研究生: |
賴妙芬 |
---|---|
論文名稱: |
促進糖尿病患者社會支持與充能效果之介入研究-以台北市石牌地區吉慶里和石牌里為例 |
指導教授: | 劉潔心 |
學位類別: |
碩士 Master |
系所名稱: |
健康促進與衛生教育學系 Department of Health Promotion and Health Education |
論文出版年: | 2002 |
畢業學年度: | 90 |
語文別: | 中文 |
論文頁數: | 143 |
中文關鍵詞: | 糖尿病 、社會支持 、充能 、社區 |
論文種類: | 學術論文 |
相關次數: | 點閱:436 下載:80 |
分享至: |
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摘要
本研究主要目的在發展「社會支持與充能效果教學模組」,並進一步探討教育介入之成效。教育內容的設計乃依據行為科學之社會認知理論、社會支持策略、健康信念模式、行為改變階段理論,並結合充能理念發展而成。
本研究採「單組前測、後測之實驗設計」,以現有的社區糖尿病患作為實驗對象來源,立意取樣台北市石牌地區吉慶里和石牌里之糖尿病患者,共49位為實驗對象。實驗組在教育介入之前一週進行前測,並接受四週的糖尿病教育介入計畫,於教育介入之後一週進行後測,以瞭解教育介入的效果。前後測問卷一致者為34人,其中有24人參與完整課程。為考慮研究設計之嚴謹性,因此於實驗對象實施後測之同時,選取相鄰之奇岩里和東華里現有的糖尿病個案進行後測,作為對照資料,來做進一步的分析比較。
本研究所得的重要結果如下:
一、 「社會支持與充能效果教學模組」之後,實驗組糖尿病患者的「社會支持」後測得分高於前測且達顯著差異。
二、 「社會支持與充能效果教學模組」之後,實驗組糖尿病患者的「充能效果」後測得分高於前測且達顯著差異;同時實驗組糖尿病患者的「掌控力」、「自我效能」和「自我照顧行為」後測得分高於前測且達顯著差異。
三、 「社會支持與充能效果教學模組」之後, 實驗組之「社會支持」和「充能效果」之後測得分高於對照組且有顯著差異。
根據本研究結果,結合社會認知理論、社會支持、健康信念模式、行為改變階段模式與充能理念於「社會支持與充能效果教學模組」,能有效的提升糖尿病患者的「社會支持」和「充能效果」,可見於以「全人」的充能觀點來教育,增進患者對社區生活資源的利用,且此具理論背景和策略之介入計畫,是具有效果的。建議在未來相關研究的推動上,考慮病患的心理社會和生活環境層面,有效結合生活資源和醫療服務,運用行為科學理論和策略於糖尿病教育,值得作進一步的研究和嘗試。
參考文獻
一、 中文部分
王曼溪(1993):第二型糖尿病病人衛教結果之評估。榮總護理,10(2),212-216。
王璟璇(1997):門診初診斷之非胰島依賴型糖尿病患的自我照護行為、血糖控制
及其相關因素之探討。高雄醫學院護理研究所碩士論文。
田玫、季瑋珠、張智仁、張玨(1988):台北縣貢寮鄉糖尿病人疾病壓力與家庭支持之研究—初步報告。中華衛誌,8(3),150-160。
台北市政府衛生局(1986) :病人衛生教育講座專輯。台北市政府衛生局。
行政院衛生署(2000):生命統計。 行政院衛生署。
行政院衛生署(1999):辦理社區健康營造計劃。衛生署保健處。
江金玲(1997):非胰島素依賴型糖尿病患者家庭支持、生活滿意度、自我照顧行
為與糖尿病控制之研究。國立台灣大學護理研究所碩士論文。
江瑾瑜(1990)住院與非住院糖尿病患者之比較分析。國防醫學院護理研究所碩士論文。
杜幸芳(1997):飲食運動衛教對非胰島素依賴型糖尿病病人之成效。長庚大學護
理研究所碩士論文。
呂秀蓉(1998):運用行動研究策略與充能理念建構「社區互助團體」--以石牌社區為例。國立陽明大學社區護理研究所碩士論文。
李淑媛(1992):社會支持與社交隔離對糖尿病患者疾病適應之探討。護理雜誌,
9(1),63-68。
林耀盛(2000)進退維谷:糖尿病患者的認同建構。中華心理衛生學刊,13,1-34。
林作慶(1996):十週運動計劃對糖尿病患者健康狀況影響之研究。國立台灣師範
大學體育研究所。
林文康、江瑾瑜、宣立人(1987):糖尿病患者之知識、態度及血糖控制之相關
性研究。護理雜誌,34(1),65-83.
