This special issue introduces researchers, practitioners, and the public to the self-help and mutual aid aspects of Fountain House mental health Clubhouses. These articles explore beyond the frameworks of the older conventional concepts of psychosocial rehabilitation; instead, they focus on newer emerging concepts of mutual aid, peer support, empowerment, and recovery. Fountain House Clubhouses have been studied and reported in the scholarly literature separate from that of mental health consumer-run (or service-user-run) self-help organizations (CROs) as they have been seen as so disparate that they have little in common. This article proposes a conceptualization of Clubhouses and CROs as mental health organizations that focuses on their mutual aid features—on what they have in common as self-help organizations. The intention is to provide a bridge so that the two literatures can be brought together to enrich each other. But, before we build this bridge (“Conceptually Integrating Clubhouses with other Mental Health CROs” below), we need to Introduce this Special Issue. Fountain House New York, the original Fountain House, is profusely thanked and greatly appreciated for its generous role in the idea for this special issue and for providing support through hosting a symposium and a subsequent meeting for researchers to present and critique their papers on Clubhouses. Fountain House is clearly devoted to independent research as their hosting role came without any strings attached. Kudos and thank yous to the Guest Editor Magnus Karlsson whose coordination of the project brought it to fruition. He encouraged
{"title":"Special Issue of Fountain House Mental Health Clubhouses as Hybrid Self-Help Organizations","authors":"T. Borkman","doi":"10.2190/SH.7.1.A","DOIUrl":"https://doi.org/10.2190/SH.7.1.A","url":null,"abstract":"This special issue introduces researchers, practitioners, and the public to the self-help and mutual aid aspects of Fountain House mental health Clubhouses. These articles explore beyond the frameworks of the older conventional concepts of psychosocial rehabilitation; instead, they focus on newer emerging concepts of mutual aid, peer support, empowerment, and recovery. Fountain House Clubhouses have been studied and reported in the scholarly literature separate from that of mental health consumer-run (or service-user-run) self-help organizations (CROs) as they have been seen as so disparate that they have little in common. This article proposes a conceptualization of Clubhouses and CROs as mental health organizations that focuses on their mutual aid features—on what they have in common as self-help organizations. The intention is to provide a bridge so that the two literatures can be brought together to enrich each other. But, before we build this bridge (“Conceptually Integrating Clubhouses with other Mental Health CROs” below), we need to Introduce this Special Issue. Fountain House New York, the original Fountain House, is profusely thanked and greatly appreciated for its generous role in the idea for this special issue and for providing support through hosting a symposium and a subsequent meeting for researchers to present and critique their papers on Clubhouses. Fountain House is clearly devoted to independent research as their hosting role came without any strings attached. Kudos and thank yous to the Guest Editor Magnus Karlsson whose coordination of the project brought it to fruition. He encouraged","PeriodicalId":64356,"journal":{"name":"自我保健","volume":"21 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87433568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Book Reviews: Sharing Experience, Living and Learning: A Study of Self-Help Groups , by K. T. Elsdon with John Reynolds and Susan Stewart","authors":"C. Munn-Giddings","doi":"10.2190/SH.7.2.H","DOIUrl":"https://doi.org/10.2190/SH.7.2.H","url":null,"abstract":"","PeriodicalId":64356,"journal":{"name":"自我保健","volume":"20 1","pages":"233-234"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81774957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deborah L. Conrad-Garrisi, Francesca M. Pernice-Duca
Individuals who experience a sense of mattering are more likely to experience higher levels of psychosocial well-being. Individuals with serious mental illness (SMI) often experience ostracism and social rejection rather than a sense of mattering, partly due to the stigma associated with SMI. Examining sense of mattering as a component of social support is a contribution of this study. Clubhouses provide support and assistance to individuals with SMI. The clubhouse program provides an intentional environment that creates a sense of community and offers an opportunity to develop sense of mattering, build skills, and develop peer relationships, which promotes recovery. A sample of 143 clubhouse members from 10 clubhouses participated in interviews about experiences of being a clubhouse member; perceptions of sense of mattering, stigma, and recovery. Results confirmed a sense of mattering is predictive of a subjective recovery. Individuals that experience a greater sense of mattering experienced less perceived stigma. *This study is part of a Dissertation completed by the first author to fulfill requirements for a Doctorate in Philosophy in Educational Psychology at Wayne State University.
