Abstract
BackgroundThe 12-item Short Form Health Survey (SF-12) as a shorter alternative of the SF-36 is largely used in health outcomes surveys. The aim of this study was to validate the SF-12 in Iran.MethodsA random sample of the general population aged 15 years and over living in Tehran, Iran completed the SF-12. Reliability was estimated using internal consistency and validity was assessed using known groups comparison and convergent validity. In addition, the factor structure of the questionnaire was extracted by performing both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).Results:In all, 5587 individuals were studied (2721 male and 2866 female). The mean age and formal education of the respondents were 35.1 (SD = 15.4) and 10.2 (SD = 4.4) years respectively. The results showed satisfactory internal consistency for both summary measures, that are the Physical Component Summary (PCS) and the Mental Component Summary (MCS); Cronbach's α for PCS-12 and MCS-12 was 0.73 and 0.72, respectively. Known-groups comparison showed that the SF-12 discriminated well between men and women and those who differed in age and educational status (P < 0.001). In addition, correlations between the SF-12 scales and single items showed that the physical functioning, role physical, bodily pain and general health subscales correlated higher with the PCS-12 score, while the vitality, social functioning, role emotional and mental health subscales more correlated with the MCS-12 score lending support to its good convergent validity. Finally the principal component analysis indicated a two-factor structure (physical and mental health) that jointly accounted for 57.8% of the variance. The confirmatory factory analysis also indicated a good fit to the data for the two-latent structure (physical and mental health).ConclusionIn general the findings suggest that the SF-12 is a reliable and valid measure of health related quality of life among Iranian population. However, further studies are needed to establish stronger psychometric properties for this alternative form of the SF-36 Health Survey in Iran.
Highlights
The 12-item Short Form Health Survey (SF-12) as a shorter alternative of the social functioning (SF)-36 is largely used in health outcomes surveys
Since previously we have developed the Iranian version of the SF-36 [27], the SF-12 was extracted from the SF-36 and used in this study
The mean score for the Physical Component Summary (PCS)-12 was 50.1 (SD = 8.5) and for the Mental Component Summary (MCS)-12 it was 46.3 (SD = 10.4). For both the PCS-12 and the MCS12 the percentage of respondents scoring at the lowest level and at highest level was almost nothing
Summary
The 12-item Short Form Health Survey (SF-12) as a shorter alternative of the SF-36 is largely used in health outcomes surveys. The SF-36 includes multi-item scales measuring eight health concepts: physical functioning (PF), role limitations due to physical health (RP), bodily pain, general health perception (GH), social functioning (SF), role limitations due to emotional problems (RE), vitality (VT), and mental health (MH). These eight scales are hypothesized to form two distinct clusters related to physical and mental health known as Physical Component Summary (PCS) and Mental Component Summary (MCS). The SF-12 Health Survey was developed as a shorter practical form of the questionnaire to permit its application in large health studies with focus on overall physical and mental health outcomes. Cross-cultural validation studies have shown that there were substantial correlation between the summary measures of the SF-36 and the SF-12 Health Survey [8,9]
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