Cross-National Validation of a Health-Related Quality of Life Measure in Five Latin American Countries: Invariance of the 8-Item Short Form Health Survey (SF-8) and Proposed 6-Item Version (SF-6)

Abstract

The objective was to analyze the factorial structure, reliability, and cross-national measurement invariance of the 8-item Short Form Health Survey (SF-8) in 1,940 individuals from five Latin American countries (El Salvador, Honduras, Guatemala, Colombia, and Venezuela). Five CFA models were estimated based on previous findings and considerations of the content validity. The results indicated that the two-factor model (physical and mental health) without items 1 and 5 provided the best fit across all countries. Item 5 was removed due to low factor loadings in all estimated models and across all countries, while item 1 was removed because it was too general, making it difficult to determine whether it measured physical or mental health. The six-item version (SF-6) demonstrated adequate reliability and strict invariance across all countries in the invariance sequence models. The reported differences in physical and mental health dimensions were negligible and minor among all countries. In conclusion, a 6-item version of the Short Form Health Survey (SF-6) was proposed, which is better represented by two dimensions (physical and mental health) and is invariant across Latin American countries.

Keywords

health invariance factorial structure short form health survey Latin America

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References

Anderson

R. T.

Aaronson

N. K.

Bullinger

McBee

W. L.

(1996). A review of the progress towards developing health-related quality-of-life instruments for international clinical studies and outcomes research. PharmacoEconomics, 10(4), 336–355. https://doi.org/10.2165/00019053-199610040-00004

Andrews

Nonnecke

Preece

(2003). Electronic survey methodology: A case study in reaching hard-to-involve Internet users. International journal of human-computer interaction, 16(2), 185–210. https://doi.org/10.1207/S15327590IJHC1602_04

Ato

López-García

J. J.

Benavente

(2013). Un sistema de clasificación de los diseños de investigación en psicología. Anales de Psicología, 29(3), 1038–1059. https://doi.org/10.6018/analesps.29.3.178511

Augustovski

F. A.

Irazola

V. E.

Velazquez

A. P.

Gibbons

Craig

B. M.

(2009). Argentine valuation of the EQ-5D health states. Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 12(4), 587–596. https://doi.org/10.1111/j.1524-4733.2008.00468.x

Bastardo

Y. M.

(2011). Health status and health behaviors in Venezuelan pharmacy students. Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 14(5), S122–S125. https://doi.org/10.1016/j.jval.2011.05.020

Ben-Shachar

M. S.

Lüdecke

Makowski

(2020). effectsize: Estimation of effect size indices and standardized parameters. Journal of Open Source Software, 5(56), Article 2815. https://doi.org/10.21105/joss.02815

Blair

Coppock

Moor

(2020). When to worry about sensitivity bias: A social reference theory and evidence from 30 years of list experiments. American Political Science Review, 114(4), 1297–1315. https://doi.org/10.1017/S0003055420000374

Boer

Hanke

(2018). On detecting systematic measurement error in cross-cultural research: A review and critical reflection on equivalence and invariance tests. Journal of Cross-Cultural Psychology, 49(5), 713–734. https://doi.org/10.1177/0022022117749042

Bowden

Fox-Rushby

J. A.

(2003). A systematic and critical review of the process of translation and adaptation of generic health-related quality of life measures in Africa, Asia, Eastern Europe, the Middle East, South America. Social Science & Medicine, 57(7), 1289–1306. https://doi.org/10.1016/S0277-9536(02)00503-8

10.

Buchcik

Westenhöfer

Fleming

Martin

C. R.

(2017). Health-related quality of life (HRQoL) among elderly Turkish and Polish migrants and German natives: The role of age, gender, income, discrimination and social support. In Muenstermann

(Ed.), People’s movements in the 21st century-Risks, challenges and benefits (pp. 55–75). InTech.

11.

Buck

Jacoby

Baker

G. A.

Ley

Steen

(1999). Cross-cultural differences in health-related quality of life of people with epilepsy: Findings from a European study. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 8, 675–685. https://doi.org/10.1023/A:1008916326411

12.