{"title":"The Relationship between Sense of Mattering, Stigma, and Recovery: An Empirical Study of Clubhouse Participants in the U.S. Midwest","authors":"Deborah L. Conrad-Garrisi, Francesca M. Pernice-Duca","doi":"10.2190/SH.7.1.D","DOIUrl":"https://doi.org/10.2190/SH.7.1.D","url":null,"abstract":"Individuals who experience a sense of mattering are more likely to experience higher levels of psychosocial well-being. Individuals with serious mental illness (SMI) often experience ostracism and social rejection rather than a sense of mattering, partly due to the stigma associated with SMI. Examining sense of mattering as a component of social support is a contribution of this study. Clubhouses provide support and assistance to individuals with SMI. The clubhouse program provides an intentional environment that creates a sense of community and offers an opportunity to develop sense of mattering, build skills, and develop peer relationships, which promotes recovery. A sample of 143 clubhouse members from 10 clubhouses participated in interviews about experiences of being a clubhouse member; perceptions of sense of mattering, stigma, and recovery. Results confirmed a sense of mattering is predictive of a subjective recovery. Individuals that experience a greater sense of mattering experienced less perceived stigma. *This study is part of a Dissertation completed by the first author to fulfill requirements for a Doctorate in Philosophy in Educational Psychology at Wayne State University.","PeriodicalId":64356,"journal":{"name":"自我保健","volume":"7 1","pages":"41-57"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80518145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many International Clubhouses are dependent on the state financially; this can potentially undermine their accountability to International Clubhouse Standards, and ultimately to members. Dependence on government funding can compromise Clubhouse autonomy and staff can end up elevating financial and regulatory accountability over member accountability. In order to shed light on how dependence on government affects accountability to members, Clubhouse affiliates in Japan, the United Kingdom, and Italy were investigated in a 2-year project funded by the Japan Society for the Promotion of Science. This study found out that reactions to accountability in Clubhouses vary according to the different kinds of staff. In the United Kingdom and Italy, where staff feel aligned with members (sympathetic staff), staff felt more of a conflict with government standards but also felt less of a need to institutionalize accountability to members. In contrast, it was found that in Japan—where staff had a professional orientation and were more concerned with the community or society at large—staff did not feel a conflict with government standards but they also elevated accountability to the community rather than accountability to members. *This research was supported by a grant from the Japan Society for the Promotion of Science.
{"title":"A Study in Accountability of Clubhouses in Japan, UK, and Italy","authors":"Rosario Laratta","doi":"10.2190/SH.7.1.F","DOIUrl":"https://doi.org/10.2190/SH.7.1.F","url":null,"abstract":"Many International Clubhouses are dependent on the state financially; this can potentially undermine their accountability to International Clubhouse Standards, and ultimately to members. Dependence on government funding can compromise Clubhouse autonomy and staff can end up elevating financial and regulatory accountability over member accountability. In order to shed light on how dependence on government affects accountability to members, Clubhouse affiliates in Japan, the United Kingdom, and Italy were investigated in a 2-year project funded by the Japan Society for the Promotion of Science. This study found out that reactions to accountability in Clubhouses vary according to the different kinds of staff. In the United Kingdom and Italy, where staff feel aligned with members (sympathetic staff), staff felt more of a conflict with government standards but also felt less of a need to institutionalize accountability to members. In contrast, it was found that in Japan—where staff had a professional orientation and were more concerned with the community or society at large—staff did not feel a conflict with government standards but they also elevated accountability to the community rather than accountability to members. *This research was supported by a grant from the Japan Society for the Promotion of Science.","PeriodicalId":64356,"journal":{"name":"自我保健","volume":"59 1","pages":"81-97"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82902683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Contemporary community-based mental health programs are predominantly individually focused. Those programs provide few opportunities to develop collective identity among service users. Yet several lines of identity research have demonstrated that strong and positive collective identity may buffer the ill effects of stigma and discrimination on individuals from stigmatized populations. This article reviews that research and through it analyzes the Fountain House model mental health clubhouse and the international clubhouse movement. The collective, mutual aid, and social movement activities within and between clubhouses are considered in light of their contribution to collective identity formation. The article concludes with an appeal to go beyond the typical services research that is focused upon incremental improvements to interventions, and to include research on basic social and psychological processes, such as identity, to inform the way mental health services are designed.
