Psychometric evaluation of a Chinese (Taiwanese) version of the SF-36 health survey amongst middle-aged women from a rural community

The SF-36 summary scales were valid, reliable, and equivalent in a Chinese population

OBJECTIVES

To find out whether the SF-36 physical and mental health summary (PCS and MCS) scales are valid and equivalent in the Chinese population in Hong Kong (HK).

STUDY DESIGN AND SETTING

The SF-36 data of a cross-sectional study on 2,410 Chinese adults randomly selected from the general population in HK were analyzed.

RESULTS

The hypothesized two-factor structure of the physical and mental health summary scales (PCS and MCS) was replicated and the expected differences in scores between known morbidity groups were shown. The internal reliability coefficients of the PCS and MCS scales ranged from 0.85 to 0.87. The effect size differences between the U.S. standard and HK-specific PCS and MCS scores were mostly <0.5. The effect size differences in the standard PCS and MCS scores of specific groups between the U.S. and H.K. populations were all <0.5.

CONCLUSION

The PCS and MCS scales were applicable to the Chinese population in HK. The high level of measurement equivalence of the scales between the U.S. and H.K. populations suggests that data pooling between the two populations could be possible. To our knowledge, this is the first study to show that the SF-36 summary scales are valid and equivalent in an Asian population.

Impact of stereopsis on quality of life

PURPOSE

To investigate the impact of stereopsis on vision-related quality of life and general health status of the elderly.

METHODS

A quota of 200 subjects aged 65 years or older and had their households registered in Guando district was recruited for a general physical examination including ophthalmic evaluation. A structured questionnaire consisting of seven vision-specific items as well as 36-item short-form survey of the Medical Outcomes Study (SF-36) was administered. Stereoscopic level was divided into three groups: no stereopsis, gross stereopsis, and fine stereopsis. Fisher's exact test was used to detect any difference in subjective visual functioning and Mann-Whitney U test was used for analyses of SF-36 scores.

RESULTS

A total of 187 volunteers were recruited and 150 were analysed for stereoscopic levels. There was no significant difference in vision-specific difficulty among the three stereoscopic groups. For SF-36, having no stereopsis scored significantly less than having gross (P=0.005) and fine (P<0.0001) stereopsis in the vitality/energy dimension. General health perception dimension fared significantly lower in the group with no stereopsis compared to the fine stereoscopic group (P=0.01). In multivariate analysis, having fine stereopsis scored significantly higher in the energy/vitality dimension than having no stereopsis (P=0.02). On the other hand, visual impairment imposed significant adverse effect on five vision-specific items and had no significant relationship with the eight dimensions of SF-36.

CONCLUSIONS

Defective stereopsis in the elderly imposes no significant adverse effect on vision-related quality of life. However, subjects may feel more exhausted in accomplishing their usual tasks.

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.

The Short Form Health Survey (SF-36): translation and validation study of the Iranian version

This was a large population-based study to develop and validate the Iranian version of the Short Form Health Survey (SF-36) for use in health related quality of life assessment in Iran. A culturally comparable questionnaire was developed and pilot tested. Then, the Iranian version of the SF-36 was administered to a random sample of 4163 healthy individuals aged 15 years and over in Tehran. The mean age of the respondents was 35.1 (SD = 16.0) years, 52% were female, mostly married (58%) and the mean years of their formal education was 10.0 (SD = 4.5). Reliability was estimated using the internal consistency and validity was assessed using known groups comparison and convergent validity. In addition factor analysis was performed. The internal consistency (to test reliability) showed that all eight SF-36 scales met the minimum reliability standard, the Cronbach's alpha coefficients ranging from 0.77 to 0.90 with the exception of the vitality scale (alpha = 0.65). Known groups comparison showed that in all scales the SF-36 discriminated between men and women, and old and the young respondents as anticipated (all p values less than 0.05). Convergent validity (to test scaling assumptions) using each item correlation with its hypothesized scale showed satisfactory results (all correlation above 0.40 ranging from 0.58 to 0.95). Factor analysis identified two principal components that jointly accounted for 65.9% of the variance. In general, the Iranian version of the SF-36 performed well and the findings suggest that it is a reliable and valid measure of health related quality of life among the general population.

