流动人口SF-12生命质量量表信度、效度评价

目的 评估SF-12生命质量量表用于评价流动人口生命质量时的信度和效度。方法 采用内部一致性信度评估SF-12生命质量量表的信度,采用集合效度、区分效度和结构效度评估SF-12量表的效度。结果 SF-12生命质量量表用于评价流动人口生命质量时的内部一致性信度cronbach'sα=0.84,各维度与总分的相关系数除了躯体活动功能(PF)=0.43,其余均>0.50;各维度的Cranach'sα系数均>0.70,且在删除相应维度后的Cronbach'sα系数均>0.70;8个维度的集合效度定标实验成功率均为100%,区分效度定标实验成功率均为100%;对量表的理论结构模型进行验证性因子分析,所得模型结构与原始假定一致,拟合指标结果为不规范拟合指数(NNFI)=0.95、比较拟合指数(CFI)=0.96、调整后的拟合优度指数(AGFI)=0.96、近似误差均方根(RMSEA)=0.06。结论 SF-12生命质量量表用于评价流动人口生命质量时具有较好的信度和效度。     

Predicting an SF-6D Preference-Based Score Using MCS and PCS Scores from the SF-12 or SF-36

Background:  The SF-6D preference-based scoring system was developed several years after the SF-12 and SF-36 instruments. A method to predict SF-6D scores from information in previous reports would facilitate backwards comparisons and the use of these reports in cost-effectiveness analyses.
Methods:  This report uses data from the 2001–2003 Medical Expenditures Panel Survey (MEPS), the Beaver Dam Health Outcomes Survey, and the National Health Measurement Study. SF-6D scores were modeled using age, sex, mental component summary (MCS) score, and physical component summary (PCS) score from the 2002 MEPS. The resulting SF-6D prediction equation was tested with the other datasets for groups of different sizes and groups stratified by age, MCS score, PCS score, sum of MCS and PCS scores, and SF-6D score.
Results:  The equation can be used to predict an average SF-6D score using average age, proportion female, average MCS score, and average PCS score. Mean differences between actual and predicted average SF-6D scores in out-of-sample tests was −0.001 (SF-12 version 1), −0.013 (SF-12 version 2), −0.007 (SF-36 version 1), and −0.010 (SF-36 version 2). Ninety-five percent credible intervals around these point estimates range from ±0.045 for groups with 10 subjects to ±0.008 for groups with more than 300 subjects. These results were consistent for a wide range of ages, MCS scores, PCS scores, sum of MCS and PCS scores, and SF-6D scores. SF-6D scores from the SF-36 and SF-12 from the same data set were found to be substantially different.
Conclusions:  Simple equation predicts an average SF-6D preference-based score from widely published information.     

Estimation and comparison of derived preference scores from the SF-36 in lung transplant patients

The purpose of this study was to estimate and compare preference scores derived from MOS Short Form-36 (SF-36) data for a sample of lung transplant patients using three methodologies: Fryback et al. (Med Decis Making 1997; 17: 1-9), Nichol et al. (Med Decis Making 2001; 21: 105-112) and Brazier et al. (J Health Econ 2002: 21: 271-292). Data were gathered from 99 lung transplant recipients using a mail survey, which included the SF-36 and other health-related quality of life (HRQL) measures. The mean preference score for the sample was 0.643 (range 0.43-0.83), 0.765 (range 0.36-1.0), and 0.697 (range 0.33-1.00) for Fryback, Nichol and Brazier methods, respectively. Correlations between the derived scores and visual analogue ratings of health (0.58-0.68) and pulmonary symptoms (-0.59 to -0.62) were moderate to good and in the expected directions. The mean preferences of patients grouped by levels of dyspnea, depression symptoms, illness burden, and self-rated general health differed significantly with all methods and supported the construct validity of the derived scores as measures of preference. The Nichol and Brazier scores, both derived with standard gamble utilities, were generally higher than Fryback scores, which are not utility-based. Given the popularity of the SF-36, these three methods could be useful where direct elicitation of preferences is not feasible. Researchers must be cognizant of the derivation method used, as absolute preference levels, hence quality adjusted life years (QALYs), will differ by method.     

