai, S. Y., Cheng, C. Y., Hsu, W. M., Su, T. P. T., Liu, J. H., & Chou, P. (2003). Association between visual impairment and depression in the elderly. Journal of The Formosan Medical Association, 102(2), 86-90.
Tsai, Y. F. (2007). Self-care management and risk factors for depressive symptoms among Taiwanese institutionalized older person. Nursing Research, 56(2), 124-131.
Uchino, B. N., Cacioppo, J. T., & Kiecolt-Glaser, J. K. (1996). The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychological Bulletin, 119(3), 488-531.
van Manen, J. G., Bindels, P. J., Dekker, F. W., IJzermans, C. J., van der Zee, J. S., & Schade E. (2002). Risk of depression in patients with chronic obstructive pulmonary disease and its determinants. Thorax, 57(5), 412-416.
Viswanathan, M. (2005). Measurement error and research design. Thousand Oaks, CA: Sage.
Vögele, C., & von Leupoldt, A. (2008). Mental disorders in chronic obstructive pulmonary disease (COPD). Respiratory Medicine, 102(5), 764-773.
Waltz, C. F., Strickland, O. L.,＆Lenz, E. R.(2005). Measurement in nursing and health research (3rd ed.). New York, NY: Springer.
Wang, K. Y., Kao, C. W., Chou, W. C., & Tarn, Y. H. (1998). The relationship of social support to quality of life among patients with chronic obstructive pulmonary disease. Journal of Medical Sciences, 19(1), 22-31.
Watson, P. B., Town, G. I., Holbrook, N., Dwan, C., Toop, L. J., & Drennan, C. J.(1997). Evaluation of a self- management plan for chronic obstructive pulmonary disease. European Respiratory Journal, 10(6), 1267-1271.
White, R., Walker, P., Roberts, S., Kalisky, S., & White, P. (2006). Bristol COPD knowledge questionnaire (BCKQ): Testing what we teach patients about COPD. Chronic Respiratory Journal, 3(3), 123-131.
WHO (2003). Adherence to long-term therapies: Evidence for action. 2005年7月1 日取自http://www.who.int/chronic_conditions/adherence report/en
WHO (2008). Chronic obstructive pulmonary disease. 2009年6月20日取自http://www.who.int/mediacentre/factsheets/fs315/en/index.html
Wigal, J. K., Creer, T. L., & Kotses, H. (1991). The COPD self-efficacy scale. Chest, 99(5), 1193-1196.
Wilde, M. H., & Garvin, S. (2007). A concept analysis of self-monitoring. Journal of Advanced Nursing, 57(3), 339-350.
Wise, R. A. (2006). The value of forced expiratory volume in 1 second decline in the assessment of chronic obstructive pulmonary disease progession. The American Journal of Medicine, 119(10), 4-7.
Wong, K. W., Wong, F. K. Y., & Chan, M. F. (2005). Effects of nurse-initiated telephone follow-up on self-efficacy among patients with chronic obstructive pulmonary disease. Journal of Advanced Nursing, 49(2), 210-222.
Wood, R., & Bandura, A. (1989). Social cognitive theory of organizational management. Academy of Management Review, 14(3), 361-384.
Wright, C. C., Barlow, J. H., Turner, A. P., & Bancroft, G. V. (2003). Self-management training for people with chronic disease: An exploratory study. British Journal of health Psychology, 8(4), 465-476.
Wu, S. F. V., Courtney, M., Edwards, H., McDowell, J., Shortridge-Bagget, L. M., & Chang, P. J. (2007). Self-efficacy, outcome expectations and self-care behaviour in people with type 2 diabetes in Taiwan. Journal of Clinical Nursing, 16(11), 250-257.
Xiaolian, J., Chaiwan, S., Panuthai, S., Yijuan, C., Lei, Y., & Jipinng, L. (2002). Family support and self-care behaviour of Chinese chronic obstructive pulmonary disease patients. Nursing and Health Sciences, 4(1-2), 41-49.
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., et al. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Reasearch, 17(1), 37-49.
Yves, L., Louis, R., & François, M. (2001). Prevalence of depressive symptoms and depressive in patients with severe oxygen-dependent chronic obstructive pulmonary disease. Journal of Cardiopulmonary Rehabilitation, 21(2), 80-86.
Zimmerman, B. W., Brown, S. T., & Bowman, J. M. (1996). A self-management program for chronic obstructive pulmonary disease：Relationship to dyspnea and self-efficacy. Rehabilitation Nursing, 21(5), 253-257.