Chinese SF-36 Health Survey: translation,cultural adaptation,validation, and normalisation

STUDY OBJECTIVE: To develop a self administered Chinese (mainland) version of the Short-Form Health Survey (SF-36) for use in health related quality of life measurements in China. DESIGN: A three stage protocol was followed including translation, tests of scaling construction and scoring assumptions, validation, and normalisation. SETTING: 1000 households in 18 communities of Hangzhou. PARTICIPANTS: 1688 respondents recruited by multi-stage mixed sampling. Main results: The assumption of equal intervals was violated for the vitality and mental health scales. The recoded item values were used to calculate scale scores. The clustering and ordering of item means was the same as that of the source and other two Chinese versions. The items in each scale had similar standard deviations except those in the physical functioning, boduily pain, social functioning scales. The item hypothesised scale correlations were identical for all except the social functioning and vitality scales. Convergent validity and discriminant validity were satisfactory for all except the social functioning scale. Cronbach's alpha coefficients ranged from 0.72 to 0.88 except 0.39 for the social functioning scale and 0.66 for the vitality scale. Two weeks test-retest reliability coefficients ranged from 0.66 to 0.94. Factor analysis identified two principal components explaining 56.3% of the total variance. The Chinese SF-36 could distinguish known groups. CONCLUSIONS: This study suggested that the Chinese (mainland) version of the SF-36 functioned in the general population of Hangzhou, China quite similarly to the original American population tested. Caution is recommended in the interpretation of the social functioning and vitality scales pending further studies.     

Single-item electronic administration of the SF-36v2 Health Survey

Purpose

To evaluate the psychometric properties and factor structure of a computerized electronic version of the SF-36v2 Health Survey (SF-36v2) with items administered one-per-page versus the traditional grid format used in the paper-and-pencil version in a sample of physician-diagnosed headache patients.

Methods

Patients (N = 180) completed the SF-36v2 administered as part of a broader study of health outcomes. Scaling assumptions, reliability, factor structure, and the tool’s ability to discriminate between headache pain severity groups were examined.

Results

Frequency distributions showed notable ceiling effects for the role emotional, social functioning, physical functioning, and role physical scales, but negligible (<1.2%) floor effects for any of the scales. Internal consistency reliability coefficients ranged from 0.81 to 0.95 for the eight health domains. Items passed tests of internal consistency and discriminant validity. Principal components’ analyses confirmed the 2-factor structure; the pattern of correlations across scales was consistent with expectations for the physical and mental health components. As expected, patients with severe headache pain had lower mean SF-36v2 scores than those with mild or moderate pain. No significant score differences were observed between mild and moderate pain severity groups.

Conclusions

Single-item electronic administration of the SF-36v2 is reliable and valid for use with headache patients.     

Psychometric evaluation of a Chinese (Taiwanese) version of the SF-36 health survey amongst middle-aged women from a rural community

To test the psychometric properties of the Chinese (Taiwanese) version of the short form 36 health survey (SF-36), 1439 women, aged 40–54 years and living in Kinmen (a Taiwanese island reflecting a predominantly rural community) were recruited to participate in this survey. The rate of unavailable data points for the 36 tested items remained consistently low, and item-discriminate validity was high (95%) for all subscales. Cronbach's α coefficient remained above the 0.70 threshold criterion for all scales except for social functioning and bodily pain. Principal components analysis supported the two major dimensions of health, physical and mental, in the internal structure of the SF-36 scales, although the dimensions did not match the hypothesized association very well. Poorer health profiles were associated with physical and mental conditions. The mental health subscores in the SF-36 test correlated highly with the associated hospital anxiety and depression score (Spearman rank correlation coefficient = −0.62). In conclusion, the reliability and validity tests performed on the data collected support the cross-cultural application of the Chinese (Taiwanese) version of the SF-36 test. This revised version was published online in June 2006 with corrections to the Cover Date.     

Reliability and construct validity of the SF-36 in Turkish cancer patients

In this study, we assessed the reliability and construct validity of the SF-36, Turkish version on 419 cancer patients. Cronbach’s α coefficients surpassed the 0.70 criterions for all subscales indicating good internal consistency. Results of the test–retest method showed that the stability coefficients for the eight subscales of the SF-36 ranged between 0.81 and 0.94. Principal components factor analysis with varimax rotation confirmed the presence of seven factors in the SF-36: physical functioning, role limitations due to physical and emotional problems, mental health, general health perception, bodily pain, social functioning, and vitality. In conclusion, the Turkish version of the SF-36 is a suitable instrument that could be employed in cancer research in Turkey.     