SF-36量表应用于外来勤杂人员健康调查的信度和效度

目的评价SF-36量表在高校外来勤杂人员的信度和效度。方法采用SF-36生存质量量表，由经过统一培训的调查员对广州市某高校133名外来勤杂人员进行面对面现场测试，计算8项内容的评分，分析信度和效度。结果量表中除社会功能（0．69）外，其余各项维度Cronbach，a系数大于0．70；集合效度和区分效度较好；因子分析产生2个公共因子，解释65．13％的方差。结论SF-36量表具有较好的信度与效度，适于评价高校外来勤杂人员的生存质量。     

Performance of a Bayesian Approach for Imputing Missing Data on the SF-12 Health-Related Quality-of-Life Measure

Background

Missing data in health-related quality-of-life outcomes are an ongoing problem. The 12-item short form health survey (SF-12) scores are no exception. Data imputation is complicated, because missingness may be partially predicted by the missing data themselves.

Factors associated with health-related quality of life: the role of social relationships among the elderly in an Italian region

OBJECTIVES: This study examines the association between social relationships and health-related quality of life (HRQL) in the elderly in Lazio Region, Italy, a Mediterranean country where the shape and role of social links has dramatically changed. METHODS: Data were extracted from a national cross-sectional survey in Italy, representative of the non-institutionalised population aged 60 years and over resident in Lazio Region during 1999--2000. HRQL was measured with the Short Health Survey Questionnaire (SF-12). Data analysis was performed using multiple linear regression models using adjustment for the main confounders. RESULTS: Among the sample, 40.4% of the elderly were not married and 27.1 % were living alone. While being married and not living alone were associated with higher scores in the physical and mental quality-of-life components (P-value<0.001), more frequent visiting/seeing friends was likely to be associated with higher scores in both the physical and the mental health components (P-value<0.05). Multiple logistic regression analysis demonstrated that low physical health scores were associated with a low frequency of meeting with relatives and with living far from relatives. CONCLUSIONS: In a region covering 9.2% of the whole Italian population, only a small proportion of the elderly lack frequent social ties, yet low frequency of relationships with friends is associated with a decline in quality of life measured through mental and physical scores. Our findings will be useful for drawing up welfare strategies both at the national and at the Mediterranean level, in countries, like Italy, where the primacy of family support of the elderly has been decreasing in recent years.     

SF-12量表用于城市建筑业农民工生存质量的信度和效度研究

目的分析SF-12量表用于评价城市建筑业农民工人群生存质量的信度和效度。方法采用内部一致性信度评估SF-12量表的信度,采用集合效度、区分效度和结构效度评估SF-12量表的效度。结果SF-12量表评价城市建筑业农民工人群的内部一致性信度Cronbach’s α系数为0.776,8个维度的集合效度定标试验成功率为100%,区分效度定标试验成功率为100%;对量表的理论模型进行验证性因子分析,所得模型与原始假定一致,拟合指标结果为RMSEA=0.052,NFI=0.973,CFI=0.982,AGFI=0.964。结论SF-12量表适用于城市建筑业农民工群体的生存质量评价。     

Use of the 12-item Short-Form (SF-12) Health Survey in an Australian heart and stroke population

The objective of this study was to validate the SF-12 Health Survey in heart and stroke patients using a community-based study. Between November 1995 and August 1996, 3,362 patients were invited to join the Hunter Heart and Stroke Register in New South Wales, Australia and to complete the SF-12 Health Survey. Of the 3,362 patients, 2,341 (70%) returned the SF-12. Of those 2,341 patients, 78% completed all 12 items. Those who did not complete the questionnaire were significantly more likely to be females, older, less educated, have stayed longer in hospital and been admitted on emergency. The SF-12 demonstrated construct validity in an analysis restricted to the 1,831 patients who completed the questionnaire: scores measuring physical and mental health status were statistically significantly higher in men than women, in younger than older, in those who had shorter than longer lengths of stay in hospital, in patients whose hospital admissions were planned than emergencies and in heart than stroke patients. Construct validity of the SF-12 among patients able to complete the SF-12 suggests considerable potential for its use in assessing health status in large-scale surveys. However, caution should be taken with the heart and stroke population because of a relatively high incompletion rate.     

