Ruta D A, Abdalla M I, Garratt A M, Coutts A, Russell I T
Department of Public Health, University of Aberdeen.
Qual Health Care. 1994 Dec;3(4):180-5. doi: 10.1136/qshc.3.4.180.
To assess the reliability of the SF 36 health survey questionnaire in two patient populations.
Postal questionnaire followed up, if necessary, by two reminders at two week intervals. Retest questionnaires were administered postally at two weeks in the first study and at one week in the second study.
Outpatient clinics and four training general practices in Grampian region in the north east of Scotland (study 1); a gastroenterology outpatient clinic in Aberdeen Royal Hospitals Trust (study 2).
1787 patients presenting with one of four conditions: low back pain, menorrhagia, suspected peptic ulcer, and varicose veins and identified between March and June 1991 (study 1) and 573 patients attending a gastroenterology clinic in April 1993.
Assessment of internal consistency reliability with Cronbach's alpha coefficient and of test-retest reliability with the Pearson correlation coefficient and confidence interval analysis.
In study 1, 1317 of 1746 (75.4%) correctly identified patients entered the study and in study 2, 549 of 573 (95.8%). Both methods of assessing reliability produced similar results for most of the SF 36 scales. The most conservative estimates of reliability gave 95% confidence intervals for an individual patient's score difference ranging from -19 to 19 for the scales measuring physical functioning and general health perceptions, to -65.7 to 65.7 for the scale measuring role limitations attributable to emotional problems. In a controlled clinical trial with sample sizes of 65 patients in each group, statistically significant differences of 20 points can be detected on all eight SF 36 scales.
All eight scales of the SF 36 questionnaire show high reliability when used to monitor health in groups of patients, and at least four scales possess adequate reliability for use in managing individual patients. Further studies are required to test the feasibility of implementing the SF 36 and other outcome measures in routine clinical practice within the health service.
评估SF-36健康调查问卷在两类患者群体中的可靠性。
邮寄调查问卷，必要时每隔两周进行两次提醒。在第一项研究中，两周后邮寄重测问卷；在第二项研究中，一周后邮寄。
苏格兰东北部格兰扁地区的门诊诊所和四家培训全科诊所（研究1）；阿伯丁皇家医院信托基金的胃肠病门诊诊所（研究2）。
1787例患有以下四种疾病之一的患者：腰痛、月经过多、疑似消化性溃疡和静脉曲张，于1991年3月至6月间确定（研究1），以及1993年4月在胃肠病诊所就诊的573例患者。
用克朗巴哈α系数评估内部一致性可靠性，用皮尔逊相关系数和置信区间分析评估重测可靠性。
在研究1中，1746例患者中有1317例（75.4%）被正确识别进入研究；在研究2中，573例患者中有549例（95.8%）。对于大多数SF-36量表，两种评估可靠性的方法得出了相似的结果。可靠性的最保守估计给出了个体患者得分差异的95%置信区间，测量身体功能和总体健康感知的量表为-19至19，测量因情感问题导致的角色限制的量表为-65.7至65.7。在每组样本量为65例患者的对照临床试验中，在所有八个SF-36量表上都能检测到20分的统计学显著差异。
当用于监测患者群体的健康状况时，SF-36问卷的所有八个量表都显示出高可靠性，并且至少有四个量表在管理个体患者方面具有足够的可靠性。需要进一步研究以测试在卫生服务机构的常规临床实践中实施SF-36及其他结果测量指标的可行性。