Assessing the validity of the SF-36 General Health Survey

Our objective was to assess the validity of the SF-36 General Health Survey against the Social Maladjustment Schedule (SMS) and two questionnaire measures, the Social Problem Questionnaire and the Nottingham Health Profile (NHP) in a random subsample of 206 men and women from the Whitehall II study, a longitudinal survey of health and disease amongst 10,308 London-based civil servants. We found that social functioning on the SF-36 correlated significantly with social contacts, total satisfaction and total management scores on the SMS, and social isolation and emotional reactions on the NHP. General mental health on the SF-36 was associated with marriage, social contacts, leisure scores, total satisfaction and total management scores on the SMS, and emotional reactions, energy level and social isolation on the NHP. Conversely, physical functioning and physical role limitations were generally not associated with the SMS but were associated with physical abilities and pain on the NHP. In conclusion, this study offers evidence of the discriminant validity of the general mental health and physical functioning scales of the SF-36. We also found moderate construct and criterion validity for the social functioning scale of the SF-36 and considerable overlap between the general mental health and social functioning scales.     

SF-36健康调查量表中文版的研制及其性能测试

目的 研制SF-36健康调查量表中文版并验证量表维度建立及记分假设、信度和效度。方法 采用多阶段混合型等概率抽样法,用SF-36健康调查量表中文版对1000户家庭的居民进行自评量表式调查;参照国际生命质量评价项目的标准程序,进行正式的心理测验学试验。结果 在收回的1985份问卷中,18岁以上的有效问卷1972份,其中应答者1688人(85．6％),1316人回答了所有条目,372人有1个或以上的缺失答案,无应答者中文盲、半文盲占65．5％。等距假设在活力(VT)和精神健康(MH)维度被打破了,按重编码后值计算维度分数;条目集群的分布接近源量表及其他2个中文译本;除了生理功能(PF)、躯体疼痛(BP)、社会功能(SF)维度,其余维度有相似的标准差;除了SF、VT维度,其余6个维度条目维度相关一致;除了SF维度,7个维度集合效度成功率范围为75％～100％,,区分效度成功率范围为87．5％～100％。一致性信度系数除了SF、VT维度,其余6维度变化范围为0．72～0．88,满足群组比较的要求。两周重测信度变化范围为0．66～0．94。因子分析产生了2个主成分,分别代表生理健康和心理健康,解释了56．3％的总方差。结论 为SF-36健康调查量表适用于中国提供了证据,已知群效度试验将为量表效度提供更有意义的证据。     

Health outcomes by self-report: validity of the SF-36 among Australian hospital patients

This paper examines the performance of the SF-36 as a self-reported outcome measure in a diverse sample of Australian hospital in-patients. The data derive from the Care Continuum and Health Outcomes Project with a total of 2088 randomly selected patients, yielding a response rate of 80%. Distributions, completion rates and, in particular, correlates of measures were used to investigate the validity of the SF-36 according to clinical and psychometric criteria. Physical functioning, bodily pain, role limitations- physical, general health and vitality scales better represented physical than mental health, with the relative strength decreasing in that order; while mental health, role limitations-emotional and social functioning scales better represented mental health, with the relative strength decreasing in order. A cultural dimension was a strong independent correlate of all scales. While the SF-36 performed satisfactorily, there were weaknesses: the social functioning scale was too narrow to cover social health, both role limitations scales had crude response categories and particular subgroups, the frail elderly and those with complex health conditions, required measures with finer gradings for scales such as physical functioning and bodily pain. Further testing is needed to develop self-reports for use in hospital outcomes measurement which is already proposed in Australia.     

PHB4 The Responsiveness of Disease-Specific and Generic Health Measures to Changes in the Severity of Rheumatoid Arthritis and to Treatment

