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Reliability and validity of the English (Singapore) and Chinese (Singapore) versions of the Short-Form 36 version 2 in a multi-ethnic Urban Asian population in Singapore

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Abstract

Purpose

We aimed to evaluate the measurement properties of the Singapore English and Chinese versions of the Short-Form 36 version 2 (SF-36v2) Questionnaire, an improved version of the widely used SF-36, for assessing health-related quality of life (HRQoL) in a multi-ethnic urban Asian population in Singapore.

Methods

SF-36v2 scores and data on medical history, demographic and lifestyle factors from the Singapore Prospective Study Programme were analyzed. Convergent and divergent validity, internal consistency, floor and ceiling effects, known group validity and factor structure of the SF-36v2 were assessed for the English and Chinese versions, respectively.

Results

Complete data for 4,917 participants (45.8 %) out of 10,747 eligible individuals were analyzed (survey language: 4,115 English and 802 Chinese). Item-scale correlations exceeded 0.4 for all items of the English SF-36v2 and for all except one item of the Chinese SF-36v2 (bathe and dress: item-scale correlation: 0.36). In the English SF-36v2, Cronbach’s alpha exceeded 0.70 for all scales. In the Chinese SF-36v2, Cronbach’s alpha exceeded 0.7 on all scales except social functioning (Cronbach’s alpha: 0.68). For known groups validity, respondents with chronic medical conditions expectedly reported lower SF-36v2 score on most English and Chinese SF-36v2 scales. In confirmatory factor analysis, the Singapore three-component model was favored over the United States two-component and Japan three-component models.

Conclusions

The English and Chinese SF-36v2 are valid and reliable for assessing HRQoL among English and Chinese-speaking Singaporeans. Test–retest reliability and responsiveness of the English and Chinese SF-36v2 in Singapore remain to be evaluated.

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Acknowledgments

The authors would like to thank Miss Sow Wei Ting and Mr. Avjeet Singh for their assistance in typesetting the manuscript. This research is supported by the Singapore Ministry of Health’s National Medical Research Council under its Individual Research Grant (grant 0838/2004) and the Biomedical Research Council (grant 03/1/27/18/216).

Conflict of interests

  The authors declare no conflict of interests.

Author information

Authors and Affiliations

  1. Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore

    Julian Thumboo & Hwee-Lin Wee

  2. Department of Medicine, National University Health System, Singapore, Singapore

    Julian Thumboo & E-Shyong Tai

  3. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Yi Wu, E-Shyong Tai & Jeannette Lee

  4. Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA

    Barbara Gandek

  5. Epidemiology and Disease Control Division, Ministry of Health, Singapore, Singapore

    Stefan Ma & Derrick Heng

  6. Department of Pharmacy, National University of Singapore, Blk S7 Level 2 Room 5, 18 Science Drive 4, Singapore, 117543, Singapore

    Hwee-Lin Wee

Authors
  1. Julian Thumboo
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  2. Yi Wu
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  3. E-Shyong Tai
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  4. Barbara Gandek
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  5. Jeannette Lee
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  6. Stefan Ma
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  7. Derrick Heng
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  8. Hwee-Lin Wee
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Corresponding author

Correspondence to Hwee-Lin Wee.

Appendix

Appendix

See Table 6.

Table 6 Comparison of subjects who were included and not included
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Thumboo, J., Wu, Y., Tai, ES. et al. Reliability and validity of the English (Singapore) and Chinese (Singapore) versions of the Short-Form 36 version 2 in a multi-ethnic Urban Asian population in Singapore. Qual Life Res 22, 2501–2508 (2013). https://doi.org/10.1007/s11136-013-0381-1

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