Bullinger

(2002). Assessing health related quality of life in medicine. An overview over concepts, methods and applications in international research. Restorative Neurology and Neuroscience, 20(3–4), 93–101. https://doi.org/10.3233/RNN-2002-001

13.

Busija

Pausenberger

Haines

T. P.

Haymes

Buchbinder

Osborne

R. H.

(2011). Adult measures of general health and health‐related quality of life: Medical outcomes study short form 36‐item (SF‐36) and short form 12‐item (SF‐12) health surveys, Nottingham health profile (NHP), sickness impact profile (SIP), medical outcomes study short form 6D (SF‐6D), health utilities index mark 3 (HUI3), quality of well‐being scale (QWB), and assessment of quality of life (AQoL). Arthritis Care & Research, 63(S11), S383–S412. https://doi.org/10.1002/acr.20541

14.

Canty

Ripley

B. D.

(2022). boot: Bootstrap functions (originally by Angelo Canty for S). R package version 1.3-28. https://CRAN.R-project.org/package=boot

15.

Castro Solano

(2014). Positive psychology in Latin America. Springer Netherlands. https://doi.org/10.1007/978-94-017-9035-2

16.

Cesnales

N. I.

Thyer

B. A.

(2014). Health-related quality of life measures. In Michalos

A. C.

(Ed.), Encyclopedia of quality of life and well-being research (pp. 2809–2814). Springer Netherlands.

17.

Chen

F. F.

(2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal, 14(3), 464–504. https://doi.org/10.1080/10705510701301834

18.

Chen

F. F.

(2008). What happens if we compare chopsticks with forks? The impact of making inappropriate comparisons in cross-cultural research. Journal of Personality and Social Psychology, 95(5), 1005–1018. https://doi.org/10.1037/a0013193

19.

Cheung

G. W.

Rensvold

R. B.

(2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal, 9(2), 233–255. https://doi.org/10.1207/S15328007SEM0902_5

20.

Cohen

(1992). A power primer. Psychological Bulletin, 112(1), 155–159. https://doi.org/10.1037/0033-2909.112.1.155

21.

Cruz

L. N.

Fleck

M. P. D. A.

Oliveira

M. R.

Camey

S. A.

Hoffmann

J. F.

Bagattini

Â. M.

Polanczyk

C. A.

(2013). Health-related quality of life in Brazil: Normative data for the SF-36 in a general population sample in the south of the country. Ciência & Saúde Coletiva, 18(7), 1911–1921. https://doi.org/10.1590/s1413-81232013000700006

22.

Dag

Dolgun

N. A.

Konar

N. M.

(2022). onewaytests: One-way tests for comparing means. R package version 2.6. https://CRAN.R-project.org/package=onewaytests

23.

Edwards

A. L.

(1957). Social desirability and probability of endorsement of items in the interpersonal check list. Journal of Abnormal Psychology, 55(3), 394–396. https://doi.org/10.1037/h0048497

24.

Ellert

Lampert

Ravens-Sieberer

(2005). Measuring health-related quality of life with the SF-8: Normal sample of the German population. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, 48(12), 1330–1337. https://doi.org/10.1007/s00103-005-1168-5

25.

Evans

J. R.

Mathur

(2005). The value of online surveys. Internet Research, 15(2), 195–219. https://doi.org/10.1108/10662240510590360

26.

Fayers

P. M.

Hays

R. D.

(Eds.), (2005). Assessing quality of life in clinical trials: Methods and practice. Oxford University Press.

27.

Ferrans

C. E.

Zerwic

J. J.

Wilbur

J. E.

Larson

J. L.

(2005). Conceptual model of health‐related quality of life. Journal of Nursing Scholarship: An Official Publication of Sigma Theta Tau International Honor Society of Nursing, 37(4), 336–342. https://doi.org/10.1111/j.1547-5069.2005.00058.x

28.

Finney

S. J.

DiStefano

(2006). Nonnormal and categorical data in structural equation models. In Hancock

G. R.

Mueller

R. O.

(Eds.), A second course in structural equation modeling (pp. 269–314). Information Age.

29.