OBJECTIVE: To compare the responsiveness of arthritisspecific and generic health outcome measures in relation to changes in the severity of osteoarthritis (OA). Clinical trial patients (n = 1,177) were assessed at baseline and again after two weeks of treatment. Criterion measures of change in severity included physician global assessment, knee pain on weight bearing, knee pain on motion, and patient global assessment.
METHODS: The responsiveness of each disease-specific and generic measure was estimated independently using the relative validity (RV) methodology, which compares F-ratios for average changes in specific and generic measures across groups differing in the amount of change in the criterion variables. RV coefficients estimate how each measure responded, relative to the best measure (RV = 1.0). OA-specific measures were based on the WOMAC questionnaire. Generic outcome measures included eight scales, physical and mental summary measures, and arthritis-specific health index (ASHI) scored from the SF-36 Health Survey.
RESULTS: The SF-36 ASHI was most valid (RV = 1.0) for 3 of the 4 clinical criteria, followed by the SF-36 bodily pain (BP) scale (RV = .74–.98) for two of the clinical criterion. SF-36 physical health (physical functioning, role physical, physical summary) and social functioning scales were consistently more valid (RV > .30) than the SF-36 mental health scales (RV > .30). The WOMAC total scale score was more valid (RV = .91–1.0) than any of the three WOMAC subscales. With the exception of the SF-36 ASHI and BP scales, the WOMAC pain (RV = .80–.83), physical functioning (RV = .76–.95), and stiffness (RV = .61–.70) subscales were more valid than SF-36 scales.
CONCLUSION: This study replicates results from previous studies showing that arthritis-specific scoring of the generic SF-36 health profile increases its responsiveness to changes in arthritis severity.     

A Chinese version of the Sleep Apnea Quality of Life Index was evaluated for reliability, validity, and responsiveness

OBJECTIVE: Obstructive sleep apnea (OSA) is a common disorder in many ethnic populations. Patients with OSA have impaired health-related quality of life (HRQOL). No sleep apnea-specific HRQOL measure has been validated in Chinese patients. STUDY DESIGN AND SETTING: A cross-sectional sample of 106 Chinese OSA patients and a longitudinal sample of 51 patients in Hong Kong completed a Chinese (Cantonese) version of SAQLI for assessment of its acceptability, scaling assumptions, reliability, validity, and responsiveness. RESULTS: The instrument was understood and seen as relevant by 97% of subjects. Internal consistency, test-retest reliability, item-scale convergent validity and discriminatory validity, and construct validity were good to excellent. Construct validity was confirmed by significant correlations with SF-36 subscale scores. However, factor analysis showed that only items of daily functioning and symptom domains all loaded on the hypothesized scales. Longitudinal data showed that SAQLI was more responsive than SF-36 to changes after treatment. CONCLUSION: Hence, this version of SAQLI was an acceptable, psychometrically valid, and responsive HRQOL measure for evaluating impact of illness and treatment effectiveness in Chinese OSA patients.     

Comparison of WHOQOL-BREF and SF-36 in patients with HIV infection

The purpose of the study was to evaluate the reliability and validity of the two generic instruments, the WHOQOL and the SF-36, for assessing health-related quality of life in 224 patients with HIV infection. The internal consistency ranged from 0.75 to 0.86 across the WHOQOL-BREF domains and from 0.72 to 0.93 across the SF-36 scales. The scores of all WHOQOL-BREF domains and SF-36 scales correlated positively with the measure of happiness, Sat-HRQOL and self-perceived health status, and correlated negatively with the number and intensity of symptoms. Patients with higher CD4 cell counts scored significantly higher on G4 (general health), three WHOQOL-BREF domains, seven SF-36 scales, and PCS (physical component summary). Patients with fewer symptoms and with less intensity of symptoms had significantly higher scores on all four domains of WHOQOL-BREF, eight scales, PCS, and MCS (mental component summary) of the SF-36 scale. The correlations between the physical, psychological, and social domains of the WHOQOL-BREF and PF (physical functioning), MH (mental health), and SF (social functioning) of the SF-36 were 0.51, 0.75, and 0.54, respectively. There is also good correlation between PCS of the SF-36 and the physical domain of the WHOQOL-BREF (r = 0.48), and between MCS and all four domains of the WHOQOL-BREF (r range = 0.60–0.75). The WHOQOL-BREF domains showed fewer floor or ceiling effect than the SF-36 scales. We concluded that both the WHOQOL-BREF and the SF-36 are reliable and valid health related quality-of-life instruments in patients with HIV infection.     

