Psychometric properties of the SF-8 Health-Related Quality of Life Scale in Costa Rican
older adults

doi:10.21203/rs.3.rs-3959368/v1

Download PDF

Research Article

Psychometric properties of the SF-8 Health-Related Quality of Life Scale in Costa Rican older adults

https://doi.org/10.21203/rs.3.rs-3959368/v1

This work is licensed under a CC BY 4.0 License

Version 1

posted

You are reading this latest preprint version

Objective

To assess the psychometric properties of the SF-8 health-related quality of life (HRQoL) scale in older adults from Costa Rica.

Method

The sample consisted of 282 Costa Ricans aged 50 years or older, with an average age of 64 years (SD = 7.55). Data were collected between 2015–2016 in the Greater Metropolitan Area of Costa Rica.

Results

Confirmatory factor analysis revealed that the three-factor model (physical health, mental health, and general health) demonstrated a good fit (χ2 = 53.5, df = 17, p < .001; CFI = .964; RMSEA = .09 [.061–.114], SRMR = .045), along with a reliability of .87, based on Cronbach's alpha. The three-factor model showed a better fit than the traditional two-factor model did. Furthermore, significant relationships were found between HRQoL and satisfaction with present life, social support networks, and functional social support, supporting the nomological validity of SF-8 as a comprehensive measure of health perception in older Costa Ricans.

Conclusions

The three-factor model proved to be a superior solution to the traditional model. The designation of the third factor as one of general health is questioned, as it could equally be considered a social factor related to health given its importance for older individuals. The results endorse the utility of the SF-8 as a valid and reliable tool for measuring HRQoL in this population.

Psychology

Geriatrics & Gerontology

Health-Related Quality of Life

Older Adults

SF-8

Costa Rica

Well-Being

Throughout the world, a widely adopted practice in research has been to assess individuals' overall health using a single question. This practice presents several challenges, such as the lack of clarity regarding what individuals consider when responding to such broad inquiries about their general health. Consequently, the information gathered by healthcare professionals regarding the self-perceived health of those they attend or study becomes ambiguous and difficult to compare, both among individuals and across different diseases. This limitation also hinders evidence-based decision making regarding health matters. This study tested a concise version of the most widely used instrument globally for self-assessment of health-related quality of life (HRQoL) in older Costa Ricans and yielded positive results. These findings provide scientific evidence to support the use of this 8-question instrument in older Costa Ricans. Additionally, similar to recent research in various countries, this study also revealed that the 8-question instrument measures an aspect beyond physical and mental health, challenging the traditional conceptualization of this measurement tool. This article discusses whether this third aspect, particularly in the case of older individuals, is indeed a social component rather than a general health component, as proposed in various studies.

Various studies have indicated that the relationship between the self-assessment of health and mortality varies among cultures and countries. This has been demonstrated among Finnish and Italian citizens [1] and Latin Americans residing in the United States under different acculturation conditions [2]. Swedes and Danes rate their health higher han Germans [3]. Similarly, the self-assessment of health in Korea and Japan is relatively low compared with that in countries such as the United States, Canada, and Australia. While there is abundant evidence regarding the relationship between perceived health and general health, knowledge about the factors that may explain these cross-cultural differences is limited [4].

Some difficulties regarding the measurement of self-assessment of health in various locations stem from the typical use of a single-item instrument [5, 6], where there is a lack of clarity about what is being measured, in addition to its conceptual and theoretical ambiguity. Thus, the most commonly used health measure (self-assessment of health) in a particular context is one of the least understood, as is the case in Costa Rica.

Hence, studies have been conducted to understand what people with different sociodemographic characteristics think about when they self-assess their own health. For example, physical functioning is one of the primary considerations in men, who tend to report higher levels of perceived health than women. The same situation occurs in individuals with higher educational levels and older ages [7, 8].

In general, the terms "quality of life" and "health-related quality of life" (HRQoL) are often considered interchangeable [9], and these measures are widely accepted today as healthcare outcome indicators [10]. Among the plethora of instruments available for measuring self-assessment of health through quality of life, the most commonly used is the Health Survey Questionnaire (SF-36) [11] by Ware et al., which has various versions, including the SF-8, an eight-item version by Ware et al. [12].

The SF-8 has been shown to function adequately in different population groups and various locations, such as Iran and Spain, both with samples of older adults [13, 14], Germany [15], Japan [16], and in a context closer to the Costa Rican reality, in Colombia with older individuals [17, 18]. The SF-8 typically reports a 2-factor structure, one related to physical health and another related to mental health, with reported reliabilities of .85 and .79, respectively [13]. However, other studies have suggested a better fit with a 3-factor structure [19, 15]. The SF-36 and its simplified versions are currently the most widely used generic instruments for assessing health-related quality of life in older individuals [20].

