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

Area of Science:

• Health Outcomes Research
• Psychometrics
• Cross-cultural Adaptation of Instruments

Background:

• Health-related quality of life (HRQoL) is crucial for patient-centered care.
• Standardized instruments are needed for valid HRQoL assessments in diverse populations.
• The Short-Form Health Survey (SF-36) is a widely used HRQoL measure.

Purpose of the Study:

• To develop and validate a self-administered Chinese (mainland) version of the SF-36.
• To enable accurate HRQoL measurements within the Chinese population.
• To compare the performance of the Chinese SF-36 with the original American version.

Main Methods:

• A three-stage protocol involving translation, psychometric testing, validation, and normalization.
• Multi-stage mixed sampling recruited 1688 respondents from 1000 households in Hangzhou.
• Statistical analyses included assumption testing, reliability (Cronbach's alpha, test-retest), validity (convergent, discriminant), and factor analysis.

Main Results:

• The Chinese SF-36 demonstrated satisfactory reliability and validity, with Cronbach's alpha ranging from 0.72 to 0.88.
• Test-retest reliability coefficients were robust, ranging from 0.66 to 0.94.
• Factor analysis revealed two principal components explaining 56.3% of the variance, and the scale could distinguish known groups, though vitality and social functioning scales require caution.

Conclusions:

• The Chinese (mainland) SF-36 is a functional tool for assessing HRQoL in the general population of Hangzhou.
• Its performance is largely comparable to the original American SF-36.
• Further research is recommended for nuanced interpretation of the vitality and social functioning scales.