SF-36用于肺结核的信度、效度及敏感性评价

目的　评价中文版SF - 36量表用于肺结核 (PTB)病人的生命质量测量的信度、效度、敏感性。方法　用自行研制的中文版SF - 36量表对肺结核病人及对照进行测量。采用Cronchbach’sα评价量表的信度 ,因子分析评价量表的效度 ,用配对t检验比较患者组和对照组的评分来评价量表的敏感性。结果　对于病人组和对照组 ,SF - 36量表效度 (因子分析聚合为 2个公因子 )、信度 (Cronchbach’sα >0 7)较好。肺结核病人各项得分均低于对照组 ,说明量表的敏感性较高。结论　中文版SF - 36量表是测量肺结核病人的生命质量的有效量表 ,但量表中个别词句的翻译仍须改动 ,并且有必要进行更大样本的调查 ,建立中国人的生命质量正常值标准 ,以利于生命质量的评价     

A community-based study of scaling assumptions and construct validity of the English (UK) and Chinese (HK) SF-36 in Singapore

Scaling assumptions and validity of the English (UK) and Chinese (HK) short form 36 health survey (SF-36) were assessed in a community-based survey of 5503 Chinese, Malays and Indians in Singapore using the international quality of life assessment project approach of item and scale level validation. Missing data for SF-36 items and scales occurred in less than 1.0% of subjects. Item level validation of both versions generally supported assumptions underlying Likert scoring and hypothesised item-order clustering. Item level factor analysis supported the eight-scale structure of the SF-36. In scale level validation, SF-36 scale scores showed wide variability and acceptable internal-consistency reliability (Cronbach's α > 0.70 for six English and seven Chinese scales), conformed to hypothesised patterns and generally varied according to hypotheses in subjects known to differ in quality of life. Scale level factor analysis of both versions yielded very similar patterns of factor correlation, comparable to that found in Japan, but differing from that seen in Western populations. Taken together, these results support the validity of the English (UK) and Chinese (HK) SF-36 versions in the multi-ethnic Asian socio-cultural context of Singapore. This revised version was published online in June 2006 with corrections to the Cover Date.     

Reliability and validity of the English (Singapore) and Chinese (Singapore) versions of the Short-Form 36 version 2 in a multi-ethnic Urban Asian population in Singapore

Purpose

We aimed to evaluate the measurement properties of the Singapore English and Chinese versions of the Short-Form 36 version 2 (SF-36v2) Questionnaire, an improved version of the widely used SF-36, for assessing health-related quality of life (HRQoL) in a multi-ethnic urban Asian population in Singapore.

Methods

SF-36v2 scores and data on medical history, demographic and lifestyle factors from the Singapore Prospective Study Programme were analyzed. Convergent and divergent validity, internal consistency, floor and ceiling effects, known group validity and factor structure of the SF-36v2 were assessed for the English and Chinese versions, respectively.

Results

Complete data for 4,917 participants (45.8 %) out of 10,747 eligible individuals were analyzed (survey language: 4,115 English and 802 Chinese). Item-scale correlations exceeded 0.4 for all items of the English SF-36v2 and for all except one item of the Chinese SF-36v2 (bathe and dress: item-scale correlation: 0.36). In the English SF-36v2, Cronbach’s alpha exceeded 0.70 for all scales. In the Chinese SF-36v2, Cronbach’s alpha exceeded 0.7 on all scales except social functioning (Cronbach’s alpha: 0.68). For known groups validity, respondents with chronic medical conditions expectedly reported lower SF-36v2 score on most English and Chinese SF-36v2 scales. In confirmatory factor analysis, the Singapore three-component model was favored over the United States two-component and Japan three-component models.

Conclusions

The English and Chinese SF-36v2 are valid and reliable for assessing HRQoL among English and Chinese-speaking Singaporeans. Test–retest reliability and responsiveness of the English and Chinese SF-36v2 in Singapore remain to be evaluated.     

Prospective versus retrospective measurement of change in health status: a community based study in Geneva, Switzerland.

STUDY OBJECTIVES: To compare prospective and retrospective measurements of change in health status. DESIGN: Health status was measured using a French language version of the short form 36 (SF-36) health survey on two occasions one year apart--in 1992 and 1993. Differences in SF-36 scores measured prospectively were compared with the patients' single item retrospective evaluation of change in health (transition item). SETTING: This was a community based study among members of two health insurance plans in Geneva, Switzerland. PARTICIPANTS: Altogether 831 young adults (mean age 30 years at baseline). MAIN RESULTS: Health status remained stable on average during the study period. The retrospective rating correlated well with changes in health measured prospectively: those who said in 1993 that their current health was "much worse" than in 1992 experienced an average decrease of 1.06 SD on the eight SF-36 scales, while those who said that their health was "much better" recorded an average improvement of 0.43 SD. The associations between prospective and retrospective assessments of change were approximately linear for all scales but physical functioning. The transition item also discriminated between time periods: transition reported for 1991-92 did not correlate with changes recorded for 1992-93. Relative validity analyses indicated that the transition item was better suited to capture changes in general health than changes in purely physical or mental aspects of health. CONCLUSIONS: The concordance between retrospective and prospective measures of change in health suggests that both are sensitive, to some extent, to true changes in health status. Using both types of assessment may improve the reliability of measurements of change.     

