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. 2009;19(6):333-41.
doi: 10.2188/jea.je20080086. Epub 2009 Sep 12.

Development and evaluation of a questionnaire for measuring suboptimal health status in urban Chinese

Yu-Xiang Yan  1 , You-Qin Liu, Man Li, Pei-Feng Hu, Ai-Min Guo, Xing-Hua Yang, Jing-Jun Qiu, Shan-Shan Yang, Jian Shen, Li-Ping Zhang, Wei Wang
Affiliations

Development and evaluation of a questionnaire for measuring suboptimal health status in urban Chinese

Yu-Xiang Yan et al. J Epidemiol. 2009.

Abstract

Background: Suboptimal health status (SHS) is characterized by ambiguous health complaints, general weakness, and lack of vitality, and has become a new public health challenge in China. It is believed to be a subclinical, reversible stage of chronic disease. Studies of intervention and prognosis for SHS are expected to become increasingly important. Consequently, a reliable and valid instrument to assess SHS is essential. We developed and evaluated a questionnaire for measuring SHS in urban Chinese.

Methods: Focus group discussions and a literature review provided the basis for the development of the questionnaire. Questionnaire validity and reliability were evaluated in a small pilot study and in a larger cross-sectional study of 3000 individuals. Analyses included tests for reliability and internal consistency, exploratory and confirmatory factor analysis, and tests for discriminative ability and convergent validity.

Results: The final questionnaire included 25 items on SHS (SHSQ-25), and encompassed 5 subscales: fatigue, the cardiovascular system, the digestive tract, the immune system, and mental status. Overall, 2799 of 3000 participants completed the questionnaire (93.3%). Test-retest reliability coefficients of individual items ranged from 0.89 to 0.98. Item-subscale correlations ranged from 0.51 to 0.72, and Cronbach's alpha was 0.70 or higher for all subscales. Factor analysis established 5 distinct domains, as conceptualized in our model. One-way ANOVA showed statistically significant differences in scale scores between 3 occupation groups; these included total scores and subscores (P<0.01). The correlation between the SHS scores and experienced stress was statistically significant (r=0.57, P<0.001).

Conclusions: The SHSQ-25 is a reliable and valid instrument for measuring sub-health status in urban Chinese.

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