The SF-36 (Ware & Sherbourne 1992) is a generic health status measure that has been translated into various languages and is used world-wide. It was designed to be applied to all health conditions and to assess general health concepts, such as functional status and well-being.  Each of the SF-36 and the SF-12 cover eight domains: physical functioning, role limitations due to physical health problems, bodily pain, general health, vitality, social functioning, role limitations due to emotional problems and mental health.  The SF-12 was introduced as a shorter alternative to the SF-36 for use in population studies (i.e. large sample sizes).. 

Number of items: The SF-36 has 36 items and the SF-12 has 12 items

Procedure/Administration: Both measures can be administered by the interviewer or the client.

How scored: The scoring is norm-based, with a general population mean score of 50 and a standard deviation of 10. The SF-12 is scored using two summary scores, a physical and a mental component score, which are norm based (the SF-36 can also be scored in this manner).

Interpretability: Higher scores indicate higher levels of health. There is published data and norms available for most health conditions as well as for the general population (in Canada and USA).

Acceptability: Since the SF-36 and SF-12 were designed to be generic, some of the walking/stair climbing questions are not applicable to individuals with SCI and thus, it has been suggested that the wording of these questions be changed from “walking/climbing” to “going”.  Another limitation is the differing interpretations of health as distinct or equivalent to disability. Further research is needed for the establishment of psychometric properties of the SF-36 and SF-12 for SCI populations.

Languages: N/a

Usability: Both forms are easy to administer and the manuals are very informative. 

Time to administer: The SF-36 requires 5-10 mins to complete and the SF-12 requires 2-4 mins

Time to score: N/a

Training required: N/a

Availability: N/a

Equipment required: None

Summary:

• The SF-36 and SF-12 are the most widely used measures of health status and allows the evaluation of various patient populations.
• Since the SF-36 and SF-12 were designed to be generic, some of the walking/stair climbing questions are not applicable to individuals with SCI and thus, it has been suggested that the wording of these questions be changed from “walking/climbing” to “going”. Another limitation is the differing interpretations of health as distinct or equivalent to disability.

Psychometric Summary

Note: TR= Test re-test; IC= Internal Consistency; Inter-O= Inter-observer; Intra-O= Intra-observer; SS= Sensitivity/Specificity; N/a= No information.

Red light= A single study involving SCI subjects which has less than adequate findings of reliability, validity, and/or responsiveness.

Yellow light= A single study involving subjects with SCI which has adequate to excellent findings of reliability, validity, and/or responsiveness.

Green light= At least 2 studies involving subjects with SCI which have adequate to excellent findings of reliability, validity, and/or responsiveness.

References

• Luther SL, Kromrey J, Powell-Cope G, Rosenberg D, Nelson A, Ahmed S, Quigley P. A pilot study to modify the SF-36V physical functioning scale for use with veterans with spinal cord injury. Arch Phys Med Rehabil 2006; 87: 1059-1066.
• McHorney C, Ware JJ, Lu R, CD S. The MOS 36-Item Short-Form Health Survey (SF-36): III. Tests of Data Quality, Scaling Assumptions, and Reliability Across Diverse Patient Groups. Med Care 1994;32:40-66.
• Ware JJ, Sherbourne C. The MOS 36-Item Short-Form Health Survey (SF-36). Med Care 1992;30:473-483.
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