In Costa Rica, one of the Latin American countries experiencing the most rapid population aging [21, 22], two studies have provided evidence for the validity of the SF-36 [23, 24]. However, to date, there has been no published validity evidence for the SF-8 in Costa Rica. The development of the SF-8 scale is important for the country as it provides instruments that, although not single-item measures, are concise, simple, and generic, which is crucial when working with older adults.

It is also useful for evaluating health-related quality of life (HRQoL) in populations with specific diseases and healthy populations, especially considering its robust predictive ability for health and survival in older individuals [5]. Its application will provide appropriate psychometric evidence, including indicators of whether it measures what it intends to measure. The development of the SF-8 will allow, among various things, a comparison of the impact of different health conditions and diseases, as well as the identification of the outcomes of health interventions and treatments.

In an accumulative and comparative sense of knowledge of the subject, its validation for the Costa Rican older adult population is necessary. This is because both the SF-36 and its simplified versions are the most widely used generic instruments for assessing health-related quality of life (HRQoL) in older individuals [20, 11], while the SF-8 has demonstrated adequate psychometric properties in various contexts and population groups. Due to all the aforementioned reasons, the objective of the present research is to assess the psychometric properties of the SF-8 health-related quality of life scale in older individuals in Costa Rica and its relationship with other well-being indicators.

Study Design

This cross-sectional study employed a nonprobabilistic sampling approach. The data reported in this article were derived from the Longitudinal Older Learners (LOL-Costa Rica) project database, which was developed through international collaboration between the School of Psychology at the Universidad Nacional in Costa Rica and the Universidad de Valencia in Spain.

Participants

The inclusion criteria for participation in the study were age ≥ 50 years and enrollment in a program for older adults at the Universidad Nacional of Costa Rica (PAIPAM-UNA). This programme offers courses that provide training on aging-related topics for comprehensive development and well-being. The target population of this program is concentrated in the province of Heredia (metropolitan-urban area).

A total of 282 Costa Ricans aged ≥ 50 years (M=64, SD=7.55) participated in the study, of whom 91% were women. This high female participation aligns with various studies conducted in the country among older adults in university programs [25, 26, 27, 28]. Regarding educational level, 38.1% had university education, 32.4% had secondary education, and 29.6% had primary education. The marital status of the participants indicated that 46.8% of the older adults were married, 21.3% were divorced, 21% were widowed, and 10.3% were single. A total of 88.9% of the participants lived in their homes.

Both the instruments and informed consent forms were administered in paper format. The participants voluntarily completed the instruments, and the data were treated anonymously.

Instruments

SF-8 Health-Related Quality of Life Scale

The SF-8 scale is a shortened version of the SF-36 scale developed by Ware et al. [29]. It constitutes a generic assessment of the cognitive and physical aspects of health-related quality of life [15]. Despite having similar characteristics and behaviors, this version is less widely used and concise. The instrument is typically structured into two factors, one physical and one cognitive, for which reliabilities of .85 and .79, respectively, have been reported [13]. However, some studies have indicated a better fit with these three factors (adding a general health factor) [19, 15]. Its items are of the Likert type, ranging from 1 to 5, with reverse scoring; that is, a lower score indicates a better perception of health.

Temporal Satisfaction with Present Life Scale

The Temporal Satisfaction with Life Scale (TSLS) [30] measures overall life satisfaction regarding the past, present, and future aspects of an individual's life. For this study, only five items related to the subscale of satisfaction with present life were used. Its adaptation to Spanish demonstrated appropriate psychometric properties, including evidence of construct and convergent validity. It consists of Likert-type items ranging from 1 (strongly disagree) to 5 (strongly agree) [31]. The reliability of the 15-item version of the instrument typically falls between .87 and .93, according to Cronbach´s alpha [30, 32], and between .81 and .86 in its Spanish version [33]. The instrument provided convergent validity evidence for the SF-8 [31].

Duke-UNC-11 Functional Social Support Questionnaire

The original version of this instrument was found in The Duke-UNC Functional Social Support Questionnaire [34]. However, in this study, a Spanish adaptation was used [35]. Duke-UNK-11 assesses perceived functional social support. The instrument comprises two dimensions: confidential support (having others to communicate with) and affective support (having demonstrations of affection, love, and empathy). It consists of 11 Likert-type items, ranging from 1 to 5. This instrument was used to provide evidence of convergent validity because it not only serves as a subjective indicator of successful aging but also because social disconnection is a relevant aspect linked to health perception [36]. There is evidence of significant correlation between SF-8 and Duke-UNC-11 [37].