Reliability and validity testing of a Chinese-translated version of the 39-item Parkinson's Disease Questionnaire (PDQ-39)

The trend toward international cooperation in research projects emphasizes the need to translate existing validated tools into local languages. The purpose of this study was to test the reliability and validity of a Chinese-translated version of the 39-item Parkinson's Disease Questionnaire (PDQ-39). Seventy-three Taiwanese individuals with Parkinson's disease were consecutively recruited. The internal consistency reliability was satisfactory for all domains (Cronbach's alpha = 0.80-0.96), except for the social support, cognition, and bodily discomfort domains (alpha = 0.58-0.63). The convergent validity was also supported by strong correlations between domains measuring related constructs of the PDQ-39 and Unified Parkinson's Disease Rating Scale (r = 0.81-0.86), and between those of the PDQ-39 and SF-36 (r = -0.70--0.93). Except for the bodily discomfort domain, all domains of the PDQ-39 significantly discriminated patients at different stages, as indicated by the Hoehn and Yahr scale. Overall, the results of this study are consistent with the reports of the PDQ-39 in other countries (e.g., UK, Spain, US, and Greece), which suggests that the PDQ-39 is appropriate for use among Taiwanese individuals with PD. This study lays the foundation for future combinations and comparisons of data cross-nationally.

Multiple Role Adaptation Among Women Who Have Children and Re-Enter Nursing School in Taiwan

This study assessed multiple role adaptation within maternal and student roles among female RNs who had children and returned to school for baccalaureate degrees in Taiwan. Using Roy's Adaptation Model as the theoretical framework, relationships were explored among demographic (number of children, age of youngest child, employment status), physical (sleep quality, health perception, activity), and psychosocial factors (self-identity, role expectation, role involvement, social support) and multiple role adaptation (role accumulation). The sample included 118 mother-students who had at least one child younger than age 18 and who were studying in nursing programs in Taiwan. The highest correlation was found between activity and role accumulation followed by significant correlations between sleep quality, health perception, maternal role expectation, and age of youngest child and role accumulation. In regression analyses, the complete model explained 46% of the variance in role accumulation. Implications for education and future research are identified.

Occupational and personal factors associated with acquired lumbar spondylolisthesis of urban taxi drivers

AIMS

To investigate the occupational and personal factors associated with lumbar spondylolisthesis in taxi drivers.

METHODS

Cross-sectional analysis of the baseline data from the Taxi Drivers' Health Study cohort. Information was retrieved from the medical records of standardised lumbosacral spine plain films, age, and anthropometric measures of 1242 subjects. Acquired spondylolisthesis (ASL) was defined as non-lytic spondylolisthesis involving lumbar spines above L5. Questionnaires were used to gather information on demographic features, health behaviours, exercise, work related physical and psychosocial factors, and driving time profiles. Multiple logistic regression was used to model the odds ratio (OR) for prevalent ASL cases associated with personal and occupational factors.

RESULTS

A total of 40 cases (3.2%) of ASL were diagnosed. Among those driving < or =5 years, 6-15 years, and >15 years, the estimated prevalence of lumbar spondylolisthesis was 1.1%, 2.4%, and 7.1% respectively. Results of multiple logistic regression suggested that taxicab driving >15 years (OR = 3.4, 95% CI 1.1 to 10.7, compared to driving < or =5 years), age (OR = 2.6, 95% CI 1.1 to 6.6 for age 46-55; and OR = 4.8, 95% CI 1.8 to 12.9 for age >55), body mass index > or =25 kg/m2 (OR = 2.2, 95% CI 1.1 to 4.6), and frequent strenuous exercise (OR = 2.2, 95% CI 1.1 to 4.5) were significantly associated with higher prevalence of spondylolisthesis. There was a consistent likely exposure-response relation between professional seniority and ASL prevalence.

CONCLUSIONS

Longitudinal studies are needed to confirm the observed association between professional driving and spondylolisthesis, and to examine further the specific occupational exposures accountable for this association.

