Psychometric properties of the Chinese version of the SF-36v2 in patients with severe mental illnesses in China: factor structure, reliability, and validity.

IF 3.2 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health and Quality of Life Outcomes Pub Date : 2025-03-06 DOI:10.1186/s12955-025-02350-6

Yang Wang, Xia Zhang, Jiajia Dong, Jianwen Zhu, Jie Fu, Sizhe Wang, Jinxin Li, Yue Zhang, Jianxiao Zheng, Lu Wen, Dianjiang Li, Hong Fan

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Abstract

Objective: Patients with severe mental illnesses(SMIs) often experience a diminished quality of life(QOL), and a validated tool to assess their QOL remains lacking. This study aimed to evaluate the psychometric characteristics of SF-36v2 among Chinese SMIs patients to determine its suitability for assessing their QOL.

Methods: We conducted a cross-sectional study involving 924 randomly selected SMIs patients from 23 community health centers in Nanjing, China. The reliability of the SF-36v2 was assessed by Cronbach's alpha and split-half reliability. Factor structure was examined by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Convergent validity was evaluated using average variance extracted (AVE) and composite reliability (CR).

Results: The SF-36v2 scale demonstrated good internal consistency, with a Cronbach's alpha of 0.941 and split-half reliability of 0.965. A slight ceiling effect was observed in the Social Function dimension (17.6%). CFA confirmed the acceptability of the hypothesized model, with the measurement model meeting all relevant fit metrics (X²/ df = 1.552, p < 0.05, RMR = 0.037, GFI = 0.950, AGFI = 0.942, CFI = 0.984, NFI = 0.955, RMSEA = 0.024). For each dimension, AVE > 0.5 and CR > 0.7, indicating good convergent validity of the scale. The square root of the AVE from the variables was greater than the correlation between the dimensions in the model, supporting the scale's discriminant validity. Additionally, the PCS (43.74 ± 10.28) and MCS (43.74 ± 10.28) scores of patients with SMIs were significantly lower than the Chinese general population norm (p < 0.001).

Conclusions: The SF-36v2 demonstrated robust psychometric properties, making it a reliable and valid tool for assessing QOL in SMIs patients. Its application can facilitate an objective evaluation of QOL in this population and inform treatment decisions accordingly.

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中文版SF-36v2在中国严重精神疾病患者中的心理测量特性：因素结构、信度和效度

目的：重度精神疾病（SMIs）患者经常经历生活质量（QOL）下降，并且仍然缺乏有效的评估其生活质量的工具。本研究旨在评估中国重度精神分裂症患者SF-36v2的心理测量特征，以确定其在评估其生活质量方面的适用性。方法：我们对来自中国南京23个社区卫生中心的924名随机选择的SMIs患者进行了横断面研究。SF-36v2的信度采用Cronbach's alpha和split-half信度进行评估。采用探索性因子分析（EFA）和验证性因子分析（CFA）检验因子结构。采用平均方差提取（AVE）和复合信度（CR）评估收敛效度。结果：SF-36v2量表具有良好的内部一致性，Cronbach's alpha为0.941，split-half信度为0.965。社会功能维度存在轻微的天花板效应（17.6%）。CFA证实了假设模型的可接受性，测量模型满足所有相关拟合指标（X2/ df = 1.552, p = 0.5, CR = 0.7），表明量表具有良好的收敛效度。各变量AVE的平方根大于模型中各维度之间的相关性，支持量表的区分效度。此外，重度精神分裂症患者的PCS（43.74±10.28）和MCS（43.74±10.28）得分显著低于中国普通人群的正常值(p)。结论：SF-36v2具有良好的心理测量特性，是评估重度精神分裂症患者生活质量的可靠有效工具。它的应用可以促进对这一人群生活质量的客观评价，并为相应的治疗决策提供依据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health and Quality of Life Outcomes 医学-卫生保健

CiteScore

7.30

自引率

2.80%

发文量

154

审稿时长

3-8 weeks

期刊介绍： Health and Quality of Life Outcomes is an open access, peer-reviewed, journal offering high quality articles, rapid publication and wide diffusion in the public domain. Health and Quality of Life Outcomes considers original manuscripts on the Health-Related Quality of Life (HRQOL) assessment for evaluation of medical and psychosocial interventions. It also considers approaches and studies on psychometric properties of HRQOL and patient reported outcome measures, including cultural validation of instruments if they provide information about the impact of interventions. The journal publishes study protocols and reviews summarising the present state of knowledge concerning a particular aspect of HRQOL and patient reported outcome measures. Reviews should generally follow systematic review methodology. Comments on articles and letters to the editor are welcome.