Do the SF-36 and WHOQOL-BREF Measure the Same Constructs? Evidence from the Taiwan Population*

Background: The SF-36 and WHOQOL-BREF are available for international use, but it is not clear if they measure the same constructs. We compared the psychometric properties and factor structures of these two instruments. Methods: Data were collected from a national representative sample (n=11,440) in the 2001 Taiwan National Health Interview Survey, which included Taiwan versions of the SF-36 and WHOQOL-BREF. We used Cronbach’s alpha coefficient to estimate scale reliability. We conducted exploratory factor analysis to determine factor structure of the scales, and applied multitrait analysis to evaluate convergent and discriminant validity. We used standardized effect size to compare known-groups validity for health-related variables (including chronic conditions and health care utilization) and self-reported overall quality of life. Structural equation modeling was used to analyze relationships among the two SF-36 component scales (PCS and MCS) and the four WHOQOL subscales (physical, psychological, social relations, and environmental). Results: Cronbach’s alpha coefficients were acceptable (⩾0.7) for all subscales of both instruments. The factor analysis yielded two unique factors: one for the 8 SF-36 subscales and a second for the 4 WHOQOL subscales. Pearson correlations were weak (<0.3) among subscales of both instruments. Correlations for subscales hypothesized to measure similar constructs differed little from those measuring heterogeneous subscales. Effect sizes suggested greater discrimination by the SF-36 for health status and services utilization known groups, but greater discrimination by the WHOQOL for QOL-defined groups. Structural equation modeling suggested that the SF-36 PCS and MCS were weakly associated with WHOQOL. Conclusions: In this Taiwan population sample, the SF-36 and WHOQOL-BREF appear to measure different constructs: the SF-36 measures health-related QOL, while the WHOQOL-BREF measures global QOL. Clinicians and researchers should carefully define their research questions related to patient-reported outcomes before selecting which instrument to use. * Presented in part at (1) 11th Annual Conference of the International Society for Quality of Life Research. Hong Kong, China, 2004. (2) 2004 Quality of Life Symposium – Conceptualization and Measurement issues in QOL. Tai-Chuan, Taiwan, 2004     

上海居民慢性病与生命质量关系的研究

目的研究上海居民慢性病患病情况及其对生命质量的影响,分析慢性病与生命质量的关系。方法采用随机、分层、多阶段抽样的方法抽取调查对象,运用自填式问卷调查方式对919名居民进行调查,问卷包括调查对象基本情况问卷及SF-36健康调查量表。结果上海居民慢性病患病率达25.14%,其中高血压患病率最高。有慢性病者的SF-36量表各维度得分均比无慢性病者低,而且慢性病数量影响生命质量,慢性病越多生命质量越差。结论慢性病已经成为一个重要的公共卫生问题,严重损害人们的生命质量。     

SF-36量表用于晚期血吸虫病患者生命质量的评价

晚期血吸虫病(晚血)是一种严重危害人民身体健康~([1]),制约疫区经济发的地言性寄生虫病,也是血防工作的重点和难点之一.     

Health Status Assessed by the SF-36 Along the Diabetes Continuum in an Australian Population

Objective: To examine the association of health status with stage along the diabetes continuum. Design, setting and participants: Self-reported health status (SF-36) was assessed in the North West Adelaide Health Study, a representative population cohort (n = 4060) aged 18 years and over in metropolitan South Australia. Impaired fasting glucose (IFG), undiagnosed diabetes, diagnosed diabetes, glycaemic control and cardiovascular disease were determined from fasting blood and self-reported data. Results: The prevalence of diagnosed diabetes was 5.6% (95% CI: 4.9–6.3), with an additional 1.0% (95% CI: 0.7–1.4) previously undiagnosed. When compared to those with normal glucose, those with diabetes were significantly impaired on all SF-36 dimensions except Mental Health, and those with IFG (4.3%) were significantly impaired in terms of Physical Functioning and Bodily Pain when controlling for the effects of age, sex and cardiovascular disease. Poor glycaemic control (HbA1c ≥ 7.0%) was also associated with impaired health status. Conclusions: Health status is impaired not only among those with diagnosed diabetes but also those with IFG and undiagnosed diabetes.     

