Introduction
Methods
The SF-36
Data collection
Statistical analyses
Group and subgroup analysis
Statistical analyses
Results
Sample background characteristics
Turkish (N = 409) | Moroccan (N = 377) | Turkish language subgroup (N = 162)a
| Moroccan-Arabic language subgroup (N = 52)b
| Dutch (N = 9,628) | |
---|---|---|---|---|---|
Gender | |||||
Female | 215 (53%) | 196 (52%) | 95 (59%) | 34 (65%) | 5,334 (55%) |
Male | 194 (47%) | 181 (48%) | 67 (41%) | 18 (35%) | 4,294 (45%) |
Age mean (sd) | 36.8 (12.1) | 36.6 (12.6) | 40.5 (12.9) | 41.4 (12.0) | 48.9 (17.0) |
Age range | 18–76 | 18–79 | 21–69 | 20–67 | 18–79 |
Age | |||||
18–49 | 331 (81%) | 316 (84%) | 114 (70%) | 39 (75%) | 5,149 (54%) |
50–79 | 77 (19%) | 60 (16%) | 47 (29%) | 12 (23%) | 4,478 (46%) |
Missing | 1 (0.2%) | 1 (0.3%) | 1 (0.6%) | 1 (2%) | 1 (0%) |
Education | |||||
Primary school or less | 177 (43%) | 166 (44%) | 106 (65%) | 41 (79%) | 1,427 (15%) |
Basic high school | 209 (51%) | 180 (48%) | 53 (33%) | 10 (19%) | 6,152 (64%) |
Advanced high school | 23 (6%) | 29 (8%) | 3 (2%) | 1 (2%) | 2,035 (21%) |
Missing | 2 (0.5%) | 14 (0.1%) | |||
Marital status | |||||
Not married | 47 (11%) | 60 (16%) | 4 (2%) | 3 (6%) | 2,023 (21%) |
Married/registered partnership | 318 (78%) | 289 (77%) | 139 (86%) | 41 (79%) | 6,359 (66%) |
Divorced | 27 (7%) | 16 (4%) | 7 (4%) | 4 (8%) | 496 (5%) |
Widowed | 15 (4%) | 7 (2%) | 11 (7%) | 2 (4%) | 740 (8%) |
Missing | 2 (0.5%) | 5 (1%) | 1 (0.6%) | 2 (4%) | 10 (0.1%) |
Comorbidity | |||||
None | 158 (39%) | 165 (44%) | 47 (29%) | 18 (35%) | 3,358 (35%) |
One | 83 (20%) | 103 (27%) | 36 (22%) | 18 (35%) | 2,669 (28%) |
Two or more | 168 (41%) | 109 (29%) | 79 (49%) | 16 (31%) | 3,601 (37%) |
Country of birth | |||||
The Netherlands | 57 (14% | 40 (11%) | 7 (4%) | 1 (2%) | |
Turkey/Morocco/else | 352 (86%) | 337 (89%) | 155 (96% | 51 (98%) | |
Reason of immigration | |||||
Work/reunion with spouse | 192 (47%) | 180 (48%) | 110 (68%) | 38 (73%) | |
Children came with parents | 132 (32%) | 117 (31%) | 36 (22%) | 10 (19%) | |
Other | 28 (7%) | 38 (10%) | 9 (6%) | 3 (6%) | |
Missing | 57 (14%) | 42 (11%) | 7 (4%) | 1 (2%) | |
Mother language | |||||
Turkish | 344 (84%) | 152 (94%) | |||
Kurdish | 8 (2%) | 1 (1%) | |||
Other Turkish | 9 (2%) | 2 (1%) | |||
Dutch | 48 (12%) | 62 (16%) | 7 (4%) | 1 (2%) | |
Moroccan-Arabic | 195 (52%) | 43 (83%) | |||