Fox-Rushby

Parker

(1995). Culture and the measurement of health-related quality of life. European Review of Applied Psychology, 45(4), 257–264.

30.

Galenkamp

Stronks

Mokkink

L. B.

Derks

E. M.

(2018). Measurement invariance of the SF-12 among different demographic groups: The HELIUS study. PLoS One, 13(9), Article e0203483. https://doi.org/10.1371/journal.pone.0203483

31.

Gonzalez

Bardach

Palacios

Peckaitis

Ciapponi

Pichón‐Riviere

Augustovski

(2021). Health‐related quality of life in patients with breast cancer in Latin America and the Caribbean: A systematic review and meta‐analysis. The Oncologist, 26(5), e794–e806. https://doi.org/10.1002/onco.13709

32.

Guermazi

Allouch

Yahia

M. T. B. A.

Huissa

T. B. A.

Ghorbel

Damak

Elleuch

M. H.

(2012). Translation in Arabic, adaptation and validation of the SF-36 health survey for use in Tunisia. Annals of Physical and Rehabilitation Medicine, 55(6), 388–403. https://doi.org/10.1016/j.rehab.2012.05.003

33.

Jorgensen

T. D.

Pornprasertmanit

Schoemann

A. M.

Rosseel

Miller

Quick

Garnier-Villarreal

(2018). semTools: Useful tools for structural equation modeling . R package version 0.5, 1.

34.

Kaplan

R. M.

Hays

R. D.

(2022). Health-related quality of life measurement in public health. Annual Review of Public Health, 43(1), 355–373. https://doi.org/10.1146/annurev-publhealth-052120-012811

35.

Kassambara

(2023). rstatix: Pipe-friendly framework for basic statistical tests. R package version 0.7.2. https://CRAN.R-project.org/package=rstatix

36.

Kline

R. B.

(2016). Principles and practice of structural equation modelling (4th ed.). Guildford Press.

37.

Lang

Zhang

Bian

Guo

(2018). Evaluating the reliability and validity of SF-8 with a large representative sample of urban Chinese. Health and Quality of Life Outcomes, 16(55), 1–8. https://doi.org/10.1186/s12955-018-0880-4

38.

Leon

(2003). Perceptions of health care quality in Central America. International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care, 15(1), 67–071. https://doi.org/10.1093/intqhc/15.1.67

39.

Lugo

L. H.

García

H. I.

Gómez

(2006). Confiabilidad del cuestionario de calidad de vida en salud SF-36 en Medellín, Colombia. Revista Facultad Nacional de Salud Pública, 24(2), 37–50. https://doi.org/10.17533/udea.rfnsp.243

40.

McDonald

R. P.

(1999). Test theory: A unified treatment. Lawrence Erlbaum Associates Publishers.

41.

Muthén

L. K.

Muthén

B. O.

(2002). How to use a Monte Carlo study to decide on sample size and determine power. Structural Equation Modeling, 9(4), 599–620. https://doi.org/10.1207/S15328007SEM0904_8

42.

Namjoo

Mirzaei

Foroughan

Harouni

G. G.

(2021). Psychometric properties of the short Form-8 health survey (SF-8) among diabetes and non-diabetes Iranian older people. Health Promotion Perspectives, 11(3), 337–343. https://doi.org/10.34172/hpp.2021.43

43.

Ojelabi

A. O.

Graham

Haighton

Ling

(2017). A systematic review of the application of Wilson and Cleary health-related quality of life model in chronic diseases. Health and Quality of Life Outcomes, 15(1), Article 241. https://doi.org/10.1186/s12955-017-0818-2

44.

Paniagua

(2016). Estrés laboral y calidad de vida asociada con la salud en los empleados de una institución de educación superior de El Salvador. Ciencia, Cultura y Sociedad, 3(1), 45–58. https://doi.org/10.5377/ccs.v3i1.2961

45.

Pestillo de Oliveira

Malheiros Caruzzo

Sakita

Mmbaga

B. T.

Boshe

Tupetz

Nickenig Vissoci

J. R.

(2022). Cross-cultural adaptation and psychometric properties of the SF-8 questionnaire in Tanzanian Swahili for injury population. Disabilities, 2(3), 428–438. https://doi.org/10.3390/disabilities2030030

46.

