Cited by 276Health Systems, Economic Evaluations, Quality of LifePsychometric Methodologies and TestingHealth Education and Validation

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The SF-36 summary scales were valid, reliable, and equivalent in a Chinese population

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Lam, Cindy L.K., Tse, Eileen Y.Y., Gandek, Barbara, Fong, Daniel Y.T.·2005·Journal of Clinical Epidemiology

DOI 10.1016/j.jclinepi.2004.12.008

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Abstract

Objectives To find out whether the SF-36 physical and mental health summary (PCS and MCS) scales are valid and equivalent in the Chinese population in Hong Kong (HK).Study design and setting The SF-36 data of a cross-sectional study on 2,410 Chinese adults randomly selected from the general population in HK were analyzed.Results The hypothesized two-factor structure of the physical and mental health summary scales (PCS and MCS) was replicated and the expected differences in scores between known morbidity groups were shown. The internal reliability coefficients of the PCS and MCS scales ranged from 0.85 to 0.87. The effect size differences between the U.S. standard and HK-specific PCS and MCS scores were mostly <0.5. The effect size differences in the standard PCS and MCS scores of specific groups between the U.S. and H.K. populations were all <0.5.Conclusion The PCS and MCS scales were applicable to the Chinese population in HK. The high level of measurement equivalence of the scales between the U.S. and H.K. populations suggests that data pooling between the two populations could be possible. To our knowledge, this is the first study to show that the SF-36 summary scales are valid and equivalent in an Asian population.

