Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2017

Open Access 01-01-2017 | Short report

Reliability and validity of the SF-36 Health Survey Questionnaire in patients with brain tumors: a cross-sectional study

Author: Adomas Bunevicius

Published in: Health and Quality of Life Outcomes | Issue 1/2017

Login to get access

Abstract

Background

Deterioration of health related quality of life (HRQoL) is common in brain tumor patients. This study evaluated validity and reliability of the Medical Outcomes Study 36-Item Short Form (SF-36) in patients with brain tumors.

Methods

Two hundred and seventy-seven patients admitted for brain tumor surgery were evaluated for HRQoL (SF-36 questionnaire); depressive symptoms (Beck Depression Inventory-II or BDI-II); and functional status (Barthel index or BI). Final histological diagnosis was obtained from pathology reports.

Results

Two-hundred and twenty-seven (completion rate of 82%) patients (69% women; mean age 55.8 ± 14.4 years) completed the SF-36 questionnaire. The most common brain tumor diagnosis was meningioma (40%), followed high-grade glioma (19%). Missing data rates were ≤4%. Internal consistency was adequate for all (Cronbach α ≥ .728) but Social Functioning (Cronbach α = .527) and General Health (Cronbach α = .693) subscales. Ceiling (≥36%) and floor (≥22%) effect rates were the greatest for the Role Limitations subscales. The SF-36 subscales pertaining physical health correlated the strongest with the BI score, while the SF-36 subscales pertaining emotional health correlated the strongest with the BDI-II score. Patients with mild-moderate depressive symptoms (BDI-II score ≥20) scored lower across all SF-36 subscales, and handicap patients (BI score <90) scored the lower across all, but Mental Health, subscales.