林秋菊(1995):健康信念、尿毒症認知和社會支持對慢性血液透析病人遵從行為之影響。高學醫學科學雜誌,8,470-480。
林冠品(1998):公衛護士家訪糖尿病個案自我照顧行為及其相關因素。高學醫學院護理學研究所碩士論文。
邱愛芳(1998):花蓮地區非胰島素依賴型糖尿病患者居家自我照顧行為及其相關
因素之探討。慈濟醫學院護理所碩士論文。
胡月娟(1994):慢性病患者所承受的衝擊與因應行為。護理研究,2(2),10-26 。
洪建德(1986)糖尿病病人的飲食與運動治療。臨床醫學,17(4),368-377。
秦玉梅(1987):高職三年級學生性知識、態度、行為及家長、教師對性教育之看法調查研究。國立台灣師範大學衛生教育研究所碩士論文。
陳滋茨、張媚、林豔君(1998):自我效能、社會支持與糖尿病病人居家自我照顧
行為相關之探討。護理研究,6(1),31-43。
陳富莉(1989):門診糖尿病個別衛生教育計劃之評價研究。國立台灣師範大學衛
生教育所碩士論文。
陳秀女(1994):老年糖尿病患之自我照顧行為與糖尿病知識、社會支持相關研究。
國防醫學院護理研究所碩士論文。
陳惠美(1992):糖尿病患者生活品質及其相關因素之探討。國防醫學院護理研究
所碩士論文。
陳姿伶、盧介祥、黃紫寶、林金玉(2000):「糖尿病共同照護計劃」實施前門診
糖尿病患照護現況。公共衛生,26(4),319-330.
陳俞琪(2000):門診血液透析病患互助團體形成過程與充能效果之探討。國立陽明大學社區護理研究所碩士論文。
莊嬌榮、鄭 綺、林佳靜、林宏達(1999)第二型糖尿病患者血糖控制自我管理模式之探討。新台北護理期刊,1(1),11-19。
郭生玉(1996):心理與教育測驗(第十版)。台北:精華書局。
曾旭正(1997): 讓社區動起來-社區總體營造。宜蘭縣立文化中心。
張立中(1990):糖尿病患者疾病壓力、社會支持、情緒適應及其遵行醫囑行為研
究。國立台灣師範大學衛生教育所碩士論文。
張念慈(2000):台北市社區領袖醫療資源利用及其相關因素探討。國立陽明大
學社區護理研究所碩士論文。
張智仁、高照村、鄭瑞棠(1997):非胰島素依賴型糖尿病的盛行率及心臟血管疾
病危險因子相關性之流行病學。行政院衛生署委託研究計劃。
張峰紫 (1997):以自我效力評估胰島素依賴型糖尿病患者之自我照顧情形。高
雄醫學科學雜誌,13(6),351-359.
傅振宗、羅世慧、陳鴻銘、戴東原(1988):糖尿病患在社區醫院急診處的使用情
形之分析。中華民國公共衛生學會雜誌,8(1),1-11。
黃春戀(2000):在宅護理服務方案對改善獨居老年糖尿病患血糖控制之成效。
國立陽明大學臨床護理研究所碩士論文。
黃靜儀(1997)糖尿病衛教人員與病人自覺衛教需求的差異研究-以北市糖尿病人保健推廣中心為例。國立台灣師範大學衛生教育研究所碩士論文。
黃麗卿、陳慶餘、謝維銓(1992) :非胰島素依賴型糖尿病患家庭功能與血糖控制--以FACES-II為工具之探討。中華民國家庭醫學雜誌,3,34-43。
詹惠敏(1983)台北市某醫院糖尿病患者居家治療情形及其相關因素之探討。公共衛生,10(3),256-272。
楊怡君(1996):社區老人施行口腔保健衛生教育成效之探討。長庚大學護理研究所碩士論文。
廖麗娟、趙珍珠、張正二(1991)台灣地區十一處山地鄉居民高血壓、糖尿病盛行率及居民對高血壓糖尿病防治認知與行為之研究。公共衛生,18(2),113-131。
劉潔心、晏涵文、 劉貴雲、邱詩揚、廖梨伶、 李佳容、 賴妙芬、羅逸平(2000)社區健康媒體之發展與評價--健康訊息傳播與社會行銷策略探討。衛生教育學報,14,69-83。
劉淑娟(1999):臺北市立醫院門診糖尿病病患健康自我管理及其相關因素之探討。榮總護理,16(3),286-298。
蔡甫昌、陳慶餘、陳淑娟、林瑞祥(1996):社區糖尿病患小組衛教課程及課後追
蹤管理模式有效性評估。中華家醫誌,6(1),21-28。
盧美秀、林秋香(1991):比較門診團體衛教和個別衛教糖尿病病人知識、態度、
行為和血糖變化的影響。護理雜誌38(12),101-111。
戴東原(1993):老年人糖尿病的治療。台灣醫界,36(6),25-27。
蘇雅玲、張媚、陳月枝(1994):某醫學中心門診非胰島素依賴型糖尿病患者壓力感受與因應方式之探討。護理研究,3,29-40。
二、 英文部分
Alcalay,R., Alvarado,M., Balcazar,H., Newman,E., Huerta,E.(1999). SALUD PARA CORAZON:a community-based latino cardiovascular disease prevention and outreach modol.Journal of Community Health, 24, 359 -379.
