Skip to main content
Log in

Performance of the Swedish SF-36 version 2.0

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Objectives: To evaluate the performance of the first non-English (Swedish) SF-36 version 2.0 (V2) regarding scaling assumptions, reliability and validity, with special emphasis on the effects of extending the response scales of the two role functioning scales, role physical (RP) and role emotional (RE), from a dichotomous to a five-step format. Methods: Questionnaires were mailed to a non-stratified, random national sample of 3000 18–75 year old Swedish residents in 1998–1999. Methods traditionally used in evaluating the original US SF-36 version 1.0 (V1) and other international versions were applied. Results: A total of 73% of the questionnaires were returned. Scaling assumptions were satisfactorily met and generally enhanced compared with V1, particularly regarding the role functioning scales. Floor/ceiling effects were reduced and reliability estimates increased for the role scales. The factor structure was replicated and the relative validity of the role scales as measures of their components increased. Overall, the tests of the criterion-based validity using known groups comparisons produced results supporting hypotheses: scales from the physical domain distinguished best between groups expected to differ in physical health; and scales comprising the mental domain distinguished best between groups expected to differ in mental health. Furthermore, hypothesized differences in mean scale scores as a function of age and social risk factors were confirmed. Conclusions: The changes to the response formats of the role functioning scales have improved their precision, reliability and validity without jeopardizing the underlying structure of the original SF-36. These changes will likely further enhance the responsiveness of the SF-36.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Ware JE, Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol 1998; 51(11): 903-912.

    Google Scholar 

  2. Shiely J-C, Bayliss MS, Keller SD, et al. SF-36 Health Survey Annotated Bibliography. Boston, MA: The Health Institute, 1996.

    Google Scholar 

  3. Tsai C, Ware JE, Bayliss MS. SF-36 Health Survey Annotated Bibliography. 1996 Supplement. Boston, MA: The Health Assessment Lab, 1997.

    Google Scholar 

  4. Ware JE, Kosinski M, Dewey JE. How to score Version Two of the SF-36® Health Survey. Lincoln, RI: QualityMetric Inc., 2000.

    Google Scholar 

  5. Jenkinson C, Stewart-Brown S, Petersen S, et al. Assessment of the SF-36 version 2 in the United Kingdom. J Epidemiol Commun Health 1999; 53: 46-50.

    Google Scholar 

  6. Gandek B, Ware JE, Aaronson NK, et al. Tests of data quality, scaling assumptions, and reliability of the SF-36 in eleven countries: Results from the IQOLA Project. J Clin Epidemiol 1998; 51(11): 1149-1158.

    Google Scholar 

  7. Hays RD, Hayashi T, Carson S, et al. User's Guide for the Multitrait Analysis Program (MAP). Santa Monica, CA: RAND Corporation, 1998; N-2876-RC.

    Google Scholar 

  8. Ware JE, Harris WJ, Gandek B, et al. MAR-R for Windows: Multitrait/Multi-item Analysis Program-Revised User's Guide. Boston, MA: Health Assessment Lab, 1997.

    Google Scholar 

  9. Stewart AL, Ware JE. Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992.

    Google Scholar 

  10. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika 1951; 16: 297-334.

    Google Scholar 

  11. Ware JE, Gandek B. Methods for testing data quality, scaling assumptions, and reliability: The IQOLA Project approach. J Clin Epidemiol 1998; 51(11): 945-952.

    Google Scholar 

  12. McHorney CA, Ware JE, Lu JFR, et al. The MOS 36-Item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994; 32: 40-66.

    Google Scholar 

  13. Sullivan M, Karlsson J, Ware JE. SF-36 Hälsoenkät: Svensk Manual och Tolknings guide. (Swedish SF-36 Manual and Interpretation Guide.) Gothenburg: Sahlgrenska University Hospital, 1994.

    Google Scholar 

  14. Persson LO, Karlsson J, Bengtsson C, Steen B, Sullivan M. The Swedish SF-36 health survey II. Evaluation of clinical validity: Results from population studies of elderly and women in Gothenborg. J Clin Epidemiol 1998; 51(11): 1095-1103.

    Google Scholar 

  15. Sullivan M, Karlsson J, Ware JE. The Swedish SF-36 health survey: I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med 1995; 41: 1349-1358.

    Google Scholar 

  16. Sullivan M, Karlsson J. The Swedish SF-36 health survey III. Evaluation of criterion-based validity: Results from normative population. J Clin Epidemiol 1998; 51(11): 1105-1113.

    Google Scholar 

  17. Kerlinger FN. Foundations of Behavioral Research. NY: Holt, Rinehart & Winston, 1973.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Taft, C., Karlsson, J. & Sullivan, M. Performance of the Swedish SF-36 version 2.0. Qual Life Res 13, 251–256 (2004). https://doi.org/10.1023/B:QURE.0000015290.76254.a5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:QURE.0000015290.76254.a5

Navigation