BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) Year: 1992 Domain: Biological, Psychological, Social Assessment Tool Category: Physical FunctioningéADLs, Quality of Life, Social Support   Variations/Translations: SF-12, SF-6, SF-20   Setting: Clinical settings, home/phone survey   Method of Delivery: Individuals can self-administer the test or it can be administered by another individual.   Description: The SF-36 is a general measure of health status and quality of life. The questionnaire consists of 36 items which measure eight health domains: physical functioning, role limitations because of physical impediments, role limitations because of social impediments, physical pain, health perceptions, vitality, social functioning, and mental health. The survey is a general tool that is implemented for many age groups. Also, it may be used with disease specific measures as an outcome measure in clinical practice and research.   Scoring/Interpretation: Items on each scale are coded, summed, and given final percentage values, ranging from 0 (worst health) to 100 (best health). Numbers are transformed to give a mean of 50. Two summary scores reflecting physical or mental health can be derived from the SF-36. As well, the second question on this test covers change in health status over the past year, and is not counted in scoring the eight dimensions but is used to estimate change in health form a cross-sectional administration of the SF-36.   Time to Administer: 5-10 minutes to complete.   Availability: Pay for use using website (see below) or use RAND website (different scoring; http://www.rand.org/health/surveys_tools/mos/mos_core_36item.html) or see McDowell (2006) Software: Online scoring service   Website: http://www.sf-36.org/   Quantitative/Qualitative:  Quantitative   Validity (Quantitative): Correlations of the test with others are quit high. With the Sickness Impact Profile, a correlation of 0.78 for 106 hip patients was found. Correlation of the eight scales with the British version of this test with the EuroQol Quality of Life Index ranged from 0.48 to 0.60 (p,0.01). The SF-36 is quite sensitive to changes: an effect size of 0.67 was obtained in a study of patients with musculoskeletal disorders was higher than that for the Nottingham Health Profile, or the Duke. The SF-36 does not discriminate well between different populations of people; however, by supplementing some questions with ones targeting a specific population, discriminant validity can be achieved.   Reliability (Quantitative): Reliability coefficients for all dimensions were greater than 0.74. The test-retest reliability of SF-36 was found to be excellent. Alpha internal consistency coefficients for the eight scales have been reported from many studies (14). The combined results show the median alpha reliability for all scales exceeds 0.80, except for the two item social functioning scale (0.76). All scales are reliable for comparing groups and the physical functioning scale for comparing individuals. The intraclass correlation was 0.85 for patients with musculoskeletal problems. Test-retest correlations (at two weeks) exceeded 0.8 for physical function, vitality, and general health perceptions. The lowest coefficient was 0.6 for social function.   References:   Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item Short-Form Health Survey (SF-36), Medical Care, 30, 473-483.   Brazier, J. E., Harper, R., Jones, N. M., O-Cathain, A., Thomas, K. J., Usherwood, T., et al. (1992). Validating the SF-36 health survey questionnaire: New outcome measure for primary care. British Medical Journal, 305, 160-164.   McDowell, I. (2006). Measuring Health: A guide to rating scales and questionnaires 3rd Ed. New York: Oxford University Press. Comments: N/A