Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
Original Article
Development and Evaluation of a Questionnaire for Measuring Suboptimal Health Status in Urban Chinese
Yu-Xiang YanYou-Qin LiuMan LiPei-Feng HuAi-Min GuoXing-Hua YangJing-Jun QiuShan-Shan YangJian ShenLi-Ping ZhangWei Wang
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2009 Volume 19 Issue 6 Pages 333-341


Background: Suboptimal health status (SHS) is characterized by ambiguous health complaints, general weakness, and lack of vitality, and has become a new public health challenge in China. It is believed to be a subclinical, reversible stage of chronic disease. Studies of intervention and prognosis for SHS are expected to become increasingly important. Consequently, a reliable and valid instrument to assess SHS is essential. We developed and evaluated a questionnaire for measuring SHS in urban Chinese.
Methods: Focus group discussions and a literature review provided the basis for the development of the questionnaire. Questionnaire validity and reliability were evaluated in a small pilot study and in a larger cross-sectional study of 3000 individuals. Analyses included tests for reliability and internal consistency, exploratory and confirmatory factor analysis, and tests for discriminative ability and convergent validity.
Results: The final questionnaire included 25 items on SHS (SHSQ-25), and encompassed 5 subscales: fatigue, the cardiovascular system, the digestive tract, the immune system, and mental status. Overall, 2799 of 3000 participants completed the questionnaire (93.3%). Test-retest reliability coefficients of individual items ranged from 0.89 to 0.98. Item-subscale correlations ranged from 0.51 to 0.72, and Cronbach’s α was 0.70 or higher for all subscales. Factor analysis established 5 distinct domains, as conceptualized in our model. One-way ANOVA showed statistically significant differences in scale scores between 3 occupation groups; these included total scores and subscores (P < 0.01). The correlation between the SHS scores and experienced stress was statistically significant (r = 0.57, P < 0.001).
Conclusions: The SHSQ-25 is a reliable and valid instrument for measuring sub-health status in urban Chinese.

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© 2009 by the Japan Epidemiological Association
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