Reliability and validity testing of the revised 12-item Short-Form Health Survey in older adults

Resnick, Barbara; Nahm, Eun S.

doi:10.1891/1061-3749.9.2.151

Cited by 255Health Systems, Economic Evaluations, Quality of LifePsychometric Methodologies and TestingHealth Education and Validation

Reliability and validity testing of the revised 12-item Short-Form Health Survey in older adults

Resnick, Barbara, Nahm, Eun S.·2001·Journal of Nursing Measurement

DOI 10.1891/1061-3749.9.2.151

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Abstract

The SF-12 Short Form Health Survey was developed to describe mental and physical health status of adults, and to measure the outcomes of health care services. The purpose of this study was to test the reliability and validity of this measure in a sample of 185 older adults living in a continuing care retirement community. The mean age of the participants was 86 + 6.1 and the majority were female (82%), unmarried (82%), Caucasian (99%), and all had at least a high school education. Initial testing of the SF-12 measurement model as proposed by Ware, Kosinski, and Keller (1995) demonstrated that the model did not fit the data (chi-squared/df = 7.8). The model was revised based on modification indices and the revised model provided evidence of reliability (alpha coefficients of .70, and .89; the majority of the R2 values were greater than .50), and validity as there was improved fit of the model to the data (chi 2 difference of 123, df difference of 1.0, p < .05). There was also evidence of construct validity, based on hypothesis testing, with a statistically significant correlation between physical health and number of chronic illnesses (r = .33, p < .05) and mental health and chronic illnesses (r = .27, p < .05), and a statistically significant difference in physical health (F = 30.5, p < .05) and mental health (F = 18.5, p < .05) between those who exercise regularly and those who do not. The revised SF-12 is a reliable and valid measure of health status in independent living o…

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The SF-12 PCS has adequate reliability and validity in older adults.
“Adequate reliability and validity of the SF-12 PCS have been demonstrated in older adults (Resnick & Nahm, 2001).”
From Cognitive-behavioral therapy for late-life anxiety: Similarities and differences between Veteran and community participants (2015) · cites this paper as Resnick & Nahm, 2001

