Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 6;23(1):20.
doi: 10.1186/s12955-025-02350-6.

Psychometric properties of the Chinese version of the SF-36v2 in patients with severe mental illnesses in China: factor structure, reliability, and validity

Yang Wang  1 , Xia Zhang  1 , Jiajia Dong  2 , Jianwen Zhu  1 , Jie Fu  2 , Sizhe Wang  2 , Jinxin Li  1 , Yue Zhang  2 , Jianxiao Zheng  2 , Lu Wen  3 , Dianjiang Li  2 , Hong Fan  4
Affiliations

Psychometric properties of the Chinese version of the SF-36v2 in patients with severe mental illnesses in China: factor structure, reliability, and validity

Yang Wang et al. Health Qual Life Outcomes. .

Abstract

Objective: Patients with severe mental illnesses(SMIs) often experience a diminished quality of life(QOL), and a validated tool to assess their QOL remains lacking. This study aimed to evaluate the psychometric characteristics of SF-36v2 among Chinese SMIs patients to determine its suitability for assessing their QOL.

Methods: We conducted a cross-sectional study involving 924 randomly selected SMIs patients from 23 community health centers in Nanjing, China. The reliability of the SF-36v2 was assessed by Cronbach's alpha and split-half reliability. Factor structure was examined by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Convergent validity was evaluated using average variance extracted (AVE) and composite reliability (CR).

Results: The SF-36v2 scale demonstrated good internal consistency, with a Cronbach's alpha of 0.941 and split-half reliability of 0.965. A slight ceiling effect was observed in the Social Function dimension (17.6%). CFA confirmed the acceptability of the hypothesized model, with the measurement model meeting all relevant fit metrics (X2/ df = 1.552, p < 0.05, RMR = 0.037, GFI = 0.950, AGFI = 0.942, CFI = 0.984, NFI = 0.955, RMSEA = 0.024). For each dimension, AVE > 0.5 and CR > 0.7, indicating good convergent validity of the scale. The square root of the AVE from the variables was greater than the correlation between the dimensions in the model, supporting the scale's discriminant validity. Additionally, the PCS (43.74 ± 10.28) and MCS (43.74 ± 10.28) scores of patients with SMIs were significantly lower than the Chinese general population norm (p < 0.001).

Conclusions: The SF-36v2 demonstrated robust psychometric properties, making it a reliable and valid tool for assessing QOL in SMIs patients. Its application can facilitate an objective evaluation of QOL in this population and inform treatment decisions accordingly.

Keywords: Psychometric properties; Quality of life; SF-36v2; Severe mental illnesses.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted in adherence to the local and international ethical principles including those in the Declaration of Helsinki. The study was approved by the Ethics Committee of Nanjing Medical University (approval number 2023-047). Written informed consent was obtained from a legally authorised representative for anonymised patient information to be published in this article. Consent for publication: The findings described in this document have not been previously published, and none of the authors are currently submitting them to another publisher for consideration. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The SF-36v2 second-order factorial model plot
See this image and copyright information in PMC

References

    1. China NHCotPsRo. Chinese norms for the management and treatment of serious mental Illnesses(2018 Edition). Chin Practical J Rural Doctor. 2018;25(7):11–22.
    1. Zhang W, Ma N, Wang X, Wu X, Zhao M, Chen R, et al. Management and services for psychosis in the People’s Republic of China in 2020. Chin J Psychiatry. 2022;55(2):122–8.
    1. Xu Y, Li Y, Jiang B. Intervention effect of comprehensive community management on troublemaking behaviors among patients with severe psychosis in China:a metaanalysis. China J Public Health. 2015;31(8):1091–4.
    1. Gronholm PC, Chowdhary N, Barbui C, Das-Munshi J, Kolappa K, Thornicroft G, et al. Prevention and management of physical health conditions in adults with severe mental disorders: WHO recommendations. Int J Mental Health Syst. 2021;15(1):22. - PMC - PubMed
    1. Fiorillo A, Luciano M, Pompili M, Sartorius N, Editorial. Reducing the mortality gap in people with severe mental disorders: the role of lifestyle psychosocial interventions. Front Psychiatry. 2019;10:3. - PMC - PubMed

Publication types

LinkOut - more resources