Tarifit | 40 (11%) | 4 (8%) | |||
Tamazight | 67 (18%) | 4 (8%) | |||
Tachelit | 6 (2%) | – | |||
Other Moroccan | 7 (2%) | – | |||
Proficiency in speaking Dutch | |||||
None | 24 (6%) | 18 (5%) | 20 (12%) | 10 (19%) | |
Low | 120 (29%) | 88 (23%) | 98 (61%) | 34 (65%) | |
Moderate | 105 (26%) | 114 (30%) | 26 (16%) | 4 (8%) | |
High | 160 (39%) | 156 (41%) | 18 (11%) | 4 (8%) | |
Missing | 1 (0.3%) |
Descriptive statistics
Turkish (N = 409) | Turkish subgroup (N = 162) | |||||||
---|---|---|---|---|---|---|---|---|
N
| Median | Mean | SD | % Floor | % Ceiling | Cronbach’s α (N) | Cronbach’s α (N) | |
PF | 408 | 90.0 | 80.4 | 24.9 | 1.0 | 38.5 | 0.93 (397) | 0.92 (159) |
RP | 408 | 100.0 | 70.8 | 41.0 | 19.6 | 61.0 | 0.93 (404) | 0.92 (160) |
BP | 409 | 74.0 | 70.9 | 31.9 | 4.4 | 45.0 | 0.95 (403) | 0.95 (159) |
GH | 408 | 65.0 | 60.2 | 23.0 | 1.0 | 2.2 | 0.81 (405) | 0.82 (160) |
VT | 408 | 55.0 | 53.8 | 22.2 | 1.5 | 1.0 | 0.76 (404) | 0.73 (158) |
SF | 409 | 87.5 | 75.6 | 26.7 | 2.4 | 38.1 | 0.77 (401) | 0.78 (162) |
RE | 406 | 100.0 | 75.0 | 39.1 | 17.2 | 67.2 | 0.89 (403) | 0.90 (160) |
MH | 408 | 68.0 | 64.5 | 21.2 | 1.2 | 2.2 | 0.81 (397) | 0.80 (157) |
Moroccan (N = 377) | Moroccan subgroup (N = 52) | |||||||
---|---|---|---|---|---|---|---|---|
N
| Median | Mean | SD | % Floor | % Ceiling | Cronbach’s α (N) | Cronbach’s α (N) | |
PF | 377 | 95.0 | 86.9 | 19.6 | 0.5 | 47.7 | 0.91 (354) | 0.84 (50)b
|
RP | 376 | 100.0 | 77.1 | 37.0 | 13.3 | 66.5 | 0.91 (373) | 0.92 (52) |
BP | 376 | 100.0 | 75.8 | 29.6 | 1.3 | 51.1 | 0.94 (359) | 0.93 (51) |
GH | 377 | 62.0 | 61.1 | 22.8 | 0 | 2.7 | 0.83 (374) | 0.79 (51) |
VT | 377 | 55.0 | 56.9 | 18.5 | 0 | 1.9 | 0.61 (374) | 0.54 (52)b
|
SF | 377 | 87.5 | 79.8 | 23.3 | 0.3 | 40.8 | 0.74 (373) | 0.63 (51)b
|
RE | 376 | 100.0 | 82.0 | 35.5 | 13.0 | 77.1 | 0.91 (375) | 0.88 (52) |
MH | 377 | 72.0 | 69.2 | 20.0 | 0.3 | 3.2 | 0.82 (374) | 0.85 (52) |
Dutch (N = 9,620a) | |||||||
---|---|---|---|---|---|---|---|
N
| Median | Mean | SD | % Floor | % Ceiling | Cronbach’s α (N) | |
PF | 9,620 | 95.0 | 85.8 | 21.9 | 0.5 | 42.4 | 0.93 (9603) |
RP | 9,620 | 100.0 | 79.3 | 35.8 | 12.1 | 70.6 | 0.91 (9610) |
BP | 9,619 | 84.0 | 78.4 | 24.7 | 0.6 | 45.5 | 0.92 (9617) |
GH | 9,620 | 72.0 | 70.3 | 20.5 | 0.1 | 3.8 | 0.77 (9599) |
VT | 9,620 | 75.0 | 69.5 | 18.9 | 0.1 | 3.4 | 0.80 (9597) |