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.     

中国9省市中老年人群体重指数与健康相关生命质量的关系

目的 研究中国中老年人BMI与健康相关生命质量(HRQOL)的关系.方法 汇集9省市(汀苏、安徽、甘肃、青海、福建、北京、吉林、江西、河南)横断面健康状况调查中老年人群数据共9539例.采用秩和检验比较BMI分类不同的中老年人生命质量的差异;用多元logistic回归模型检验排除性别、年龄、婚姻状况、学历、运动水平和慢性病史等混杂因素后,中老年人BMI分类与生命质最的相关性.结果 与体重正常的中老年人相比,体重过轻组SF-36的生理领域(P<0.001)、心理领域(P<0.01)及其8个维度(生理机能、精神健康,P<0.05;生理职能、躯体疼痛、健康状况、精力、社会功能、情感职能,P<0.01)生命质量均显著较差;超重组心理领域生命质量显著较好(P<0.05);肥胖组生理机能维度显著较差(P<0.01),心理领域(P<0.05)、精神健康维度(P<0.01)显著较好.排除已知的混杂因素后,体重过轻组在生理领域(OR=1.67,95%CI:1.35～2.06)、心理领域(OR=1.39,95%CI:1.13～1.70)以及所有8个维度生命质量减损的危险度显著增高;超重组心理领域(OR=0.86,95%CI:0.78～0.95)及其生理职能、精力、社会功能、情感职能、精神健康维度生命质最受损的危险度显著降低;肥胖组生理机能维度(OR=1.51,95%CI:1.27～1.80)受损的危险度显著增高,心理领域(OR=0.71,95%CI:0.60～0.85)及其精力、情感职能、精神健康维度生命质量受损的危险度显著降低.结论 BMI分类不同的中老年人其SF-36各领域生命质量不同,体重过轻组生理领域和心理领域生命质量均较差,超重和肥胖组心理领域生命质最较好,肥胖组生理领域生命质量较差.超重和肥胖的中老年人生命质量的减损与慢性疾病有关.     

Changes in the Severity of Frailty Among Older Adults After 12 Months of Supervised Home-Based Physical Exercise: A Randomized Clinical Trial

ObjectiveTo investigate the effects of 12 months of physiotherapist-supervised, home-based physical exercise on the severity of frailty and on the prevalence of the 5 frailty phenotype criteria, using secondary analyses.DesignRandomized clinical trial, with 1:1 allocation into 12-month home-based physical exercise, or usual care. The multicomponent exercise sessions (60 minutes) were supervised by the physiotherapist and included strength, balance, functional, and flexibility exercises twice a week at participants' homes.Setting and ParticipantsHome-dwelling older adults aged ≥65 years who were frail (meeting 3-5 criteria) or prefrail (1-2 criteria) according to frailty phenotype criteria.MethodsThe severity of frailty (nonfrail, prefrail, or frail) was assessed using frailty phenotype criteria, and the prevalence of each frailty criterion (weight loss, low physical activity, exhaustion, weakness, and slowness) were assessed at baseline and at 12 months.ResultsTwo hundred ninety-nine persons were included in the analyses, of whom 184 were prefrail and 115 were frail at baseline. Their mean age was 82.5 (SD 6.3) years, and 75% were women. There was a significant difference between the exercise and usual care groups' transitions to different frailty states from baseline to 12 months among those who at baseline were prefrail (P = .032) and frail (P = .009). At 12 months, the mean number of frailty criteria had decreased in the exercise group (?0.27, 95% CI –0.47, ?0.08) and remained unchanged in the usual care group (0.01, 95% CI –0.16, 0.18; P = .042). The prevalence of the exhaustion (P = .009) and the low physical activity (P < .001) criteria were lower at 12 months in the exercise group than in the usual care group.Conclusions and ImplicationsThe severity of frailty can be reduced through 12-month supervised home-based exercise training. Exercise should be included in the care of older adults with signs of frailty.     

