Age and Ageing, Vol 28, 562-566, Copyright © 1999 by British Geriatrics Society
EM Andresen, GW Gravitt, ME Aydelotte and CA Podgorski
OBJECTIVE: to assess test characteristics of the Medical Outcomes Study
SF-36 (Short-Form 36) with residents of nursing homes. RESEARCH DESIGN:
nursing home residents with 17 or more points on the Mini-Mental State
Examination (MMSE) and > or = 3 months residence (128 of 552 screened)
were selected randomly. Interviewers administered the SF-36 (repeated after
1 week), Geriatric Depression Scale and MMSE. We recorded activities of
daily living and medication data from medical records. Data analysis
included test-retest intraclass correlations, item completion, score
distributions and SF-36 correlations with measures of physical and mental
functioning. RESULTS: 97 nursing home residents (75.8%) consented.
Test-retest intraclass correlation coefficients were good to excellent
(range = 0.55 to 0.82). Convergent validity between SF-36 physical health
scales and the activities of daily living index was modest (r range = -0.37
to -0.43). About 25% of residents scored zero (lowest score) on at least
one SF-36 physical function measure. SF- 36 mental health scales correlated
strongly with the Geriatric Depression Scale (r range = -0.63 to -0.71) and
modestly with bodily pain (r = -0.35). No SF-36 scales correlated strongly
with the MMSE. CONCLUSION: only one in five nursing home residents met
minimal participation criteria, suggesting limited utility of the SF-36 in
nursing homes. Reliability and validity characteristics were fairly good.
Skewed scores were noted for some SF-36 scales. The utility of the SF-36
may be limited to assessments of subjects with higher cognitive and
physical functioning than typical nursing home residents. The SF-36 might
benefit from modification for this setting, or by tests of proxy ratings.
ARTICLES
Limitations of the SF-36 in a sample of nursing home residents
Department of Community Health, St Louis University School of Public Health, MO 63108, USA. Andresen@slu.edu
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