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Problems with the performance of the SF-36 among people with type 2 diabetes in general practice

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Abstract

Objective: To validate the short form-36 (SF-36) among people with type 2 diabetes in general practice, and to make comparisons with the Audit of Diabetis Dependent Quality of Life (ADDQoL). Design: Postal survey with one reminder. Setting: Four general practices. Patients: One hundred and eighty-four eligible patients (30–70 years) with type 2 diabetes on 14 general practitioner lists. Measures: SF-36 response rates, distribution of dimension scores and internal consistency. Median scores in relation to sociodemography and self-reported health. Comparisons with ADDQoL scores. Results: One hundred and thirty-one patients responded (71%). Distributions of SF-36 dimension scores were mostly skewed. Internal consistency and construct validity were acceptable, with predictable sociodemographic trends. People with illness related to or unrelated to diabetes scored significantly lower on most dimensions. SF-36 dimension scores correlated best with relevant diabetes-specific ADDQoL scores amongst respondents reporting no comorbidity. Conclusions: Although valid and reliable, SF-36 scores are strongly affected by non-diabetic comorbidity in type 2 diabetes, supporting the complementary use of a diabetes-specific measure, providing information about the impact of diabetes specifically.

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References

  1. Williams R. Diabetes Mellitus. In: Stevens A, Raftery J (eds), Health Care Needs Assessment. The Epidemiologically Based Needs Assessment Reviews, Oxford: Radcliffe Medical Press, 1993.

    Google Scholar 

  2. Ruta DA, Garrett AM. Health status to quality of life measurement. In: Jenkinson C (ed), Measuring Health and Medical Outcomes, London: UCL Press, 1994; 138–159.

    Google Scholar 

  3. Kinmonth A-L, Spiegal N, Woodcock A. Developing a training programme in patient centred consulting for evaluation in a randomised controlled trial; diabetes care from diagnosis in British Primary Care. J Pat Educ Couns 1996; 29: 75–86.

    Article  CAS  Google Scholar 

  4. Ware JE, Brook RH, Williams KN, Stewart AL, Davies-Avery A. Conceptualisation and Measurement of Health for Adults in the Health Insurance Study. Vol. 1 Model of Health and Methodology. Santa Monica, California: Rand Corporation, 1980. (Publication no. R-1987/1–HEW.)

    Google Scholar 

  5. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston Mass: New England Medical Centre, The Health Institute, 1993.

    Google Scholar 

  6. Brazier JE, Harper R, Jones NMB, et al. Validating the SF-36 health survey questionnaire: New outcome measure for primary care. Br Med J 1992; 305: 160–164.

    CAS  Google Scholar 

  7. Bradley C, Todd C, Gorton T, Symonds E, Martin A, Plowright R. The development of an individualised questionnaire measure of perceived impact of diabetes on quality of life: The ADDQoL. Qual of Life Res 1999; 8: 79–91.

    Article  CAS  Google Scholar 

  8. Lyons RA, Perry HM, Littlepage BNC. Evidence of the validity of the short-form 36 questionnaire (SF-36). Age Ageing 1994; 23: 182–184.

    PubMed  CAS  Google Scholar 

  9. Lyons RA, Lo SV, Littlepage BNC. Comparative health status of patients with 11 common illnesses in Wales. J Epidemiol Comm Health 1994; 48: 388–390.

    Article  CAS  Google Scholar 

  10. Polonsky WH. Understanding and assessing diabetes-specific quality of life. Diabet Spectr 2000; 13: 17–22.

    Google Scholar 

  11. Greenhalgh J. Involving the user perspective in outcome measurement: An introduction. Outcomes Briefing Issue 8. 1996; October: pp. 10–16.

  12. Office of Population Censuses and Surveys, Classification of Occupations 1980 and coding index. Vol. 2 (2nd ed.), 1985; Vol. 3, 1991 London: Her Majesty's Stationery Office, 1980.

  13. Norusis MJ. The SPSS guide to data analysis for SPSS/PC+. Chicago, IL: SPSS, 1988.

    Google Scholar 

  14. Dunn G. Design and Analysis of Reliability Studies. London: Oxford University Press, 1989.

    Google Scholar 

  15. Streiner DL, Norman GR. Health Measurement Scales. Oxford: Oxford University Press, 1995.

    Google Scholar 

  16. Nunnally JC. Psychometric Theory. New York: McGraw-Hill, 1978.

    Google Scholar 

  17. Verbruggen LM. Gender and health an update on hypotheses and evidence. J Health Soc Behav 1985; 26: 156–182.

    Article  Google Scholar 

  18. Nathanson CA. Sex, illness and medical care: A review of data, theory and method. Soc Sci Med 1977; 11: 13–25.

    Article  PubMed  CAS  Google Scholar 

  19. Chaturvedi N, Jarrett J, Shipley MJ, Fuller JH. Socioeconomic gradient in morbidity and mortality in people with diabetes: Cohort study findings from the Whitehall Study and the WHO Multinational Study of Vascular Disease in Diabetes. Br Med J 1998; 316: 100–105.

    CAS  Google Scholar 

  20. Marmot MG, Smith GD, Stansfield S, Patel C, North F, Head J, White I, Brunner E, Feeney A. Health inequalities among British Civil servants: The Whitehall II study. Lancet 1991; 337: 1387–1393.

    Article  PubMed  CAS  Google Scholar 

  21. Ware JE. Measuring patients' views: The optimum outcome measure: SF-36; a valid, reliable assessment of health from the patient's point of view. Br Med J 1993; 306: 1429–1430.

    Article  CAS  Google Scholar 

  22. McColl E, Jacoby A, Thomas L, et al. The conduct and design of questionnaire surveys in healthcare research. In: Stevens A, Abrams K, Brazier J, Fitzpatrick R, Liford R (eds), The Advanced Handbook of Methods in Evidence Based Health Care, London: Sage, 2001; pp. 247–271.

    Google Scholar 

  23. Kinmonth AL, Woodcock A, Griffin S, Spiegal N, Campbell MJ. Randomised controlled trial of patient centred care of diabetes in general practice: Impact on current wellbeing and future disease risk. Br Med J 1998; 317: 1202–1208.

    CAS  Google Scholar 

  24. Bradley C. What about quality of life? Balance 1994; 140: Special issue on the implications of the Diabetes Control and Complications Trial June/July, viii–ix.

    Google Scholar 

  25. Bradley C. Importance of differentiating health status from quality of life The Lancet 2001; 357: 7–8.

    CAS  Google Scholar 

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Woodcock, A.J., Julious, S.A., Kinmonth, A.L. et al. Problems with the performance of the SF-36 among people with type 2 diabetes in general practice. Qual Life Res 10, 661–670 (2001). https://doi.org/10.1023/A:1013837709224

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