Health-related quality of life of hemodialysis patients in Taiwan: a multicenter study

BACKGROUND/AIMS

Health-related quality of life (HRQOL) is an important determinant of treatment effectiveness in dialysis patients. To our knowledge, there are no reports evaluating HRQOL of hemodialysis (HD) in Chinese patients. The purpose of this study is to present our results about HRQOL using the 36-Item Short-Form (SF-36) questionnaire on Taiwanese hemodialysis patients.

METHODS

HRQOL was measured by using the SF-36 questionnaire in 497 HD patients in five hospitals.

RESULTS

The following attributes, male gender, age <50 years old, higher education level (HEL), marriage status, employment status (EPS), less comorbid medical condition (CMC), and non-diabetic patients (NDP) were all predicted on a better Physical Component Scale (PCS). Age <50 years old, body mass index >18.5, HEL, EPS and NDP were all predicted on a higher Mental Component Scale (MCS). Scales contributing to a summary measure of physical health, the PCS score was significantly lower in women (35.0 +/- 12.3) than in men (37.9 +/- 12.3). However, there was no difference in the MCS score between women and men. In multivariate analysis, age, CMC, diabetes, serum creatinine (SCr), and erythropoietin responsiveness were significant independent predictors of PCS. Diabetes, educational level, SCr, and erythropoietin responsiveness were significant independent predictors of MCS. All of the individual scales were lower in Taiwanese HD patients than in both the general Taiwanese and US population. Each of the individual scales and MCS scores were substantially lower in the Taiwan HD group than in the US HD cohort. However, the bodily pain of PCS was significantly higher in the Taiwan HD group, although the mean PCS scores for the Taiwan HD group and the US HD study participants were nearly equal at 36.3 and 36.1, respectively.

CONCLUSION

The physical and mental aspects of quality of life are substantially lower for Taiwanese HD patients, except for higher bodily pain tolerance. A number of demographic and clinical characteristics have a significant impact on HRQOL in Taiwanese HD patients.

The beneficial effect of regular endurance exercise training on blood pressure and quality of life in patients with hypertension

Regular aerobic exercise can reduce blood pressure and is recommended as part of the lifestyle modification to reduce high blood pressure and cardiovascular risk. Hypertension itself, or/and pharmacological treatment for hypertension is associated with adverse effects on some aspects of quality of life. This study was performed to evaluate the effects of regular endurance exercise training on quality of life and blood pressure. Patients with mild to moderate hypertension (systolic blood pressure 140-180 or diastolic blood pressure 90-110 mm Hg) were randomized to a moderate-intensity aerobic exercise group training for 3 sessions/week over 10 weeks or to a non-exercising control group. Health-related quality of life was assessed with the Short Form 36-item Health Survey (SF-36) at baseline and after 6 and 10 weeks. In the 102 subjects (47 male, mean age 47 years) who completed the study, reductions in blood pressure in the exercise group at 10 weeks (-13.1/-6.3 mm Hg) were significant (P < 0.001) compared to baseline and to the control group (-1.5/+6.0 mm Hg). Unlike the control group, the exercise group showed an increase in exercise capacity from 8.2 +/- 1.6 to 10.8 +/- 2.2 METS (P < 0.01) and showed higher scores on 7 out of 8 subscales (P < 0.05) of the SF-36. Improvement in bodily pain and general health sub-scores correlated with reduction in systolic blood pressure. Regular endurance training improves both blood pressure and quality of life in hypertensive patients and should be encouraged more widely.

The relationship between quality of life and psychiatric impairment for a Taiwanese community post-earthquake