Revised Lubben Social Network Scale (LSNS-R)

The revised version developed by Lubben et al. [38] measures the size, closeness, and frequency of social contact among older adults. In this study, a Spanish adaptation was used [39].

Additionally, there is convergent validity evidence between the SF-8 and social support for both the family and friends subscales [37]. The LSNS-R comprises 12 Likert-type items that distinguish between the social networks of friends and family. Participants can score between 0 and 60 points in total or between 0 and 30 on each subscale. A higher score indicates a higher level of support from the social network [40, 41].

Collection Procedures

Students from PAIPAM-UNA courses were invited to participate. The researchers explained the project, the purpose of the research, how the data would be gathered, and the voluntary, anonymous, and confidential nature of participation, emphasizing that the data would be used solely for scientific purposes.

Individual interviews were planned with older adults who were unable to respond to the questionnaire independently. Finally, the surveys were administered along with informed consent. Sociodemographic variables were assessed, along with the rest of the psychosocial items and instruments.

Statistical Analysis

Confirmatory factor analysis was conducted to assess the fit of the theoretical structure of the SF-8 health-related quality of life scale in the utilized sample, initially testing the traditional 2-factor structure and subsequently the 3-factor structure. A comparative fit index (CFI) above .90, root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR) for observed errors below .08 were considered indicators of good fit [42].

Internal consistency was examined using Cronbach's alpha for the SF-8 factors and instruments, aimed at providing evidence of nomological validity. Bivariate Pearson correlations were then performed to evaluate convergent validity. The data composition did not allow for invariance analysis between gender and other sociodemographic variables because of limitations in the number of parameters in the Confirmatory Factor Analysis theoretical model. For instance, in the case of gender, the sample size for men (N=19) was insufficient compared to the required number of parameters, preventing the analysis. Two software programs were employed for the analyses: IBM SPSS version 25 (IBM Corp., 2017) and the statistical software Jamovi, v. 2.3.18.0 (Jamovi Project, 2023).

Regarding the Confirmatory Factor Analysis, the original two-factor model exhibited insufficient fit indices to support the bifactorial structure of the measurement model (χ2 = 207.438, df = 19, p < .001; CFI = .936; RMSEA = .188 [.165–.211], SRMR = .070). Various studies have suggested an improved fit with a three-factor solution, incorporating an additional general health factor composed of items 4 (energy or vitality) and 8 (general health perception) [19, 15]. Consequently, the three-factor model revealed a good fit (χ2 = 53.5, df = 17, p < .001; CFI = .964; RMSEA = .09 [.061–.114], SRMR = .045), along with items demonstrating statistically significant loadings that explained a substantial portion of the associated variance. The reported alphas for the three factors are .85 for physical health, .84 for mental health, and .57 for the third factor.

Table 1 Fit Indices of the Confirmatory Factor Analysis Model

Models	x²	Gl	P	CFI	RMSEA IC 90%	SRMR
2-factor Model	207.438	19	<.001	.936	.165 - .211	.070
3-factor Model	53.5	17	<.001	.964	.061 - .114	.045

Table 2 Items and Standardized Factor Loadings for the SF-8 Health-Related Quality of Life Scale

Factor	Item	β
Physical Health	1. How many physical health problems have limited your usual physical activity (walking, climbing stairs)?	.848
	2. How many difficulties have you experienced in your daily routine at home or outside the home due to your physical health?	.880
	3. How many physical pains have you had?	.703
Mental Health	5. To what extent did your physical health or emotional problems limit your usual social activities with family and friends?	.866
	6. How much have emotional problems (feeling anxious, depressed, irritable) bothered you?	.693
	7. To what extent did personal or emotional problems prevent you from performing your work, classes, or other usual daily activities?	.737
General Health	8. Overall, how would you rate your health during the past month?	.738
	4. How much energy have you had?	.543

Table 3 Internal consistency coefficients, descriptive statistics, and correlations for the study variables

Variable	n	𝛂	M	SD	1	2	3	4
1. HRQoL (SF-8)	282	.81	2.2	.84	—
2. Satisfaction with present life	280	.90	3.9	.93	.-30^**	—
3. Social Network (LSNS-R)	279	.82	3.0	.94	-.19**	.23**	—
4. Functional Social Support (Duke UNK-11)	282	.89	3.9	.94	-.25**	.36**	.46**	—

^*p < .05. ^**p < .01. Min. = 1, Max. = 5. Lower scores on the SF-8 indicate better Health-Related Quality of Life (HRQoL).

