Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations
Abstract
The primary objectives of this research were to translate, validate, and generate normative data on the SF-36 Health Survey for use among Dutch-speaking residents of the Netherlands. Translation of the SF-36 into Dutch followed the stepwise, iterative procedures developed by the IQOLA Project. Following extensive pilot testing, the SF-36 was administered to: (1) a random sample of adult residents of Amsterdam (n = 4172); (2) a random, nationwide sample of adults (n = 1742); (3) a sample of migraine sufferers (n = 423); and (4) a sample of cancer patients undergoing active anti-neoplastic treatment (n = 485). Data quality across the four studies was consistently high. The rates of missing data ranged from 1% to 5% at the item level, and from 1.2% to 2.6% at the scale level. Multitrait scaling analysis confirmed the hypothesized scale structure of the SF-36 and associated scale scoring in all four samples. Cronbach's alpha coefficients surpassed the 0.70 criterion for group comparisons in all but one case (the Social Functioning scale in the cancer sample), with a mean alpha coefficient across all scales and samples of 0.84. Known-group comparisons yielded consistent support for the validity of the SF-36. In the two community samples, statistically significant differences in SF-36 mean scale scores were observed as a function of age, gender, and the prevalence of chronic health conditions. In the migraine and cancer samples, mean SF-36 scale scores varied significantly as a function of various indicators of disease severity. The SF-36 profiles for the two community samples were highly similar. The cancer sample yielded the lowest SF-36 scores, with the migraine sample holding an intermediate position. On-going studies will generate data on the responsiveness of the SF-36 to within-group changes in health over time. Efforts are underway to translate and validate the questionnaire for use among ethnic minority groups in the Netherlands.
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The questionnaires used to operationalize the outcome domains have adequate to good psychometric properties.
“We operationalized these outcome domains using the most relevant scales of various questionnaires administered in the DCCSS-LATER 2 study (Table S1), which have adequate to good psychometric properties [15, 19-25].”
From Risk and Protective Factors of Psychosocial Functioning in Survivors of Childhood Cancer: Results of the DCCSS-LATER Study (2024) · cites this paper as [22]
The SF-36 has confirmed validity and reliability.
“Studies confirmed the SF-36's validity and reliability (44–46).”
The SF-36 is a reliable and valid instrument with a Cronbach's alpha coefficient of 0.90.
“The SF-36 is a reliable and valid instrument with a Cronbach's alpha coefficient of 0.90 [42-43].”
From Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism. (2013) · cites this paper as [43]
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“➢ Short Form 36 (SF‐36) [22] of which the scale general health perceptions was used (range 0–100).”
ACT with Pain : measurement, efficacy and mechanisms of Acceptance & Commitment Therapy
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- Authors
- Aaronson, N. K., Muller, M., Cohen, P. D. A., Essink-Bot, M.-L., Fekkes, M., Sanderman, R., Sprangers, M. A. G., te Velde, A., & Verrips, E.
- Affiliations
- The Netherlands Cancer Institute (NL)
- University of Amsterdam (NL)
- Netherlands Organisation for Applied Scientific Research (NL)
- University of Groningen (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Aaronson, Neil K.
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 1998-11
- Volume
- 51
- Issue
- 11
- Pages
- 1055-1068
- ISSN
- 0895-4356 (ISSN-L)
- OpenAlex
- W2102471539
- Cited by
- 2,276
- References
- 41
- Citations by year
- 2026: 31 · 2025: 54 · 2024: 97 · 2023: 93 · 2022: 80 · 2021: 105 · 2020: 88 · 2019: 99 · 2018: 112 · 2017: 106 · 2016: 115 · 2015: 120 · 2014: 121 · 2013: 124 · 2012: 104
- FWCI
- 40.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- TNO Repository (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Repository hosted by TU Delft Library (TU Delft) (submittedVersion)
- 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
- Social Sciences › Education › Health Education and Validation
- Keywords
- SF-36, health-related quality of life, Dutch translation, cross-cultural adaptation, reference values, migraine, cancer patients, chronic disease, community population, known-groups validity, scale structure, disease severity
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Cross-Cultural Comparison, Female, Health Status Indicators, Humans, Male, Middle Aged, Netherlands, Quality of Life, Surveys and Questionnaires, Translations, Reproducibility of Results
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