The dissertation uses health related quality of life (HRQoL) for evaluating treatment effectiveness. The research settings in the dissertation include observational cohort study and randomized clinical trial. The first research project examines the effect of Sahaja Yoga Meditation on quality of life. The study investigates whether the post intervention HRQoL, perceived anxiety assessment and hypertensive control is different in patients treated with meditation plus conventional therapy than patients treated with conventional therapy alone. The study shows that Sahaja Yoga Meditation treatment is associated with significant improvements in quality of life, anxiety reduction and blood pressure control. The second research project examines the association of age on clinical and quality of life outcomes in the Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial (BARI 2D); specifically, among patients with both type 2 diabetes and coronary heart disease, whether a treatment strategy (prompt revascularization or medical therapy for heart disease and insulin sensitizing or insulin providing drugs for type 2 diabetes) is more preferable for older individuals in terms of clinical and HRQoL endpoints. The study shows that older patients are at greater risk for cardiovascular events but the effectiveness of cardiac treatment strategies and glycemic control strategies does not differ by age. Older patients experience an accelerated decline in health status than their younger peers. The third research project investigates the longitudinal relationship between body mass index (BMI) and heath status outcomes in BARI 2D. The study reports an inverse association between BMI and health status outcomes in patients with both stable ischemic heart disease and type 2 diabetes. Weight reduction is desirable for obese patients, but may not be necessary for overweight but non-obese patients to achieve improvements in functional capacity and perceived Energy outcomes. The public health significance of the dissertation lies in the research findings on treatments that result in better clinical or quality of life outcomes for patients with chronic diseases, but also contrasts the strength and weakness of HRQoL studies and demonstrates strategies to overcome the methodological challenges in conducting HRQoL research in clinical studies.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04122010-173142 |
| Date | 28 June 2010 |
| Creators | Chung, Sheng-Chia |
| Contributors | Sheryl F Kelsey, Judith L Balk, Maria M Brooks, Roslyn A Stone, Joyce T Bromberger |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-04122010-173142/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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