Confirmatory and bi-factor analysis of the Short Form Health Survey 8 (SF-8) scale structure in a German general population sample

BACKGROUND: The SF-8 is a short form of the SF-36 Health Survey, which is used for generic assessment of physical and mental aspects of health-related quality of life (HRQoL). Each of the 8 dimensions of the SF-36 is covered by a single item in the SF-8. The aim of the study was to examine the latent model structure of the SF-8. METHOD: One-, two- and three dimensional as well as bi-factor structural models were defined and estimated adopting the ML- as well as the WLSMV-algorithm for ordinal data. The data were collected in a German general population sample (N = 2545 persons). RESULTS: A two- (physical and mental health) and a three-dimensional CFA structure (in addition overall health) represent the empirical data information adequately [CFI = .987/.995; SRMR = .024/.014]. If a general factor is added, the resulting bi-factor models provide a further improvement in data fit [CFI = .999/.998; SRMR = .001]. The individual items are much more highly associated with the general HRQoL factor (loadings: .698 to .908) than with the factors physical, mental, and overall health (loadings: −.206 to .566). CONCLUSIONS: In the SF-8, each item reflects mainly general HRQoL (general factor) as well as one of the three components physical, mental, and overall health. The findings suggest in particular that the evaluation of the information of the SF-8 items can be validly supplemented by a general value HRQoL. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12955-021-01699-8.