Conclusions

The SF-36 is a valid and reliable instrument in brain tumor patients and therefore can be reliably applied for evaluation of HRQoL in neuro-oncology setting. Further studies exploring other psychometric properties of the SF-36 in brain tumor patients across disease progression stages are warranted.
Literature
2.
go back to reference Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. American Society of Clinical Oncology. J Clin Oncol. 1996, 14:671–679. Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. American Society of Clinical Oncology. J Clin Oncol. 1996, 14:671–679.
3.
go back to reference Bunevicius A, Tamasauskas S, Deltuva V, Tamasauskas A, Radziunas A, Bunevicius R. Predictors of health-related quality of life in neurosurgical brain tumor patients: focus on patient-centered perspective. Acta Neurochir. 2014;156:367–74.CrossRefPubMed Bunevicius A, Tamasauskas S, Deltuva V, Tamasauskas A, Radziunas A, Bunevicius R. Predictors of health-related quality of life in neurosurgical brain tumor patients: focus on patient-centered perspective. Acta Neurochir. 2014;156:367–74.CrossRefPubMed
4.
go back to reference Bosma I, Reijneveld JC, Douw L, Vos MJ, Postma TJ, Aaronson NK, Muller M, Vandertop WP, Slotman BJ, Taphoorn MJ, et al. Health-related quality of life of long-term high-grade glioma survivors. Neuro Oncol. 2009;11:51–8.CrossRefPubMedPubMedCentral Bosma I, Reijneveld JC, Douw L, Vos MJ, Postma TJ, Aaronson NK, Muller M, Vandertop WP, Slotman BJ, Taphoorn MJ, et al. Health-related quality of life of long-term high-grade glioma survivors. Neuro Oncol. 2009;11:51–8.CrossRefPubMedPubMedCentral
5.
go back to reference Mainio A, Tuunanen S, Hakko H, Niemela A, Koivukangas J, Rasanen P. Decreased quality of life and depression as predictors for shorter survival among patients with low-grade gliomas: a follow-up from 1990 to 2003. Eur Arch Psychiatry Clin Neurosci. 2006;256:516–21.CrossRefPubMed Mainio A, Tuunanen S, Hakko H, Niemela A, Koivukangas J, Rasanen P. Decreased quality of life and depression as predictors for shorter survival among patients with low-grade gliomas: a follow-up from 1990 to 2003. Eur Arch Psychiatry Clin Neurosci. 2006;256:516–21.CrossRefPubMed
7.
go back to reference Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–83.CrossRefPubMed Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–83.CrossRefPubMed
9.
go back to reference Treanor C, Donnelly M. A methodological review of the Short Form Health Survey 36 (SF-36) and its derivatives among breast cancer survivors. Qual Life Res. 2015;24:339–62.CrossRefPubMed Treanor C, Donnelly M. A methodological review of the Short Form Health Survey 36 (SF-36) and its derivatives among breast cancer survivors. Qual Life Res. 2015;24:339–62.CrossRefPubMed
10.
go back to reference Reulen RC, Zeegers MP, Jenkinson C, Lancashire ER, Winter DL, Jenney ME, Hawkins MM. The use of the SF-36 questionnaire in adult survivors of childhood cancer: evaluation of data quality, score reliability, and scaling assumptions. Health Qual Life Outcomes. 2006;4:77.CrossRefPubMedPubMedCentral Reulen RC, Zeegers MP, Jenkinson C, Lancashire ER, Winter DL, Jenney ME, Hawkins MM. The use of the SF-36 questionnaire in adult survivors of childhood cancer: evaluation of data quality, score reliability, and scaling assumptions. Health Qual Life Outcomes. 2006;4:77.CrossRefPubMedPubMedCentral
11.
go back to reference Beck AT, Steer RA, Brown GK. BG: Manual for the Beck Depression Inventory (BDI-II). 2nd ed. San Antonio: The Psychological Association; 1996. Beck AT, Steer RA, Brown GK. BG: Manual for the Beck Depression Inventory (BDI-II). 2nd ed. San Antonio: The Psychological Association; 1996.
12.
go back to reference Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med. 1965:61–5 Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med. 1965:61–5
13.
go back to reference Brantley PJ, Dutton Gareth R, Wood Karen B. The Beck Depression Inventory - II (BDI-II) and the Beck Depression Inventory-Primary Care (BDI-PC). In: Maruish ME, editor. The use of psychological testing for treatment planning and outcome assessment. 3rd ed. Mahwah: Lawrence Erlbaum Associates; 1999. p. 313–25. Brantley PJ, Dutton Gareth R, Wood Karen B. The Beck Depression Inventory - II (BDI-II) and the Beck Depression Inventory-Primary Care (BDI-PC). In: Maruish ME, editor. The use of psychological testing for treatment planning and outcome assessment. 3rd ed. Mahwah: Lawrence Erlbaum Associates; 1999. p. 313–25.
