University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany.
Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Tübingen, Germany.
Health Qual Life Outcomes. 2021 May 4;19(1):137. doi: 10.1186/s12955-021-01722-y.
The translated and culturally adapted German version of the Veterans Rand 36 Items Health Survey (VR-36), and its short form, the VR-12 counterpart, were validated in a German sample of orthopedic (n = 399) and psychosomatic (n = 292) inpatient rehabilitation patients.
The instruments were analyzed regarding their acceptance, distributional properties, validity, responsiveness and ability to discriminate between groups by age, sex and clinically specific groups. Eligible study participants completed the VR-36 (n = 169) and the VR-12 (n = 177). They also completed validated patient-reported outcome measures (PROs) including the Euroqol-5 Dimensions 5 Level (EQ-5D-5L); Depression, Anxiety and Stress Scale (DASS); Hannover Functional Abilities Questionnaire (HFAQ); and CDC Healthy Days. The VR-12 and the VR-36 were compared to the reference instruments MOS Short Form-12 Items Health Survey (SF-12) version 1.0 and MOS Short Form-36 Items Health Survey (SF-36) version 1.0, using percent of completed items, distributional properties, correlation patterns, distribution measures of known groups validity, and effect size measures.
Item non-response varied between 1.8%/1.1% (SF/RE) and 6.5%/8.6% (GH/GH). PCS was normally distributed (Kolmogorov-Smirnov tests: p > 0.05) with means, standard deviations and ranges very similar between SF-36 (37.5 ± 11.7 [13.8-66.1]) and VR-36 (38.5 ± 10.1 [11.7-67.8]), SF-12 (36.9 ± 10.9 [15.5-61.6]) and VR-12 (36.2 ± 11.5 [12.7-59.3]). MCS was not normally distributed with slightly differing means and ranges between the instruments (MCS: 36.2 ± 14.2 [12.9-66.6], MCS: 39.0 ± 15.6 [2.0-73.2], MCS: 37.2 ± 13.8 [8.4-70.2], MCS: 39.0 ± 12.3 [17.6-65.4]). Construct validity was established by comparing correlation patterns of the MCS and PCS with measures of physical and mental health. For both PCS and MCS there were moderate (≥ 0.3) to high (≥ 0.5) correlations with convergent (PCS: 0.55-0.76, MCS: 0.60-0.78) and small correlations (< 0.1) with divergent (PCS: < 0.12, MCS: < 0.16) self-report measures. Known-groups validity was demonstrated for both VR-12 and VR-36 (MCS and PCS) via comparisons of distribution parameters with significant higher mean PCS and MCS scores in both VR instruments found in younger patients with fewer sick days in the last year and a shorter duration of rehabilitation.
The psychometric analysis confirmed that the German VR is a valid and reliable instrument for use in orthopedic and psychosomatic rehabilitation. Yet further research is needed to evaluate its usefulness in other populations.
经翻译和文化调适的德国退伍军人 Rand 36 项健康调查（VR-36）及其简短形式 VR-12 对应版本在骨科（n=399）和身心（n=292）住院康复患者的德国样本中得到了验证。
通过分析接受度、分布特性、有效性、反应性以及区分年龄、性别和临床特定群体的能力来评估这些工具。合格的研究参与者完成了 VR-36（n=169）和 VR-12（n=177）。他们还完成了经过验证的患者报告的结果测量（PRO），包括欧洲五维健康量表 5 级（EQ-5D-5L）；抑郁、焦虑和压力量表（DASS）；汉诺威功能能力问卷（HFAQ）；以及 CDC 健康日。VR-12 和 VR-36 与参考工具 MOS 短形式 12 项健康调查（SF-12）版本 1.0 和 MOS 短形式 36 项健康调查（SF-36）版本 1.0 进行了比较，使用完成项目的百分比、分布特性、相关模式、已知组有效性的分布度量和效应量度量。
项目无应答率在 1.8%/1.1%（SF/RE）和 6.5%/8.6%（GH/GH）之间变化。PCS 呈正态分布（柯尔莫哥洛夫-斯米尔诺夫检验：p>0.05），SF-36（37.5±11.7 [13.8-66.1]）和 VR-36（38.5±10.1 [11.7-67.8]）、SF-12（36.9±10.9 [15.5-61.6]）和 VR-12（36.2±11.5 [12.7-59.3]）之间的均值和范围非常相似。MCS 呈非正态分布，各仪器之间的均值和范围略有不同（MCS：36.2±14.2 [12.9-66.6]，MCS：39.0±15.6 [2.0-73.2]，MCS：37.2±13.8 [8.4-70.2]，MCS：39.0±12.3 [17.6-65.4]）。通过比较 MCS 和 PCS 与身体和心理健康测量值的相关模式，建立了结构有效性。对于 PCS 和 MCS，与收敛性（PCS：0.55-0.76，MCS：0.60-0.78）的中度（≥0.3）到高度（≥0.5）相关性以及与发散性（PCS：<0.12，MCS：<0.16）自我报告测量的小相关性（<0.1）均存在中度至高度相关性。通过比较分布参数，VR-12 和 VR-36（MCS 和 PCS）的已知组有效性得到了证明，在年龄较小、过去一年病假较少和康复时间较短的患者中，两个 VR 仪器的 PCS 和 MCS 评分均显著较高。
心理计量学分析证实，德国 VR 是一种有效的、可靠的骨科和身心康复工具。然而，还需要进一步的研究来评估其在其他人群中的有用性。