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The Effectiveness of a Proactive Multicomponent Intervention Program on Disability in Independently Living Older People: A Randomized Controlled Trial
van Lieshout, M.-R. J., Bleijenberg, N., Schuurmans, M. J., & de Wit, N. J. (2018) · The journal of nutrition health & aging · doi:10.1007/s12603-018-1101-x · Cited by 40 · see citing works
Quality of life after curative liver resection: A single center analysis
Bruns, H. (2010) · World Journal of Gastroenterology · doi:10.3748/wjg.v16.i19.2388 · Cited by 40 · see citing works
Physical Activity, Obesity, Nutritional Health and Quality of Life in Low-Income Hispanic Adults With Diabetes
Hu, J., Wallace, D. C., & Tesh, A. S. (2010) · Journal of Community Health Nursing · doi:10.1080/07370011003704933 · Cited by 39 · see citing works
“The SF-12 has demonstrated good internal-consistency reliability, with alpha coefficients on the components ranging from =.72 to =.89 (Parker, 2001; Resnick & Nahm, 2001), and it has been used with both genders, and multiple age and ethnic populations in a variety of settings.”
Perceived discrimination and mental health among older African Americans: the role of psychological well-being
Yoon, E., Coburn, C., & Spence, S. A. (2018) · Aging & Mental Health · doi:10.1080/13607863.2017.1423034 · Cited by 39 · see citing works
“Both MCS-36 and MCS12 have indicated very good correlation and agreement in the general population (Ware, Kosinski, & Keller, 1994), the elderly (Resnick & Nahm, 2001), and some specific populations (Lacson et al., 2010).”
Background
Beyond memory problems: multiple obstacles to health and quality of life in older people seeking help for subjective memory complaints
Rotenberg, S., Sternberg, S. A., & Maeir, A. (2017) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1370729 · Cited by 38 · see citing works
“33), and a significant difference between the two scales [43] among older adults.”
BackgroundMethod
The Impact of a Short-Term Iyengar Yoga Program on the Health and Well-Being of Physically Inactive Older Adults
Vogler, J., O’Hara, L., Gregg, J., & Burnell, F. (2011) · International Journal of Yoga Therapy · doi:10.17761/ijyt.21.1.e15852u665l710r1 · Cited by 37 · see citing works
Physical and psychological effects of Qigong exercise in community-dwelling older adults: An exploratory study
Chang, P., Knobf, M. T., Oh, B., & Funk, M. (2017) · Geriatric Nursing · doi:10.1016/j.gerinurse.2017.07.004 · Cited by 37 · see citing works
Multilevel Examination of Facility Characteristics, Social Integration, and Health for Older Adults Living in Nursing Homes
Leedahl, S. N., Chapin, R. K., & Little, T. D. (2014) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbu112 · Cited by 37 · see citing works
“This study used the physical health and mental health scale scores as suggested by Cernin, Cresci, Jankowski, and Lichtenberg (2010) and Resnick and Nahm (2001).”
Method
Functional outcomes of acutely infected knee arthroplasty: a comparison of different surgical treatment options
Dzaja, I., Howard, J. L., Somerville, L. E., & Lanting, B. A. (2015) · Canadian Journal of Surgery · doi:10.1503/cjs.017614 · Cited by 37 · see citing works
Care satisfaction among older people receiving public care and service at home or in special accommodation
Karlsson, S., Edberg, A., Jakobsson, U., & Hallberg, I. R. (2013) · Journal of Clinical Nursing · doi:10.1111/jocn.12115 · Cited by 36 · see citing works
“The SF-12 is preferable to the longer version for use among older people because it contains fewer questions, which makes it easier to answer, and because questions about work are excluded (Resnick & Nahm 2001).”
Method
Five- to 8-Year Results of the Uncemented Duracon Total Knee Arthroplasty System
Chana, R., Shenava, Y., Nicholl, A. P., Lusted, F. J., Skinner, P. W., & Gibb, P. A. (2008) · The Journal of Arthroplasty · doi:10.1016/j.arth.2007.06.002 · Cited by 36 · see citing works
“Clinical and functional assessment was performed at each of these visits using the Knee Society Score (KSS) [1], SF-12 Health Status Questionnaire [2], and Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) [3].”
Method
Physical activity and quality of life after colorectal cancer: overview of evidence and future directions
Lynch, B. M., van Roekel, E. H., & Vallance, J. K. (2016) · Expert Review of Quality of Life in Cancer Care · doi:10.1080/23809000.2016.1129902 · Cited by 35 · see citing works
“Physical activity is being assessed via accelerometer, and quality of life is being assessed via both generic (SF-12) [51] and disease-specific measures (FACT-C).”
Method
Health promotion practices of older adults: testing an individualized approach
Resnick, B. M. (2002) · Journal of Clinical Nursing · doi:10.1046/j.1365-2702.2003.00700.x · Cited by 34 · see citing works
Self-citation
The prevalence of hearing impairment and its burden on the quality of life among adults with Medicare Supplement Insurance
Hawkins, K., Bottone, F. G., Ozminkowski, R. J., Musich, S. A., Bai, M., Migliori, R. J., & Yeh, C. S. (2011) · Quality of Life Research · doi:10.1007/s11136-011-0028-z · Cited by 33 · see citing works
“The VR12 is widely used, and its use has been validated with older adult populations [29–31].”
Method
The Mind Body-Wellness in Supportive Housing (Mi-WiSH) study: Design and rationale of a cluster randomized controlled trial of Tai Chi in senior housing
Wayne, P. M., Gagnon, M. M., Macklin, E. A., Travison, T. G., Manor, B., Lachman, M. E., Thomas, C. P., & Lipsitz, L. A. (2017) · Contemporary Clinical Trials · doi:10.1016/j.cct.2017.07.005 · Cited by 32 · see citing works
“89) within numerous elderly populations, including community-dwelling older adults[65, 66], minorities[67] and those with physical[68] and mental[69] disabilities.”
Background
Effects of a behavioral medicine intervention on pain, health, and behavior among community-dwelling older adults: a randomized controlled trial
Cederbom, S., Leveille, S. G., & Bergland, A. (2019) · Clinical Interventions in Aging · doi:10.2147/cia.s208102 · Cited by 32 · see citing works
“The PCS and MCS are scored using norm-based standards and transformed so that the general population has a mean of 50 and a SD of 10.(48) 5F-12 has reported to be valid for use among older individuals.”
BackgroundMethod
A population-based study of asthma, quality of life, and occupation among elderly Hispanic and non-Hispanic whites: a cross-sectional investigation
Arif, A. A., Rohrer, J. E., & Delclos, G. L. (2005) · BMC Public Health · doi:10.1186/1471-2458-5-97 · Cited by 32 · see citing works
“The SF-12, an abbreviated version of the SF-36, is commonly included in populationbased studies to assess perceived health status [19], and its use has been validated in studies of older persons [20] and in clinical and community settings [21].”
Background
Frail older adults with minor fractures show lower health-related quality of life (SF-12) scores up to six months following emergency department discharge