14.
go back to reference Bunevicius A, Deltuva V, Tamasauskas S, Tamasauskas A, Bunevicius R. Screening for psychological distress in neurosurgical brain tumor patients using the Patient Health Questionnaire-2. Psychooncology. 2013;22:1895–1900.CrossRefPubMed Bunevicius A, Deltuva V, Tamasauskas S, Tamasauskas A, Bunevicius R. Screening for psychological distress in neurosurgical brain tumor patients using the Patient Health Questionnaire-2. Psychooncology. 2013;22:1895–1900.CrossRefPubMed
15.
go back to reference Nunnaly J, Bernstein I. Psychometric Theory. New York: McGraw-Hill Book Co; 1994. Nunnaly J, Bernstein I. Psychometric Theory. New York: McGraw-Hill Book Co; 1994.
16.
go back to reference Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34–42.CrossRefPubMed Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34–42.CrossRefPubMed
17.
go back to reference McHorney CA, Ware Jr JE, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994;32:40–66.CrossRefPubMed McHorney CA, Ware Jr JE, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994;32:40–66.CrossRefPubMed
18.
go back to reference Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R, Sprangers MA, te Velde A, Verrips E. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998;51:1055–68.CrossRefPubMed Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R, Sprangers MA, te Velde A, Verrips E. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998;51:1055–68.CrossRefPubMed
19.
go back to reference Alonso J, Prieto L, Anto JM. [The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire): an instrument for measuring clinical results]. Med Clin. 1995;104:771–6. Alonso J, Prieto L, Anto JM. [The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire): an instrument for measuring clinical results]. Med Clin. 1995;104:771–6.
20.
go back to reference Anderson C, Laubscher S, Burns R. Validation of the Short Form 36 (SF-36) health survey questionnaire among stroke patients. Stroke. 1996;27:1812–6.CrossRefPubMed Anderson C, Laubscher S, Burns R. Validation of the Short Form 36 (SF-36) health survey questionnaire among stroke patients. Stroke. 1996;27:1812–6.CrossRefPubMed
21.
go back to reference Krokavcova M, van Dijk JP, Nagyova I, Rosenberger J, Gavelova M, Gdovinova Z, Groothoff JW. Perceived health status as measured by the SF-36 in patients with multiple sclerosis: a review. Scand J Caring Sci. 2009;23:529–38.CrossRefPubMed Krokavcova M, van Dijk JP, Nagyova I, Rosenberger J, Gavelova M, Gdovinova Z, Groothoff JW. Perceived health status as measured by the SF-36 in patients with multiple sclerosis: a review. Scand J Caring Sci. 2009;23:529–38.CrossRefPubMed
22.
go back to reference Osoba D, Brada M, Prados MD, Yung WK. Effect of disease burden on health-related quality of life in patients with malignant gliomas. Neuro Oncol. 2000;2:221–8.PubMedPubMedCentral Osoba D, Brada M, Prados MD, Yung WK. Effect of disease burden on health-related quality of life in patients with malignant gliomas. Neuro Oncol. 2000;2:221–8.PubMedPubMedCentral
23.
go back to reference Boele FW, Rooney AG, Grant R, Klein M. Psychiatric symptoms in glioma patients: from diagnosis to management. Neuropsychiatr Dis Treat. 2015;11:1413–20.CrossRefPubMedPubMedCentral Boele FW, Rooney AG, Grant R, Klein M. Psychiatric symptoms in glioma patients: from diagnosis to management. Neuropsychiatr Dis Treat. 2015;11:1413–20.CrossRefPubMedPubMedCentral
24.
go back to reference Cheng JX, Liu BL, Zhang X, Lin W, Zhang YQ, Liu WP, Zhang JN, Lin H, Wang R, Yin H. Health-related quality of life in glioma patients in China. BMC Cancer. 2010;10:1471–2407.CrossRef Cheng JX, Liu BL, Zhang X, Lin W, Zhang YQ, Liu WP, Zhang JN, Lin H, Wang R, Yin H. Health-related quality of life in glioma patients in China. BMC Cancer. 2010;10:1471–2407.CrossRef
25.
go back to reference Rooney AG, McNamara S, Mackinnon M, Fraser M, Rampling R, Carson A, Grant R. Frequency, clinical associations, and longitudinal course of major depressive disorder in adults with cerebral glioma. J Clin Oncol. 2011;29:4307–12.CrossRefPubMed Rooney AG, McNamara S, Mackinnon M, Fraser M, Rampling R, Carson A, Grant R. Frequency, clinical associations, and longitudinal course of major depressive disorder in adults with cerebral glioma. J Clin Oncol. 2011;29:4307–12.CrossRefPubMed
