Abstract
BackgroundThis study aims to evaluate data quality, scaling properties, and reliability of the Swedish RAND-36 in a general population sample and to present reference data for the Swedish population.MethodsTesting of data quality, scaling assumptions and reliability followed methods recommended for the International Quality of Life Assessment Project, previously used for psychometric testing of SF-36 and RAND-36. Data were collected via regular mail for a random stratified sample of the general population in a Swedish county. Weighted means for RAND-36 scores were used and differences by sex, age, education, and occupational groups were tested.ResultsThe response rate was 42%, and the sample comprised 3432 persons (45% men, 55% women) with a median age of 56.9 years. The internal consistency reliability was satisfactory, with Cronbach’s alphas > 0.80 for all eight scales. The percentage of missing items was low, ranging between 1.3% and 3.2%. No floor effects (≥15%) were noted, while ceiling effects were observed for physical functioning, role-functioning/physical, pain, role-functioning/emotional, and social functioning. Item–scale correlations were satisfactory (r ≥ 0.40). Correlations among the physical health scales were strong (range 0.58–0.68) as were the correlations among the mental health scales (range 0.58–0.73). Men reported significantly better health-related quality of life (HRQoL) on all scales, although the gender differences were small. Comparisons among age groups showed approximately equal scores among those 20–29, 30–39, and 40–49 years, while significant decreases in physical health were observed in the older age groups. Substantially worse physical health scores were observed in the oldest age group (80+). Significant differences among age groups were noted also for the mental health scales; however, better energy/fatigue and emotional well-being scores were seen in the older age groups, except for the oldest (80+). Those with university education reported significantly better scores on all scales compared to those with mandatory education.ConclusionsThe study suggests that the Swedish version of RAND-36 is an acceptable and reliable instrument for measuring HRQoL in the general population. The study provides reference data that can be used for norm-based comparisons.
Highlights
This study aims to evaluate data quality, scaling properties, and reliability of the Swedish RAND-36 in a general population sample and to present reference data for the Swedish population
The sample had a lower proportion of people aged 20–59 and a greater representation of people aged 60 years and older compared with the general Swedish population (Table 1)
No floor effects were noted, but ceiling effects were observed for all role-functioning/physical, pain, role-functioning/ emotional, and social functioning items, all physical functioning items except PF1, one general health item (GH2), and two emotional well-being items (EW1, emotional well-being item 2 (EW2))
Summary
This study aims to evaluate data quality, scaling properties, and reliability of the Swedish RAND-36 in a general population sample and to present reference data for the Swedish population. Scale scores for RAND-36 and SF-36v1 are identical for six of the eight scales, whereas scoring algorithms for the pain and general health scales are slightly different. A Swedish version of SF-36v1 was presented in the early 1990s [4,5,6], while a Swedish translation of RAND36 has been available since 2013 [7, 8]. A difference between them, is that algorithms for calculation of the physical and mental summary scores (PCS and MCS) obtained for the Swedish SF-36v1 [6], are not available for the Swedish RAND-36 [8]
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