On behalf of the Canadian Emergency Team Initiative on Mobility in Aging, Provencher, V., Sirois, M., Émond, M., Perry, J. J., Daoust, R., Lee, J. S., Griffith, L. E., Batomen, B., Despeignes, L. R., et al. (2016) · Health and Quality of Life Outcomes · doi:10.1186/s12955-016-0441-7 · Cited by 32 · see citing works
“This tool has been shown to be a reliable and valid measure of health status in older adults living independently [20].”
Method
The Role of Caregiver Burden in Understanding African American Custodial Grandmothers
Carr, G. F., Hayslip, B., & Gray, J. (2012) · Geriatric Nursing · doi:10.1016/j.gerinurse.2012.03.004 · Cited by 31 · see citing works
Evaluating Task Modification as an Objective Measure of Functional Limitation: Repeatability and Comparability
Manini, T. M., Cook, S. B., VanArnam, T., Marko, M., & Ploutz‐Snyder, L. L. (2006) · The Journals of Gerontology Series A · doi:10.1093/gerona/61.7.718 · Cited by 31 · see citing works
“—Self-reported physical function and the physical composite score were documented via the SF-12 version 2 survey (18).”
Method
Trauma-Related Sleep Problems and Associated Health Outcomes in Police Officers: A Path Analysis
Chopko, B. A., Palmieri, P. A., & Adams, R. E. (2018) · Journal of Interpersonal Violence · doi:10.1177/0886260518767912 · Cited by 31 · see citing works
“The RAND 36-Item Health Survey has been demonstrated to possess sound psychometric properties as a measure of overall health (Resnick & Nahm, 2001).”
Method
Physical and psychological states interfere with health-related quality of life of institutionalized elderly: a cross-sectional study
Farias, I. P. S. E., Montenegro, L. D. A. S., Wanderley, R. L., de Pontes, J. C. X., Pereira, A. C., de Almeida, L. D. F. D., & Cavalcanti, Y. W. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01791-6 · Cited by 30 · see citing works
Effects of a tailor-made exercise program on exercise adherence and health outcomes in patients with knee osteoarthritis: a mixed-methods pilot study
Lee, F.-K. I., Lee, T.-F. D., & So, W. K. W. (2016) · Clinical Interventions in Aging · doi:10.2147/cia.s111002 · Cited by 30 · see citing works
A review of screening, assessment and outcome measures for drug and alcohol settings.
Deady, M. (2009) · Cited by 30 · see citing works
Functional Outcomes of Infected Hip Arthroplasty: A Comparison of Different Surgical Treatment Options
Herman, B. V., Nyland, M. A., Somerville, L. E., MacDonald, S. J., Lanting, B. A., & Howard, J. L. (2016) · Hip International · doi:10.5301/hipint.5000455 · Cited by 29 · see citing works
Sarcopenia Prevalence and Risk Factors among Residents in Aged Care
Darroch, P., O’Brien, W. J., Mazahery, H., & Wham, C. A. (2022) · Nutrients · doi:10.3390/nu14091837 · Cited by 29 · see citing works
“The SF-12 has been validated for the older adult population, with significant correlations between physical and mental health and number of chronic illnesses [25].”
Method
Cognitive-behavioral therapy for late-life anxiety: Similarities and differences between Veteran and community participants
Barrera, T. L., Cully, J. A., Amspoker, A. B., Wilson, N. L., Kraus-Schuman, C., Wagener, P. D., Calleo, J. S., Teng, E. J., Rhoades, H. M., Masozera, N., et al. (2015) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2015.04.005 · Cited by 28 · see citing works
“Adequate reliability and validity of the SF-12 PCS have been demonstrated in older adults (Resnick & Nahm, 2001).”
Background
Psychometric Characteristics of the Self-Care of Chronic Illness Inventory in Older Adults Living in a Middle-Income Country
Arapi, A., Vellone, E., Ivziku, D., Duka, B., Taҫi, D., Notarnicola, I., Stievano, A., Prendi, E., Rocco, G., & Maria, M. D. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20064714 · Cited by 28 · see citing works
Outcomes of bone morphogenetic protein-2 in mature adults: posterolateral non–instrument-assisted lumbar decompression and fusion
Hamilton, D. K., Jones-Quaidoo, S. M., Sansur, C. A., Shaffrey, C. I., Oskouian, R. J., & Jane, J. A. (2008) · Surgical Neurology · doi:10.1016/j.surneu.2007.09.008 · Cited by 28 · see citing works
Sleep complaints and their association with comorbidity and health-related quality of life in an older population in Sweden
Fagerström, C., & Hellström, A. (2010) · Aging & Mental Health · doi:10.1080/13607863.2010.513039 · Cited by 28 · see citing works
“SF-12 has been found to have an acceptable internal consistency when looking at different older age groups (Resnick & Nahm, 2001).”
Background
Increasing exercise frequency is associated with health and quality-of-life benefits for older adults
Kell, K. P., & Rula, E. Y. (2019) · Quality of Life Research · doi:10.1007/s11136-019-02264-z · Cited by 28 · see citing works
Biopsychosocial characteristics of overweight and obese primary care patients: do psychosocial and behavior factors mediate sociodemographic effects?
Baughman, K. R., Logue, E. E., Sutton, K., Capers, C. F., Jarjoura, D. G., & Smucker, W. D. (2003) · Preventive Medicine · doi:10.1016/s0091-7435(03)00095-1 · Cited by 28 · see citing works
Physical activity in relation to quality of life in newly diagnosed colon cancer patients: a 24-month follow-up
Tsinovoi, C. L., Xun, P., & He, K. (2014) · Quality of Life Research · doi:10.1007/s11136-014-0679-7 · Cited by 26 · see citing works
“Additionally, racial disparities have been found in pain perception, treatment, and assessment across all clinical settings (i.e., emergency room, outpatient) and all categories of pain (i.e., chronic, acute, cancer-related) [65]; this might help explain the moderation of race on the association between vigorous exerc…”
MethodInfluential
Evaluating Walking Intensity with Hip-Worn Accelerometers in Elders
Corbett, D. B., Valiani, V., Knaggs, J. D., & Manini, T. M. (2016) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001018 · Cited by 26 · see citing works
Occupation-focused health promotion for well older people — A cost-effectiveness analysis
Zingmark, M., Nilsson, I., Fisher, A. G., & Lindholm, L. H. (2015) · British Journal of Occupational Therapy · doi:10.1177/0308022615609623 · Cited by 26 · see citing works
“The SF-12, developed from the SF-36, has established validity and reliability for use with older populations (Resnick and Nahm, 2001) and has similar responsiveness to change as does the SF-36 (Muller-Nordhorn et al., 2004).”
Method
The challenge of validating SF-12 for its use with community-dwelling elderly in Israel
Bentur, N., & King, Y. (2009) · Quality of Life Research · doi:10.1007/s11136-009-9562-3 · Cited by 26 · see citing works
“These psychometric properties are in concordance with Resnick and Nahm [25], who studied the validity of SF-12 and Peek et al.”
BackgroundResult
Reliance on God’s Help as a Measure of Intrinsic Religiosity in Healthy Elderly and Patients with Chronic Diseases. Correlations with Health-Related Quality of Life?
Büssing, A., Fischer, J., Ostermann, T., & Matthiessen, P. F. (2009) · Applied Research in Quality of Life · doi:10.1007/s11482-009-9068-8 · Cited by 25 · see citing works

