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UNIVERSITI PUTRA MALAYSIA RELATIONSHIP OF PSYCHOLOGICAL WELL-BEING WITH PERCEIVED STRESS, COPING STYLES, AND SOCIAL SUPPORT AMONGST UNIVERSITY UNDERGRADUATES ANNETTE ANANTHI ARULRAJAH FPP 2000 20
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UNIVERSITI PUTRA MALAYSIA

RELATIONSHIP OF PSYCHOLOGICAL WELL-BEING WITH PERCEIVED STRESS, COPING STYLES, AND SOCIAL SUPPORT

AMONGST UNIVERSITY UNDERGRADUATES

ANNETTE ANANTHI ARULRAJAH

FPP 2000 20

RELATIONSHIP OF PSYCHOLOGICAL WELL-BEING WITH PERCEIVED STRESS, COPING STYLES, AND SOCIAL SUPPORT AMONGST

UNIVERSITY UNDERGRADUATES

By

ANNETTE ANANTHI ARULRAJAH

Thesis Submitted in Fu lfi lment of the Requirements for the Degree of Master of Science in the Faculty of Educational Studies

Universiti Putra Malaysia

May 2000

DEDICATION

To the one person who bel ieved that all th ings are possib le for her ch i ldren , to my greatest mentor, encourager and prayer warrior - MUM!

Th is thesis is a toast to the passion you have inspired me with .

II

Abstract of thesis presented to the Senate of Universiti Putra Malaysia in fulfi lment of the requirements for the degree of Master of Science

RELATIONSHIP OF PSYCHOLOGICAL WELL-BEING WITH PERCEIVED STRESS, COPING STYLES, AND SOCIAL S UPPORT AMONGST

UNIVERSITY UNDERGRADUATES

By

ANNETTE ARULRAJAH

May 2000

Chairman : Dr. Li ly Mastura Haji Harun

Faculty : Educational Studies

The psycholog ical well-being of undergraduates in Malaysia in relation to

their perceived stress, coping styles , and social support has not been

thorough ly investigated. The a ims of the study are (a) to explore the level

of psycholog ical wel l-being , perceived stress , coping styles , and social

support; (b) to get an accurate description of the demographic variables;

(c) to explore the relationships between psycholog ical well-being , perceived

stress , coping styles , and social support; (d) to exp lore the relationships

between psychologica l wel l-being, perceived stress, coping styles, and

social support after control l ing for the possible intervening (demog raph ic)

iii

variables; and (e) to explore the differences in psycholog ical well-being ,

perceived stress , coping styles , and social support with reference to gender,

status of learner, and rel ig iosity each in its turn .

A random stratified cluster sample of 422 from the facu lty of

Educational Studies was taken , as a representative of undergraduates in

that particular facu lty in Un iversiti Putra Malaysia . The sample came from

each of the six programmes in the faculty - the Physical Education

programme, the Agricultura l Sciences programme, Teaching English As A

Second Language programme, Gu idance And Counseling prog ramme, the

Home Sciences programme, and Teaching Malay As A First Language

prog ramme.

It was found that coping styles and social support had a positive

relationship with psycholog ical well-being, whi le perceived stress had a

negative relationship after having controlled for al l other variables.

Intervening variab les such as gender, rel igiosity, and status of learner did

not have any relationship with all the major variables like perceived stress ,

coping styles, social support and psycholog ical wel l being . There was one

exception though , there was a relationship between status of learner and

psycholog ical well-being .

iv

On the whole, the Malaysian undergraduates were found to be

psychologically wel l . Enhancing the social support of the undergraduate in

h is natural community, as well as providing tra in ing skil ls in positive intrusive

thoughts as well as problem-focused coping is strongly recommended. The

need for cou nselors in each faculty is also strongly advocated.

v

Abstrak tesis yang dikemukakan kepada Senat U n iversiti Putra Malaysia sebagai memenuhi keperluan untuk ijazah Master Sains

HUBUNGAN KESIHATAN PSIKOLOGI DENGAN PERSEPSI TEKANAN, STAlL MENANGANI TEKANAN, DAN SOKONGAN SOSIAL 01 KALANGAN PElAJAR UNIVERSITI

