( 您好!臺灣時間:2022/12/10 10:17
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::


論文名稱(外文):The Relationship Between Social Support And Self-Management In Chronic Obstructive Pulmonary Disease Patients:The Direct Effect Or Indirect Effect.
指導教授(外文):WANG, KWUA-YUN
外文關鍵詞:Chronic Obstructive Pulmonary Diseasesocial supportself managementmediationindirect effectPROCESS regression
  • 被引用被引用:0
  • 點閱點閱:513
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:2
背景與目的:慢性阻塞性肺疾病(COPD) 為不完全可逆且反覆急性發作的慢性疾病,症狀出現已是疾病嚴重度中度或更為嚴重,因此病人所經歷的痛苦是疾病逐步對日常生活產生困擾而非死亡。因此,除病人醫療處置所需外,首重提供後續慢性病的自我管理,若能藉社會支持的輔佐作用,更能加強、維持病人的自我管理。本研究目的探討自我效能對COPD病人社會支持與自我管理關係之影響。
研究方法:本研究為橫斷研究設計,方便取樣方法,結構式問卷進行資料收集,包含基本屬性、社會支持(ISEL)、自我效能(GSES)及自我管理量表(PIH 2010 scale)為資料收集之工具。收案期間自2016年11月21日至2017年2月06日,選取79位臺灣北部某醫學中心胸腔內科門診COPD病人做研究樣本,以最新GOLD 2017版本作為疾病分類為依據,其資料以描述性統計、獨立t檢定、變異數分析(ANOVA)、皮爾森相關係數及PROCESS迴歸分析等方式進行分析。
研究結果:(一)參與此研究病人年齡平均為76.89歲,以男性、國中至高中職、已婚者、與家人同住、有宗教信仰、月收入低於2 萬元居多。此外,平均患病年數為 8.69年,疾病分類為Level II(B、C、D組)、FEV1以≤65% 及COPD相關用藥以服用兩種藥物者佔多數。(二)自我效能總分平均值為35.8(SD=7.7),社會支持總分平均值為37.39(SD=10.3),自我管理量表結果為總分平均值為83.5,三者之間呈高度的正相關。(三)社會支持與自我管理之關係為間接效應,自我效能可作為部分中介因子,但於不同疾病分類其自我效能扮演之中介因子會有所差異,Level I(GOLD A)病人自我效能為完全中介因子,Level II自我效能為部分中介因子。
結論與建議:較無呼吸困難症狀(mMRC≤1)及低急性惡化風(過去一年無急性惡化住院)之Level I病人,提升其自我管理應著重於病人對自身健康想法與信念的變化,其自我效能高低決定自我管理之成果。而有較多呼吸困難情形(mMRC≥2)或有較高急性惡化風險(因急性惡化住院≥1次)Level II病人自我管理主要受到社會支持的影響,因此提升此組病人之自我管理首重給予病人良好之社會支持。
Background and aim: Chronic Obstructive Pulmonary Disease is a type of chronic diseases with incomplete reversibility and repeated acute attacks. Often, the occurrence of symptoms signifies that the disease has turned into moderate severity or even severe severity; as a result, the patients mainly suffer from pain caused by the disease’s gradual disturbance to their daily life instead of threat of death. In this sense, in addition to medical treatment for the patients, self-management for the subsequent chronic disease treatment is the focus. In the meanwhile, with adjuvant action of social support and self-efficacy, the patients’ self-management can be further enhanced and maintained. Therefore, in this research, we aimed to explore self-efficacy’s influence on the relationship of COPD patients’ social support and self-management.
Methods: In this research, cross-sectional survey, convenience sampling, and structured questionnaire were adopted for data collection, and the research tools included demographic and disease characteristics, ISEL, GSES, and PIH 2010 scale. The case acceptance period ranged from November 21, 2016, to February 6, 2017, with 79 COPD patients in the outpatient service in the Chest Medicine Dept. in a Medical Center in northern Taiwan as the research sample. Based on the latest GOLD 2017 as the disease classification, the collected data was analyzed by descriptive statistics, independent t-test, analysis of variance, Pearson correlation coefficient, and PROCESS.
Result: The average age of the patients who participated in this research was 76.89 years old. Most of them were mostly male, married, and with educational background of junior to senior/vocational high school. Besides, most of them had a religious belief, and earned monthly salary lower than 20,000 NTD. On the other hand, the patients’ average number of years of illness was 8.69 years, while most patients’ disease classification was Level II, FEV1 ≤65%, and took two COPD related drugs.
The average value of the total score in respect with self-efficacy was 35.8 (SD=7.7), the average value of the total score in respect with social support was 37.39 (SD=10.3), and the average value of the total score of self-management scale was 83.5—the three items show significantly positive correlation. The relationship between social support and self-management had indirect effect. In addition, self-efficacy could function as partial mediation. However, since Level I patients’ self-efficacy was complete mediation, Level II patients’ self-efficacy was partial mediation.
Conclusion: For Level I patients (mMRC≤1 and and no admitted with an acute exacerbation), their self-management enhancement should target at raising self-efficacy, which can determine the performance outcome of self-management. Otherwise, for Level II patients (mMRC≥2 or be hospitalized due to acute exacerbation ≥1 ), self-management is primarily influenced by social support; therefore, providing sound social support can serve as the buffer factor of the disease.
