Abstract
BackgroundSuboptimal health status (SHS) is characterized by ambiguous health complaints, general weakness, and lack of vitality, and has become a new public health challenge in China. It is believed to be a subclinical, reversible stage of chronic disease. Studies of intervention and prognosis for SHS are expected to become increasingly important. Consequently, a reliable and valid instrument to assess SHS is essential. We developed and evaluated a questionnaire for measuring SHS in urban Chinese.MethodsFocus group discussions and a literature review provided the basis for the development of the questionnaire. Questionnaire validity and reliability were evaluated in a small pilot study and in a larger cross-sectional study of 3000 individuals. Analyses included tests for reliability and internal consistency, exploratory and confirmatory factor analysis, and tests for discriminative ability and convergent validity.ResultsThe final questionnaire included 25 items on SHS (SHSQ-25), and encompassed 5 subscales: fatigue, the cardiovascular system, the digestive tract, the immune system, and mental status. Overall, 2799 of 3000 participants completed the questionnaire (93.3%). Test-retest reliability coefficients of individual items ranged from 0.89 to 0.98. Item-subscale correlations ranged from 0.51 to 0.72, and Cronbach’s α was 0.70 or higher for all subscales. Factor analysis established 5 distinct domains, as conceptualized in our model. One-way ANOVA showed statistically significant differences in scale scores between 3 occupation groups; these included total scores and subscores (P < 0.01). The correlation between the SHS scores and experienced stress was statistically significant (r = 0.57, P < 0.001).ConclusionsThe SHSQ-25 is a reliable and valid instrument for measuring sub-health status in urban Chinese.
Highlights
A surprisingly large number of city dwellers in China suffer from poor health and many die prematurely.[1]
The item pool for the questionnaire was generated from the themes pertaining to perceived health complaints that were discussed in the focus groups
The focus group discussions were not initially centered on stress, but encompassed themes related to health and wellbeing, such as the participants’ own state of health and the reasons for poor health in urban Chinese
Summary
A surprisingly large number of city dwellers in China suffer from poor health and many die prematurely.[1]. SHS is a physical state between health and disease, and is characterized by the perception of health complaints, general weakness, and low energy.[2] It is regarded as a subclinical, reversible stage of chronic disease. We developed and evaluated a questionnaire for measuring SHS in urban Chinese. Questionnaire validity and reliability were evaluated in a small pilot study and in a larger crosssectional study of 3000 individuals. Analyses included tests for reliability and internal consistency, exploratory and confirmatory factor analysis, and tests for discriminative ability and convergent validity. Results: The final questionnaire included 25 items on SHS (SHSQ-25), and encompassed 5 subscales: fatigue, the cardiovascular system, the digestive tract, the immune system, and mental status. Conclusions: The SHSQ-25 is a reliable and valid instrument for measuring sub-health status in urban Chinese
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