Evaluation of Medical Outcomes Study Short Form-36 Taiwan Version in Assessing Elderly Patients with Hip Fracture

The Medical Outcomes Study Short Form-36 (SF-36) is a widely used measure of generic health related quality of life. The purpose of this study is to establish the validity and reliability of the SF-36, Taiwan Version, when applied to a sample of elderly patients with hip fracture in Taiwan. Data from two samples were used, the first sample (n = 87) from a prospective descriptive study for testing psychometric scaling assumptions, scale responsiveness and criterion validity, and the second sample (n = 69) from a clinical trial for examining the validity of the differences in the group. The SF-36 Taiwan version demonstrated good evidence of supporting the scaling assumption. Cronbach's alpha coefficients above 0.70 for all scales support the internal consistency. The Physical Function (PF) scale had an effect size of 0.88 from months 1 to 3, and 0.59 from months 3 to 6 after discharge, which appears to have the best responsiveness to clinical changes. Notable floor and ceiling effects (> 15%) for Role Emotion (RE), Role-Physical (RP) and PF scales were found. High correlation of 0.62 between the PF and measures of activities of daily living (ADLs), and between RP and instrumental activities of daily living (IADLs) (0.63) supports the construct validity. Significantly higher performance in most SF-36 scales in elders without risk for depression than those who were at risk supported the validity of the group differences. In its current form, the SF-36 Taiwan version demonstrated good reliability and validity as applied to patients with hip fracture.