第一章 緒論
第一節 研究動機及重要性
第二節 研究目的
第三節 研究假設
第四節 研究問題
第二章 文獻探討
第一節 慢性阻塞性肺疾病之相關概念
第三節 自我管理之影響因素及其相關研究
第三章 研究方法
第一節 研究架構
第二節 名詞界定
第三節 研究場所及研究對象
第四節 研究工具
第五節 研究步驟
第六節 資料分析
第七節 研究倫理與考量
第四章 研究結果
第一節 COPD病人基本屬性之現況分佈
第二節 COPD病人社會支持、自我效能、自我管理得分情形
第三節 病人基本屬性與自我管理之關係
第四節 自我效能對社會支持與自我管理關係之影響
第五章 討論
第一節 COPD病人基本屬性之概況
第二節 自我效能、社會支持與自我管理之概況
第三節 自我效能在社會支持與自我管理之間的中介關係
第六章 結論與建議
第一節 研究結論
第二節 研究建議
第三節 研究限制
Abrams, T. E., Vaughan-Sarrazin, M., & Van der Weg, M. W. (2011). Acute exacerbations of chronic obstructive pulmonary disease and the effect of existing psychiatric comorbidity on subsequent mortality. Psychosomatics, 52(5), 441-449. doi:10.1016/j.psym.2011.03.005
Agusti, A., Morla, M., Sauleda, J., Saus, C., & Busquets, X. (2004). NF-kappaB activation and iNOS upregulation in skeletal muscle of patients with COPD and low body weight. Thorax, 59(6), 483-487.
AIHW (2014). Cardiovascular disease, diabetes and chronic kidney disease: Australian facts: prevalence and incidence. Cardiovascular, diabetes and chronic kidney disease series no. 2. Cat. no. CDK 2. Canberra: AIHW.
Albrecht, G. L., Walker, V. G., & Levy, J. A. (1982). Social distance from the stigmatized. A test of two theories. Social Science and Medicine, 16(14), 1319-1327.
Aliverti, A., & Macklem, P. T. (2008). The major limitation to exercise performance in COPD is inadequate energy supply to the respiratory and locomotor muscles. Journal of Applied Physiology, 105(2), 749-751. doi:10.1152/japplphysiol.90336.2008
Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215.
Bandura, A. (1995). Self-efficacy in changing societies: Cambridge university press.
Barlow, J., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002). Self-management approaches for people with chronic conditions: a review. Patient Education and Counseling, 48(2), 177-187.
Barnett, M. (2009). Promoting self-management for patients with COPD. Journal of Community Nursing, 23(9), 4-10.
Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173-1182.
Battersby, M. W., Ask, A., Reece, M. M., Markwick, M. J., & Collins, J. P. (2003). The Partners in Health scale: The development and psychometric properties of a generic assessment scale for chronic condition self-management. Australian Journal of Primary Health, 9(3), 41-52.
Benzo, R. P., Abascal-Bolado, B., & Dulohery, M. M. (2015). Self-management and quality of life in chronic obstructive pulmonary disease (COPD): The mediating effects of positive affect. Patient Education and Counseling, 99(4), 617-623.
Bodenheimer, T., Lorig, K., Holman, H., & Grumbach, K. (2002). Patient self-management of chronic disease in primary care. JAMA, 288(19), 2469-2475.
Borge, C. R., Wahl, A. K., & Moum, T. (2010). Association of breathlessness with multiple symptoms in chronic obstructive pulmonary disease. Journal of Advanced Nursing, 66(12), 2688-2700. doi:10.1111/j.1365-2648.2010.05447.x
Bos-Touwen, I., Schuurmans, M., Monninkhof, E. M., Korpershoek, Y., Spruit-Bentvelzen, L., Ertugrul-van der Graaf, I., Trappenburg, J. (2015). Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: a cross-sectional survey study. PloS One, 10(5), 1-15.
Cameron, J., Worrall-Carter, L., Riegel, B., Lo, S. K., & Stewart, S. (2009). Testing a model of patient characteristics, psychologic status, and cognitive function as predictors of self-care in persons with chronic heart failure. Heart & Lung: The Journal of Acute and Critical Care, 38(5), 410-418. doi:http://dx.doi.org/10.1016/j.hrtlng.2008.11.004
Caplan, G. (1974). Support systems and community mental health: Lectures on concept development: Behavioral Publications.
Cassel, J. (1976). The contribution of the social environment to host resistance. American Journal of Epidemiology, 104(2), 107-123.
Cené, C. W., Haymore, L. B., Dolan-Soto, D., Lin, F.-C., Pignone, M., DeWalt, D. A., . . . Corbie-Smith, G. (2013). Self-care confidence mediates the relationship between perceived social support and self-care maintenance in adults with heart failure. Journal of Cardiac Failure, 19(3), 202-210.
Chen, C. (1994). An exploration of postpartum depression model using LISREL. Gaoxiong yi xue ke xue za zhi= The Kaohsiung journal of medical sciences, 10(5), 229-238.