This purpose of this study was to investigate the relationship between quality of life and psychiatric impairment in a Taiwanese community located near the epicenter of the 1999 earthquake, as assessed four to six months after the natural catastrophe. Trained assistants interviewed the 4223 respondents using the disaster-related psychological screening test (DRPST), an instrument specifically designed and validated by senior psychiatrists for assessment of psychiatric impairment after natural catastrophe. Additionally, the 36-Item Short-Form Health Survey (SF-36) was used to evaluate quality of life. The collected results were analyzed using Windows SPSS 10.0 software. Psychiatric impairment rated moderate to severe was assessed for 1448 (34.3%) of the responding residents. The 4223 respondents were divided into 4 psychiatric-impairment groups based on DPRST score: healthy (n = 952); mild impairment (n = 1823); moderate impairment (n = 1126); and, severe impairment (n = 322). The four groups were compared for a number of salient factors, including gender, age, current marital status and psychiatric-impairment score, to determine impact on quality of life. Respondents assessed as psychiatrically impaired tended to be older, female, divorced/widowed, and less educated, and they were more likely to have experienced major familial financial loss as an immediate consequence of the earthquake. Further, the greater the severity of the psychiatric impairment, the lower the scores for quality of life, for both the physical and mental aspects of this important general indicator.

Quality of life and related risk factors in a Taiwanese Village population 21 months after an earthquake

OBJECTIVE

To investigate quality of life and related risk factors of Taiwanese earthquake survivors with different psychiatric disorders 21 months after the earthquake.

METHOD

This was a population survey. Trained assistants used the Medical Outcomes Study Short Form-36 (MOS SF-36) and questionnaires to interview 461 respondents (209 males and 252 females) 16 years or older who were equally exposed to the earthquake. Psychiatrists interviewed the same respondents using the Mini-International Neuropsychiatric Interview (MINI), with an adjusted response rate of 79.9%.

RESULTS

The prevalence of varied psychiatric disorders in earthquake survivors ranged from 3.3% to 18%. However, there was almost a positive trend in quality of life in survivors among the following groups: posttraumatic stress disorder combined with major depressive episode; major depressive episode; posttraumatic stress disorder; other psychiatric diseases; and healthy mentality groups on the physical aspect or mental aspect of the MOS SF-36. When survivors were elderly or female and had experienced prominent financial loss immediately after the earthquake, social network change, and mental impairment, their quality of life tended to be worse.

CONCLUSION

The earthquake survivors had a higher percentage of psychiatric disorders. The risk factors that affected quality of life in survivors were age, female sex, financial loss, social network change, and mental impairment.

Knee pain and driving duration: a secondary analysis of the Taxi Drivers' Health Study

OBJECTIVES

We explored a postulated association between daily driving time and knee pain.

METHODS

We used data from the Taxi Drivers' Health Study to estimate 1-year prevalence of knee pain as assessed by the Nordic musculoskeletal questionnaire.

RESULTS

Among 1242 drivers, the prevalence of knee pain, stratified by duration of daily driving (< or = 6, > 6 through 8, > 8 through 10, and > 10 hours), was 11%, 17%, 19%, and 22%, respectively. Compared with driving 6 or fewer hours per day, the odds ratio of knee pain prevalence for driving more than 6 hours per day was 2.52 (95% confidence interval = 1.36, 4.65) after we adjusted for socioeconomic, work-related, and personal factors in the multiple logistic regression.

CONCLUSIONS

The dose-related association between driving duration and knee pain raises concerns about work-related knee joint disorders among professional drivers.

Quality of life of lung cancer patients: validation of the Taiwan Chinese version of the EORTC QLQ-C30 and QLQ-LC13

The purpose of this study was to test the validity and reliability of the Taiwan Chinese translation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30, version 3) and Quality of Life Questionnaire Lung Cancer-13 (QLQ-LC13) questionnaires. Consecutively 51 patients with lung cancer undergoing active chemotherapy and 48 such patients undergoing regular follow-up completed the questionnaires. The intraclass correlation between test and retest ranged from 0.46 to 0.85 for the QLQ-C30 and was 0.76 for dyspnea for the QLQ-LC13. The kappa coefficients between test and retest ranged from 0.51 to 0.73 for single items of the QLQ-C30 and 0.49-0.68 for five of the nine items in the QLQ-LC13. The Cronbach's alpha coefficients were > or = 0.70 for all scales of the two questionnaires apart from that of cognitive functioning. The correlation coefficients between indices measuring similar dimensions of the EORTC QLQ-C30 and the SF-36 questionnaires ranged from 0.43 to 0.73, and that between the dyspnea scales of the two EORTC questionnaires was 0.70. Patients in the follow-up group revealed higher scores of global status/quality of life, and lower scores of nausea/vomiting, as also physical functioning. The questionnaires could also detect expected adverse effects of radiotherapy, cisplatin, and paclitaxel.

