Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia.
School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
J Glob Health. 2022 Oct 1;12:04077. doi: 10.7189/jogh.12.04077.
Suboptimal health status (SHS) is a reversible stage between health and illness that is characterized by health complaints, low energy, general weakness, and chronic fatigue. The Suboptimal Health Status Questionnaire-25 (SHSQ-25) has been validated in three major populations (African, Asian, and Caucasian) and is internationally recognized as a reliable and robust tool for health estimation in general populations. This study focused on the development of K-SHSQ-25, a Korean version of the SHSQ-25, from its English version.
The SHSQ-25 was translated from English to Korean according to international guidelines set forth by the World Health Organization (WHO) for health instrument translation between different languages. A subsequent cross-sectional survey involved 460 healthy South Korean participants (aged 18-83 years; 65.4% females) to answer the 25 questions focusing on the health perspectives of 5 domains, 1) fatigue, 2) cardiovascular health, 3) digestive tract, 4) immune system and 5) mental health. The K-SHSQ-25 was further validated using tests for reliability, internal consistency, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA).
The version of K-SHSQ-25 achieved linguistic, cultural, and conceptual equivalence to the English version. The intraclass correlation coefficient (ICC) of test-retest reliability for individual items ranged from 0.88 to 0.99. Reliability estimates based on internal consistency reached a Cronbach's α of 0.953; the Cronbach's α for each domain ranged from 0.76 to 0.94. Regarding construct validity, the EFA of the K-SHSQ-25 generally replicated the multidimensional structure (fatigue, cardiovascular, digestive, immune system, and mental health) and 25 questions. The CFA revealed that the root mean square error of approximation (RMSEA), goodness-of-fit index (GFI) and adjusted goodness of fit index (AGFI) were excellent (RMSEA = 0.069<0.08, GFI = 0.929>0.90, AGFI = 0.907>0.90). The five domains of the K-SHSQ-25 showed significant correlations with each other (r = 0.59-0.81, P<0.001). The cut-off point of K-SHSQ-25 for SHS was determined as an SHS score of 25. The prevalence of SHS in this study was 60.0% (276/460), with 47.8% (76/159) for males and 58.5% for females (176/301).
Our results indicate that the Korean version of SHSQ-25, K-SHSQ-25, is a transcultural equivalent, robust, valid, and reliable assessment tool for evaluating SHS in the Korean-speaking population.
亚健康状态（SHS）是一种介于健康和疾病之间的可逆阶段，其特点是出现健康投诉、精力不足、全身无力和慢性疲劳。亚健康状态问卷-25 项（SHSQ-25）已在三大人群（非洲、亚洲和白种人）中得到验证，被国际公认为一般人群健康评估的可靠和强大工具。本研究专注于开发 K-SHSQ-25，这是 SHSQ-25 的韩语版本，源自其英文版本。
根据世界卫生组织（WHO）为不同语言之间的健康仪器翻译制定的国际准则，将 SHSQ-25 从英文翻译成韩文。随后的横断面调查涉及 460 名健康的韩国参与者（年龄 18-83 岁；65.4%为女性），回答 25 个问题，重点关注 5 个领域的健康观点，1）疲劳，2）心血管健康，3）消化道，4）免疫系统和 5）心理健康。使用可靠性测试、内部一致性测试、探索性因素分析（EFA）和验证性因素分析（CFA）进一步验证了 K-SHSQ-25。
K-SHSQ-25 版本在语言、文化和概念上与英文版本等效。个体项目的组内相关系数（ICC）测试-重测信度范围为 0.88 至 0.99。基于内部一致性的可靠性估计达到了 Cronbach's α 为 0.953；每个域的 Cronbach's α 范围为 0.76 至 0.94。关于构念效度，K-SHSQ-25 的 EFA 通常复制了多维结构（疲劳、心血管、消化、免疫系统和心理健康）和 25 个问题。CFA 显示，近似均方根误差（RMSEA）、拟合优度指数（GFI）和调整拟合优度指数（AGFI）均为优秀（RMSEA=0.069<0.08，GFI=0.929>0.90，AGFI=0.907>0.90）。K-SHSQ-25 的五个域彼此之间存在显著相关性（r=0.59-0.81，P<0.001）。该研究中，K-SHSQ-25 的亚健康状态截断点定为 25 分。本研究中，亚健康状态的患病率为 60.0%（276/460），男性为 47.8%（76/159），女性为 58.5%（176/301）。
我们的结果表明，韩语版的 SHSQ-25，即 K-SHSQ-25，是一种跨文化等效、稳健、有效和可靠的评估工具，可用于评估韩语人群中的亚健康状态。