Anderson,R.M., Arnold,M.S., Funnell,M.M., Fitzgerald,J.T., Butler,P.M., Feste,C.C.(1995).Patient empowerment. Diabetes Care,18(7), 943-949.
Auslander,W.,et al.(2000).The short-term impact of a health promotion program for low-income African American women. Social Work Practice, 10(1),78-97.
Bandura,A.(1997).Self-efficacy:the exercise of control. New York:Freeman.
Barrera,M., Sandier,I.N., Ramsay,T.B.(1981).Prelimiary development of a scale of social support:studies on college stuents. American Journal of Community Psychology,9(4),435-447.
Bandura,A.(1977).Self-Efficacy:Toward a Unifying Theory of Behavior Change. Psychological Review,84,191-215.
Bandura,A.(1978).The Self System in Reciprocal Determinism. American Psychologist ,33,344-358.
Bandura,A.(1982).Self-Efficacy Mechanism in Human Agency. American Psychologist ,37,122-147.
Bandura,A.(1986).Social Foundation of Thought and Action:A Social Cognitive Theory. Englewood Cliffs,N.J.:Prentice Hall.
Bjaras,G.,Ahlbom,A.,Alvarsson,M.,Burstrom,B.,Diderichsen,F.,Efendic,S.,Grill,V.,Haglund,B.,J.,Norman,A.,Persson,P.G.,Svanstrom,L.,Tillgren,P.,Ullen,H.,Ostenson,C.G.(1997).Strategies and methods for implementing a community-based diabetes primary prevention program in Sweden. Health promotion International, 12(2),151-159.
Bjork,S.(2001)The cost of diabetes and diabetes care. Diabetes Reseach and Clinical Practice,54,13-18.
Bonnet,C., Gagnayre, R., d’Ivernois,J.-F.(1998). Learning difficulties of diabetes patient :a survey of educators. Patient Education And Counseling,35, 139-147.
Bradley,C.(1995).Health belief and knowledge of patients and doctors in clinical practice and research.Patient Education and Counseling,26, 99-106.
Baranowski, T., Perry,C.L., Parcel,G..S. (1977).Social Cognitive Theory. In Glanz,K., Lewis,F.M., Rimer,B.K., (1977).Health Behavior and Health Education – Thoery, Research, and Practice(edsⅡ). Jossey-Bass, San Francosco.
Caserta, M.S.(1995).Health Promotion and the older population: Expanding our theoretical horizons. Journal of Community Health,20(3),282-293.
Carlos,E.C.-P., Guillermo,G-P., Guadalupe,V.-L., Mercedes,G.-H., Mayari,C.-L., Manuel,G.-O., Esperanza,M.-A., Alejandro,G.O.(2000).Effects of behavior-modifying education in the metabolic profile of the Type 2 diabetes mellitus patient,14,322-326.
Chen,K.-R.(1999)Psychosocial determinants of compliance behavior and its impact on the management of diabetes among elderly patients in Taiwan. University of California ,Los Angeles .
