Abstract
BackgroundSince its translation to Thai in 2000, the SF-36 Health Survey has been used extensively in many different clinical settings in Thailand. Its popularity has increased despite the absence of published evidence that the translated instrument satisfies scoring assumptions, the psychometric properties required for valid interpretation of the SF-36 summated ratings scales. The purpose of this paper was to examine these properties and to report on the reliability and validity of the Thai SF-36 in a non-clinical general population.Methods1345 distance-education university students who live in all areas of Thailand completed a questionnaire comprising the Thai SF-36 (Version 1). Median age was 31 years. Psychometric tests recommended by the International Quality of Life Assessment Project were used.ResultsData quality was satisfactory: questionnaire completion rate was high (97.5%) and missing data rates were low (< 1.5% for all items). The ordering of item means within scales generally were clustered as hypothesized and scaling assumptions were satisfied. Known groups analysis showed good discriminant validity between subgroups of healthy persons with differing health states. However, some areas of concern were revealed. Possible translation problems of the Physical Functioning (PF) items were indicated by the comparatively low ceiling effects. High ceiling and floor effects were seen in both role functioning scales, possibly due to the dichotomous format of their response choices. The Social Functioning scale had a low reliability of 0.55, which may be due to cultural differences in the concept of social functioning. The Vitality scale correlated better with the Mental Health scale than with itself, possibly because a healthy mental state is central to the concept of vitality in Thailand.ConclusionThe summated ratings method can be used for scoring the Thai SF-36. The instrument was found to be reliable and valid for use in a general non-clinical population. Version 2 of the SF-36 could improve ceiling and floor effects in the role functioning scales. Further work is warranted to refine items that measure the concepts of social functioning, vitality and mental health to improve the reliability and discriminant validity of these scales.
Highlights
Since its translation to Thai in 2000, the Short Form 36 (SF-36) Health Survey has been used extensively in many different clinical settings in Thailand
Data quality The percent of missing item-level data was low – 32 of the 36 items showed less than 1% missing (Table 1)
This paper demonstrated that psychometric properties of the Thai Social Functioning (SF)-36 were satisfactory according to the criteria set by the International Quality of Life Assessment (IQOLA) project protocol
Summary
Since its translation to Thai in 2000, the SF-36 Health Survey has been used extensively in many different clinical settings in Thailand. Its popularity has increased despite the absence of published evidence that the translated instrument satisfies scoring assumptions, the psychometric properties required for valid interpretation of the SF-36 summated ratings scales. Since its translation to Thai in 2000[1], the SF-36 Health Survey had been used extensively for assessing healthrelated quality of life (QOL) in Thai patients with a range of health conditions. Given the increasing popularity of the Thai SF-36, it is important to be assured that the psychometric properties required for valid interpretation of the SF-36 scores have been retained in the translation process
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