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Medical outcomes study short form 36: testing and cross-validating a second-order factorial structure for health
1University of Tennessee-Memphis, College of Pharmacy, Department of Pharmacy Practice and Pharmacoeconomics 38163, USA.
Health Services Research
|December 29, 1998
Summary
The SF-36 questionnaire
Area of Science:
- Psychometrics
- Health Status Measurement
- Factor Analysis
Background:
- The SF-36 is a widely used health status questionnaire.
- Its factorial validity is crucial for accurate health assessment.
Purpose of the Study:
- To test the factorial validity of the SF-36.
- To evaluate its second-order factorial structure using advanced statistical methods.
Main Methods:
- Confirmatory factor analysis (CFA).
- Structural equation modeling (SEM).
- Analysis of data from health system employees (1995-1996).
Main Results:
- Mental Health and Physical Health are not independent.
- Cross-loadings observed between mental and physical health constructs.
- Subscale instabilities noted across different demographic subgroups.
Conclusions:
- The SF-36 supports a second-order factorial structure with modifications.
- Covariance between Physical and Mental Health improves model fit.
- Subgroup instabilities indicate caution in comparing SF-36 scores.