Oleh

ANNETTE ANANTH I ARULRAJAH

Mei 2000

Pengerusi: Dr. Lily Mastura Haji Harun

Fakulti Pengajian Pendid ikan

Kesihatan psikolog i para mahasiswa di Malaysia berhubung dengan

persepsi tekanan, stai l menangani tekanan , dan sokongan sosial masih

belum lag i dite l iti dengan bersungguh-sungguh . Objektif kaj ian ini adalah

(a) untuk menentukan tahap kesihatan psikolog i , persepsi tekanan , stai l

menangani tekanan serta sokongan sosial;(b) untuk mendapat gambaran

yang tepat mengenai pembolehubah-pembolehubah demog rafi; (c) untuk

menentukan hubungan antara kesihatan psikolog i , persepsi tekanan , stai l

menangani tekanan , dan sokongan sosial; (d) untuk menentukan hubungan

antara kesihatan psikolog i , persepsi tekanan, stai l menangani tekanan, dan

sokongan sosial setelah mengawal pembolehubah luaran (demografi); dan

(e) untuk menentukan perbezaan dalam kesihatan psikolog i , persepsi

tekanan , stai l menangani tekanan, dan sokongan sosial dibanding dengan

pembolehubah jantina, status pelajar, dan keagamaan.

vi

Satu persampelan kelompok secara rambang seramai 422 orang

daripada Faku lti Pengajian Pendidikan telahpun diambi l untuk mewakili

pelajar di fakulti tersebut, di Un iversiti Putra Malaysia . Sampel in i telah

dipil ih daripada enam program dalam Fakulti Pengajian Pendidikan , iaitu -

program Pendidikan Jasman i , program Sains Pertanian , program Mengajar

Bahasa I nggeris Sebaga i Bahasa Kedua, program Bimbingan dan

Kaunseling , program Sains Rumahtangga , serta prog ram Mengajar Bahasa

Melayu Sebaga i Bahasa Pertama.

Didapati bahawa stai l menangani tekanan serta sokongan sosial

mempunyai perhubungan yang positif dengan kesihatan psikolog i .

Manakala pula, persepsi tekanan mempunyai hubungan yang negatif

setelah pembolehubah lain dikawal . Pembolehubah seperti jantina ,

keagamaan , serta status pelajar tidak mempengaruh i pembolehubah­

pembolehubah utama seperti persepsi tekanan , stai l menangan i tekanan,

sokongan sosia l , serta kesihatan psikolog i . Hanya satu pengecualian iaitu ,

didapati h ubungan antara status pelajar dan kesihatan psikolog i .

Secara keseluruhan , didapati bahawa golongan mahasiswa adalah

s ihat dari seg i psikolog i . Memperbaiki sokongan sosial dalam komuniti sedia

ada mahasiswa, serta memberi latihan cara-cara menangan i tekanan -

vii

seumpamanya cara-cara mempunyai fikiran positif, dan cara-cara

menyelesaikan berfokuskan masalah telahpun dikemukakan . J uga ,

keperluan kaunselor d i setiap fakulti telah disuarakan .

vi i i

ACKNOWLEDGEMENTS

An artist knows that behind every one of h is work of art , there were

many moments of inspiration and hope . This thesis is a lso a modest piece of

art by an amateur. Many are the persons who added their flavor of

inspiration.

I recal l that my concerns were b i rthed in a Commun ity Counsel ing

class. Dr. Li ly , you i nspired and challenged me to take issues in our

community seriously. Tru ly, you have been a g reat lecturer as wel l as a

mentor. I q uivered when g iving you my drafts knowing that your sharp eyes

would note everyth ing . Yet, I thrived on the critique and enjoyed the process

of being stretched . Dr. Rusnan i , your encouragement and "other"

perspective enriched my understanding . Dr. Rohan i , the statistics you taught

and your presence has stood me in good stead . Thank you .

A special bouquet of thanks to you, Professor Emeritus from Ohio

State U n iversity Dr. David McCracken , for the fou ndations you laid in

research methodology. You were also an inspiration in shaping my thoug hts ,

concerns, and my research topic and hypotheses. Your u rg ing me to try

Structure B and your bel ief in me gave me confidence . Also to Dr. Kenneth

Nowack, you read ily shared your instrument (The Stress Assessment

ix

Profi le) with me. Thank you for the pointers and encouragement through the

electronic mai l .

To the commun ity I stud ied , the undergrad uates! Your struggles,

aspirations, and your l ife was another school I enrol led in - the school of l ife!

You taught me with your strugg les to grow on . I was inspired . Thank you .

