Objective: To test the construct validity of the Short-Form 36 (SF-36) Health Survey, using structural equation modeling (SEM).
Methods: Cross-sectional survey was conducted. Data were collected from 1007 participants in a stratified sample of adult general population, interviewed face-to-face by trained interviewers.
Results: SEM analyses supported the superiority of the eight first-order factor model of health. Higher-order analyses suggested that a model with three correlated second-order factors (physical health, general well-being, general mental health) and one third-order factor (health) provided a satisfactory fit to the data.
Conclusions: These results confirm the multidimensional structure of the SF-36 and underscore the feasibility of multinational comparisons of health status using this instrument. They also support the use of eight subscale scores in parallel with three second-order summary scores rather than one overall score.