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.
Cheng, S.-L., Chan, M.-C., Wang, C.-C., Lin, C.-H., Wang, H.-C., Hsu, J.-Y., . . . Yu, C.-J. (2015). COPD in Taiwan: a national epidemiology survey. International Journal of Chronic Obstructive Pulmonary Disease, 10, 2459.
Chiu, T.-Y., Hu, W.-Y., Lue, B.-H., Yao, C.-A., Chen, C.-Y., & Wakai, S. (2004). Dyspnea and its correlates in Taiwanese patients with terminal cancer. Journal of Pain and Symptom Management, 28(2), 123-132.
Chung, K. F., & Adcock, I. M. (2008). Multifaceted mechanisms in COPD: inflammation, immunity, and tissue repair and destruction. European Respiratory Journal, 31(6), 1334-1356. doi:10.1183/09031936.00018908
Chung, K. F., Caramori, G., & Adcock, I. M. (2009). Inhaled corticosteroids as combination therapy with β-adrenergic agonists in airways disease: present and future. European Journal of Clinical Pharmacology, 65(9), 853-871.
Clark, N. M. (2003). Management of chronic disease by patients. Annual Review of Public Health, 24(1), 289-313.
Cohen, S., & Syme, S. L. (1985). Issues in the study and application of social support. Social support and health, 3, 3-22.
Corbin, J. M., & Strauss, A. (1988). Unending work and care: Managing chronic illness at home: Jossey-Bass.
Cramm, J. M., Strating, M. M. H., de Vreede, P. L., Steverink, N., & Nieboer, A. P. (2012). Validation of the self-management ability scale (SMAS) and development and validation of a shorter scale (SMAS-S) among older patients shortly after hospitalisation. Health and Quality of Life Outcomes, 10, 1-7. doi:10.1186/1477-7525-10-9
Creer, T. L., Renne, C. M., & Christian, W. P. (1976). Behavioral contributions to rehabilitation and childhood asthma. Rehabilitation Literature, 226-232.
Crotty, M. M., Henderson, J., Ward, P. R., Fuller, J., Rogers, A., Kralik, D., & Gregory, S. (2015). Analysis of social networks supporting the self-management of type 2 diabetes for people with mental illness. BMC Health Services Research, 15(1), 1-12. doi:10.1186/s12913-015-0897-x
Cully, J. A., Graham, D. P., Stanley, M. A., Ferguson, C. J., Sharafkhaneh, A., Souchek, J., & Kunik, M. E. (2006). Quality of life in patients with chronic obstructive pulmonary disease and comorbid anxiety or depression. Psychosomatics, 47(4), 312-319. doi:10.1176/appi.psy.47.4.312
Curtin, R. B., Mapes, D., Schatell, D., & Burrows-Hudson, S. (2005). Self-management in patients with end stage renal disease: exploring domains and dimensions. Nephrology Nursing Journal, 32(4), 389-395.
Deaton, C. (2000). Outcome measurement: self-management in heart failure. Journal of Cardiovascular Nursing, 14(4), 116-118.
Dempsey, J. A., Sheel, A. W., St Croix, C. M., & Morgan, B. J. (2002). Respiratory influences on sympathetic vasomotor outflow in humans. Respiratory Physiology & Neurobiology, 130(1), 3-20.
DeWalt, D. A., Berkman, N. D., Sheridan, S., Lohr, K. N., & Pignone, M. P. (2004). Literacy and Health Outcomes: A Systematic Review of the Literature. Journal of General Internal Medicine, 19(12), 1228-1239. doi:10.1111/j.1525-1497.2004.40153.x
Dickson, V. V., Buck, H., & Riegel, B. (2013). Multiple comorbid conditions challenge heart failure self-care by decreasing self-efficacy. Nursing Research (Taiwan), 62(1), 2-9. doi:10.1097/NNR.0b013e31827337b3
DiMatteo, M. R. (2004). Social support and patient adherence to medical treatment: a meta-analysis. Health Psychology, 23(2), 207-218. doi:10.1037/0278-6133.23.2.207
Disler, R., Gallagher, R., & Davidson, P. (2012). Factors influencing self-management in chronic obstructive pulmonary disease: an integrative review. International Journal of Nursing Studies, 49(2), 230-242.
Do, V., Young, L., Barnason, S., & Tran, H. (2015). Relationships between activation level, knowledge, self-efficacy, and self-management behavior in heart failure patients discharged from rural hospitals. F1000Res, 4, 150. doi:10.12688/f1000research.6557.1
Dulohery, M. M., Schroeder, D. R., & Benzo, R. P. (2015). Cognitive function and living situation in COPD: is there a relationship with self-management and quality of life? International Journal of Chronic Obstructive Pulmonary Disease, 10, 1883-1889.
D'Zurilla, T. J., & Goldfried, M. R. (1971). Problem solving and behavior modification. Journal of Abnormal Psychology, 78(1), 107-126.