{"title":"Collective Identity Formation in the Mental Health Clubhouse Community","authors":"J. Mandiberg, M. Edwards","doi":"10.2190/SH.7.1.C","DOIUrl":"https://doi.org/10.2190/SH.7.1.C","url":null,"abstract":"Contemporary community-based mental health programs are predominantly individually focused. Those programs provide few opportunities to develop collective identity among service users. Yet several lines of identity research have demonstrated that strong and positive collective identity may buffer the ill effects of stigma and discrimination on individuals from stigmatized populations. This article reviews that research and through it analyzes the Fountain House model mental health clubhouse and the international clubhouse movement. The collective, mutual aid, and social movement activities within and between clubhouses are considered in light of their contribution to collective identity formation. The article concludes with an appeal to go beyond the typical services research that is focused upon incremental improvements to interventions, and to include research on basic social and psychological processes, such as identity, to inform the way mental health services are designed.","PeriodicalId":64356,"journal":{"name":"自我保健","volume":"16 1","pages":"19-39"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79706548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this article is to trace the historical development of self-help groups in Japan, and to discuss current issues that Japanese self-help groups face in their relationships with professionals and in civil society. This particular history is divided into five phases: from ancient times to the 1910s, the 1920s to the early 1950s, the late 1950s through the 1970s, the 1980s to the 1990s, and 2000 and beyond. In addition, the political situations and the influence of Western culture on self-help groups are described. Current issues in self-help groups’ relationships with professionals are caused by the professionals’ disregard for communal learning of “experiential knowledge” through self-help groups, and also their confusion concerning the difference between peer-led self-help groups and professional-led support groups. Furthermore, I discuss problems relating to changes in the Japanese legal status of “public benefit corporation” which impacts self-help groups.
{"title":"Self-Help Groups in Japan: Historical Development and Current Issues","authors":"T. Oka","doi":"10.2190/SH.7.2.G","DOIUrl":"https://doi.org/10.2190/SH.7.2.G","url":null,"abstract":"The purpose of this article is to trace the historical development of self-help groups in Japan, and to discuss current issues that Japanese self-help groups face in their relationships with professionals and in civil society. This particular history is divided into five phases: from ancient times to the 1910s, the 1920s to the early 1950s, the late 1950s through the 1970s, the 1980s to the 1990s, and 2000 and beyond. In addition, the political situations and the influence of Western culture on self-help groups are described. Current issues in self-help groups’ relationships with professionals are caused by the professionals’ disregard for communal learning of “experiential knowledge” through self-help groups, and also their confusion concerning the difference between peer-led self-help groups and professional-led support groups. Furthermore, I discuss problems relating to changes in the Japanese legal status of “public benefit corporation” which impacts self-help groups.","PeriodicalId":64356,"journal":{"name":"自我保健","volume":"19 1","pages":"217-232"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74837855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This second special issue on Fountain House mental health clubhouses completes our offerings on this well established form of collectivity that has many self-help/ mutual aid features. The research in these two issues has shown extensive similarity across Clubhouses in different countries as well as diversity in various welfare and cultural contexts. The similarity is partly due to the 36 international standards and the training of staff and members in these standards that define the model and which provide the opportunity for a specific Clubhouse to be named as such (see www.iccd.org). The diversity stems from the cultural interpretation of standards as well as restraining factors of the welfare context and civil society within specific countries. Magnus Karlsson, Guest Editor of these special issues, invited Thomas Craig, a senior psychiatrist familiar with the Clubhouse research from the UK to review the articles for the special issue, situate the Clubhouse as a social intervention to mitigate the effects of mental illness, and comment on how the research in these articles extends our knowledge on Clubhouses. Thomas Craig’s article titled “Expanding knowledge of peer-based mental health organizations: The experience of Clubhouse” is the lead article in this issue. His article and three others comprise this special issue on Clubhouses. Kimiko Tanaka reports the results of her qualitative look at how peer support is manifested for members through their participation in the work-ordered day in one Clubhouse in New York City. Francesca Pernice-Duca and her colleagues accomplish two aims: first, they show how the recently popularized concept of recovery from mental illness (defined in a consensus statement through a U.S.