Use of the SF-36 in low-income Chinese American primary care patients

BACKGROUND

Measures of health status have been increasingly utilized but most research in the United States has been conducted on middle-class, English-speaking white persons. Although Asians reportedly often have a better health status than white persons, previously surveyed samples may not be representative of low-income non-English-speaking Asian immigrant populations.

MATERIALS AND METHODS

This cross-sectional study surveyed a convenience sample of low-income Chinese patients attending a community health center in Chinatown (New York City). We sought to evaluate the known-groups validity of self-administered Chinese and English versions of the Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36) and to determine if scores differed from a community-based sample of Chinese Americans and the United States general population.

RESULTS

Eight hundred fifty-six persons were approached and data were obtained from 523 participants (61%); 90% completed the questionnaire in Chinese and 74% earned less than 15,000 US dollars. Known-group comparisons based upon differences in age, gender, and number of medical problems yielded support for the validity of the SF-36 in this sample. The sample's SF-36 subscale scores were lower than scores from the community-based sample of Chinese Americans and tended to be lower than scores from the United States general population. Mean scores were lowest for persons reporting depression, anxiety, or an emotional problem.

CONCLUSIONS

The SF-36 demonstrated known-groups validity in this low-income Chinese sample. Collecting data in the primary care setting enables both a better understanding of the relative burden of disease in low-income Chinese and targeted program planning for preventive interventions.

Chinese SF-36 Health Survey: translation, cultural adaptation, validation, and normalisation

STUDY OBJECTIVE

To develop a self administered Chinese (mainland) version of the Short-Form Health Survey (SF-36) for use in health related quality of life measurements in China.

DESIGN

A three stage protocol was followed including translation, tests of scaling construction and scoring assumptions, validation, and normalisation.

SETTING

1000 households in 18 communities of Hangzhou.

PARTICIPANTS

1688 respondents recruited by multi-stage mixed sampling.

MAIN RESULTS

The assumption of equal intervals was violated for the vitality and mental health scales. The recoded item values were used to calculate scale scores. The clustering and ordering of item means was the same as that of the source and other two Chinese versions. The items in each scale had similar standard deviations except those in the physical functioning, boduily pain, social functioning scales. The item hypothesised scale correlations were identical for all except the social functioning and vitality scales. Convergent validity and discriminant validity were satisfactory for all except the social functioning scale. Cronbach's alpha coefficients ranged from 0.72 to 0.88 except 0.39 for the social functioning scale and 0.66 for the vitality scale. Two weeks test-retest reliability coefficients ranged from 0.66 to 0.94. Factor analysis identified two principal components explaining 56.3% of the total variance. The Chinese SF-36 could distinguish known groups.

CONCLUSIONS

This study suggested that the Chinese (mainland) version of the SF-36 functioned in the general population of Hangzhou, China quite similarly to the original American population tested. Caution is recommended in the interpretation of the social functioning and vitality scales pending further studies.

Quality of life in patients of nasopharyngeal carcinoma: validation of the Taiwan Chinese version of the EORTC QLQ-C30 and the EORTC QLQ-H&N35

The authors followed the guidelines of translation and pilot testing of the EORTC QLQ-C30 and EORTC-QLQ-H&N35 questionnaires. The questionnaires were given to 50 nasopharyngeal carcinoma patients under active treatment and 50 under follow-up at our institution from November 2000 to June 2001. A retest was conducted 2 weeks after the first interview/form completion for the follow-up group. The intraclass correlation coefficients of the two questionnaires were moderate to high in the follow-up group. Cronbach's alpha coefficients of all scales of the two questionnaires were > or = 0.70 except that of cognitive functioning. Correlation of scales measuring similar dimensions of the QLQ-C30 and the SF-36 were moderate to high, while that of the QLQ-H&N35 and the QLQ-C30 and the SF-36 were moderate to low. Patients in the active treatment group had more serious acute problems due to disease and chemotherapy. Patients in the follow-up group had more serious chronic problems due to radiation therapy. We concluded that the Taiwan Chinese version of the EORTC QLQ-C30 and the EORTC QLQ-H&N35 had moderate to high test-retest reliability, high internal consistency in most scales, and could show the expected differences between patients in active treatment and follow-up group.

