How useful are the SF-36 sub-scales in older people? Mokken scaling of data from the HALCyon programme

Mishra, Gita D., Gale, Catherine R., Sayer, Avan Aihie, Cooper, Cyrus, Dennison, Elaine M., Whalley, Lawrence J., Craig, Leone, Kuh, Diana, Deary, Ian J. and HALCyon Study Team (2011) How useful are the SF-36 sub-scales in older people? Mokken scaling of data from the HALCyon programme. Quality of Life Research, 20 7: 1005-1010. doi:10.1007/s11136-010-9838-7

Author Mishra, Gita D.
Gale, Catherine R.
Sayer, Avan Aihie
Cooper, Cyrus
Dennison, Elaine M.
Whalley, Lawrence J.
Craig, Leone
Kuh, Diana
Deary, Ian J.
HALCyon Study Team
Title How useful are the SF-36 sub-scales in older people? Mokken scaling of data from the HALCyon programme
Journal name Quality of Life Research   Check publisher's open access policy
ISSN 0962-9343
Publication date 2011-09-01
Sub-type Article (original research)
DOI 10.1007/s11136-010-9838-7
Volume 20
Issue 7
Start page 1005
End page 1010
Total pages 6
Place of publication Dordrecht, The Netherlands
Publisher Springer Netherlands
Language eng
Formatted abstract
Purpose To evaluate two psychometric properties of SF-36, namely unidimensionality and reliability.
Methods The data are from three cohorts in the HALCyon collaborative research programme into healthy ageing:Aberdeen Birth Cohort 1936 (n = 428), Hertfordshire
Ageing Study (n = 358) and Hertfordshire Cohort Study (n = 3,216). The Mokken scaling model was applied to each sub-scale of SF-36 to evaluate unidimensionality as indicated by scalability. The lower bound for internal consistency reliability was determined by Cronbach’s
Results All six sub-scales of SF-36, with the exception of general health (GH) and mental health (MH), demonstrated strong scalability (0.5 B H\1). The results were consistent across all 3 cohorts. Both GH and MH showed medium scalability (0.4 B H\0.55), although individual items ‘sick easier..’, ‘as healthy as..’ and ‘expect to get worse’ of the GH sub-scale and ‘nervous’, ‘happy’ in the MH subscale
had low scalability (H\0.4) in the oldest cohort (aged 73–83). Cronbach’s alphas for all sub-scales were between 0.70 and 0.92.
Conclusions The unidimensionality and reliability of the sub-scales of SF-36 are sufficient to make this a useful measure of health-related quality of life in older people.
Caution is needed when interpreting the results for GH and MH in the oldest cohort due to the poor unidimensionality.
Keyword Sf-36
Psychometric properties
Cronbach's alpha
Mokken scaling
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status Non-UQ
Additional Notes Published online: 12 January 2011

Document type: Journal Article
Sub-type: Article (original research)
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