Ohlsson-Nevo Emma, Hiyoshi Ayako, Norén Paulina, Möller Margareta, Karlsson Jan
School of Health Sciences, Department of Surgery, Örebro University, Örebro, Sweden.
University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
J Patient Rep Outcomes. 2021 Aug 4;5(1):66. doi: 10.1186/s41687-021-00331-z.
This study aims to evaluate data quality, scaling properties, and reliability of the Swedish RAND-36 in a general population sample and to present reference data for the Swedish population.
Testing of data quality, scaling assumptions and reliability followed methods recommended for the International Quality of Life Assessment Project, previously used for psychometric testing of SF-36 and RAND-36. Data were collected via regular mail for a random stratified sample of the general population in a Swedish county. Weighted means for RAND-36 scores were used and differences by sex, age, education, and occupational groups were tested.
The response rate was 42%, and the sample comprised 3432 persons (45% men, 55% women) with a median age of 56.9 years. The internal consistency reliability was satisfactory, with Cronbach's alphas > 0.80 for all eight scales. The percentage of missing items was low, ranging between 1.3% and 3.2%. No floor effects (≥15%) were noted, while ceiling effects were observed for physical functioning, role-functioning/physical, pain, role-functioning/emotional, and social functioning. Item-scale correlations were satisfactory (r ≥ 0.40). Correlations among the physical health scales were strong (range 0.58-0.68) as were the correlations among the mental health scales (range 0.58-0.73). Men reported significantly better health-related quality of life (HRQoL) on all scales, although the gender differences were small. Comparisons among age groups showed approximately equal scores among those 20-29, 30-39, and 40-49 years, while significant decreases in physical health were observed in the older age groups. Substantially worse physical health scores were observed in the oldest age group (80+). Significant differences among age groups were noted also for the mental health scales; however, better energy/fatigue and emotional well-being scores were seen in the older age groups, except for the oldest (80+). Those with university education reported significantly better scores on all scales compared to those with mandatory education.
The study suggests that the Swedish version of RAND-36 is an acceptable and reliable instrument for measuring HRQoL in the general population. The study provides reference data that can be used for norm-based comparisons.
本研究旨在评估瑞典版RAND-36在普通人群样本中的数据质量、量表特性及信度，并给出瑞典人群的参考数据。
数据质量测试、量表假设检验及信度分析遵循国际生活质量评估项目推荐的方法，该方法曾用于SF-36和RAND-36的心理测量测试。通过普通邮件收集瑞典一个县普通人群随机分层样本的数据。使用RAND-36得分的加权均值，并对性别、年龄、教育程度和职业群体间的差异进行检验。
回复率为42%，样本包含3432人（45%为男性，55%为女性），中位年龄为56.9岁。内部一致性信度令人满意，所有八个量表的Cronbach's α系数均>0.80。缺失项目的百分比很低，在1.3%至3.2%之间。未观察到地板效应（≥15%），但在生理功能、角色功能/生理、疼痛、角色功能/情感和社会功能方面观察到天花板效应。项目与量表的相关性令人满意（r≥0.40）。身体健康量表之间的相关性很强（范围为0.58 - 0.68），心理健康量表之间的相关性也很强（范围为0.58 - 0.73）。男性在所有量表上报告的健康相关生活质量（HRQoL）显著更好，尽管性别差异较小。年龄组间比较显示，20 - 29岁、30 - 39岁和40 - 49岁人群的得分大致相等，而在年龄较大的组中观察到身体健康显著下降。在年龄最大的组（80岁以上）中观察到身体健康得分明显更差。心理健康量表在年龄组间也存在显著差异；然而，除年龄最大的组（80岁以上）外，年龄较大的组在精力/疲劳和情感幸福感方面得分更高。与接受义务教育的人群相比，受过大学教育的人群在所有量表上的得分显著更高。
该研究表明瑞典版RAND-36是测量普通人群HRQoL的可接受且可靠的工具。该研究提供了可用于基于常模比较的参考数据。