Simplified scoring and psychometrics of the revised 12-item Short-Form Health Survey.
Resnick, B. M., & Parker, R. (2002) · PubMed · Cited by 96 · see citing works
Self-citation
Reliability and Validity Testing of the Short-Form Health Survey in a Sample of Community-Dwelling African American Older Adults
Cernin, P. A., Cresci, K., Jankowski, T. B., & Lichtenberg, P. A. (2010) · Journal of Nursing Measurement · doi:10.1891/1061-3749.18.1.49 · Cited by 40 · see citing works
The Reliability and Validity of Short Form-12 Health Survey Version 2 for Chinese Older Adults
Su, S., & Wang, D. (2020) · Iranian Journal of Public Health · doi:10.18502/ijph.v48i6.2898 · Cited by 23 · see citing works
Reliability and validity of 12-item Short-Form health survey (SF-12) for the health status of Chinese community elderly population in Xujiahui district of Shanghai
Shou, J., Ren, L., Wang, H., Yan, F., Cao, X., Wang, H., Wang, Z., Zhu, S., & Liu, Y. (2015) · Aging Clinical and Experimental Research · doi:10.1007/s40520-015-0401-9 · Cited by 114 · see citing works
PNS59 Reliability and Validity of the SF-12V2 Health-Related Quality of Life Survey and Disutilities Associated with Relevant Conditions in the U.S. Older Adult Population
Shah, C. H., & Brown, J. D. (2020) · Value in Health Regional Issues · doi:10.1016/j.vhri.2020.07.478

