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Is traditional rural lifestyle a barrier for quality of life assessment? A case study using the Short Form 36 in a rural Chinese population

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Abstract

Purpose

The majority of existing quality of life measures are based on urban-living environments. This study aimed at exploring the validity of using an urban-lifestyle-based health questionnaire with individuals living a traditional rural lifestyle.

Methods

The Short Form-36 (SF-36) interview was administered to 1603 rural Chinese residents. Semantic ambiguity of the items was investigated using tests of internal consistency, test–retest reliability, exploratory factor analysis, and clustering and ordering of item mean scores. The self-explanations from the respondents were adopted to interpret the implications of the changes in meanings of the items.

Results

Cronbach’s α reliability coefficients were high, whereas test–retest reliabilities were low. Consistent with the original factor structure, eight factors were extracted using exploratory factor analysis. However, the composition of these eight factors was not in full accordance with the priori assignment of items to scales. Seven items violated the clustering and ordering of item mean scores. The association between the identified problems in validity and the change in semantic meanings in the context of the rural lifestyle was established.

Conclusions

Quality of life assessment instruments based on urban-living arrangements may not be reliably used with individuals living in rural environments.

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Fig. 1

Abbreviations

SF-36:

Short Form 36

PF:

Limitations in physical activities because of health problems

RP:

Limitations in usual role activities because of physical health problems

BP:

Bodily pain

GH:

General health perception

VT:

Vitality (energy and fatigue)

SF:

Limitations in social functioning due to health problems

RE:

Limitations in usual role activities because of emotional problems

MH:

Mental health

ICC:

Intraclass correlation coefficient

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Acknowledgments

This research was approved by Sichuan University ethics committee and funded by the National Natural Science Foundation of China (30571594) and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Authors and Affiliations

  1. School of Public Health, La Trobe University, Bundoora, VIC, 3086, Australia

    Chaojie Liu

  2. West China School of Public Health, Sichuan University, 610041, Chengdu, Sichuan, China

    Ningxiu Li, Xiaohui Ren & Danping Liu

Authors
  1. Chaojie Liu
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  2. Ningxiu Li
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Correspondence to Chaojie Liu.

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Liu, C., Li, N., Ren, X. et al. Is traditional rural lifestyle a barrier for quality of life assessment? A case study using the Short Form 36 in a rural Chinese population. Qual Life Res 19, 31–36 (2010). https://doi.org/10.1007/s11136-009-9567-y

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