To m y col leagues, you have been a brick. Thank you Yoke Yee for

the many words of encouragement and redipping my q uestionaire. Same to

the 'g irls' - Lean Sze and G lory. To Mary, your help i n locating resources

was such a b lessing . To Lee Ang , who helped me complete my keying in of

data - that was a g reat rel ief. To Kim Cheng who typed in my bib l iography,

that was patient of you . To the rest who prayed me through , I have fin ished

thanks to your prayers. Al l your labor of love is appreciated .

To mum and Johnathan, you were the ones who knew my dark

nights . You u rged me on , even when I was on the verge of qu itting . This

thesis is testimony that you saw me throug h .

Final ly , to my Lord Jesus, thank You . Creativity , i nspiration ,

knowledge , friends, teachers have al l been g ifts from You .

x

I certify that an Examination Committee met on 17th May 2000 to cond uct the final examination of An nette Ana nthi Aru l rajah o n h e r Master of Science thesis e ntitled "Relationship of Psychological Well-being With Perceived

Stress, Coping Styles, And Social S u pport Amongst University Undergrad uates" in accordance with Universiti Pertania n Malaysia (Hig her Deg ree) Act 1980 and Universiti Pertanian Malaysia (Hig her Deg ree) Reg ulations 1 981 . The Committee recommends that the ca ndidate be awarded the relevant degree. Members of the Exa min ation Committee are

as follows:

HABIBAH ELIAS, PhD.

P rofesor Madya Facu lty of Ed ucation al Studies University P utra Malaysia (Chairman)

LILY MASTURA HAJI HARUN, Ph.D

Lecturer, Facu lty of Education a l Studies Universiti P utra Malaysia (Member)

ROHANI AHMAD TARMIZI, Ph.D

Lecturer, Faculty of Education a l Studies Universiti P utra Malaysia (Member)

RUSNANI BT. ABDUL KADIR, Ph.D

Lecturer, Faculty of Ed ucation a l Studies Universiti P utra Malaysia (Member)

Date: 24 MAY 2000 xi

This Thesis was submitted to the Senate of Universiti Putra Malaysia and was accepted as fulfi l lment of the requirements for the degree of Master of Science .

xii

f&i� KAMI A'WANG, Ph.D, Associate Professor Dean of Graduate School , Universiti Putra Malaysia

Date : 1 3 JUt 2000

DECLARATION

I hereby declare that the thesis is based on my orig inal work except for quotations and citations which have been duly acknowledged. I also declare that it has not been previously or concurrently submitted for any other degree at UPM or other institutions.

Candidate. Annette Ananthi Arulrajah

Date : 1 7th May 2000

xiii

TABLE OF CONTENTS

pages

[)E:[)IC;I\TI()� ----------------------------------------------------------------- i i I\B S TRI\ C; T -------------------------------------------------------------------- i i i I\BSTRI\� ---------------------------------------------------------------------- vi 1\ C � N () WL E: [) G E: M E: � T --------------------------------------------------- I X I\P P R ()V I\L S HE: E:TS ------------------------------------------------------ xi [)E:CLI\RI\ TI()� F()RM ---------------------------------------------------- xiv LIST ()F T I\BLE:S ----------------------------------------------------------- xix LI S T () F F IG U R E: S --------------------------------------------------------- xx i LIST ()F I\BBRE:VII\ TI()�S ---------------------------------------------- xxi i i

Chapter

INTFtO[)LJCTION ---------------------------------------------------- 1 Background ()f The Study --------------------------------------- 1

Health I n 1\ �ew E:ra ------------------------------------------- 1 C;ontextualizing The Population's Health ----------------- 1 0 Health I\s 1\ Transactional Variable ----------------------- 1 6 The Cancer ()f Mental Health ------------------------------ 1 8 Commun ity Counsel ing I\nd Priority To Prevention --- 22 I\n I nteg rated Perspective To Psycholog ical

We I I-be in g ------------------------------------------------ 25 Statement ()f The Problem ------------------------------------- 29 Research ()bjectives --------------------------------------------- 32 Research Q uestions ---------------------------------------------- 33 Research Hypotheses -------------------------------------------- 34 [)efi n iti 0 n ()f Term s ----------------------------------------------- 38

Psychological Wel l-being ----------------------------------- 39 Perceived Stress --------------------------------------------- 39 Coping Styles ------------------------------------------------- 40 Social Support ----------------------------------------------- 4 1