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Background
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Method
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Method
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Efficacy of Pulsed Radiofrequency to Cervical Nerve Root for Postherpetic Neuralgia in Upper Extremity
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Predictors of functional deterioration in Chinese patients with Psoriatic arthritis: a longitudinal study
Leung, Y.-Y., Ho, K. W., Li, E. K., Li, M., Kwok, L., Wong, P. C. H., Li, T. K., ZHU, T. Y., Kun, E. W. L., & Tam, L. (2014) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-15-284 · Cited by 12
Clinical observation of CT-guided intra-articular conventional radiofrequency and pulsed radiofrequency in the treatment of chronic sacroiliac joint pain
Ding, Y., Li, H., Yao, P., Hong, T., Zhao, R., & Zhao, G. (2018) · Journal of Pain Research · doi:10.2147/jpr.s179712 · Cited by 12
Rituximab for Refractory Rheumatoid Arthritis: A 24-Week Open-Label Prospective Study
Ho, L. Y., Mok, C. C., To, C. H., Mak, A., Cheung, M. Y., & Yu, K. L. (2007) · The Open Rheumatology Journal · doi:10.2174/1874312900701010001 · Cited by 12
“Quality of life was assessed by the short form (SF)-36 questionnaire (Hong Kong Chinese version) [12].”
Method
The effect of a therapeutic regimen of Traditional Chinese Medicine rehabilitation for post-stroke cognitive impairment: study protocol for a randomized controlled trial
Huang, J., Lin, Z., Wang, Q., Liu, F., Liu, J., Fang, Y., Chen, S., Zhou, X., Hong, W., Wu, J., et al. (2015) · Trials · doi:10.1186/s13063-015-0795-x · Cited by 12
“This questionnaire consists of 36 items related to physical and mental health, which are grouped in eight dimensions: physical functioning; role-physical, or the limitation in daily role functioning due to physical problems; role-emotional, or the limitation in daily role functioning due to emotional problems; bodily…”
Background
Minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture: analysis of surgical and patient-reported outcomes
Wang, X., Meng, C., Li, D., Ying, Y., Ma, Y., Fan, S., Li, X., Yang, K., Wang, B., Guan, H., et al. (2024) · International braz j urol · doi:10.1590/s1677-5538.ibju.2023.0393 · Cited by 11
Sarcopenia in people living with HIV in Hong Kong: which definition correlates with health outcomes?
Luk, F., Li, T., Ho, H. Y., Chan, Y. Y., Cheung, S. K., Wong, V., Kwok, T. C. Y., & Lui, G. C.-Y. (2022) · Journal of the International AIDS Society · doi:10.1002/jia2.25988 · Cited by 11
“Sarcopenia defined by AWGS-2014 criteria and severe sarcopenia defined by AWGS-2019 criteria were associated with problems with mobility, physical functioning domain and PCS of SF-36.”
MethodInfluential
Pulmonary valve replacement and quality-of-life assessment
Tsang, F. H. F., Wong, S. J., & Cheung, Y. (2015) · Asian Cardiovascular and Thoracic Annals · doi:10.1177/0218492315617631 · Cited by 11
“The SF36 tool has been translated and validated for Chinese adults in Hong Kong.14,15 The SF-36v2 questionnaire was administered in Cantonese by a single interviewer (SJW) to each patient before the operation and 6 months after operation in the out-patient clinic.”
MethodInfluential
Restoration of the intravertebral stability in Kümmell’s disease following the treatment of severe postmenopausal osteoporosis by 1-34PTH—a retrospective study
Gou, P., Wang, Z., Zhao, Z., Wang, Y., Jiang, Y., & Xue, Y. (2021) · Osteoporosis International · doi:10.1007/s00198-020-05761-x · Cited by 12
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Chow, P. (2021) · International Journal of Cardiology Congenital Heart Disease · doi:10.1016/j.ijcchd.2021.100279 · Cited by 15
Effects of Wab-WPPEP on post-intensive care syndrome-family in family caregivers of heart valve replacement patients: A randomized controlled trial
Xiong, J., Wu, T., Cai, H., He, J.-Y., Wang, T., Lin, X., & Li, H. (2024) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2024.103817 · Cited by 10
SF-36v2 norms and its’ discriminative properties among healthy households of tuberculosis patients in Malaysia
Atif, M., Sulaiman, S. A. S., Shafie, A. A., Asif, M., & Ahmad, N. (2012) · Quality of Life Research · doi:10.1007/s11136-012-0337-x · Cited by 10
“Standard scoring algorithms were used based on the recommendations of the developers [23] and an Asian study [32].”
BackgroundMethodResultInfluential
Efficacy of Phase 1 of Life Goals Programme on symptom reduction and mood stability for bipolar disorder
So, S. H., Mak, A. D. P., Chan, P.-S., Lo, C. C.-W., Na, S., Leung, M. H.-T., Ng, I. H.-C., Chau, A. K. C., & Lee, S. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.11.019 · Cited by 10
Human Umbilical Cord Mesenchymal Stem Cells to Treat Neuromyelitis Optica Spectrum Disorder (hUC–MSC–NMOSD): A Study Protocol for a Prospective, Multicenter, Randomized, Placebo-Controlled Clinical Trial
Yao, X., Xie, L. H., Cai, Y. C., Zhang, Y., Deng, Y., Gao, M., Wang, Y., Xu, H., Gao, W., Ding, J., et al. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.860083 · Cited by 10
“This study was supported by the National Key Research and Development Project of Stem Cell and Translational Research by the Ministry of Science and Technology (Project No. 2020YFA0113100), National Natural Science Foundation of China (Project Nos.”
MethodInfluential
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Gou, P., Zhao, Z., Yu, C., Hou, X., Gao, G., Zhang, T., & Chang, F. (2022) · Orthopaedic Surgery · doi:10.1111/os.13470 · Cited by 10
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“The validated Chinese (Hong Kong) version of SF-36 was employed in this study [15, 16].”
Method
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Gao, Q., Leung, K. L., Reinhardt, J. D., Zhang, F., Liang, Q., Chen, B., Meng, W., Lee, W. C. C., & He, H. (2015) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-2004 · Cited by 10
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He, L., Yi, C., Hak, D. J., & Hou, Z. (2019) · European Spine Journal · doi:10.1007/s00586-019-05900-x · Cited by 10
The Difference in Paraspinal Muscle Parameters and the Correlation with Health-Related Quality of Life among Healthy Individuals, Patients with Degenerative Lumbar Scoliosis and Lumbar Spinal Stenosis
Liu, Y., Yuan, L., Zeng, Y., Ni, J., & Yan, S. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13101438 · Cited by 9
“Due to the lack of data on the mainland population, this study was conducted according to the Hong Kong version [11].”
Method
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Zhou, X., Jiang, H., Zhou, Y.-P., Wang, X., Ren, H., Tian, X.-F., & Zhang, Q. (2024) · World Journal of Psychiatry · doi:10.5498/wjp.v14.i3.409 · Cited by 9
