Elsevier

Journal of Clinical Epidemiology

Volume 61, Issue 12, December 2008, Pages 1279-1284.e6
Journal of Clinical Epidemiology

Original Article
The Argentine–Spanish SF-36 Health Survey was successfully validated for local outcome research

https://doi.org/10.1016/j.jclinepi.2008.05.004Get rights and content

Abstract

Objective

To evaluate psychometric properties of the Argentine–Spanish SF-36 and to validate the physical component summary (PCS) and mental component summary (MCS) measures.

Study Design and Setting

A self-administration of the SF-36 with 1-year follow-up was performed in a University-based ambulatory center in Buenos Aires. Diagnoses were abstracted from the chart. Univariate analysis, psychometric methods, and confirmatory factor analyses were conducted.

Results

Of 3,290 subjects, 2,638 had computable scores and were included: 1,938 at their initial contact and 700 from a random sample of other enrollees. Cronbach's alpha ranged from 0.79 to 0.92 in all subscales except for General Health. Age was related to PCS scores (lower in the elderly) but not to MCS scores. PCS and MCS provided good discrimination among mutually exclusive disease categories; minor medical (52.2 vs. 51.1), psychosocial (48.1 vs. 43.0), chronic medical (46.2 vs. 51.0) and both chronic and mental conditions (44.9 vs. 45.1) in PCS and MCS, respectively (P < 0.01). Mean annual doctor visits increased from 3.6 to 5.3 in subjects with PCS > 55 and PCS < 35, and from 4.4 to 6.0 in subjects with MCS > 55 and MCS < 35, respectively (P < 0.0001).

Conclusions

SF-36 is a valid tool for outcome research in Argentina although normative general population studies are needed.

Section snippets

Background

What is new?

Key findings

  1. This study shows that the SF-36 was a valid tool for outcome research in Argentina.

What this adds to what was known

  1. Although the SF-36 is perhaps the most widely used Patient Reported Outcome instrument worldwide, there have been very few formal validation studies in Latin America, and none in Argentina.

What is the implication, what should change now

  1. These results might contribute to a wider use of the SF-36 in Argentina and other Spanish-speaking countries of the region, though normative studies on the general population are still needed.

There is an increasing

Methods

This study was approved by the Hospital Italiano IRB, and it was undertaken on an adult population of a large university-based ambulatory care center serving a population of 60,000 adults. The SF-36 Argentine–Spanish version was self-administered to a sample composed of two subgroups of subjects: consecutive individuals who made the first routine visit after HMO enrollment, and a random sample of subjects with at least 1 year of enrollment. To test the empirical validity of the instrument, we

Results

From a total of 3,290 subjects recruited during the last trimester of 2002, 80% (N = 2,638) had all computable scales and are the subject of this report regarding MCS and PCS (1,938 at the first visit to their doctor and 700 from a random sample of enrollees, see study chart Fig. 1). The mean age was 41.4 years (SD = 14.77), 61.3% were women, 55.8% were married, and 76.7% had more than 7 years of education. Domain scores (mean, SD) were the following (transformed to a 0–100 scale): PF 89.07

Discussion

Although generic health status measures such as the SF-36 are well established for outcome measurement in many countries [1], [3], [4], [5], [6], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], its crosscultural adaptation is critical to be able to use and interpret their results in a local setting [30], [31], [32].

We used the Argentine–Spanish version of the SF-36 developed by IQOLA in a large HMO adult sample. Our psychometric features were in agreement with

Conclusions

The Argentine–Spanish version of the SF-36 was shown to be a valid and reliable tool for outcome research in our country. This is the first large study conducted in Argentina, and one of the largest in Spanish-speaking countries. The SF-36 scale and its summary measures showed both psychometric and clinical validities with similar general results as the other developed and a few developing countries where it has been studied up to the present. The results support the use of the SF-36 survey for

Acknowledgments

We thank Barbara Gandek, M.S., for providing the translated version, SF-36 scoring algorithms, and advice on data analysis. We also acknowledge the Health Assessment Lab, Boston, and The Institute of Clinical Research and Health Policy Studies, and Tufts-New England Medical Center.

References (32)

  • R.W. Evans et al.

    The quality of life of patients with end-stage renal disease

    N Engl J Med

    (1985)
  • D.R. Nerenz et al.

    Ongoing assessment of health status in patients with diabetes mellitus

    Med Care

    (1992)
  • P.H. Rockey et al.

    Behavioral dysfunction on hyperthyroidism: improvement with treatment

    Arch Intern Med

    (1980)
  • J.E. Ware et al.

    SF-36 physical and mental health summary scales: a user's manual

    (1994)
  • J. Alonso et al.

    La versión española del ‘SF-36® Health Survey’ (Cuestionairo de Salud SF-36®): un instrumento para la medida de los resultados clínicos

    Med Clin (Barc)

    (1995)
  • L. Duran-Arenas et al.

    Salud Publica Mex

    (2004)

    • Cited by (0)

    Granting Institution: Servicio de Medicina Familiar y Comunitaria, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

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