Earnest, M. A. (2002). Explaining Adherence to Supplemental Oxygen Therapy: The Patient's Perspective. Journal of General Internal Medicine, 17(10), 749-755. doi:10.1046/j.1525-1497.2002.20218.x
Elkington, H., White, P., Addington-Hall, J., Higgs, R., & Edmonds, P. (2005). The healthcare needs of chronic obstructive pulmonary disease patients in the last year of life. Palliative Medicine, 19(6), 485-491.
Eriksson, G., Jarenback, L., Peterson, S., Ankerst, J., Bjermer, L., & Tufvesson, E. (2015). A new approach to assess COPD by identifying lung function break-points. International Journal of Chronic Obstructive Pulmonary Disease, 10, 2193-2202. doi:10.2147/copd.s86059
Federman, A. D., Wolf, M. S., Sofianou, A., Martynenko, M., O'Connor, R., Halm, E. A., . . . Wisnivesky, J. P. (2014). Self‐Management Behaviors in Older Adults with Asthma: Associations with Health Literacy. Journal of the American Geriatrics Society, 62(5), 872-879.
Fix, G. M., Cohn, E. S., Solomon, J. L., Cortes, D. E., Mueller, N., Kressin, N. R., . . . Bokhour, B. G. (2014). The role of comorbidities in patients' hypertension self-management. Chronic Illness, 10(2), 81-92. doi:10.1177/1742395313496591
Foster, C., Breckons, M., Cotterell, P., Barbosa, D., Calman, L., Corner, J., . . . Smith, P. W. (2015). Cancer survivors’ self-efficacy to self-manage in the year following primary treatment. Journal of Cancer Survivorship, 9(1), 11-19. doi:10.1007/s11764-014-0384-0
Franssen, F. M., & Han, M. K. (2013). The ABC of GOLD ABCD. European Respiratory Journal, 42(5), 1166-1168.
Gagnon, P., Guenette, J. A., Langer, D., Laviolette, L., Mainguy, V., Maltais, F., . . . Saey, D. (2014). Pathogenesis of hyperinflation in chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease, 9, 187-201. doi:10.2147/copd.s38934
Gallagher, R., Donoghue, J., Chenoweth, L., & Stein‐Parbury, J. (2008). Self‐management in older patients with chronic illness. International Journal of Nursing Practice, 14(5), 373-382.
Gallant, M. P. (2003). The influence of social support on chronic illness self-management: a review and directions for research. Health Education and Behavior, 30(2), 170-195.
GOLD. (2016). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Retrieved from http://www.goldcopd.com
GOLD. (2017). Global Strategy for the Diagnosis, Management and Prevention of COPD. Retrieved from http://goldcopd.org
Goossens, L. M. A., Leimer, I., Metzdorf, N., Becker, K., & Rutten-van Mölken, M. P. M. H. (2014). Does the 2013 GOLD classification improve the ability to predict lung function decline, exacerbations and mortality: a post-hoc analysis of the 4-year UPLIFT trial. BMC Pulmonary Medicine, 14(1), 163. doi:10.1186/1471-2466-14-163
Grzela, K., Litwiniuk, M., Zagorska, W., & Grzela, T. (2016). Airway remodeling in chronic obstructive pulmonary disease and asthma: the role of matrix metalloproteinase-9. Archivum Immunologiae et Therapiae Experimentalis, 64(1), 47-55.
Gysels, M., & Higginson, I. (2009). Self-management for breathlessness in COPD: the role of pulmonary rehabilitation. Chronic Respiratory Disease, 6(3), 133-140.
Harrison, S. L., Janaudis-Ferreira, T., Brooks, D., Desveaux, L., & Goldstein, R. S. (2015). Self-management following an acute exacerbation of COPD: a systematic review. Chest, 147(3), 646-661. doi:10.1378/chest.14-1658
Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling: University of Kansas, KS.
Hill-Briggs, F. (2003). Problem solving in diabetes self-management: a model of chronic illness self-management behavior. Annals of Behavioral Medicine, 25(3), 182-193.
Hogg, J. C. (2004). Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. Lancet, 364(9435), 709-721. doi:10.1016/s0140-6736(04)16900-6
Hogg, J. C., Chu, F., Utokaparch, S., Woods, R., Elliott, W. M., Buzatu, L., . . . Pare, P. D. (2004). The nature of small-airway obstruction in chronic obstructive pulmonary disease. The New England Journal of Medicine, 350(26), 2645-2653. doi:10.1056/NEJMoa032158
Holman, H., & Lorig, K. (2004). Patient self-management: a key to effectiveness and efficiency in care of chronic disease. Public Health Reports, 119(3), 239-243.
Isen, A., & Reeve, J. (2002). Positive affect promotes intrinsic motivation. Ithaca: Cornell University.
Johnson, J. L., Campbell, A. C., Bowers, M., & Nichol, A.-M. (2007). Understanding the Social Consequences of Chronic Obstructive Pulmonary Disease. Proceedings of the American Thoracic Society, 4(8), 680-682. doi:10.1513/pats.200706-084SD
Jonkman, N. (2016). Self-management interventions for patients with a chronic disease: what works and in whom?
Jordan, R. E., Majothi, S., Heneghan, N. R., Blissett, D. B., Riley, R. D., Sitch, A. J., . . . Bayliss, S. (2015). Supported self-management for patients with moderate to severe chronic obstructive pulmonary disease (COPD): an evidence synthesis and economic analysis.
