Quality Of Life Scale Sf-36 Applicability Of Stroke Patients In China

Background: Quality of life(QOL) assessment is an important index for assessing the health status of stroke patients comprehensively, while seldom being used in China at present, and it is urgent to introduce or produce good QOL instruments for assessing the treatment effect of stroke. Purpose: Assess the reliability and validity of SF-36 when applying on older Chinese stroke patients. Materials and Methods: study design: cross-sectional study. 197 stroke patients within 6 months after onset were assessed with SF-36, and the social-demographic characteristics, neurological functional defect scale(NFDS), classification of overall living ability, Activities of Daily Living(ADL), Quality of Life Index(QLl), supports index were also recorded and assessed. Reliability were tested by Cronbach's a coefficient of internal consistency and Guttman's split-half method, methods of factor analysis, correlation analysis and multivarible analysis of variance(MANOVA) were used to test the construct validity, criteria validity and discriminant validity, effect size of some subscales were calculated and their responsiveness were compared, comments were given on modification of some subscales. Results: In a word, SF-36 has good reliability and validity when applying on Chinese stroke patients, except domain of Bodily Pain(BP) and Vitality(VT), Cronbach's a coefficients were between 0.75-0.95, Guttman's split half reliability: over 0.6; eight principle component extracted that X >1, explained 77% of total variance, and other seven subscales had only one principle component that X >1 except VT, attributed variances from 51% to 91.5%; the factor analysis results of six domain were accorded with the original construction, while VT and Mental Health(MH) had some differences with the original ones; all eight subscales were capable to detect the differences when patients were classified into two groups by QLI scores, most can discriminate the differences then groups were classified by other criterion(NFDS and ADL). Conclusions: as a general QOL instrument, SF-36 has good reliability and validity when applying on older Chinese stroke patients. For the differences of cultural background and specification of disease and sample, there are some shortages and need to be modified when generalized to similar populations, such as the subscale of Role Physical(RP), MH and VT: RP has65serious "floor effect" and do not fit stroke patients, the construction validity ofMH and VT need further validation. Discussion: In spite of the several limits ofthis study(the areas of popu1ation, status and time of the disease, access of themedica1 care services), more attentions shou1d be paid to on the shortages ofsome subscaIes of SF-36 when used on Chinese stroke patientS. lt isrecommended that it should be modified, added with some specific issues ofstroke,.orjoined with other specific QOL instruments.