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Background <p>The Thai Short Form Health Survey, version 2 (SF-12v2), is widely used to evaluate health-related quality of life (HRQoL) in Thailand. Lifestyle changes during the COVID-19 pandemic may have influenced how individuals interpreted and responded to SF-12v2 items across pre- and post-pandemic time periods. This study examined differences in mean scores, item interpretations due to differential item functioning (DIF), and factor structure invariance using confirmatory factor analysis (CFA) between the pre- and post-pandemic periods.</p> Methods <p>Data was drawn from two national surveys (<i>n</i> = 1,200 prepandemic; <i>n</i> = 2,000 postpandemic). CFA was conducted on randomly selected subsamples (<i>n</i> = 1,050 prepandemic; <i>n</i> = 1,850 postpandemic), with 150 participants per group reserved for DIF analyses using two-way ANOVA. Subscale score differences were assessed using generalized linear models.</p> Results <p>The CFA confirmed the two-factor model (PCS and MCS). Older participants and those with comorbidities scored significantly lower on physical subscales (PF, RP, BP, GH, and PCS), while only comorbid participants reported significantly lower on SF and RE subscales (all <i>p</i> &lt; 0.05). A non-uniform DIF was observed for PF and PCS against dataset, age, and health status, and for MCS against dataset and age.</p> Conclusions <p>The SF-12v2 factor structure was stable across time points. Although MCS scores increased after the pandemic, this change may not accurately reflect the impact of COVID-19 due to the absence of participants who had recovered from the infection. To improve generalizability, future studies should include COVID-19 cases and broader assessments of mental health.</p>

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Factor structure and trends in SF-12v2 health-related quality of life scores among pre-and post-pandemic samples in Thailand: confirmatory factor analysis and Rasch analysis

  • 期刊论文

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  • 发表日期：

    2025年7月21日

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  • Krittaphas Kangwanrattanakul

摘要

Background

The Thai Short Form Health Survey, version 2 (SF-12v2), is widely used to evaluate health-related quality of life (HRQoL) in Thailand. Lifestyle changes during the COVID-19 pandemic may have influenced how individuals interpreted and responded to SF-12v2 items across pre- and post-pandemic time periods. This study examined differences in mean scores, item interpretations due to differential item functioning (DIF), and factor structure invariance using confirmatory factor analysis (CFA) between the pre- and post-pandemic periods.

Methods

Data was drawn from two national surveys (n = 1,200 prepandemic; n = 2,000 postpandemic). CFA was conducted on randomly selected subsamples (n = 1,050 prepandemic; n = 1,850 postpandemic), with 150 participants per group reserved for DIF analyses using two-way ANOVA. Subscale score differences were assessed using generalized linear models.

Results

The CFA confirmed the two-factor model (PCS and MCS). Older participants and those with comorbidities scored significantly lower on physical subscales (PF, RP, BP, GH, and PCS), while only comorbid participants reported significantly lower on SF and RE subscales (all p < 0.05). A non-uniform DIF was observed for PF and PCS against dataset, age, and health status, and for MCS against dataset and age.

Conclusions

The SF-12v2 factor structure was stable across time points. Although MCS scores increased after the pandemic, this change may not accurately reflect the impact of COVID-19 due to the absence of participants who had recovered from the infection. To improve generalizability, future studies should include COVID-19 cases and broader assessments of mental health.