Putnick

D. L.

Bornstein

M. H.

(2016). Measurement invariance conventions and reporting: The state of the art and future directions for psychological research. Developmental Review: DR, 41, 71–90. https://doi.org/10.1016/j.dr.2016.06.004

47.

Rahman

Mittelhammer

R. C.

Wandschneider

P. R.

(2011). Measuring quality of life across countries: A multiple indicators and multiple causes approach. The Journal of Socio-Economics, 40(1), 43–52. https://doi.org/10.1016/j.socec.2010.06.002

48.

Ramírez-Vélez

Agredo-Zuñiga

R. A.

Jerez-Valderrama

A. M.

(2010). Confiabilidad y valores normativos preliminares del cuestionario de salud SF-12 (Short Form 12 Health Survey) en adultos Colombianos. Revista de Salud Pública, 12(5), 807–819.

49.

Rhemtulla

Brosseau-Liard

P. É.

Savalei

(2012). When can categorical variables be treated as continuous? A comparison of robust continuous and categorical SEM estimation methods under suboptimal conditions. Psychological Methods, 17(3), 354–373. https://doi.org/10.1037/a0029315

50.

Roberts

Browne

Ocaka

K. F.

Oyok

Sondorp

(2008). The reliability and validity of the SF-8 with a conflict-affected population in northern Uganda. Health and Quality of Life Outcomes, 6, 1–10. https://doi.org/10.1186/1477-7525-6-108

51.

Rodríguez

J. J.

Barrett

Narváez

Caldas

J. M.

Levav

Saxena

(2007). Sistemas de salud mental en El Salvador, Guatemala y Nicaragua: resultados de una evaluación mediante el WHO-AIMS. Revista Panamericana de Salud Públic, 22(5), 348–357.

52.

Romero

Vivas-Consuelo

Alvis-Guzman

(2013). Is health Related Quality of Life (HRQoL) a valid indicator for health systems evaluation? SpringerPlus, 2(1), Article 664. https://doi.org/10.1186/2193-1801-2-664

53.

Rosseel

(2012). lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1–36. https://doi.org/10.18637/jss.v048.i02

54.

Salazar

F. R.

Bernabé

(2015). The Spanish SF-36 in Peru: Factor structure, construct validity, and internal consistency. Asia-Pacific Journal of Public Health, 27(2), NP2372–NP2380. https://doi.org/10.1177/1010539511432879

55.

Schumacker

R. E.

Lomax

R. G.

(2015). A beginner’s guide to structural equation modeling (4th ed.). Routledge.

56.

Sinha

van den Heuvel

W. J.

Arokiasamy

(2013). Validity and reliability of MOS short form health survey (SF-36) for use in India. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 38(1), 22–26. https://doi.org/10.4103/0970-0218.106623

57.

Stewart

A. L.

Ware

J. E.

(Eds.), (1992). Measuring functioning and well-being: The medical outcomes study approach. Duke university Press.

58.

Tokuda

Okubo

Ohde

Jacobs

Takahashi

Omata

Fukui

Hinohara

(2009). Assessing items on the SF‐8 Japanese version for health‐related quality of life: A psychometric analysis based on the nominal categories model of item response theory. Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 12(4), 568–573. https://doi.org/10.1111/j.1524-4733.2008.00449.x

59.

Tomás

J. M.

Galiana

Fernández

(2018). The SF–8 Spanish version for health-related quality of life assessment: Psychometric study with IRT and CFA models. Spanish Journal of Psychology, 21, Article E1. https://doi.org/10.1017/sjp.2018.4

60.

Turner-Bowker

D. M.

Bayliss

M. S.

Ware

J. E.

Kosinski

(2003). Usefulness of the SF-8™ health survey for comparing the impact of migraine and other conditions. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 12(8), 1003–1012. https://doi.org/10.1023/A:1026179517081

61.