Charron-Prochownik,D., Sereika,S.M., Becker,D., Jacober,S., Mansfield,J., White,N.H., Hughes,S., Dean-McElhinny,T., Trail,L.(2001).Reproductive health beliefs and behaviors in teens with diabetes: application of the Expanded Health Belief Model. Pediatric Diabetes ,2, p30-39
Cox,D.J., Gonder-Frederick L.(1992).Major Development in Behavioral Diabetes Research. Journal of Consulting and Clinical Psychology, 60(4),628-638.
Cobb,S.(1976).Social support as a moderator of life stress. Psychosomatic Medicine,38(5),300-314.
Crowley,K.M., Shakeh,P.Y., Kaftarian,S.J.(2000).Prevention actions and activities make a difference:a structural equation model of coalition building. Evaluation and Planning,23,381-388.
Cummings, K. M. (1982). Determinants of drugs treatment maintenance among hypertensive persons in inner city deteroit. Public Health Report, 97, 99-106.
Daniel M., Green L.W ., Marion S.A., Gamble D., Herbert G.P., Hertzman C., Sheps S. B. (1999).Effectiveness of community-directed diabetes prevention and control in a rural Aboriginal population in British Columbia,Canada. Social Science and Medicine ,48,815-832.
Dean,K.(1989).Conceptual,theoretical and methodological issues in self-care research .Social Science and Medicine,29,117-123.
Dufault,K.,Martocchio,B.C.(1985).Hpoe:Its spheres and dimensions. Nursing Clinics of North America,20(2),379-391.
Esberger,K.K., Hughes,S.T.(1989).Diabetes:Nursing Care of the Aged. Norwalk:Appleton & Lange.
Ewart,C.K., Taylor,C.B., Reese,L.B., and Debusk,R.F.(1983).Effects of Early Postmyocardial Infarction Exercise Testing on Self-Perception and Subsequent Physical Activity. American Journal of Cardiology,51, 1076-1080.
Fetterman,D.M.(1996).Empowerment evaluation:a introduction to theory and pratices. Empowerment Evaluation, SAGE Publication.
Fetterman D. M.(1994).Empowerment evaluation. Evaluation Pratice, 15(1), 1-15.
Fincham,F.D., Bradbury,T.N.(1990).Social support in marriage:the role of social cognition. Journal of Social and Clinical Psychology,9, 31-42.
Folden,S.L.(1994).Managing the effects of a stroke. Rehabilitation Nursing Research,3,79-85.
Farran,C.J., Wilken,C., Popovich,J.M.(1992).Clinical assessment of hope. Issues in Mental Health Nursing,13,129-138.
Foote,A.W., Piazza,D., Holcombe,J.,Paul,P.,Daffin,O.(1990).Hope,self esteem and social support in persons with multiple sclerosis. Journal of Neuroscience Nursing,22(3),155-159.
Fincham and Bradbury(1990).Social support in marriage:the role of social cognition. Journal of Social and Clinical Psychology,9,31-42.
G’omez,C.A., Goldstein,E.(1996).The HIV Prevention Evaluation Initiative.In Fetterman D. M.,Kaftarian S.J., Wandersman A.(Eds.), Empowerment Evaluation—Knowledge and Tools for Self-Assessment & Accountability (pp.100-122). Sage Publications.
Glanz,K., Lewis,F.M., Rimer,B.K.(1997).Health Behavior and Health Education(Eds ǁ).San Francisco:Jossey-Bass.
Green,L.W., Kreuter,M.W.(1999).Health Promotion Planning: An Educational and Ecological Approach(3nd ed.). PaloAlto: Mayfield Publications.
Graber, A. L. (1977).Education of diabetes patient- education program. Diabetes, 26, 61-64.
Graham,C.(1991)Exercise and aging:Implications for persons with diabetes. Diabetes Educator ,17(3),189-195.
House,J.S.(1981).Work Stress and Social Support. Reading,Miss:Addison-Wesley.
Howorka,K., Pumprla,J., Wagner-Nosiska,D., Grillmayr,H., Schlusche,C., Schabmann,A. (2000). Empowering diabetes out-patients with structured education:Short-term and long-term effects of functional insulin treatment on perceived control over diabeted. Journal of Psychosomatic Research 48,37-44.
Heaney,C.A.,Israel,B.A.(1997)Social Networks and Social Support. In Glanz,K., Lewis,F.M., Rimer,B.K.(Eds.), Health Behavior and Health Education.(pp179-202).San Francisco:Jossey-Bass.