Advances in methods for assessing the impact of epilepsy and antiepileptic drug therapy on patients' health-related quality of life

We studied 31 previously validated and newly developed generic and epilepsy-specific scales to evaluate their usefulness for assessing the impact of epilepsy and anti-epileptic drug (AED) therapy on health-related quality of life (HRQOL). Included were the MOS SF-36 Health Survey, additional measures of mental health, cognition, epilepsy-specific perception of control, behavioural problems, distress, worries and experiences, the Liverpool Epilepsy Impact and Seizure Severity scales, and a patient-completed symptom checklist. Questionnaires were completed twice by 136 patients on AED therapy in a multicentre study in the UK. Validity was assessed in relation to disease severity, defined as time since last seizure, and to patient-reported symptoms. Statistical analyses to estimate the contribution of HRQOL information of each scale relative to that of others were conducted. The 171-item questionnaire could be completed by out-patients with epilepsy with good data quality. With few exceptions, generic and epilepsy-specific measures satisfied psychometric tests of hypothesized item groupings and scale score reliability (internal consistency and test-retest reliability) and differentiated well between groups of patients differing in time since last seizure and in symptom impact, regardless of time since last seizure. However, scales differed widely in their validity in discriminating between groups of patients known to differ clinically. The SF-36 Role Physical scale best discriminated among groups differing in disease severity. The epilepsy-specific Mastery, Impact, Experience, Worry, Distress, and Agitation scales were among the 10 best measures in discriminating among groups differing in disease severity. Generic measures, especially measures of social and role functioning and mental health, were best at differentiating groups of patients differenting in symptom impact. Recommendations are offered for concepts and specific scales most likely to be useful in future studies of the HRQOL burden of epilepsy and the HRQOL benefits of AED therapy.     

The rand 36-item health survey 1.0

Recently, Ware and Sherbourne¹ published a new short-form health survey, the MOS 36-Item Short-Form Health Survey (SF-36), consisting of 36 items included in long-form measures developed for the Medical Outcomes Study. The SF-36 taps eight health concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, general mental health, social functioning, energy/fatigue, and general health perceptions. It also includes a single item that provides an indication of perceived change in health. The SF-36 items and scoring rules are distributed by MOS Trust, Inc. Strict adherence to item wording and scoring recommendations is required in order to use the SF-36 trademark. The RAND 36-Item Health Survey 1.0 (distributed by RAND) includes the same items as those in the SF-36, but the recommended scoring algorithm is somewhat different from that of the SF-36. Scoring differences are discussed here and new T-scores are presented for the 8 multi-item scales and two factor analytically-derived physical and mental health composite scores.     

Reliability and validity of the SF-36 in HIV-infected homeless and marginally housed individuals

Objective: To assess the reliability and validity of the Short-Form 36 (SF-36) health survey as a health status indicator among HIV-infected homeless and marginally housed (HMH) individuals. Methods: Between July 1996 and May 2000, a sample of HMH individuals completed interviews that included the SF-36. Responses to the SF-36 were analyzed for missing data, range, internal consistency, and construct validity. Results: Among 330 individuals interviewed, 83% were male, 43% were African-American, and the median age was 39 years. All internal consistency reliability coefficients exceeded 0.70, all item–scale correlations exceeded 0.40, all items were more strongly correlated with their hypothesized scale than any other scale, and all reliability coefficients exceeded inter-scale correlations for the same scale. Three of four physical health scales were significantly associated with CD4 cell count and HIV viral load. All scales were significantly associated with depression. Discussion: We found that scales were internally consistent, items correlated to an acceptable degree with their hypothesized scales, items were distinct from other scales, physical scales were associated with CD4 cell count and viral load, and all scales were associated with depression. These analyses provide evidence for the reliability and validity of the SF-36 as a measure of health status in HIV-positive HMH individuals.     

Outcome measurement in functional somatic syndromes: SF-36 summary scores and some scales were not valid

Objective

This study aimed to test the validity of the 36-item Short-Form Health Survey (SF-36) scales and summaries in patients with severe functional somatic syndromes (FSS), such as fibromyalgia and irritable bowel syndrome.