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Alfano, P., Cuttitta, G., Audino, P., Fazio, G., Grutta, S. L., Marcantonio, S., Snamid Palermo Cooperative Group, & Bucchieri, S. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11030656 · Cited by 10
“PCS and MCS were confirmed as a valid instrument for the assessment of quality of life related to physical and mental health, respectively [47], whereas SF-36 has generally been used in many studies [48,49] as a useful tool for clinical management.”
Method
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Health-related quality of life of men with primary osteoporosis and its changes after bisphosphonates treatment
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“Domains of PF, RP, BP and GH could be merged in a comprehensive index for physical functioning (physical component summary, PCS), as well as VT, SF, RE and MH could compose a comprehensive index for mental functioning (mental component summary, MCS) [26].”
Background
Assessment of the Chinese-Version SF-36 in the Chinese Opiate Addicts
Yan, S., Lian, Z., Sun, G., Bao, Y., Ge, Y., & Liu, Z. (2011) · Substance Use & Misuse · doi:10.3109/10826084.2011.589880 · Cited by 8
“This result was consistent with the findings from other studies (Buchholz, Krol, Rist, Nieuwkerk, & Schippers, 2008; Lam et al., 2005).”
Result
Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial
Yu, F.-T., Liu, C., Ni, G.-X., Cai, G., Liu, Z., Zhou, X.-Q., Ma, C.-Y., Meng, X.-L., Tu, J., Li, H., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-054566 · Cited by 11
Norms and demographic differences of the Short Form‐12 Health Survey version 2 in Chinese adolescents
Mak, K., Ho, S. Y., Fong, D., Lo, W., Lai, Y., & Lam, T. (2011) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.2010.01939.x · Cited by 8
Self-citation
Health related quality of life in Chinese pregnant women at advanced maternal age: a cross-sectional study
Gao, L., Yang, J.-P., Wang, D., & Sun, K. (2020) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2020.1788209 · Cited by 7
“The absolute scores are transformed into a score between 0 and 100, with higher scores indicating better quality of life (Lam et al., 2005).”
Background
Depression in children with nephrotic syndrome related to parents’ stress, quality of life, and depression
Huang, H., He, W., Gao, X.-Y., Sun, H., & Bao, Y. (2022) · World Journal of Pediatrics · doi:10.1007/s12519-022-00622-5 · Cited by 10
“The total SF-36 score provided a measure of the overall effect of physical and mental impairments, with higher scores indicating better quality of life [9].”
Background
Health‐related quality‐of‐life questionnaire for women with polycystic ovary syndrome: a Chinese translation and validation study
Chung, J., Kwan, A., Kwok, J. L. Y., & Chan, S. (2016) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.14217 · Cited by 7
Effects of strength‐based intervention on health outcomes of family caregivers of persons with dementia: A study protocol
Yu, D. S. F., Cheng, S., Chow, E. O.-W., Kwok, T. C. Y., & McCormack, B. G. (2020) · Journal of Advanced Nursing · doi:10.1111/jan.14470 · Cited by 7
Seven-year excess mortality, functional outcome and health status after trauma in Hong Kong
Hung, K. K. C., Rainer, T. H., Yeung, J. H. H., Cheung, C. S. K., Leung, Y. K., Leung, L. Y., Chong, K. C., Ho, H. F., Tsui, K. L., Cheung, N. K., et al. (2021) · European Journal of Trauma and Emergency Surgery · doi:10.1007/s00068-021-01714-z · Cited by 7
Medical Outcomes Study Short Form-36 (SF-36) and the World Health Organization Quality of Life (WHOQoL) Assessment: Reporting of Psychometric Validity Evidence
Chan, E. K. H., Zumbo, B., Zhang, W., Chen, M. Y., Darmawanti, I., & Mulyana, O. (2014) · Social indicators research series · doi:10.1007/978-3-319-07794-9_14 · Cited by 7
Efficacy and safety of Shi-style cervical manipulation therapy for treating acute and subacute neck pain: study protocol for a randomized controlled trial
Zhang, M., Du, G., Liu, C., Li, W., Yang, J., Chen, B., Yu, X., Xiong, Y., Jiang, E., Gao, N., et al. (2021) · Trials · doi:10.1186/s13063-021-05062-6 · Cited by 6
“The clinical observation indices were as follows: (1) cervical pain is the primary observation index, measured by NRS; secondary indices include: (2) cervical dysfunction index, measured by patient self-evaluation using cervical NDI; (3) cervical activity measurement, measured by the cervical vertebra mobility measure…”
MethodInfluential
Comparing the effects of pulsed and radiofrequency catheter ablation on quality of life, anxiety, and depression of patients with paroxysmal supraventricular tachycardia: a single-center, randomized, single-blind, standard-controlled trial
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“We used the Chinese version of the SF-36, which has established reliability and validity in Chinese population [26].”
Method
Health-related quality of life of preschool caregivers in Hong Kong
Chan, C. M. S. (2012) · Health Promotion International · doi:10.1093/heapro/das058 · Cited by 6
“(Lam et al., 2005) report that the socio-demographic characteristics of Hong Kong Chinese population in their 1999 samples closely match up with Hong Kong”
Follow Your Virtual Trainer (FYVT): a randomised controlled trial protocol of IT-based lifestyle intervention programme to promote physical activity and health among middle-aged Hong Kong Chinese
Hui, S. S., Xie, Y. J., Kwok, R. C.-W., Tam, E. W., Mak, W. W. S., & Mo, P. K. H. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-017908 · Cited by 6
“The PCS and MCS have been identified as valid and equivalent in the Chinese population in Hong Kong.34 sleep quality and quantity Sleep quality will be measured by the Chinese version of the Pittsburgh Sleep Quality Index (PSQI).35 The 19-item PSQI assesses seven dimensions of sleep quality over the past month: sleep…”
Method
Sexuality-Related Factors and Quality of Life Among Reproductive-Aged Married Female Migrant Workers: A Cross-Sectional Study in Southern China
Li, B., Liu, N., Li, B., Huang, L., Wang, X., Wu, X. Y., Fu, L., Wu, Y., Su, Z., & Wang, P. (2019) · Sexual Medicine · doi:10.1016/j.esxm.2019.06.012 · Cited by 6
“The PCS and MCS scores were calculated according to the report of Lam.21”
Method
Adjustments to amputation and artificial limb, and quality of life in lower limb amputees
Sinha, R. (2013) · University of Groningen research database (University of Groningen / Centre for Information Technology) · Cited by 6
Cognitive behavioural therapy for insomnia as an early intervention of mood disorders with comorbid insomnia: A randomized controlled trial
Chung, K., Lee, C., Au, C. W., Kam, K., Lee, C., Yeung, W., Lau, E. Y. Y., Ho, F. Y., & Ho, L. (2023) · Early Intervention in Psychiatry · doi:10.1111/eip.13435 · Cited by 6
“ISI, HADS, ESS, MFI, SF-36, DBAS, and SHPS have previously been validated in Chinese populations (Chung, 2000; Chung et al., 2011, 2014, 2016; Lam et al., 2005; Leung et al., 1999; Lin et al., 2009).”
Method