Kaptein, A. A., Fischer, M. J., & Scharloo, M. (2014). Self-management in patients with COPD: theoretical context, content, outcomes, and integration into clinical care. International Journal of Chronic Obstructive Pulmonary Disease, 9, 907-917.
Kerr, E. A., Heisler, M., Krein, S. L., Kabeto, M., Langa, K. M., Weir, D., & Piette, J. D. (2007). Beyond Comorbidity Counts: How Do Comorbidity Type and Severity Influence Diabetes Patients’ Treatment Priorities and Self-Management? Journal of General Internal Medicine, 22(12), 1635-1640. doi:10.1007/s11606-007-0313-2
Kindig, D. A., Panzer, A. M., & Nielsen-Bohlman, L. (2004). Health Literacy: A Prescription to End Confusion: National Academies Press.
Kisokanth, G., Prathapan, S., Indrakumar, J., & Joseph, J. (2013). Factors influencing self-management of Diabetes Mellitus; a review article. Journal of Diabetes, 3, 1-7.
Lahaije, A. J., van Helvoort, H. A., Dekhuijzen, P. R., Vercoulen, J. H., & Heijdra, Y. F. (2013). Resting and ADL-induced dynamic hyperinflation explain physical inactivity in COPD better than FEV 1. Respiratory Medicine, 107(6), 834-840.
Liddy, C., Johnston, S., Guilcher, S., Irving, H., Hogel, M., & Jaglal, S. (2015). Impact of a chronic disease self-management program on healthcare utilization in eastern Ontario, Canada. Preventive Medicine Reports, 2, 586-590. doi:10.1016/j.pmedr.2015.07.001
Lorig, K. (2003). Self-management education: more than a nice extra. Medical Care, 41(6), 699-701.
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., Lubeck, D., Kraines, R. G., Seleznick, M., & Holman, H. R. (1985). Outcomes of self‐help education for patients with arthritis. Arthritis and Rheumatism, 28(6), 680-685.
Loring, S. H., Garcia-Jacques, M., & Malhotra, A. (2009). Pulmonary characteristics in COPD and mechanisms of increased work of breathing. Journal of Applied Physiology, 107(1), 309-314. doi:10.1152/japplphysiol.00008.2009
Lou, P., Zhu, Y., Chen, P., Zhang, P., Yu, J., Zhang, N., . . . Zhao, J. (2012). Prevalence and correlations with depression, anxiety, and other features in outpatients with chronic obstructive pulmonary disease in China: a cross-sectional case control study. BMC Pulmonary Medicine, 12(1), 1-9. doi:10.1186/1471-2466-12-53
Lu, Y., Li, Z., & Arthur, D. (2014). Mapping publication status and exploring hotspots in a research field: chronic disease self-management. Journal of Advanced Nursing, 70(8), 1837-1844. doi:10.1111/jan.12344
Luszczynska, A., Scholz, U., & Schwarzer, R. (2005). The general self-efficacy scale: multicultural validation studies. The Journal of psychology, 139(5), 439-457.
Marciniuk, D. D., Goodridge, D., Hernandez, P., Rocker, G., Balter, M., Bailey, P., . . . Brown, C. (2011). Managing dyspnea in patients with advanced chronic obstructive pulmonary disease: A Canadian Thoracic Society clinical practice guideline. Canadian Respiratory Journal : Journal of the Canadian Thoracic Society, 18(2), 69-78.
Mathew, R., Gucciardi, E., De Melo, M., & Barata, P. (2012). Self-management experiences among men and women with type 2 diabetes mellitus: a qualitative analysis. BMC Family Practice, 13(1), 1-12. doi:10.1186/1471-2296-13-122
Maurer, J., Rebbapragada, V., Borson, S., Goldstein, R., Kunik, M. E., Yohannes, A. M., . . . Depression in, C. (2008). Anxiety and Depression in COPD: Current Understanding, Unanswered Questions, and Research Needs. Chest, 134(4 Suppl), 43-56. doi:10.1378/chest.08-0342
McNicholas, W. T. (2000). Impact of sleep in COPD. CHEST Journal, 117(2), 48S-53S.
McNicholas, W. T., Verbraecken, J., & Marin, J. M. (2013). Sleep disorders in COPD: the forgotten dimension. European Respiratory Review, 22(129), 365-375. doi:10.1183/09059180.00003213
Merlin, J. S., Walcott, M., Kerns, R., Bair, M. J., Burgio, K. L., & Turan, J. M. (2015). Pain Self‐Management in HIV‐Infected Individuals with Chronic Pain: A Qualitative Study. Pain Medicine, 16(4), 706-714.
Miller, W. R., Lasiter, S., Bartlett Ellis, R., & Buelow, J. M. (2015). Chronic disease self-management: a hybrid concept analysis. Nursing Outlook, 63(2), 154-161. doi:10.1016/j.outlook.2014.07.005
Monninkhof, E., van der Valk, P., Van der Palen, J., Van Herwaarden, C., Partridge, M., & Zielhuis, G. (2003). Self-management education for patients with chronic obstructive pulmonary disease: a systematic review. Thorax, 58(5), 394-398.
