▼ The purpose of this study was to determine the ability of selected clinical variables to predict functional capacity measured by maximum oxygen consumption (VO2max) in older women with diastolic heart failure. The clinical predictor variables of interest in this study are the Six-Minute Walk test (6-MW), Body Mass Index (BMI), body weight (WT), E-wave velocity, and E/A wave ratio. The researcher developed a formula that will help health care providers to predict the VO2max for older women with diastolic heart failure. This formula can be useful for clinicians to use as a diagnostic tool and determine prognosis. A descriptive research design using secondary data analysis was selected to address the research questions. The sample for this study consisted of 12 women (mean age= 63.3years, sd = ± 5.4) with diastolic heart failure who completed the VO2 test, the six-minute-walk test (6-MW test), and the Doppler echocardiogram. All of the 12 women from the original study were included in the secondary data analysis. All subjects were considered overweight or obese (mean BMI=35.8 kg/cm2, sd= ± 6.7; fat %= 44.4%, ± 4.5). Linear regression analysis was used to determine which variables provided the best prediction of the dependent variable (VO2 max). The F test was performed to test significance of each model. The overall level of significance was set at the .05 level. Results from the regression analysis were that only the total distance walked during the 6-MW test was found to be a significant and strong predictor, accounting for 60% of the variance in VO2max for older women with diastolic heart failure (R2 = .6, F(1,10) = 14.75, p = .003). The regression equation obtained from the analysis was [Predicted VO2max = 4.7 + .01*(6-MW distance walked)]. Neither BMI or BW nor E/A ratio or E-wave velocity were significant predictors in this sample. This finding supports the ability of the 6-MW test as an alternative screening and diagnostic tool in the clinical settings. Advisors/Committee Members: Baas, Dr. Linda.

▼ Presymptomatic genetic testing (PGT) makes it possible to predict the onset of diseases that may occur later in life. PGT may also, in the case of multifactorial illness, have an impact on motivation to change behavior and therefore, personal health. The purposes of this study were (a) to explore the influence of engagement in health promoting behaviors (HPB) on the decision to have presymptomatic genetic testing (PGT) for selected adult- onset multifactorial disease and (b) to identify the influence of hypothetical-positive genetic test results on HPB. Pender's Health Promotion Model provided the theoretical framework and the definition for HPB (a multidimensional pattern of self-initiated actions and perceptions that serve to maintain or enhance wellness). The study used a descriptive-comparative design and a convenience sample of 294 individuals living in one Ohio community. Subjects completed a survey in two parts (A and B). Part A contained two data collection instruments: Health Promoting Lifestyle Profile II (HPLPII) to measure HPB and an investigator-developed questionnaire to measure the decision to have PGT. For Part B, subjects were asked to consider that they had received a hypothetical-positive PGT result for one of four pre-selected diseases (heart disease, diabetes, depression, prostate/ovarian cancer) and again complete the HPLPII. Subjects were stratified into either a low (n=128) or high (n=150) HPB group based on HPLPII scores from form A. The majority of subjects (94%) demonstrated an interest in PGT regardless of whether they had high or low HPB (t=-1.096, df=276, n.s). Subjects were less willing to engage in PGT for depression (Cochran's Q = 52.382, df=9, p<.05) when compared to other multifactorial diseases (diabetes, heart disease, high blood pressure, colon, breast, prostate, and ovarian cancers, glaucoma, stroke, and high cholesterol). Finally, a significant increase in HPB from baseline (F=396.662, df=3, p<.05) was found upon introduction of a hypothetical-positive PGT result. For PGT to be a successful tool in healthcare, it must be valued and viewed as useful by the people for whom it is intended. Subjects showed interest not only in having PGT but also indicated they would change HPB when confronted with positive test results. Advisors/Committee Members: Sommers, Dr. Marilyn S.