26.
go back to reference Pelletier G, Verhoef MJ, Khatri N, Hagen N. Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues. J Neurooncol. 2002;57:41–9.CrossRefPubMed Pelletier G, Verhoef MJ, Khatri N, Hagen N. Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues. J Neurooncol. 2002;57:41–9.CrossRefPubMed
27.
go back to reference Bunevicius A, Deltuva V, Tamasauskas S, Tamasauskas A, Laws Jr ER, Bunevicius R. Low triiodothyronine syndrome as a predictor of poor outcomes in patients undergoing brain tumor surgery: a pilot study: clinical article. J Neurosurg. 2013;118:1279–87.CrossRefPubMed Bunevicius A, Deltuva V, Tamasauskas S, Tamasauskas A, Laws Jr ER, Bunevicius R. Low triiodothyronine syndrome as a predictor of poor outcomes in patients undergoing brain tumor surgery: a pilot study: clinical article. J Neurosurg. 2013;118:1279–87.CrossRefPubMed
28.
go back to reference Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 health survey: manual and interpretation guide. Boston: New England Medical Center, the Health Institute; 1993. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 health survey: manual and interpretation guide. Boston: New England Medical Center, the Health Institute; 1993.
29.
go back to reference Hammerlid E, Taft C. Health-related quality of life in long-term head and neck cancer survivors: a comparison with general population norms. Br J Cancer. 2001;84:149–56.CrossRefPubMedPubMedCentral Hammerlid E, Taft C. Health-related quality of life in long-term head and neck cancer survivors: a comparison with general population norms. Br J Cancer. 2001;84:149–56.CrossRefPubMedPubMedCentral
30.
go back to reference Wyrwich KW, Tierney WM, Babu AN, Kroenke K, Wolinsky FD. A comparison of clinically important differences in health-related quality of life for patients with chronic lung disease, asthma, or heart disease. Health Serv Res. 2005;40:577–91.CrossRefPubMedPubMedCentral Wyrwich KW, Tierney WM, Babu AN, Kroenke K, Wolinsky FD. A comparison of clinically important differences in health-related quality of life for patients with chronic lung disease, asthma, or heart disease. Health Serv Res. 2005;40:577–91.CrossRefPubMedPubMedCentral
31.
go back to reference Carlson ML, Tveiten OV, Yost KJ, Lohse CM, Lund-Johansen M, Link MJ. The Minimal Clinically Important Difference in Vestibular Schwannoma Quality-of-Life Assessment: An Important Step beyond P < .05. Otolaryngol Head Neck Surg. 2015;153:202–8.CrossRefPubMed Carlson ML, Tveiten OV, Yost KJ, Lohse CM, Lund-Johansen M, Link MJ. The Minimal Clinically Important Difference in Vestibular Schwannoma Quality-of-Life Assessment: An Important Step beyond P < .05. Otolaryngol Head Neck Surg. 2015;153:202–8.CrossRefPubMed
32.
go back to reference Leplege A, Ecosse E, Verdier A, Perneger TV. The French SF-36 Health Survey: translation, cultural adaptation and preliminary psychometric evaluation. J Clin Epidemiol. 1998;51:1013–23.CrossRefPubMed Leplege A, Ecosse E, Verdier A, Perneger TV. The French SF-36 Health Survey: translation, cultural adaptation and preliminary psychometric evaluation. J Clin Epidemiol. 1998;51:1013–23.CrossRefPubMed
33.
go back to reference Osoba D, Aaronson NK, Muller M, Sneeuw K, Hsu MA, Yung WK, Brada M, Newlands E. The development and psychometric validation of a brain cancer quality-of-life questionnaire for use in combination with general cancer-specific questionnaires. Qual Life Res. 1996;5:139–50.CrossRefPubMed Osoba D, Aaronson NK, Muller M, Sneeuw K, Hsu MA, Yung WK, Brada M, Newlands E. The development and psychometric validation of a brain cancer quality-of-life questionnaire for use in combination with general cancer-specific questionnaires. Qual Life Res. 1996;5:139–50.CrossRefPubMed
Metadata
Title
Reliability and validity of the SF-36 Health Survey Questionnaire in patients with brain tumors: a cross-sectional study
Author
Adomas Bunevicius
Publication date
01-01-2017
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2017
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-017-0665-1

Other articles of this Issue 1/2017

Health and Quality of Life Outcomes 1/2017 Go to the issue