Huzar,J.G., Cerrato,P.L.(1989)The role of diet and drug.RN,52(4),46-50.
Irwin,C., Braithwaite,R.(1998)A Church-Based Diabetes Education Program for Older, African-American Women. American Journal of Health Studies,13(1), 1-11.
Israel,B.A., Checkoway,B., Schulz,A., Zimmerman,M.(1994).Health Education and Community Empowerment: Conceptualizing and Measuring Perceptions of Individual, Organizational, and Commuity Control. Health Education Quarterly, 21(2),149-170.
Josefowitz,N.(1980).Path to power. Addison-Wesley, Reading, Masschusetts.
Kahn,R.L., Antonucci,T.C.(1980).Convoys over the Life Course:Attachments, Roles and Social Support. In P. B. Baltes and O.Brin(eds.),Life Span Development and Behaver.Vol.3. Orlando, Fla.:Academic Press.
Kodiath,M.E., Kodiath,A.(1995)A comparative study of patienta who experience chronic malignant pain in India and the United States. Cancer Nursing ,18,189-196.
Lowe,J.M., Bowen,K.(1997).Evaluation of a diabetes education program in Newcastle,MSW. Diabetes Research and Clinical Practice, 38,91-99.
Macaulay,A.C., Paradis,G., Potvin,L., Cross,E.J., Saad-Haddad,C., McComber,A., Desrosiers,S., Kirby,R., Montour,L.T., Lamping,D.L., Leduc,N., Rivard,M.(1997).The Kahnawake Schools Diabetes Prevention Project:Intervention, Evaluation, and Baeline Results of a Diabetes Primary Prevention Program with a Native Community in Canada. Prevention Medicine,26,779-790.
Maibach,E., Murphy,D.A.(1995).Self-Efficacy in Health Promotion Research and Practice:Conceptualization and Measurement. Health Education Research,10, 37 - 50.
Maton, K. I.(1988).Social support , organizational characteristics, psychological well-being, and group appraisal in three self-help group populations. American Journal of Community Psychology, 16(1), 53-77.
Maton, K. I., Salem, D. A. (1995). Organizational characteristics of empowering community settings:a multiple case study approach. American Journal of Community Psychology , 23 (5) , 631-657.
Macdonald,G, Davies,K.J.(1998).Reflection and Vision –Proving and improving the promotion of health. In Quality, Evidence & effectiveress in health Promotion chap one. 5-1
Mcwilliam,C.L., Stewart,M., Brown,J.B., Mcnair,S., Desai,K., Patterson,M.L., Maestro,N.D., Pittman,B.J. (1997). Creating empowering meaning:an interactive process of promoting health with chronically ill older Canadians. Health Promotion International 12(2),111-123.
Mithaug,D.E.(1996).Fairness, Liberty, and Empowerment Evaluation. In Fetterman D. M.,Kaftarian S.J., Wandersman A.(Eds.), Empowerment Evaluation— Knowledge and Tools for Self-Assessment & Accountability (pp.100-122) . Sage Publications.
Mertes,G.(1998).Efficacy and safety of acasbose in the treatment of Type 2 diabetes:data from a 2-year sureillance study.Diabetes Research and Clinical Practice,40,63-70.
Montgomery K. (1993).The Harvard Alcohol Project: Promoting the designated driver on television.In Backer TE, Rogers EM (cds.), Organization Aspects of Health Communication Campaigns:What Works. Newbury Park, CA, Sage.
Paterson,B., Thorne,S.(1999)Living with diabetes as a Transformational Experience. Qualitative Health Research,9(6), 786-803.
Parcel,G.S., and other.(1995).Measurement of Self-Efficacy for Diet-Related Behavior Among Elementary School Children. Journal of School Health,65, 23-27.
Piette,J.D., Weinberger ,M., McPhee,S.J., Mah,C.A., Kraemer, F.B., Crapo,L.M. (2000).Do Automated Calls with Nurse Follow-up Improve Self-Care Glycemic Control among Vulnerable Patient with Diabetes?. The American Joernal of Medicine,108,20-27.
Prochaska,JO., Redding,C.A., Evers,K.E.(1997).The Transtheoretical Model and Stages of Change. In Glanz,K., Lewis,F.M., Rimer,B.K.(Eds.), Health Behavior and Health Education.(pp60-84).San Francisco:Jossey-Bass.