Sign ificance ()f The Study -------------------------------------- 4 1 Limitations ()f The Study ---------------------------------------- 43 [)el imitations ()f The Study ------------------------------------ 44

xiv

I I LITERATURE REVIEW ---------------------------------------------- 46 I ntrod uctio n ------------------------------------------------------------- 46 Psych 0 I og i ca I We 11-be i n g -------------------------------------------- 53 Perce iv ed Stress ------------------------------------------------------- 68 Cop i n g Sty les ------------------------------------------------------------ 84 Social Support ---------------------------------------------------------- 1 00

Demographic Variables ----------------------------------------------- 1 1 3 Gender --------------------------------------------------------------- 1 1 3 Status Of Learner ------------------------------------------------- 1 1 7

Relig ios ity ----------------------------------------------------------- 124 Co n cI u s ion -------------------------------------------------------------- 1 27

I I I METHODOLOGY --------------------------------------------------- 1 29 I ntrod u ctio n ----------------------------------------------------------- 1 29 Resea rch Des ig n --------------------------------------------------- 1 3 1 I n stru m e ntati 0 n ------------------------------------------------------ 1 35

Measuring The Variable --------------------------------------- 1 35

Backgrou nd Of The I nstrument ----------------------------- 136 Research Questionaire --------------------------------------- 138 Val id ity And Rel iabi l ity Of The I nstrument ---------------- 1 4 1 Scoring Method -------------------------------------------------- 1 42 Pilot Test ------------------------------- --------------------------- 1 45

Data Collection Procedures -------------------------------------- 1 48 Population And Sampl ing Procedures ------------------------- 1 49

Pop u lati on --------------------------------------------------------- 1 49 Sampl ing Procedures : S ize ---------------------------------- 150 Sampl ing Proced ures : P lan Of Action --------------------- 1 53

Data An a I ys i s --------------------------------------------------------- 1 54 Descriptive Analysis -------------------------------------------- 156 I nferential Analysis ---------------------------------------------- 160

The Actual Cond itions Of Sampl ing ---------------------------- 174 Limitations ------------------------------------------------------------- 175

xv

IV RESEARCH FINDINGS --------------------------------------------- 178 I ntrod uctio n ------------------------------------------------------------- 178 Descriptive Analysis -------------------------------------------------- 178 Descriptions On Demograph ic Variables ----------------------- 179 Description Of The Major Variables ----------------------------- 181 I nferential Analysis ---------------------------------------------------- 184

Relationsh ips Between Psycholog ical Wel l-being And The I ndependent Variables ---------------- 184

Relationsh ips Between The I ndependent Variables ---- 187 I nterven ing Variables I n Relation To Psycholog ical

Wel l-being -------------------------------------------- 189 I nterven i ng Variables I n Relation To Perceived Stress - 191 I nterven ing Variables I n Relation To Coping Styles ----- 192 I nterven ing Variables I n Relation To Social Support ---- 193 Differences I n Gender, Status Of Learner, Rel ig iosity -- 194 Multiple Regression And Semi-Partial Correlation Of

Psycholog ical Factors On Psycholog ical Wel l-being - 206 Multiple L inear Equation For Psycholog ical Wel l-being -- 217

Conclusion ---------------------------------------------------------------- 219

V DISCUSSION, IMPLICATIONS AND 221 RECOMMENDATIONS The Research Problem Revisited -------------------------------- 221 D iscu ss ion -------------------------------------------------------------- 223

The General Health Environment As Seen From The M a j 0 r Va ri abies ---------------------------------------------- 223

Psycholog ical Wel l-being I n The Context Of Its R e lati 0 n s h ips ------------------------------------------------- 226

Oth e r I nte r -re I ati 0 n s h ips ---------------------------------------- 231 I nte rv en i n g Va ri a b I es -------------------------------------------- 233 Relationship Of Psychological Wel l-being With

Perceived Stress, Coping Styles, And Social Support Among U n ivers ity U nderg raduates - 237

I mpl ications - Where Do We Go From Here? ------------------ 238 Recommendations - Pushing Back The Frontiers Of

Research ------------------------------------------------------- 242 Sum mary ---------------------------------------------------------------- 246

xvi

BIB LI OG RA P HY ------------------------------------------------------ 248

APPENDICES A Inventori Kesihatan --------------------------------- 278

B Permission To Translate And Use The Stress Assessment Profi le ------------------------ 289

\fllrA ----------------------------------------------------------------------- 290

xvii

LIST OF TABLES

Table Page

1 Summary of Valid ity and Reliabil ity Measures for the SAP --- 1 43

2 Summary of the Rel iab i l ity MeasureS for the I-K ---------------- 1 47

3 Summary of the Statistical Analyses Used I n Answering Research Q uestions and Hypotheses ----------------------------- 1 57