The physical health factor was significantly related to satisfaction with present life (r=-.17, p<.01), as well as functional social support (r=-.13, p<.02); however, it was not correlated with social network. The mental health factor were correlated with satisfaction with present life (r=-.32, p< ".01"), functional social support (r=-.27, p< ".01"), and the social network (r=-.22, p< ".01"). The general health factor is correlated with satisfaction with present life (r=-.27, p< ".01"), functional social support (r=-.24, p< ".01"), and the social network (r=-.18, p< ".01").

Regarding evidence of nomological validity, significant relationships were found with different instruments in a theoretically congruent manner, where it is important to note that a lower HRQoL score implies a better HRQoL. Thus, a significant relationship was found between HRQoL and present life satisfaction (r=-.16, p<.008), as well as between HRQoL and both measures aimed at assessing social resources, such as the Lubben Revised Social Network Scale (LSNS-R) (r= -.19, p<.002) and the Duke-UNK-11 Functional Social Support Scale (r= -.25, p<. "01").

Concerning HRQoL and sociodemographic variables, no significant relationships were found with age, the number of children or grandchildren older adults had, the frequency of contact they maintained with them, or the level of education. There was a very limited number of men to make mean comparisons by gender, which also applies to certain groups in terms of current occupation. Finally, no differences were found based on whether they had an emotional partner.

The objective of this study to evaluate the psychometric properties of the SF-8 scale in older adults in Costa Rica and its relationship with other well-being indicators has been achieved. The results of the confirmatory factor analysis suggest that a three-factor model provides a suitable fit for the SF-8 among older adults in Costa Rica. Various studies have referred to the three-factor model as a better solution than the traditional two-factor model [19, 15]. Additionally, significant relationships were found between HRQoL and other health and well-being indicators, as established by the literature on perceived social support [37], social networks [36, 37], and life satisfaction [31, 43, 44], supporting the nomological validity of the SF-8.

It has been pointed out that under a two-factor structure, the SF-8 provides adequate psychometric properties once the item related to how much energy the person has felt is set aside [14]. Making this adjustment in the present research under the traditional structure, the modification shows an improvement compared to the complete scale (χ2 = 36.7, df = 13, p < .001; CFI = .98; RMSEA = .08 [.05–.111], SRMR = .037), with appropriate Cronbach's alpha for the two factors; .85 for physical health and .84 for mental health.

However, it is worth emphasizing that the assessment of vitality is one aspect that receives the lowest scores according to a systematic review [20]. Therefore, owing to its ability to alert health conditions, it is inconvenient to eliminate it. On the other hand, this third factor suggests something that should not be ignored: the fact that older adults may consider an additional aspect beyond physical and cognitive aspects in the overall assessment of their health. Various studies that have reported a better fit with the three factors have categorized this factor as a dimension of general health [19, 15]. Thus, the three-factor solution appears to be a better alternative even though the third factor does not show satisfactory reliability. This factor is composed of two items, one asking about the overall health of the person in the last month and the other about the energy or vitality experienced. That is, if the third factor is composed of only two items, the designation of its content can be derived from both the item asking about general health and that asking about experienced energy or vitality.

Given this, we must consider that for older adults, the social aspect is crucial to their well-being [36], as also found in a systematic review [20]. Even from a theoretical perspective, in a literature review [9], HRQoL consists of three domains: physical, mental, and social. All of the above leads to the question of whether the third factor should be designated as a social health factor instead of a general health factor. In this case, it would involve energy directed towards motivating social bonds and relationships in old age, and there is evidence to support this second interpretation as well.

This social interpretation of the factor aligns with the Socioemotional Selectivity Theory (SST) of development, according to which the perception of available time changes motivational priorities. In this regard, older adults would place greater importance on emotional goals related to others than younger individuals [45]. They selectively prioritize relationships that provide greater benefits and those they consider more valuable. Therefore, this third factor, which has been designated as a general health factor in some studies, could also suggest a social aspect as a goal towards which vitality or energy is directed during old age.