Prochaska,J.O., DiClemente,C.C.(1983).Stages and Processes of self-change of smoking:toward an intergrative model of change. Journal of Consulting and Clinical Psychology,51,390-395.
Pistrang,N., Barker,C., Rutter,C.(1997).Social support as conversation : analysing breast cancer patients’ interactions with their partners. Social Science and Medicine,45(5), 73-782.
Rodwell, C.R.(1996).An analysis of the concept of empowerment. Journal of Advanced Nursing,23,305-313
Rubin,R.R., Peyrot,M., Saudek C.D. (1989).Effect of Diabetes Education on Self-Care,Metabolic Control,and Emotional Well-Being. Diabetes Care,12,673-679.
Reed,D.A.(1997).Health Education:A Congnitive-behavioral Approach. Jones and Bartlett Publisher,Inc.
Sarason,I.G., Sarason,B.R., Pierce,G.R.(1994). Relationship-specific social support:toward a model for the analysis of support interaction. In Communication of Social Support:Message, Interactions, Relationships and Community, eds B.R. Burleson, T.L. Albrecht and I.G. Sarason, pp.91- 112. Sage,Thousand Oaks,CA.
Samaras,K., Ashwell,S., Mackintosh,A.-M., Fleury,A.C., Campbell,L.V., Chisholm,D.J.(1997).Will older sedentary people with non-insulin-dependent diabetes mellutus start exercising? A health promotion model.Diabetes Research and Clinical Pratice,37,121-128.
Sheeshka,J.D., Woolcott,J.D., MacKinnon,N.J.(1993).Social Cognitive Theory as a Framework to Explain Interventions to Practice Healthy Eating Behaviors. Journal of Applied Social Psychology,23,1547-1573.
Steckler,A.,Allegrante,J.P.,Altman,D.,Brown,R.,Burdine,J.N.,Goodman,R.M.,Jogensen,C.(1995).Recommendations for future research. Health educ Q. 22(3),307-329.
Stone,J.B., Bluhm,H.P., white,M.I.,(1984).Relationship between health locus of control, health value, and social support and compliance of person with diabetes mellitus. Diabetes Care,7, 566-574.
Strauss,A.,Corbin,J.(1988).Shaping a new health care system. San Francisco, CA:Jossey-Bass.
Schwartz,C.E., Sendor,R.M.(1999).Helping other helps oneself:response shift effects in peer support. Social Sciense and Medicine,48,1563-1575.
Strecher,V.J., Rosenstock,I.M.(1997). The Health Belief Model. In Glanz,K., Lewis,F.M., Rimer,B.K.(Eds.), Health Behavior and Health Education.(pp41-59).San Francisco:Jossey-Bass.
Sarason,I.G., Sarason,B.R., Pierce,G.R.(1994). Relationship-specific social support:towards a model for the analysis of supportive interaction. In Communication of Social Support:Messages, Interactions, Relationships and Community,eds B.R.Burleson, T.L. Alberecht and I.G. Sarason, pp.91-112.Sage,Thousand Oaks,CA.
Thoits,P.A.(1986) . Social Support as Coping Assistance. Journal of Consulting and Clinical Psychology,54,416-413
Thompson,S.J., Gifford,S.M. (2000).Trying to Keep a Balance: the meaning of health and diabetes in an urban Aboriginal community. Social Science and Medicine, 51,1457-1472.
Wang,C.-Y., Abbott,L.J.(1998).Development of a Community-Based Diabeted and Hypertention Preventive Program. Public Health Nursing,15(6), 406-414.
Wallack ,L(1990).Mass communication and health promotion,.In Rice RE, Atkin CE (cds.): Public Communication Campaigns (2nd cd.). Newbury Park, CA, Sage.
Wenger,G.C.(1994).Sopport Network of Older People:A Guide for Practitioners. Bangor, Wales:University of Wales Print Unit.
Wethington, E., Kessler,R.C.,(1986).Perceived Support, Received Support, and Adjustment to Stressful Life Event. Journal of Health and Social Behavior,27,78-89.
Yin,K.R., Kaftarian,S.J., Jacobs,N.F.(1996). Empowerment Evaluation at Federal and Local Level:Dealing With Quality. In Fetterman D. M.,Kaftarian S.J., Wandersman A.(Eds.),Empowerment Evaluation—Knowledge and Tools for Self-Assessment & Accountability(pp.188-207) .Sage Publications.