Fibromyalgia (FM) is an elusive syndrome that affects 2% of the United States population, with health care costs exceeding $20 billion in 1998. FM alters lives with its symptoms and by interfering with everyday life. This dissertation explored the association between subgroups of women with FM and their functional status. The first study examined the effectiveness of an Internet-based health promotion intervention to improve the clinical outcomes for two subgroups of women with FM: those with high Fibromyalgia Impact Questionnaire (FIQ) scores (n = 5) and those with low FIQ scores (n = 5). Single subject design and grouped data revealed that the intervention had mixed results for the two subgroups. The clinical response to the intervention depended on the method of analysis (individual versus group) and the target behavior of interest. The second study examined the associations among objective and subjective measures, and two target outcomes: physical activity and functional status (FIQ total score), and then used the data to classify FM subgroups (n = 72). Using Exhaustive Chi-square Automatic Interaction Detector (Exhaustive CHAID), we developed two models. Model I, with the target outcome of physical activity, yielded 9 distinct subgroups, whose members had characteristics that were significantly associated with very unfavorable to very favorable physical activity outcomes. Model II, with the target outcome of the FIQ total score, yielded 5 distinct subgroups whose members had characteristics that were significantly associated with very unfavorable to very favorable functional status outcomes. The third study used qualitative and quantitative methods to identify clinically relevant triggers of FM flares, experienced by three subgroups women with low (n = 6), average (n = 5), and high (n = 4) FM impact, to explore the effect of triggers on their functional status. Using mixed methods, we were able to substantiate, quantify, and qualify the affects of FM on the lives of persons with FM and the direct consequences of those affects on activities. Overall activity, FM symptoms, and weather were the most prominent triggers. Findings from these studies suggest that the influence of FM on functional status affects women differently based on subgroup membership.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04252006-112020 |
| Date | 26 April 2006 |
| Creators | Breland, Hazel L. |
| Contributors | Terence W. Starz, MD, Margo B. Holm, Ph.D., OTR/L, Joan C. Rogers, Ph.D., OTR/L, Molly T. Vogt, Ph.D., DrPH |
| 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-04252006-112020/ |
| Rights | unrestricted, 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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