Authors: Resnick, B., & Nahm, E. S.
Affiliations: University of Maryland, College Park (US)
ORCID: Resnick, Barbara
Nahm, Eun S.
Venue: Journal of Nursing Measurement
Publisher: Springer Publishing Company
Published: 2001-09
Volume: 9
Issue: 2
Pages: 151-161
ISSN: 1061-3749 (ISSN-L)
1945-7049
DOI: 10.1891/1061-3749.9.2.151
OpenAlex: W149961092
Cited by: 255
References: 0
Citations by year: 2026: 2 · 2025: 7 · 2024: 5 · 2023: 8 · 2022: 10 · 2021: 20 · 2020: 17 · 2019: 14 · 2018: 8 · 2017: 19 · 2016: 15 · 2015: 10 · 2014: 18 · 2013: 9 · 2012: 11
FWCI: 11.79
Type: journal article
Language: en
Open access: closed
Locations: Journal of Nursing Measurement (publishedVersion)
PubMed (publishedVersion)
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: older adults, reliability statistics, validity, health status measurement, model revision, construct validity, chronic disease, physical health, mental health, physical activity, continuing care retirement communities, independent living
MeSH terms: Activities of Daily Living, Aged, Aged, 80 and over, Analysis of Variance, Chronic Disease, Factor Analysis, Statistical, Female, Health Status, Health Surveys, Humans, Male, Mental Health, Predictive Value of Tests, Health Behavior, Exercise, Geriatric Assessment, Chi-Square Distribution, Likelihood Functions, Housing for the Elderly

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Reliability and validity testing of the revised 12-item Short-Form Health Survey in older adults

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