Returning to the traditional factors, when comparing the mental health factor and the physical health factor, we observed that the former is related to satisfaction with present life, social networks, and social support. In contrast, the physical factor not only shows smaller effect sizes with the variables, but also does not correlate with the social network, meaning the size, closeness, and frequency of social contact. This aligns with several findings [46, 47], suggesting that subjective health assessments are more influential than objective indicators. This reinforces the assertion by some authors regarding the relevance of subjective well-being in aging [48, 44] and underscores the importance of addressing socioemotional aspects in the care of older adults concerning their support networks, which tend to decrease in size with age [48].

Regarding the contributions of this research, there are few psychometric studies of the SF-8 scale in the Latin American context [18], and this study constitutes one of them. It is important to have brief tools that provide adequate psychometric properties for assessing perceived health. The practice of assessing perceived health through a single item hinders the understanding of the phenomenon, limiting decision-making for the well-being of this population, especially considering demographic aging and the pressure placed on the healthcare system, social security, and programs aimed at this population in Costa Rica and other countries in the region. Hence, it is important to have a more specific understanding that contributes to better care, that is, comprehensive care, allowing, for example, the comparison of the impact of different diseases and health situations. Available evidence on the topic will help allocate resources, enable more effective interventions in the face of demographic challenges, and benefit aging and well-being programs.

Limitations and Recommendations

The reliability presented by the third factor implies that reservations should be made when drawing inferences. In this regard, it is recommended that psychometric studies be conducted in the country and region with other brief versions of the SF-36. In the Costa Rican context, it is desirable that such investigations be conducted in an older adult population that is not necessarily linked to educational programs, where participants may have specific characteristics. These characteristics include not only being more stimulated and active compared to the general population but also potentially c[23onsisting of samples with higher levels of education and socioeconomic status. Both aspects are associated with a higher HRQoL [49, 50, 51, 52]. Finally, the high participation of women in this study, in line with the national trend in studies on older adults [25, 26, 27, 28], constitutes a significant limitation of this study and emphasizes the need in the Costa Rican context to conduct research on older men regarding different indicators of well-being.

Funding

This research was funded by an academic support fund (Fondo de Apoyo Académico, FIDA) for 2017 from the Vice Presidency of Research at the Universidad Nacional in Costa Rica. The authors declare that no other funding or support has contributed to this research in the form of grants or otherwise.

Competing interests

The authors declare that they have no conflicts of interest.

Ethics approval

This research has the approval of the Scientific Ethics Committee of the Universidad Nacional in Costa Rica (UNA-CECUNA-ACUE-26-2017).

Author contributions

Román-Quirós, R: Development of the Introduction, Analysis of Results, and Discussion

Blanco-Molina, M: Structuring the Methodological Design Used, Data Collection, Analysis of Results, and Development of the Discussion

Pinazo-Hernandis, S: Structuring the utilized methodological design, document review, and development of the discussion.

Consent to participate

Participation in this research was entirely voluntary. Participants were individually provided with a paper informed consent form, and each participant signed the form.

Consent to publish

Within the informed consent, participants were informed that their data would be treated anonymously for the purpose of academic publication.