{"title":"A Second Special Issue of Research on Mental Health Clubhouses","authors":"T. Borkman","doi":"10.2190/SH.7.2.A","DOIUrl":"https://doi.org/10.2190/SH.7.2.A","url":null,"abstract":"This second special issue on Fountain House mental health clubhouses completes our offerings on this well established form of collectivity that has many self-help/ mutual aid features. The research in these two issues has shown extensive similarity across Clubhouses in different countries as well as diversity in various welfare and cultural contexts. The similarity is partly due to the 36 international standards and the training of staff and members in these standards that define the model and which provide the opportunity for a specific Clubhouse to be named as such (see www.iccd.org). The diversity stems from the cultural interpretation of standards as well as restraining factors of the welfare context and civil society within specific countries. Magnus Karlsson, Guest Editor of these special issues, invited Thomas Craig, a senior psychiatrist familiar with the Clubhouse research from the UK to review the articles for the special issue, situate the Clubhouse as a social intervention to mitigate the effects of mental illness, and comment on how the research in these articles extends our knowledge on Clubhouses. Thomas Craig’s article titled “Expanding knowledge of peer-based mental health organizations: The experience of Clubhouse” is the lead article in this issue. His article and three others comprise this special issue on Clubhouses. Kimiko Tanaka reports the results of her qualitative look at how peer support is manifested for members through their participation in the work-ordered day in one Clubhouse in New York City. Francesca Pernice-Duca and her colleagues accomplish two aims: first, they show how the recently popularized concept of recovery from mental illness (defined in a consensus statement through a U.S.","PeriodicalId":64356,"journal":{"name":"自我保健","volume":"68 1","pages":"115-118"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85639785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of the study was to delineate peer support among clubhouse members in the context of the “work-ordered day (WOD),” the core of the clubhouse model for psychiatric recovery. The study drew on qualitative data collected in 2009-2011 via participant observation and in-depth interviews with 45 members and 11 staff of a clubhouse in New York City. A grounded theory approach to data analysis yielded themes including “peer to peer collaboration” during WOD and “circle of personal peer relationships” expanded as secondary to WOD participation. The study also highlighted how side-by-side WOD participation mediates these personal relationships. The clubhouse peer support, while paralleling daily patterns seen in the outside world of work, also embraced ranges of positive self-help group experiences. An underlying notion seemed to be the sense of normalcy, which can be integral to recovery. Future research should compare peer support across clubhouses in different cultures and societies.
{"title":"Clubhouse Peer Support among Individuals with Psychiatric Illness","authors":"Kimiko Tanaka","doi":"10.2190/SH.7.2.C","DOIUrl":"https://doi.org/10.2190/SH.7.2.C","url":null,"abstract":"The purpose of the study was to delineate peer support among clubhouse members in the context of the “work-ordered day (WOD),” the core of the clubhouse model for psychiatric recovery. The study drew on qualitative data collected in 2009-2011 via participant observation and in-depth interviews with 45 members and 11 staff of a clubhouse in New York City. A grounded theory approach to data analysis yielded themes including “peer to peer collaboration” during WOD and “circle of personal peer relationships” expanded as secondary to WOD participation. The study also highlighted how side-by-side WOD participation mediates these personal relationships. The clubhouse peer support, while paralleling daily patterns seen in the outside world of work, also embraced ranges of positive self-help group experiences. An underlying notion seemed to be the sense of normalcy, which can be integral to recovery. Future research should compare peer support across clubhouses in different cultures and societies.","PeriodicalId":64356,"journal":{"name":"自我保健","volume":"7 1","pages":"131-149"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87591477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Given the well-documented underrepresentation of ethnic participants in mainstream support groups and the disparity in breast cancer survivorship among ethnic minorities, the current proliferation of ethnic-specific cancer support groups is not surprising. This study employed qualitative and quantitative methods, including cultural consensus analysis, to examine core elements of breast cancer support group models among African-American, European American, and Latina women and describe the perceived role of support groups in the recovery experience. Results indicate a core cultural model of breast cancer support groups exists and the fundamental elements of peer support and encouragement, helping others, talking about worries/ fears, staying active/involved, friendship/bonding, and learning from others are broadly shared across ethnically diverse communities. Elements distinctive to ethnic-specific self-help groups were also identified. Findings provide insight into factors motivating attendance and retention in support groups and may guide recommendations for better meeting the social support needs of culturally diverse patients.
