Assessing the Validity of the SF-36 Health Survey Among Chinese Individuals with Spinal Cord Injuries
Author(s)
Fan Zhang, Ms1, Chengaxin Duan, Ms1, Xue Li, PhD2, Kun Zhao, MS2, Han Sijie, MSc3, Luah Xiao Wen, MSc, Rph4.
1China Health Economics Association, Beijing, China, 2China National Health Development Research Center, Beijing, China, 3Coloplast (China) Medical Devices Ltd., Beijing, China, 4Coloplast A/S, Copenhagen, Denmark.
1China Health Economics Association, Beijing, China, 2China National Health Development Research Center, Beijing, China, 3Coloplast (China) Medical Devices Ltd., Beijing, China, 4Coloplast A/S, Copenhagen, Denmark.
Presentation Documents
OBJECTIVES: This study aimed to evaluate the reliability and validity of the SF-36 Health Survey in a Chinese SCI population, providing a foundation for its use in clinical and policy-making contexts.
METHODS: A cross-sectional study was conducted as part of the second National Quality of Life and Disease Survey Project for Individuals with SCI in China. A total of 3,059 valid questionnaires were collected from SCI patients across seven geographical regions of mainland China via an online platform. The study assesses internal consistency, reliability, and validity of the SF-36. Internal consistency was evaluated using Cronbach’s alpha, while confirmatory factor analysis (CFA) was performed to examine the factor structure. Ceiling and floor effects were analyzed to determine the instrument's sensitivity.
RESULTS: The SF-36 demonstrated good overall internal consistency (Cronbach’s alpha = 0.87). Subscales for Physical Functioning (PF), Role-Physical (RP), and Role-Emotional (RE) showed high reliability (α > 0.89), whereas Bodily Pain (BP), General Health (GH), Vitality (VT), and Mental Health (MH) subscales exhibited lower internal consistency (α < 0.70). Significant floor effects were observed in the RP and RE subscales, and a notable ceiling effect was present in the RE subscale. CFA indicated a poor fit of the SF-36’s theoretical model to the data (CFI = 0.750; TLI = 0.682; RMSEA = 0.104; SRMR = 0.144).
CONCLUSIONS: While the SF-36 Health Survey exhibits satisfactory overall reliability in assessing HRQoL among Chinese SCI patients, certain subscales demonstrate inadequate internal consistency and poor structural validity. Cultural factors and specific characteristics of the Chinese SCI population may influence these outcomes, indicating a need for further refinement or cultural adaptation of the SF-36 to enhance its validity and reliability in this context. Future studies should explore tailored modifications and longitudinal assessments to better capture the nuanced quality of life experiences of Chinese individuals with SCI.
METHODS: A cross-sectional study was conducted as part of the second National Quality of Life and Disease Survey Project for Individuals with SCI in China. A total of 3,059 valid questionnaires were collected from SCI patients across seven geographical regions of mainland China via an online platform. The study assesses internal consistency, reliability, and validity of the SF-36. Internal consistency was evaluated using Cronbach’s alpha, while confirmatory factor analysis (CFA) was performed to examine the factor structure. Ceiling and floor effects were analyzed to determine the instrument's sensitivity.
RESULTS: The SF-36 demonstrated good overall internal consistency (Cronbach’s alpha = 0.87). Subscales for Physical Functioning (PF), Role-Physical (RP), and Role-Emotional (RE) showed high reliability (α > 0.89), whereas Bodily Pain (BP), General Health (GH), Vitality (VT), and Mental Health (MH) subscales exhibited lower internal consistency (α < 0.70). Significant floor effects were observed in the RP and RE subscales, and a notable ceiling effect was present in the RE subscale. CFA indicated a poor fit of the SF-36’s theoretical model to the data (CFI = 0.750; TLI = 0.682; RMSEA = 0.104; SRMR = 0.144).
CONCLUSIONS: While the SF-36 Health Survey exhibits satisfactory overall reliability in assessing HRQoL among Chinese SCI patients, certain subscales demonstrate inadequate internal consistency and poor structural validity. Cultural factors and specific characteristics of the Chinese SCI population may influence these outcomes, indicating a need for further refinement or cultural adaptation of the SF-36 to enhance its validity and reliability in this context. Future studies should explore tailored modifications and longitudinal assessments to better capture the nuanced quality of life experiences of Chinese individuals with SCI.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PCR168
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Injury & Trauma