Jylha, M., Guralnik, J. M., Ferrucci, L., Jokela, J., & Heikkinen, E. (1998). Is Self-Rated Health Comparable across Cultures and Genders? The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 53B(3), S144-S152. https://doi.org/10.1093/geronb/53B.3.S144
Finch, B. K., Hummer, R. A., Reindl, M., & Vega, W. A. (2002). Validity of Self-rated Health among Latino(a)s. American Journal of Epidemiology, 155(8), 755-759. https://doi.org/10.1093/aje/155.8.755
Jürges, H. (2007). True health vs response styles: Exploring cross-country differences in self-reported health. Health Economics, 16(2), 163-178. https://doi.org/10.1002/hec.1134
Choi, J. H., & Miyamoto, Y. (2022). Cultural Differences in Self‐Rated Health: The Role of Influence and Adjustment. Japanese Psychological Research, 64(2), 156-169. https://doi.org/10.1111/jpr.12405
Jylhä, M. (2009). What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Social Science & Medicine, 69(3), 307-316. https://doi.org/10.1016/j.socscimed.2009.05.013
Krause, N. M., & Jay, G. M. (1994). What Do Global Self-Rated Health Items Measure?: Medical Care, 32(9), 930-942. https://doi.org/10.1097/00005650-199409000-00004
Peersman, W., Cambier, D., De Maeseneer, J., & Willems, S. (2012). Gender, educational and age differences in meanings that underlie global self-rated health. International Journal of Public Health, 57(3), 513-523. https://doi.org/10.1007/s00038-011-0320-2
Vivaldi, F., & Barra, E. (2012). Bienestar Psicológico, Apoyo Social Percibido y Percepción de Salud en Adultos Mayores. Terapia psicológica, 30(2), 23-29. https://doi.org/10.4067/S0718-48082012000200002
Kaplan, R. M., & Hays, R. D. (2022). Health-Related Quality of Life Measurement in Public Health. Annual Review of Public Health, 43(1), 355-373. https://doi.org/10.1146/annurev-publhealth-052120-012811
Ruotolo, I., Berardi, A., Sellitto, G., Panuccio, F., Polimeni, A., Valente, D., & Galeoto, G. (2021). Criterion Validity and Reliability of SF-12 Health Survey Version 2 (SF-12v2) in a Student Population during COVID-19 Pandemic: A Cross-Sectional Study. Depression Research & Treatment, 2021(6624378) 1-10. https://doi.org/10.1155/2021/6624378
López-García, E., Banegas, J. R., Graciani Pérez-Regadera, A., Gutiérrez-Fisac, J. L., Alonso, J., & Rodríguez-Artalejo, F. (2003). Valores de referencia de la versión española del Cuestionario de Salud SF-36 en población adulta de más de 60 años. Medicina Clinica, 120(15), 568-573. https://doi.org/10.1016/s0025-7753(03)73775-0
Ware, J., Kosinski, M., Dewey, J., & Gandek, B. (2001). How to score and interpret single-item health status measures: A manual for users of the SF-8 health survey. Boston: QualyMetric.
Namjoo, S., Mirzaei, M., Foroughan, M., & Harouni, G. G. (2021). Psychometric properties of the Short Form-8 Health Survey (SF-8) among diabetes and non-diabetes Iranian older people. Health Promotion Perspectives, 11(3), 337-343. https://doi.org/10.34172/hpp.2021.43
Tomás, J. M., Galiana, L., & Fernández, I. (2018). The SF-8 Spanish Version for Health-Related Quality of Life Assessment: Psychometric Study with IRT and CFA Models. The Spanish Journal of Psychology, 21, E1. https://doi.org/10.1017/sjp.2018.4
Wirtz, M. A., Schulz, A., & Brähler, E. (2021). Confirmatory and bi-factor analysis of the Short Form Health Survey 8 (SF-8) scale structure in a German general population sample. Health and Quality of Life Outcomes, 19(1), 1-12. https://doi.org/10.1186/s12955-021-01699-8
Sugimoto, M., Takegami, M., Suzukamo, Y., Fukuhara, S., & Kakehi, Y. (2008). Health-related quality of life in Japanese men with localized prostate cancer: Assessment with the SF-8. International Journal of Urology: Official Journal of the Japanese Urological Association, 15(6), 524-528. https://doi.org/10.1111/j.1442-2042.2008.02046.x
Muñoz, D. I., Gomez, O. L., & Ballesteros, L. C. (2014). Factores correlacionados con la calidad de vida en pacientes diabéticos de bajos ingresos en Bogotá. Revista de Salud Pública, 16(2), 246-259. https://doi.org/10.15446/rsap.v16n2.38964
Lucumí, D. I., Gomez, L. F., Brownson, R. C., & Parra, D. C. (2015). Social capital, socioeconomic status, and health-related quality of life among older adults in Bogotá (Colombia). Journal of Aging and Health, 27(4), 730-750. https://doi.org/10.1177/0898264314556616