4: Status of the Demographic Variables I nvolved in the Study - 1 80

5 : Descriptive Measures of the Major Variables -------------------- 1 82

6: Correlation Matrix of Relationships Between the Major Variab les ------------------------------------------------------------------- 185

7 Correlation Coefficients of Coping Styles with Other Major Variab les ------------------------------------------------------------------- 1 87

8 Correlation Coefficients of I ntervening Variables in Relation to the Major Variables -------------------------------------------------- 1 90

9 t-test Examin ing Gender D ifferences For The Level Of Psycholog ical Wel l-being --------------------------------------------- 1 96

10 t-test Examin ing Gender Differences For The Level Of Perceived Stress --------------------------------------------------------- 1 97

1 1 t-test Examin ing Gender Differences For The Level Of Coping Styles ------------------------------------------------------------- 1 98

12 t-test Examin ing Gender Differences For The Level Of Social Support ------------------------------------------------------------ 1 99

13 t-test Examin ing Status Of Learner Differences For The Level Of Psycholog ical Wel l-being --------------------------- 200

14 t-test Examin ing Status Of Learner Differences For The Level Of Perceived Stress -------------------------------------- 201

xviii

15 t-test Examin ing Status Of Learner D ifferences For The Overall Level Of Coping Styles --------------------------------- 202

16 t-test Examin ing Status Of Learner D ifferences For The Level Of Social Support ------------------------------------------ 203

17 Analysis of Variance of Psychological Well-being Between D ifferent Relig iosity Levels -------------------------------------------- 204

1 8 Analysis of Variance Coping Styles Between Different Re Iig ios ity Levels -------------------------------------------------------- 205

1 9 Analysis of Variance Social Support Between Different Rei ig iosity Levels -------------------------------------------------------- 206

20 Multiple Reg ression of Psycholog ical Wel l-being Analysed in Two Sets --------------------------------------------------------------- 208

21 Analysis Of Variance And R2 of Perceived Stress, Coping Styles, Social Support In The Regression Of Psycholog ical We I I-b e i n g ---------------------------------------------------------------- 209

22 Analysis Of Variance And R2 of Perceived Stress, Coping Styles In The Reg ression Of Psycholog ical Wel l-being ----- 210

23 Analysis Of Variance And R2 of Perceived Stress, Social Support I n The Regression Of Psycholog ical Wel l-being -- 2 10

24 Analysis Of Variance And R2 of Coping Styles, Social Support I n The Reg ression Of Psycholog ical Wel l-being - - 2 10

25 Semi Partial Mu ltip le Regression Coefficients for the Un iq ues I ndependent Variables (Set B) After Control l ing for Other Independent Variables To Be Partialled Out (Set A) ------------------------------------------------------------------ 212

26 The Contribution Of The Partial Regression Coefficient AndThe Beta Weights Towards The Regression Eq uation --------------------------------------------------------------- 2 17

xix

LIST OF FIGURES

Fig ure Page

1 : A Simplified Model of the Ecology of Development ------------ 1 2

2 : A Transactional Model of Psycholog ical Wel l-being , Perceived Stress, Social Support and Coping Styles ---------- 1 8

3 : Schematic Model of the Psycholog ical Wel l-being of U ndergraduates with Relation to Perceived Stress, Coping Styles and Social Support ---------------------------------- 27

4 : An I ntegrative and Hol istic Model of the Various Theoretical U nderp inn ings Affecting Psychological Wel l-being , Perceived Stress , Coping Styles , and Social Sup port --------------------------------------------------------------------- 28

5 : Dohrendwend Model of the Process Whereby Psychosocia l Stress I nduces Psychopathology ---------------- 56

6 : The Dohrendwends' Six Competing Hypotheses --------------- 59

7 : The Social Readjustment Scale ------------------------------------- 7 1

8 : Stress Appra isal of S ituations ---------------------------------------- 77

9 : The Biopsychosocia l Stress Model --------------------------------- 83

1 0 : Transactional Model of Coping -------------------------------------- 88

1 1 : Rival Models of the Effect of Social Support on Health ------ 1 05

1 2 : Social Support and the Buffering Hypothesis i n Detai l ------- 107

1 3 : Sex Differences in the I ncidence of Atypical Development - 1 1 5

xx

14 : Erikson's Stages of Psychosocial Development --------------------- 119

15 : Schematic Model of the Relationsh ips U nder Study ---------------- 134

16: The Regression Ballantine for Extraneous Variables (Set A) with Perceived Stress, Coping Styles and Social Support (Set B) -------------------------------------------------------------------------- 167

