Translation and Psychometric Evaluation of a Chinese Version of the SF-36 Health Survey in the United States

Abstract

Outcome measures are rapidly becoming standard tools in the assessment of clinical effectiveness and in the measurement of health status in populations. In this article we document the development of a self-administered Chinese version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and report the results of psychometric testing among 156 adult Chinese Americans in Boston, Massachusetts. Following the standard guidelines, a Chinese version of the SF-36 was developed through forward-backward translation techniques and committee review. We used psychometric methods to test assumptions underlying construction and scoring of scales and to evaluate the reliability and validity of the Chinese SF-36 as a measure of health status. The preliminary results indicated that missing value rates for the 36 items were consistently low. Item-discriminant validity was high (over 90% scaling successes) for six of the eight scales (Physical Functioning, Role-Physical, Bodily Pain, General Health, Role-Emotional, and Mental Health). Cronbach's alpha coefficient was above 0.70 criterion for all scales except Social Functioning. Reliability estimates also appeared to vary by sample characteristics. We discuss the implications of these findings and identify where further work will be required.