Lang, L., Zhang, L., Zhang, P., Li, Q., Bian, J., & Guo, Y. (2018). Evaluating the reliability and validity of SF-8 with a large representative sample of urban Chinese. Health and Quality of Life Outcomes, 16(1), 16, 2-8. https://doi.org/10.1186/s12955-018-0880-4
Barceló Reyna, R., Ornelas Contreras, M., & Blanco Vega, H. (2021). Utilización del Cuestionario de Salud SF-36 en personas mayores. Revisión sistemática. Ansiedad y Estrés, 27(2-3), 95-102. https://doi.org/10.5093/anyes2021a13
Programa Estado de la Nación. (2022). Envejecimiento poblacional: un logro en desarrollo humano con importantes retos. https://estadonacion.or.cr/envejecimiento-poblacional-un-logro-en-desarrollo-humano-con-importantes-retos/
United Nations Economic Comission for Latin America and the Caribbean. (2018). Envejecimiento, personas mayores y Agenda 2030 para el Desarrollo Sostenible. Perspectiva regional y de Derechos Humanos. United Nations. https://repositorio.cepal.org/bitstream/handle/11362/44369/1/S1800629_es.pdf
Araya-Marín, N., Barrantes-Valverde, K., Fernández-Castro, M., Rodríguez, M., & García-Castro, J. D. (2017). Propiedades psicométricas del cuestionario de salud sf-36 en estudiantes universitarios de San Ramón, Alajuela—Sede Occidente, Universidad de Costa Rica. InterSedes, 18(38). https://doi.org/10.15517/isucr.v18i38.32670
Valdivieso-Mora, E., Ivanisevic, M., Shaw, L. A., Garnier-Villarreal, M., Green, Z. D., Salazar-Villanea, M., Moncada-Jiménez, J., & Johnson, D. K. (2018). Health-Related Quality of Life of Older Adults in Costa Rica as Measured by the Short-Form-36 Health Survey. Gerontology and Geriatric Medicine, 4, 2333721418782812. https://doi.org/10.1177/2333721418782812
Blanco- Molina, M., Castro-Rojas, M. D., & Ortega-Moreno, R. (2023). Envejecimiento saludable: Un primer acercamiento a la revisión de indicadores subjetivos de salud en zonas urbanas y rurales en Costa Rica. Interdisciplinaria, 40(2), 281-298. https://doi.org/10.16888/interd.2023.40.2.17
Pinazo-Hernándis, S., Blanco-Molina, M., Ortega-Moreno, R. (2022). Aging in Place: Connections, Relationships, Social Participation and Social Support in the Face of Crises Situations. International Journal of Environmental Research and Public Health, 19(24), 16623. https://doi.org/10.3390/ijerph192416623.
Tomás, J. Sancho, P., Blanco-Molina, M & Pinazo-Hernandis, S. (2022). Measurement invariance of the self-care Scale for older people in Costa Rica and Spain. Educational Gerontology, 49(3), 190-200. https://doi.org/10.1080/03601277.2022.2096307
Blanco-Molina, M., Pinazo-Hernandis, S., Montoro-Rodriguez, J., & Tomas, J. M. (2021). Testing a Proactive Model of Successful Aging Among Older Adults in Costa Rica and Spain. The International Journal of Aging and Human Development, 93(1), 619–635. https://doi.org/10.1177/0091415020974621
Ware, J. E., Snow, K.K., Kosinski, M., Gandek, B. (1993). SF-36 Health Survey Manual and Interpretation Guide. New England Medical Center, the Health Institute.
Pavot, W., Diener, E., & Suh, E. M. (1998). The Temporal Satisfaction with Life Scale. Journal of Personality Assessment, 70(2), 340-354. https://doi.org/10.1207/s15327752jpa7002_11
Galiana, L., Oliver, A., Tomás, J. M., Sancho, P., & Gutiérrez, M. (2015). Propiedades psicométricas de la versión española de la Escala Temporal de Satisfacción con la Vida (Temporal Satisfaction With Life Scale, TSLS): Un estudio en mayores que acuden a programas universitarios. European Journal of Investigation in Health, Psychology and Education, 5(3), 335-344. https://doi.org/10.1989/ejihpe.v5i3.136
Akyurek, G., Efe, A., & Aki, E. (2019). Psychometric properties of the temporal satisfaction with life scale among Turkish people. Psychiatry and Clinical Psychopharmacology, 29(2), 204–211. 10.1080/24750573.2018.14 45898
Carrillo, A., Etchemendy, E., and Baños, R. M. (2021). Past, present, and future life satisfaction: the role of age, positive and negative mood. Current Psychology, 40, 629–638. 10.1007/s12144-018-9981-9
Broadhead, W. E., Gehlbach, S. H., Degruy, F. V., & Kaplan, B. H. (1988). The DukeUNC Functional Social Support Questionnaire: Measurement for Social Support in Family Medicine Patients. Medicine Care, 26(7), 709-723.
Bellón Saameño, J. A., Delgado Sánchez, A., Luna del Castillo, J. de D., & Lardelli Claret, P. (1996). Validez y fiabilidad del cuestionario de apoyo social funcional Duke-UNC-11. Atención primaria: Publicación oficial de la Sociedad Española de Familia y Comunitaria, 18(4), 153-163.
