Wolinsky F D, Wan G J, Tierney W M
School of Public Health, Saint Louis University, MO 63108-3342, USA.
Med Care. 1998 Nov;36(11):1589-98. doi: 10.1097/00005650-199811000-00008.
The present study assessed changes in the Medical Outcomes Study 36-item short-form health survey (SF-36) during a 12-month period and examined the relation of those changes to selected baseline characteristics.
The study was a 12-month follow-up evaluation of 786 disadvantaged adults aged 50 to 99 years old who had participated in a randomized controlled clinical trial in the general medicine outpatient clinics of a major academic medical center. Descriptive and psychometric analyses of changes in the SF-36 scale scores during a 12-month period were performed, and two series of multivariable logistic regressions of increases or decreases greater than one standard error of measurement (SEM) versus stability on selected baseline characteristics were done. Measures were the eight SF-36 scales.
Mean baseline scores on the SF-36 scales were substantially below age-specific national norms. Problematic floor and/or ceiling effects were found for the bodily pain, social function, role--physical, and role--emotional scales, consistent with age-specific national norms. Internal consistency was unacceptable for the general health perceptions scale, adequate for the social function scale, and good for all the other SF-36 scales. Improvements greater than one standard error of measurement were found for between one fifth and one third of the patients, and declines greater than one standard error of measurement were found for between one fifth and one third of the patients. Selected baseline characteristics generally were unrelated to either improvements or declines on the SF-36 scales.
The SF-36 scales appear to be sufficiently sensitive for measuring changes in health outcomes during a 1-year period in older patients with debilitating disease. Little of the measured change, however, was predictable.
本研究评估了医学结局研究简明健康调查问卷（SF - 36）在12个月期间的变化，并检验了这些变化与选定基线特征之间的关系。
该研究是一项针对786名年龄在50至99岁之间的弱势成年人进行的为期12个月的随访评估，这些成年人曾参与一家大型学术医疗中心普通内科门诊的随机对照临床试验。对SF - 36量表分数在12个月期间的变化进行了描述性和心理测量学分析，并针对选定的基线特征，对大于一个测量标准误（SEM）的增加或减少与稳定性进行了两组多变量逻辑回归分析。测量指标为SF - 36的八个量表。
SF - 36量表的平均基线分数显著低于特定年龄的全国规范。在身体疼痛、社会功能、角色 - 身体和角色 - 情感量表上发现了有问题的地板效应和/或天花板效应，这与特定年龄的全国规范一致。一般健康感知量表的内部一致性不可接受，社会功能量表的内部一致性足够，而所有其他SF - 36量表的内部一致性良好。五分之一至三分之一的患者出现了大于一个测量标准误的改善，五分之一至三分之一的患者出现了大于一个测量标准误的下降。选定的基线特征通常与SF - 36量表的改善或下降无关。
SF - 36量表似乎对测量患有衰弱性疾病的老年患者在1年期间的健康结局变化具有足够的敏感性。然而，所测量的变化几乎无法预测。