{"title":"Ethnic Differences in Cultural Models of Breast Cancer Support Groups","authors":"J. Corvin, J. Coreil, Rebecca Nupp, K. Dyer","doi":"10.2190/SH.7.2.F","DOIUrl":"https://doi.org/10.2190/SH.7.2.F","url":null,"abstract":"Given the well-documented underrepresentation of ethnic participants in mainstream support groups and the disparity in breast cancer survivorship among ethnic minorities, the current proliferation of ethnic-specific cancer support groups is not surprising. This study employed qualitative and quantitative methods, including cultural consensus analysis, to examine core elements of breast cancer support group models among African-American, European American, and Latina women and describe the perceived role of support groups in the recovery experience. Results indicate a core cultural model of breast cancer support groups exists and the fundamental elements of peer support and encouragement, helping others, talking about worries/ fears, staying active/involved, friendship/bonding, and learning from others are broadly shared across ethnically diverse communities. Elements distinctive to ethnic-specific self-help groups were also identified. Findings provide insight into factors motivating attendance and retention in support groups and may guide recommendations for better meeting the social support needs of culturally diverse patients.","PeriodicalId":64356,"journal":{"name":"自我保健","volume":"38 1","pages":"193-215"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74405372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clubhouses are supposed to follow the International Clubhouse Standards, but they also need to make adaptations according to national and local contexts. This article compares the implementation of peer support elements in the clubhouse model in two different social contexts: the Swedish and the Japanese welfare systems. Participatory observations and interviews with members and staff at a Swedish and a Japanese clubhouse were conducted in order to explore how the idea of peer support was carried out in everyday life. Peer support seemed to be a core element in both organizations, but it was organized in slightly different ways. The Swedish clubhouse employed an experience-based way of working and involved members in almost all decision-making processes. The Japanese clubhouse employed a manual-based work method and members' involvement in decision making was relatively limited. The different approaches were due to dissimilar organizational structures, regulatory requirements, and societal expectations that were related to two different welfare systems. (Less)
{"title":"Global Model and Local Applications: Peer Support in the Clubhouse Model and Its Practices in Sweden and in Japan","authors":"Y. Matsui, A. Meeuwisse","doi":"10.2190/SH.7.1.E","DOIUrl":"https://doi.org/10.2190/SH.7.1.E","url":null,"abstract":"Clubhouses are supposed to follow the International Clubhouse Standards, but they also need to make adaptations according to national and local contexts. This article compares the implementation of peer support elements in the clubhouse model in two different social contexts: the Swedish and the Japanese welfare systems. Participatory observations and interviews with members and staff at a Swedish and a Japanese clubhouse were conducted in order to explore how the idea of peer support was carried out in everyday life. Peer support seemed to be a core element in both organizations, but it was organized in slightly different ways. The Swedish clubhouse employed an experience-based way of working and involved members in almost all decision-making processes. The Japanese clubhouse employed a manual-based work method and members' involvement in decision making was relatively limited. The different approaches were due to dissimilar organizational structures, regulatory requirements, and societal expectations that were related to two different welfare systems. (Less)","PeriodicalId":64356,"journal":{"name":"自我保健","volume":"2010 1","pages":"59-79"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82592516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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