Cornwell, E. Y., & Waite, L. J. (2009). Social Disconnectedness, Perceived Isolation, and Health among Older Adults. Journal of Health and Social Behavior, 50(1), 31-48. https://doi.org/10.1177/002214650905000103
Tomás Miguel, J. M., Galiana Llinares, L., Gutiérrez Sanmartín, M., Sancho Requena, P., & Oliver Germes, A. (2016). Predicción del bienestar hedónico y eudaimónico en envejecimiento con éxito. EJIHPE: European Journal of Investigation in Health, Psychology and Education, 6(3), 167-176.
Lubben, J., Gironda, M., & Lee, A. (2002). Refinements to the Lubben Social Network Scale: The LSNS-R. The Behavioral Measurements Letter, 7(2), 2-11. http://bmdshapi.com/newsletters/7-2-winter-2002.pdf
Lubben, J., & Gironda, M. (2003). Measuring social networks and assessing their benefits. In C. Phillipson, G. Allan, & D. Morgan (Eds.), Social networks and social exclusion: Sociological and policy perspectives (pp. 20-34). Ashgate Publishing Company.
Boston College. (2023). Lubben Social Network Scale. https://www.bc.edu/content/bc-web/schools/ssw/sites/lubben/description.html
University of West Ontario. (2023). Biopsychosocial assessment tools for the elderly. https://instruct.uwo.ca/health-sciences/9641/Assessments/Social/LSNS-R.html
Marsh, H. W., Hau, K. T., & Wen, Z. (2004). In search of golden rules: Comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler's (1999) findings. Structural Equation Modeling, 11(3), 320-341. https://doi.org/10.1207/s15328007sem1103_2
Gwozdz, W., & Sousa-Poza, A. (2010). Ageing, health and life satisfaction of the oldest old: An analysis for Germany. Social Indicators Research, 97, 397-417. https://link.springer.com/article/10.1007/s11205-009-9508-8
Pruchno, R., & Carr, D. (2017). Successful Aging 2.0: Resilience and Beyond. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 72(2), 201-203. https://doi.org/10.1093/geronb/gbw214
Carstensen, L. L. (2006). The Influence of a Sense of Time on Human Development. Science (New York, N.Y.), 312(5782), 1913-1915. https://doi.org/10.1126/science.1127488
Kunzmann, U., Little, T. D., & Smith, J. (2000). Is age-related stability of subjective well-being a paradox? Cross-sectional and longitudinal evidence from the Berlin Aging Study. Psychology and Aging, 15(3), 511-526. https://doi.org/10.1037/0882-7974.15.3.511
Smith, J., Borchelt, M., Maier, H., & Jopp, D. (2002). Health and Well-Being in the Young Old and Oldest Old. Journal of Social Issues, 58(4), 715-732. https://doi.org/10.1111/1540-4560.00286
Kahana, E., Kelley-Moore, J., & Kahana, B. (2012). Proactive aging: A longitudinal study of stress, resources, agency, and well-being in late life. Aging & Mental Health, 16(4), 438-451. https://doi.org/10.1080/13607863.2011.644519
Alfaro Vargas, N., & Espinoza Herrera, R. (2021). Personas mayores en Costa Rica: Un acercamiento a las percepciones sobre su calidad de vida. Revista ABRA, 41(63), 99-124. https://doi.org/10.15359/abra.41/63.5
Dalstra, J. A. A., Kunst, A. E., Mackenbach, J. P., & EU Working Group on Socioeconomic Inequalities in Health. (2006). A comparative appraisal of the relationship of education, income and housing tenure with less than good health among the elderly in Europe. Social Science & Medicine (1982), 62(8), 2046-2060. https://doi.org/10.1016/j.socscimed.2005.09.001
Kunst, A. E., Bos, V., Lahelma, E., Bartley, M., Lissau, I., Regidor, E., Mielck, A., Cardano, M., Dalstra, J. A. A., Geurts, J. J. M., Helmert, U., Lennartsson, C., Ramm, J., Spadea, T., Stronegger, W. J., & Mackenbach, J. P. (2005). Trends in socioeconomic inequalities in self-assessed health in 10 European countries. International Journal of Epidemiology, 34(2), 295-305. https://doi.org/10.1093/ije/dyh342
Rodríguez Sepúlveda, S. E. (2017). Percepción de la calidad de vida en anciano con dolor crónico secundario a patología osteoarticular y musculoesquelética. Gerokomos, 28(4), 168-172. https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1134-928X2017000400168

The authors declare no competing interests.

Download PDF

Version 1

posted

You are reading this latest preprint version

Psychometric properties of the SF-8 Health-Related Quality of Life Scale in Costa Rican older adults

Status:

Version 1

Abstract

Objective

Method

Results

Conclusions

Plain English summary

Introduction

Method

Results

Discussion

Declarations

References

Additional Declarations

Status:

Version 1