Nortvedt M W, Riise T, Myhr K M, Nyland H I
Department of Public Health and Primary Health Care, University of Bergen, Norway.
Med Care. 2000 Oct;38(10):1022-8. doi: 10.1097/00005650-200010000-00006.
Multiple sclerosis (MS) patients accumulate both physical and mental health problems along with disease progression. Valid and sensitive outcome measures are important to measure disease effects and the effect of treatment.
The objective of this study was to test the performance of the physical and mental summary scales of SF-36, SF-12, and RAND-36.
The scales were evaluated by comparing the scores of a cohort of 194 MS patients with general population data and using the Expanded Disability Status Scale (EDSS) and the Incapacity Status Scale-mental as criterion variables for physical functioning and mental health.
All 3 physical summary scales were markedly reduced and correlated highly with the EDSS. The SF-36 mental summary score was only slightly reduced among MS patients (0.2 SD) compared with the general population, despite significantly reduced scores on all 4 health scales being most related to mental health and despite a high prevalence of mental health problems. This results from the poor physical functioning (mean scale score, 2.3 SD below the general population) and the orthogonal factor rotation used to derive independent measures of physical and mental health. Similar results were found for the SF-12. The nonorthogonal RAND-36 physical and mental summary scores were both markedly reduced. This is more compatible with the disease progression in MS and the results of the other measures of physical and mental health used in the study.
The SF-36 and SF-12 mental health summary scales appear to overestimate mental health in people with MS.
随着疾病进展，多发性硬化症（MS）患者会累积身心健康问题。有效且敏感的结局指标对于衡量疾病影响和治疗效果很重要。
本研究的目的是测试SF-36、SF-12和RAND-36的身体和心理总结量表的性能。
通过将194名MS患者队列的得分与一般人群数据进行比较，并使用扩展残疾状态量表（EDSS）和失能状态量表-心理作为身体功能和心理健康的标准变量，对这些量表进行评估。
所有3种身体总结量表均显著降低，且与EDSS高度相关。与一般人群相比，MS患者中SF-36心理总结得分仅略有降低（0.2个标准差），尽管所有4个与心理健康最相关的健康量表得分均显著降低，且心理健康问题患病率很高。这是由于身体功能较差（平均量表得分比一般人群低2.3个标准差）以及用于得出身心健康独立指标的正交因子旋转所致。SF-12也得到了类似结果。非正交的RAND-36身体和心理总结得分均显著降低。这与MS的疾病进展以及本研究中使用的其他身心健康指标的结果更相符。
SF-36和SF-12心理健康总结量表似乎高估了MS患者的心理健康状况。
