Measuring health status in Israeli patients with fibromyalgia syndrome and widespread pain and healthy individuals: utility of the short form 36-item health survey (SF-36)

Abstract

Objectives: To examine the usefulness of the Medical Outcomes Study Short Form-36 (MOS SF-36) in measuring health-related quality of life (QOL) in fibromyalgia syndrome (FMS) patients, and to determine whether subscale scores of SF-36 could distinguish patients with FMS from patients with widespread pain alone, and from healthy individuals.

Methods: The study population included three groups of women: 90 patients with FMS, 96 patients with widespread pain, and 50 healthy controls. In all subjects, health-related QOL was assessed by SF-36. The Health Assessment Questionnaire was used to evaluate functional disability, helplessness and psychological status. FMS-related symptoms and tenderness also were assessed.

Results: The 8 subscales of SF-36 showed a consistent pattern for physical function, physical role functioning, body pain, general health, vitality, and social function, with the lowest scores in patients with FMS, intermediate scores in patients with widespread pain alone, and the highest scores in healthy subjects. Emotional role functioning and mental health scores were significantly higher among healthy controls than among patients. The SF-36 subscales of physical functioning, bodily pain, and social functioning were highly correlated with another measure of functional disability (from the Health Assessment Questionnaire) in all patient groups. Most of the subscales were associated with psychological variables (helplessness, depression, and anxiety). All eight subscales of SF-36 were strongly correlated with the mean score of another measure of quality of life, QOL-16.

Conclusions: Most of the SF-36 subscales represent health dimensions relevant to patients with FMS and widespread pain alone. The severity of functional impairment as assessed by the SF-36, distinguishes patients with FMS and widespread pain alone from healthy individuals, and also discriminates between patients with widespread pain alone and FMS patients.