Murphy, K., Casey, D., Dinneen, S., Lawton, J., & Brown, F. (2011). Participants’ perceptions of the factors that influence Diabetes Self‐Management Following a Structured Education (DAFNE) programme. Journal of Clinical Nursing, 20(9‐10), 1282-1292.
Murphy, K., Chuma, T., Mathews, C., Steyn, K., & Levitt, N. (2015). A qualitative study of the experiences of care and motivation for effective self-management among diabetic and hypertensive patients attending public sector primary health care services in South Africa. BMC Health Services Research, 15(1), 1-9.
Naik, A. D., Teal, C. R., Rodriguez, E., & Haidet, P. (2011). Knowing the ABCs: A comparative effectiveness study of two methods of diabetes education. Patient Education and Counseling, 85(3), 383-389.
Nannini, L. J., Cates, C. J., Lasserson, T. J., & Poole, P. (2007a). Combined corticosteroid and long‐acting beta‐agonist in one inhaler versus long‐acting beta‐agonists for chronic obstructive pulmonary disease. The Cochrane Library.
Nannini, L. J., Cates, C. J., Lasserson, T. J., & Poole, P. (2007b). Combined corticosteroid and long‐acting beta‐agonist in one inhaler versus placebo for chronic obstructive pulmonary disease. The Cochrane Library.
Neuman, Å., Gunnbjörnsdottir, M., Tunsäter, A., Nyström, L., Franklin, K. A., Norrman, E., & Janson, C. (2006). Dyspnea in relation to symptoms of anxiety and depression: a prospective population study. Respiratory Medicine, 100(10), 1843-1849.
Ng, T. P., Niti, M., Tan, W. C., Cao, Z., Ong, K. C., & Eng, P. (2007). Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life. JAMA Internal Medicine, 167(1), 60-67. doi:10.1001/archinte.167.1.60
Nutbeam, D. (1998). Health promotion glossary. Health Promotion International, 13(4).
Nutbeam, D. (2000). Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259-267.
O'Donnell, D. E., & Webb, K. A. (2008). The major limitation to exercise performance in COPD is dynamic hyperinflation. Journal of Applied Physiology, 105(2), 753-755. doi:10.1152/japplphysiol.90336.2008b
O'Neill, E. S. (2002). Illness representations and coping of women with chronic obstructive pulmonary disease: a pilot study. Heart and Lung, 31(4), 295-302.
Orem, D. (2001). Nursing: Concepts of practice (6th ed.). St. Louis, MO: Mosby: Inc.
Owens, R. L., & Malhotra, A. (2010). Sleep-Disordered Breathing and COPD: The Overlap Syndrome. Respiratory Care, 55(10), 1333-1346.
Parmet, S., Lynm, C., & Glass, R. M. (2003). CHronic obstructive pulmonary disease. JAMA, 290(17), 2362-2362. doi:10.1001/jama.290.17.2233
Paterson, B. L. (2001). The shifting perspectives model of chronic illness. Journal of Nursing Scholarship, 33(1), 21-26.
Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2002). Health promotion in nursing practice (4th ed.). Upper Saddle River, NJ: Pearson Education.
Petkov, J., Harvey, P., & Battersby, M. (2010). The internal consistency and construct validity of the partners in health scale: validation of a patient rated chronic condition self-management measure. Quality of Life Research, 19(7), 1079-1085.
Ploughman, M., Austin, M. W., Murdoch, M., Kearney, A., Godwin, M., & Stefanelli, M. (2012). The path to self-management: a qualitative study involving older people with multiple sclerosis. Physiotherapy Canada, 64(1), 6-17.
Pooler, A., & Beech, R. (2014). Examining the relationship between anxiety and depression and exacerbations of COPD which result in hospital admission: a systematic review. International Journal of Chronic Obstructive Pulmonary Disease, 9, 315-330. doi:10.2147/COPD.S53255
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., . . . Vivian, E. (2015). Diabetes Self-management Education and Support in Type 2 Diabetes A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. The Diabetes Educator, 41(4), 417-430.
Pride, N. B. (2005). Ageing and changes in lung mechanics. European Respiratory Journal, 26(4), 563-565. doi:10.1183/09031936.05.00079805
Pumar, M. I., Gray, C. R., Walsh, J. R., Yang, I. A., Rolls, T. A., & Ward, D. L. (2014). Anxiety and depression—Important psychological comorbidities of COPD. Journal of Thoracic Disease, 6(11), 1615-1631.
Raluy-Callado, M., Lambrelli, D., MacLachlan, S., & Khalid, J. M. (2015). Epidemiology, severity, and treatment of chronic obstructive pulmonary disease in the United Kingdom by GOLD 2013. International Journal of Chronic Obstructive Pulmonary Disease, 10, 925-937.
Reyes Fernández, B., Montenegro Montenegro, E., Knoll, N., & Schwarzer, R. (2014). Self-Efficacy, Action Control, and Social Support Explain Physical Activity Changes Among Costa Rican Older Adults. Journal of physical activity & health, 11(8).