Authors: Lam, C. L. K., Tse, E. Y. Y., Gandek, B., & Fong, D. Y. T.
Affiliations: University of Hong Kong (HK)
Corresponding author: Lam, Cindy L.K.
ORCID: Lam, Cindy L.K.
Venue: Journal of Clinical Epidemiology
Publisher: Elsevier BV
Published: 2005-08
Volume: 58
Issue: 8
Pages: 815-822
ISSN: 0895-4356 (ISSN-L)
DOI: 10.1016/j.jclinepi.2004.12.008
OpenAlex: W2137450779
Cited by: 276
References: 31
Citations by year: 2026: 12 · 2025: 9 · 2024: 20 · 2023: 22 · 2022: 21 · 2021: 21 · 2020: 23 · 2019: 17 · 2018: 14 · 2017: 5 · 2016: 10 · 2015: 16 · 2014: 22 · 2013: 10 · 2012: 12
FWCI: 12.22
Type: journal article
Language: en
Open access: green
hdl.handle.net
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Clinical Epidemiology (publishedVersion)
PubMed (publishedVersion)
The HKU Scholars Hub (University of Hong Kong) (submittedVersion, cc-by-nc-nd)
Topics: Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Health Sciences › Nursing › Research and Theory › Health Education and Validation
Keywords: SF-36, physical component summary, mental component summary, measurement invariance, cross-cultural validation, Chinese adults, Hong Kong, internal consistency, factor structure, data pooling, Asian populations
MeSH terms: Adult, Aged, Algorithms, Cross-Cultural Comparison, Epidemiologic Methods, Female, Health Status Indicators, Hong Kong, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Quality of Life, United States, Asian People

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The SF-36 summary scales were valid, reliable, and equivalent in a Chinese population

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