Study Design and Setting

One hundred twenty patients with severe FSS enrolled in a randomized controlled trial filled in the SF-36 questionnaire. We tested for data quality, central scaling assumptions, and agreement with the conceptual model.

Results

Most SF-36 scales were found to be valid; however, three scales (role physical, role emotional, and general health) did not satisfy predefined criteria for construct validity, internal consistency, or targeting to the sample. The correlations between SF-36 scales differed considerably from those reported in the general population. As a consequence, the SF-36 summaries, physical component summary (PCS) and mental component summary (MCS), did not accurately reflect their underlying scales and were negatively correlated (r = −0.46, 95% CI [−0.60 to −0.31]).

Conclusion

Although the SF-36 is a valuable instrument to assess perceived health in patients with severe FSS, there are problems with some of the scales and with the scoring procedure of the summaries. The SF-36 PCS may, therefore, not accurately measure the physical health status of these patients. Alternative summary measures are needed.     

Improving the response choices on the veterans SF-36 health survey role functioning scales: results from the Veterans Health Study

Role functioning and its limitations due to one's health is an important aspect of health-related quality of life (HRQoL). The Medical Outcomes Study (MOS) SF-36 includes 2 role functioning scales: role limitations due to physical health problems (RP) or emotional problems (RE). Although they capture important concepts of HRQoL, these 2 scales have some limitations in their measurement properties. Using dichotomized sets of response choices, the scales are limited in their distributional properties (eg, higher standard deviation than other SF-36 scales) and ability to discriminate between clinically relevant groups. In this study, we ascertain the improvements to these 2 scales using 5-point ordinal response choices for each of the scale items. Two thousand one hundred sixty-two patients from the Veterans Health Study (VHS), an observational study of health outcomes in patients receiving ambulatory care, completed a health status questionnaire and a medical history. The health questionnaire included (1) the MOS SF-36, in which the RP and RE items used dichotomized yes/no responses; and (2) a set of modified RP and RE items that used 5-response choices for each of the items, ranging from "no, none of the time" to "yes, all of the time." We compared the original and modified RP and RE scales using internal consistency reliability and factor analysis. We tested item convergent and discriminant validity using multitrait scaling, and scale discriminant validity using ordinary least squares regression. Results indicate that the modifications to the original RP and RE scales accomplish important gains in the distributional properties of the scales. The floor and ceiling effects of the 2 scales have been reduced and the reliability of the RP scale has increased (0.87-0.95). Factor analysis and multitrait scaling tests indicate that the modified items have the same interpretation as the original items. Tests of discriminant validity indicate that the modified RP and RE scales have greater explanatory power for measures of disease burden, depression, and disease severity. The modified SF-36 role scales are clearly superior to the original versions. The modifications have increased the explained variability, suggesting greater explanatory power and more information obtained by the role functioning measures. The modified RP and RE are capturing a wider spectrum of disease severity, in part due to the lowering of the floor and raising of the ceiling of the scales. Additional work needs to test these improvements in other populations and to expand the analysis to track the responsiveness of the modified scales to clinically and socially important changes over time.     

农村空巢老人SF-36量表应用信度及效度评价

目的 评价简明健康调查量表(SF-36)应用于农村空巢老人生存质量测量时的信度和效度。方法 采用中文版SF-36量表,对江苏省徐州市分层整群随机抽取218名农村空巢老人进行面访调查,评价该量表的信度和效度。结果 SF-36量表的分半系数为0.84,生理职能(RP)、生理功能(PF)、躯体疼痛(BP)、总体健康(GH)、精力(VT)、社会功能(SF)、情感职能(RE)和精神健康(MH)8个维度Cronbach's α系数为0.79、0.88、0.86、0.81、0.77、0.76、0.88、0.77,量表具有良好的分半信度和内部一致性信度;效度分析表明,集合效度和区分效度试验成功率分别为97.14%和97.96%,因子分析(RMSEA=0.12,CFI=0.91),PF、VT、RE、MH 4个维度在因子负荷上与理论模型完全一致;量表反应度评价表明,除RP、BP、SF 3个维度天花板效应分别为42.63%、48.79%、26.45% 外,其他维度地板效应和天花板效应均不显著。结论 SF-36量表适用于农村空巢老人生存质量评价,但尚需根据实际情况对部分条目进行完善。