Assessment of Differential Item Functioning for Demographic Comparisons in the MOS SF-36 Health Survey

Objective: To investigate whether items of the Medical Outcomes Study (MOS) 36-Item Short-Form Health Status Survey (SF-36) exhibited differential item functioning (DIF) with respect to age, education, race, and gender. Methods: The data for this study come from two large national datasets, the MOS and the 1990 National Survey of Functional Health Status (NSFHS). We used logistic regression to identify items exhibiting DIF. Results: We found DIF to be most problematic for age comparisons. Items flagged for age DIF were vigorous activities, bend/kneel/stoop, bathing or dressing, limited in kind of work, health in general, get sick easier than others, expect health to get worse, felt calm and peaceful, and all four vitality items. Items flagged for education DIF include vigorous activities, health in general, health is excellent, felt calm and peaceful, and been a happy person. Vigorous activities, walk more than a mile, health in general, and expect health to get worse were identified as DIF when comparing African-Americans with whites. No items were identified for gender DIF. Conclusions: We found several consistent patterns of DIF using two national datasets with different population characteristics. In the current study, the effect of DIF rarely transferred to the scale level. Further research is needed to corroborate these results and determine qualitatively why DIF may occur for these specific items. This work was completed while Dr. McHorney was at Indiana University. Dr. McHorney is now with Outcomes Research & Management, Merck & Co., Inc.     

Construct validation of the USA-Spanish version of the SF-36 health survey in a Cuban-American population with benign prostatic hyperplasia

This study examined the USA-Spanish version of the SF-36 health survey (validated in Mexican- Americans) and tested its construct validity in Cuban-Americans with benign prostatic hyperplasia (BPH). The study evaluated the SF-36 and American Urological Association (AUA) Symptom Index scores of 264 individuals with BPH. Individuals were assigned to one of the following groups: non-Hispanics who received the English version, Cubans who received the English version and Cubans who received the Spanish version. The objective was to determine the correlation between the individuals' SF-36 and AUA Symptom Index scores. It was expected that patients in the severe category would have the lowest quality of life (QoL) scores. The analysis was conducted using a MANOVA with a planned comparisons procedure. For all eight scales, the English and Spanish versions of the SF-36 were able to classify individuals with mild/moderate symptoms of BPH as having statistically higher QoL scores than those with severe symptoms of BPH. We concluded that the USA-Spanish version of the SF-36 can differentiate between levels of symptom severity in individuals with BPH. More importantly the construct validity of the English and Spanish versions of the SF-36 was demonstrated through significant correlation with the theorized constructs.     

Nature and correlates of SF-12 physical and mental quality of life components among low-income HIV adults using an HIV service center

Objectives: This study describes health-related quality of life (HRQOL) among low-income HIV adults using an HIV service center, compares participants scores to US published norms for the general population and persons with chronic conditions, and examines relationships between patient characteristics, nonadherence, and HRQOL. Methods: A cross-sectional survey of individuals on antiretroviral therapy was conducted. The Medical Outcomes Study SF-12 was used to assess HRQOL. Medication nonadherence was assessed using the 9-item Morisky Adherence Scale. Data also were collected on social support, CD4 cell count, and time since diagnosis. Results: Approximately 84% of the 86 participants were male, 50% were white, and 39% were black. The ean ± SD Physical component summary (PCS-12) score of 41.0 ± 12.5 and Mental component summary (MCS-12) score of 41.9 ± 11.0 were lower than US general population norms (p < 0.001). PCS-12 scores were similar to those of patients with other chronic conditions. Respondents reported lower MCS-12 scores than patients with hypertension and diabetes (p < 0.006). Employment and higher social support had positive associations with PCS-12 scores and nonadherence had a negative association with MCS-12 scores (p < 0.05). Conclusions: HRQOL in this sample of low-income HIV adults was comparable to other HIV populations. Identifying strategies for increasing social support and medication adherence for economically disadvantaged persons with HIV/AIDS may improve their HRQOL.Rodney Anderson: At the time of the study Dr. Anderson was Director of Health & Education Services The Damien Center 1350 Pennsylvania Indianapolis, IN 46202, USA