Valles

Guilera

Briones

Gomar

Canet

Alonso

ARISCAT Group . (2010). Validity of the Spanish 8-item short-form generic health-related quality-of-life questionnaire in surgical patients: A population-based study. The Journal of the American Society of Anesthesiologists, 112(5), 1164–1174. https://doi.org/10.1097/ALN.0b013e3181d3e017

62.

Van De Vijver

F. J.

(2009). Types of comparative studies in cross-cultural psychology. Online Readings in Psychology and Culture, 2(2), 1–12. https://doi.org/10.9707/2307-0919.1017

63.

Viladrich

Angulo-Brunet

Doval

(2017). Un viaje alrededor de alfa y omega para estimar la fiabilidad de consistencia interna. Anales de Psicología, 33(3), 755–782. https://doi.org/10.6018/analesps.33.3.268401

64.

Wang

Luan

Lei

Kuang

Chan

(2007). Development and evaluation of Chinese version of short form 8. Modern Preventive Medicine, 34(6), 1022–1024.

65.

Ware

J. E.

Jr. Gandek

(1998). Overview of the SF-36 health survey and the international quality of life assessment (IQOLA) project. Journal of Clinical Epidemiology, 51(11), 903–912. https://doi.org/10.1016/S0895-4356(98)00081-X

66.

Ware

J. E.

Jr. Kosinski

Bayliss

M. S.

McHorney

C. A.

Rogers

W. H.

Raczek

(1995). Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: Summary of results from the medical outcomes study. Medical Care, 33(4), AS264–AS279. https://www.jstor.org/stable/3766635

67.

Ware

J. E.

Jr. Sherbourne

C. D.

(1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.

68.

Ware

J. E.

Keller

S. D.

Kosinski

(1994). SF-36 physical and mental health summary scales. Health Assessment Lab Boston.

69.

Ware

J. E.

Kosinski

Dewey

Gandek

(2001a). How to score and interpret single-item health status measures: A manual for users of the SF–8 health survey. QualyMetric.

70.

Ware

J. E.

Kosinski

Dewey

J. E.

Gandek

(2001b). A manual for users of the SF-8 health survey. QualityMetric Incorporated.

71.

Ware

J. E.

Kosinski

Keller

S. D.

(1996). A 12-Item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233. https://doi.org/10.1097/00005650-199603000-00003

72.

Whittaker

T. A.

(2013). The impact of noninvariant intercepts in latent means models. Structural Equation Modeling: A Multidisciplinary Journal, 20(1), 108–130. https://doi.org/10.1080/10705511.2013.742397

73.

Whoqol Group . (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551–558. https://doi.org/10.1017/S0033291798006667

74.

Wilson

I. B.

Cleary

P. D.

(1995). Linking clinical variables with health-related quality of life: A conceptual model of patient outcomes. JAMA, 273(1), 59–65. https://doi.org/10.1001/jama.1995.03520250075037

75.

Winton

B. G.

Sabol

M. A.

(2022). A multi-group analysis of convenience samples: Free, cheap, friendly, and fancy sources. International Journal of Social Research Methodology, 25(6), 861–876. https://doi.org/10.1080/13645579.2021.1961187

76.

Wirtz

M. A.

Schulz

Brähler

(2021). Confirmatory and bi-factor analysis of the short form health survey 8 (SF-8) scale structure in a German general population sample. Health and Quality of Life Outcomes, 19(1), 1–12. https://doi.org/10.1186/s12955-021-01699-8

77.

World Health Organization . (2002). Towards a common language for functioning, disability and health. World Health Organization.

78.

Yactayo-Alburquerque

M. T.

Alen-Méndez

M. L.

Azañedo

Comandé

Hernández-Vásquez

(2021). Impact of oral diseases on oral health-related quality of life: A systematic review of studies conducted in Latin America and the Caribbean. PLoS One, 16(6), Article e0252578. https://doi.org/10.1371/journal.pone.0252578

79.

Zarate

Kind

Valenzuela

Vignau

Olivares-Tirado

Munoz

(2011). Social valuation of EQ-5D health states: The Chilean case. Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 14(8), 1135–1141. https://doi.org/10.1016/j.jval.2011.09.002

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