Questions or comments about this article may be directed to Albert Westergren, RN PhD, at
J Neurosci Nurs. 2014 Feb;46(1):34-45. doi: 10.1097/JNN.0000000000000027.
The 12-item Short-Form Health Survey (SF-12) was developed to measure perceived physical and mental health. Some studies of the psychometric properties, using classical test theory, of the SF-12 provide support for its use in patients with stroke, but it has not been scrutinized using recommended modern test theory approaches such as the Rasch measurement model among stroke survivors.
This study sought to explore the measurement properties of the SF-12 physical and mental health scales among people with stroke using the Rasch measurement model.
A cross-sectional design was used in this study.
All patients discharged from a dedicated stroke unit in southern Sweden during 6 months were asked to participate 6 months later. Of 120 stroke survivors, 89 (74%) agreed to participate. Rasch analysis was used to assess the measurement properties of the SF-12 physical and mental component summary scores (PCS-12 and MCS-12, respectively).
For the PCS-12, we identified problems with targeting, overall and item-level fit, representing local response dependency, and multidimensionality. For the MCS-12, there were problems related to targeting (the persons felt better than the scale could conceptualize) and response categories that did not function as expected. However, MCS-12 items displayed reasonable model fit without indications of multidimensionality but with signs of local response dependency.
The measurement properties of the MCS-12 in stroke appear reasonable unless milder mental health problems are of interest, whereas those of the PCS-12 are less acceptable. Given the interdependence between MCS-12 and PCS-12 that is inherent with the standard SF-12 scoring algorithm, such data should be interpreted with caution.
12 项简明健康调查（SF-12）是为衡量感知身心健康而开发的。一些使用经典测试理论对 SF-12 的心理测量特性的研究为其在中风患者中的应用提供了支持，但它尚未使用推荐的现代测试理论方法（如中风幸存者的 Rasch 测量模型）进行仔细检查。
本研究旨在使用 Rasch 测量模型探索中风患者 SF-12 身心健康量表的测量特性。
本研究采用横断面设计。
在瑞典南部的一个专门的中风病房中，所有在 6 个月内出院的患者都被要求在 6 个月后参加。在 120 名中风幸存者中，有 89 名（74%）同意参加。使用 Rasch 分析评估 SF-12 生理和心理成分综合评分（PCS-12 和 MCS-12）的测量特性。
对于 PCS-12，我们发现存在目标定位、整体和项目水平拟合、局部反应依赖性和多维性方面的问题。对于 MCS-12，存在与目标定位（患者感觉比量表能够概念化的更好）和反应类别不符合预期有关的问题。然而，MCS-12 项目显示出合理的模型拟合，没有多维性的迹象，但有局部反应依赖性的迹象。
除非关注更轻微的心理健康问题，否则中风患者的 MCS-12 测量特性似乎是合理的，而 PCS-12 的测量特性则不太可接受。鉴于标准 SF-12 评分算法中固有的 MCS-12 和 PCS-12 之间的相互依赖性，应谨慎解释此类数据。