17: The Semipartial Correlation Ballantine for Extraneous Variables (Set A) with Perceived Stress, Coping Styles and Social Support (Set B) ---------------------------------------------- 170

18: The Semipartial Correlation Ballantine for Extraneous Variables, Coping Styles and Social Support (Set A) with Perceived Stress (Set B) -------------------------------------------------- 171

19: The Semipartial Correlation Bal lantine for Extraneous Variables, Perceived Stress and Social Support (Set A) with Coping Styles (Set B) ------------------------------------------------------ 172

20: The Semipartial Correlation Bal lantine for Extraneous Variables, Perceived Stress and Coping Styles (Set A) with Social Support (Set B) ---------------------------------------------------- 173

21: The Ballantine For Coping Styles , and Social Support (Set A) With Perceived Stress (Set B) -------------------------------- 214

22: The Ballantine For Perceived Stress , Social Support (Set A) With Coping Styles (Set B) ------------------------------------ 215

23: The Ballantine For Perceived Stress , Coping Styles (Set A) With Social Support (Set B) --------------------------------------------- 216

24 : Relationship of Psychological Wel l-being with Perceived Stress , Coping Styles , Social Support and Demographic Va ri a b I es --------------------------------------------------------------------- 222

xxi

AFRO

DSM I I I R

DSM IV

ERIC

GAS

I-K

LES

MRC

NMHA

PF-SOC

SAP

SPSS

SSO

UPM

WB

WCC

WCO

WHO

LIST OF ABBREVIATIONS

African Reg ional Office

Diagnostic and Statistical Manual of Mental D isorders I I I R

Diagnostic and Statistical Manual of Mental D isorders IV

Educational Resources I nformation Center

Genera l Adaptation Syndrome

I nventori Kesihatan

Life Experiences Survey

Mu lt iple Regression I Correlation

N ational Mental Health Association

Problem-Focused Style Of Coping

Stress Assessment Profi le

Statistical Package for the Social Sciences

Social Support Ouestionaire

U niversiti Putra Malaysia

World Bank

Ways of Coping Checkl ist

Ways of Coping Ouestionaire

World Health Organization

xxii

Health In A New Era

CHAPTER 1

INTRODUCTION

Background Of The Study

We stand at the dawn of a new era. L ike the canvas of an

artist, this most important decade in the history of civi l ization is

coloured by stunn ing technolog ical innovations, economic

opportun ities as wel l as crashes, political reforms and g reat cultural

rebirths. Yet, l i ke the g l immering shadows i ncluded in the creative

work of an artist, increas ing ly we can feel the g nawing hunger pangs

for continued health and wel l-being as part of this whole new

dawning era.

This wi l l be a decade l ike none that has come before because

it wi l l culm inate i n the mi l len ium, the year 2000. What for centuries

has been a monumental symbol ic date that stood for the future and

what we would make of it, is fast seeing the l ig ht of day break. We

have fal len under its domin ion , and as we march towards the new

mil lenium, visions of excellence spur us towards breakthroughs. Yet,

l ike a growing chi ld throwing away the cloak of ch i ldhood , many who

march on do so in a spirit of realism , with a q uest not on ly for

success and grandeur but for psycholog ical , physical , and emotional

health or wel l-being . People are becoming more aware that health

exerts the power of determin ing how we l ive our l ives. Whilst not

everyone may consciously invest in health although that is a

phenomena fast changing , no one can deny that poor health wi l l

mean a deterioration of meaning , joy, and power for l iving , as wel l as

an inabi l ity to enjoy al l other conquests and breakthroughs.

Accord ing to Naisbitt ( 1 996) , the most excit ing breakthroughs

of the 21 st century wi l l occur n ot because of technology but because

of an expanding concept of what it means to be human . These words

come from the pen of an author who has spent a large portion of h is

l ife watch ing out for chang ing trends in the world and in Asia too .

Accord ing to him, as we approach the year 2000 , the mi l lenium is

reemerg ing as a metaphor for the future which ign ites our vision for a

better world , yet holds together with it our n ightmares of the world's

end . A better world , not just because of technology and g lobal ization

but because of robustness and wel l-being , a state of health and a

deepen ing u nderstand ing of what it means to be human encourages

us to confront and resolve our problems so we can meet the

mi l len ium with a clean state.

2


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