Rotheram-Borus, M. J., Ingram, B. L., Swendeman, D., & Lee, A. (2012). Adoption of Self-management Interventions for Prevention and Care. Primary care, 39(4), 649-660. doi:10.1016/j.pop.2012.08.006
Rothman, R. L., DeWalt, D. A., Malone, R., Bryant, B., Shintani, A., Crigler, B., . . . Pignone, M. (2004). Influence of patient literacy on the effectiveness of a primary care–based diabetes disease management program. JAMA, 292(14), 1711-1716.
Ryu, Y. J., Chun, E.-M., Lee, J. H., & Chang, J. H. (2010). Prevalence of Depression and Anxiety in Outpatients with Chronic Airway Lung Disease. The Korean Journal of Internal Medicine, 25(1), 51-57. doi:10.3904/kjim.2010.25.1.51
Salehi, L., Eftekhar, H., Mohammad, K., Tavafian, S. S., Jazayery, A., & Montazeri, A. (2010). Consumption of fruit and vegetables among elderly people: a cross sectional study from Iran. Nutrition Journal, 9(1), 1.
Schnell, K. N., Naimark, B. J., & McClement, S. E. (2006). Influential factors for self-care in ambulatory care heart failure patients: a qualitative perspective. Canadian Journal of Cardiovascular Nursing, 16(1), 13-19.
Schnell, K., Weiss, C. O., Lee, T., Krishnan, J. A., Leff, B., Wolff, J. L., & Boyd, C. (2012). The prevalence of clinically-relevant comorbid conditions in patients with physician-diagnosed COPD: a cross-sectional study using data from NHANES 1999–2008. BMC Pulmonary Medicine, 12(1), 1-9. doi:10.1186/1471-2466-12-26
Schols, A. M., & Wouters, E. F. (2000). Nutritional abnormalities and supplementation in chronic obstructive pulmonary disease. Clinics in Chest Medicine, 21(4), 753-762.
Schuurmans, H., Steverink, N., Frieswijk, N., Buunk, B. P., Slaets, J. P. J., & Lindenberg, S. (2005). How to Measure Self-management Abilities in Older People by Self-report. The Development of the SMAS-30. Quality of Life Research, 14(10), 2215-2228. doi:10.1007/s11136-005-8166-9
Shao, R. (2012). Chronic diseases and health promotion. Geneva: World Health Organization.
Sheel, A. W., Derchak, P. A., Morgan, B. J., Pegelow, D. F., Jacques, A. J., & Dempsey, J. A. (2001). Fatiguing inspiratory muscle work causes reflex reduction in resting leg blood flow in humans. The Journal of Physiology, 537(Pt 1), 277-289. doi:10.1111/j.1469-7793.2001.0277k.x
Siafakas, N., Vermeire, P., Pride, N. a., Paoletti, P., Gibson, J., Howard, P., . . . Postma, D. (1995). Optimal assessment and management of chronic obstructive pulmonary disease (COPD). European Respiratory Journal, 8(8), 1398-1420.
Simpson, E., & Jones, M. (2013). An exploration of self-efficacy and self-management in COPD patients. British Journal of Nursing, 22(19), 1105-1109.
Sohn, S. K., Kim, M. S., Lee, Y. S., Park, H. K., & Roh, M. Y. (2014). The mediating effect of social support and stress on optimism and psychological well-being in clinical nurses. Journal of East-West Nursing Research, 20(1), 63-71.
Sousa, V. D., Zauszniewski, J. A., Musil, C. M., McDonald, P. E., & Milligan, S. E. (2004). Testing a conceptual framework for diabetes self-care management. Research and Theory for Nursing Practice, 18(4), 293-316.
St Croix, C. M., Morgan, B. J., Wetter, T. J., & Dempsey, J. A. (2000). Fatiguing inspiratory muscle work causes reflex sympathetic activation in humans. The Journal of Physiology, 529(Pt 2), 493-504. doi:10.1111/j.1469-7793.2000.00493.x
Steverink, N. (2009). Self-Management Ability Scale: SMAS-30/versie 2. Achtergrond, handleiding en scoring. Via www. nardisteverink. nl (zie kopje Materials), 1-15.
Steverink, N., Lindenberg, S., & Slaets, J. P. (2005). How to understand and improve older people’s self-management of wellbeing. European journal of ageing, 2(4), 235-244.
Szymczyk, I., Wojtyna, E., Lukas, W., Kępa, J., & Pawlikowska, T. (2013). How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations?: a study in polish primary care. BMC Family Practice, 14, 1-10. doi:10.1186/1471-2296-14-165
Tolsdorf, C. C. (1976). Social networks, support, and coping: An exploratory study. Family Process, 15(4), 407-417.
Tzani, P., Aiello, M., Elia, D., Boracchia, L., Marangio, E., Olivieri, D., . . . Chetta, A. (2011). Dynamic hyperinflation is associated with a poor cardiovascular response to exercise in COPD patients. Respiratory Research, 12, 150-157. doi:10.1186/1465-9921-12-150
Vanfleteren, L. E., Spruit, M. A., Groenen, M., Gaffron, S., van Empel, V. P., Bruijnzeel, P. L., . . . Franssen, F. M. (2013). Clusters of comorbidities based on validated objective measurements and systemic inflammation in patients with chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 187(7), 728-735.
von Leupoldt, A., & Dahme, B. (2007). Psychological aspects in the perception of dyspnea in obstructive pulmonary diseases. Respiratory Medicine, 101(3), 411-422.
Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., . . . Aboyans, V. (2013). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2163-2196.
Wagner, E. H., Austin, B. T., Davis, C., Hindmarsh, M., Schaefer, J., & Bonomi, A. (2001). Improving chronic illness care: translating evidence into action. Health Affairs, 20(6), 64-78.
Wang, K.-Y., Sung, P.-Y., Yang, S.-T., Chiang, C.-H., & Perng, W.-C. (2012). Influence of family caregiver caring behavior on COPD patients' self-care behavior in Taiwan. Respiratory Care, 57(2), 263-272.
Warren-Findlow, J., Seymour, R. B., & Brunner Huber, L. R. (2012). The Association Between Self-Efficacy and Hypertension Self-Care Activities Among African American Adults. Journal of Community Health, 37(1), 15-24. doi:10.1007/s10900-011-9410-6
Watz, H., Waschki, B., Meyer, T., Kretschmar, G., Kirsten, A., Claussen, M., & Magnussen, H. (2010). Decreasing cardiac chamber sizes and associated heart dysfunction in COPD: role of hyperinflation. Chest, 138(1), 32-38. doi:10.1378/chest.09-2810
Wedzicha, J. A. (2004). Role of viruses in exacerbations of chronic obstructive pulmonary disease. Proceedings of the American Thoracic Society Journal, 1(2), 115-120. doi:10.1513/pats.2306030
Weng, L. C., Dai, Y. T., Huang, H. L., & Chiang, Y. J. (2010). Self‐efficacy, self‐care behaviours and quality of life of kidney transplant recipients. Journal of Advanced Nursing, 66(4), 828-838.
Wilski, M., Tasiemski, T., & Kocur, P. (2015). Demographic, socioeconomic and clinical correlates of self-management in multiple sclerosis. Disability and Rehabilitation, 37(21), 1970-1975.
Wortz, K., Cade, A., Menard, J. R., Lurie, S., Lykens, K., Bae, S., . . . Coultas, D. (2012). A qualitative study of patients' goals and expectations for self-management of COPD. Primary Care Respiratory Journal, 21(4), 384-391. doi:10.4104/pcrj.2012.00070
Yang, L., Wu, Q., Hao, Y., Cui, Y., Liang, L., Gao, L., . . . Yin, H. (2017). Self-management behavior among patients with diabetic retinopathy in the community: a structural equation model. Quality of Life Research, 26(2), 359-366. doi:10.1007/s11136-016-1396-1
Yildirim, A., Asilar, R. H., Bakar, N., & Demir, N. (2013). Effect of anxiety and depression on self-care agency and quality of life in hospitalized patients with chronic obstructive pulmonary disease: a questionnaire survey. International Journal of Nursing Practice, 19(1), 14-22. doi:10.1111/ijn.12031
Yohannes, A. M., Willgoss, T. G., Baldwin, R. C., & Connolly, M. J. (2010). Depression and anxiety in chronic heart failure and chronic obstructive pulmonary disease: prevalence, relevance, clinical implications and management principles. International Journal of Geriatric Psychiatry, 25(12), 1209-1221. doi:10.1002/gps.2463
Yoo, H., Kim, C. J., Jang, Y., & You, M. A. (2011). Self-efficacy associated with self-management behaviours and health status of South Koreans with chronic diseases. International Journal of Nursing Practice, 17(6), 599-606. doi:10.1111/j.1440-172X.2011.01970.x
Zhang, C., Wang, W., Li, J., Cai, X., Zhang, H., Wang, H., & Wang, X. (2013). Development and validation of a COPD self-management scale. Respiratory Care, 58(11), 1931-1936. doi:10.4187/respcare.02269
Zhang, J. X., & Schwarzer, R. (1995). Measuring optimistic self-beliefs: A Chinese adaptation of the General Self-Efficacy Scale. Psychologia: An International Journal of Psychology in the Orient, 38(3), 174-181.
Zulman, D. M., Rosland, A. M., Choi, H., Langa, K. M., & Heisler, M. (2012). The influence of diabetes psychosocial attributes and self-management practices on change in diabetes status. Patient Education and Counseling, 87(1), 74-80. doi:10.1016/j.pec.2011.07.013
Zwerink, M., Brusse-Keizer, M., van der Valk, P. D., Zielhuis, G. A., Monninkhof, E. M., van der Palen, J., . . . Effing, T. (2014). Self management for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 3(3).

吳明隆、涂金堂(2007).SPSS與統計應用分析(二版) .台北市:五南圖書出版股份有限公司。
林正常、林貴福、徐台閣、吳慧君(譯)(2002).運動生理學-體適能與運動表現的理論與應用(原作者:S. K. Powers).台北:藝軒圖書。
蕭文龍(2016).統計分析入門與應用:SPSS中文版+SmartPLS 3.台北:碁峰資訊。

第一頁 上一頁 下一頁 最後一頁 top