Quality of life and menopausal transition for middle-aged women on Kinmen island

Although it seems reasonable to suggest that most women experience significant changes in quality of life (QOL) during the menopausal period, few researchers have quantified these changes. A total of 1497 women, aged 40-54 years and living on the island of Kinmen, were recruited for this survey. However, 137 were eliminated leaving 1360 for analysis. Women who used hormonal therapy or who had undergone surgically induced menopause were excluded. The subjects with incomplete data or who exhibited mental retardation or severe psychiatric disease were also eliminated. Univariate analysis demonstrated that, in general, QOL scores were poorer for perimenopausal and postmenopausal status. Comparing pre- and postmenopausal women, significant statistical differences were demonstrated for role limitations due to physical and emotional problems, even after adjusting for age, education level, body mass index, menarche, and chronic illness. A strong association was demonstrated between menopausal symptoms and premenstrual syndrome (PMS). Women with menopausal symptoms and PMS had significantly lower scores on all SF-36 dimensions. The results of this study suggest that poorer health status is experienced by peri- and postmenopausal women compared to premenopausal women.

Quality of life of breast cancer patients in Taiwan: Validation of the Taiwan Chinese version of the EORTC QLQ-C30 and EORTC QLQ-BR23

The objective of this study was to test the reliability and validity of the Taiwan Chinese version of the EORTC QLQ-C30 (version 3) and EORTC QLQ-BR23. The authors followed the guidelines of translation and pilot testing of the questionnaires. The questionnaires were given to 35 breast cancer patients under active treatment and 54 under follow-up at the National Taiwan University Hospital from November 2000 to October 2001. A retest was conducted one to two weeks after the first interview/form completion for the follow-up group. The intraclass correlation coefficients of the two questionnaires were moderate to high in the follow-up group. The Cronbach's alpha coefficients of most scales of the two questionnaires were > or = 0.70 except that of physical functioning (0.68), cognitive functioning (0.53), and arm symptoms (0.59). Correlations of scales measuring similar dimensions of the EORTC QLQ-C30 and the SF-36 were moderate. Patients in the active treatment group had more serious QOL problems due to disease and treatment. Results of this study showed that the Taiwan Chinese version of the two questionnaires had good test/retest reliability, high internal consistency in most scales, and could show the expected differences between patients in active chemotherapy and follow-up group.

Validation of a Chinese version of the Oral Health Impact Profile (OHIP)

OBJECTIVES

To translate the original English version of Oral Health Impact Profile (OHIP) into a Chinese version, to validate the translated instrument for use among the elderly in Hong Kong and to derive a Chinese short-form OHIP.

METHODS

The original English version of OHIP was translated into Chinese. Elderly persons aged 60-80 years were interviewed by two trained interviewers and examined clinically by one of two calibrated dentists. Information on subjects' demographic background and oral health conditions were collected.

RESULTS

A total of 586 elderly persons were interviewed and clinically examined. Cronbach's alpha of the translated OHIP subscales ranged from 0.69 to 0.84 and the test-retest correlation coefficient ranged from 0.72 to 0.92. Construct validity of the translated Chinese version was supported by the finding that the OHIP-49 and subscale scores increased as the subject's perceived oral health status changed from healthy to unhealthy. Also, those who had a perceived dental treatment need had higher mean OHIP-49 and subscale scores compared to those who did not. The short-form OHIP derived in this study demonstrated comparable validity and reliability with the full version of OHIP.

CONCLUSION

The translated Chinese version of OHIP demonstrated good validity and reliability. It is available for use by researchers in oral health-related quality of life studies in Chinese elderly populations. In situations where a Chinese short-form of OHIP is desirable, there are now two validated Chinese versions for researchers to choose.