Cultural issues in using the SF-36 Health Survey in Asia: results from Taiwan.

BACKGROUND: The feasibility of using the SF-36 in non-Western cultures is important for researchers seeking to understand cultural influences upon health status perceptions. This paper reports on the performance of the Taiwan version of the SF-36, including the implications of cultural influences. METHODS: A total of 1191 volunteered subjects from the general population answered the translated SF-36 Taiwan version, which was developed following IQOLA project protocols. RESULTS: Results from tests of scaling assumptions and reliability generally were satisfactory. Convergent validity, as assessed by comparing the SF-36 to a mental health oriented inventory, was acceptable. Results of principal components analysis were similar to US results for many scales. However, differences were seen for the Vitality scale which was a stronger measure of mental health than physical health in Taiwan. Results are compared to those from other Asian studies and the U.S. CONCLUSION: The results raise important questions regarding cultural influences in international studies of health status assessment. Further research into the conceptualization and components of mental health in Asian countries is warranted.