SF | 9,618 | 100.0 | 85.5 | 21.5 | 0.7 | 55.0 | 0.78 (9612) |
RE | 9,618 | 100.0 | 89.6 | 26.6 | 5.6 | 84.2 | 0.84 (9611) |
MH | 9,620 | 84.0 | 80.1 | 15.9 | 0.1 | 6.6 | 0.83 (9605) |
Factor analysis
SF-36 item | Loading | |||
---|---|---|---|---|
Turkish (n = 409) | Moroccan (n = 377)a
| Dutch (n = 9,620) | ||
PF by | PF1 Vigorous activities | 0.892 | 0.864 | 0.880 |
PF2 Moderate activities | 0.906 | 0.874 | 0.934 | |
PF3 Lifting/carrying | 0.912 | 0.881 | 0.904 | |
PF4 Climbing several stairs | 0.914 | 0.936 | 0.956 | |
PF5 Climbing 1 flight stairs | 0.896 | 0.929 | 0.970 | |
PF6 Bending/kneeling | 0.893 | 0.868 | 0.861 | |
PF7 Walking a km | 0.919 | 0.916 | 0.920 | |
PF8 Walking few 100 m | 0.964 | 0.940 | 0.966 | |
PF9 Walking 100 m | 0.918 | 0.891 | 0.987 | |
PF10 Bathing/dressing | 0.823 | 0.787 | 0.849 | |
RP by | RP1 Cut down time | 0.957 | 0.945 | 0.928 |
PR2 Accomplished less | 0.967 | 0.923 | 0.945 | |
RP3 Limited in kind | 0.990 | 0.974 | 0.977 | |
PP4 Difficulty performing | 0.971 | 0.981 | 0.978 | |
BP by | BP1 Pain | 0.949 | 0.971 | 0.933 |
BP2 Pain interfere | 0.995 | 0.960 | 0.993 | |
GH by | GH1 General health | 0.850 | 0.898 | 0.846 |
GH2 Easier sick | 0.615 | 0.696 | 0.634 | |
GH3 As healthy | 0.633 | 0.635 | 0.596 | |
GH4 Health get worse | 0.615 | 0.581 | 0.501 | |
GH5 Health excellent | 0.884 | 0.863 | 0.925 | |
VT by | VT1 Full of pep | 0.485 | 0.155 | 0.682 |
VT2 A lot of energy | 0.795 | 0.631 | 0.811 | |
VT3 Worn out | 0.777 | 0.794 | 0.743 | |
VT4 Tired | 0.747 | 0.738 | 0.759 | |
SF by | SF1 Social-extent | 0.886 | 0.849 | 0.889 |
SF2 Social-time | 0.834 | 0.861 | 0.873 | |
RE by | RE1 Cut down time | 0.975 | 0.975 | 0.959 |
RE2 Accomplished less | 0.978 | 0.972 | 0.993 | |
RE3 Not careful | 0.914 | 0.967 | 0.855 | |
MH by | MH1 Nervous | 0.617 | 0.717 | 0.663 |
MH2 Down in dumps | 0.840 | 0.913 | 0.845 | |
MH3 Calm and peaceful | 0.660 | 0.554 | 0.727 | |
MH4 Downhearted/blue | 0.861 | 0.902 | 0.848 | |
MH5 Happy | 0.601 | 0.629 | 0.704 |
Internal consistency reliability
Known-groups validity
Sex | Age | Marital status | Education | Comorbidity | ||||||
---|---|---|---|---|---|---|---|---|---|---|
∆ (BI) | ES | ∆ (BI) | ES | ∆ (BI) | ES | ∆ (BI) | ES | ∆ (BI) | ES | |
Turkish sample (n = 409) | ||||||||||
PF | 9.5 (4.7–14.3)* | 0.42 | 32.4 (27.0–37.7)* | 1.70 | 0.8 (−5.1 to 6.7) | 0.03 | 16.7 (12.0–21.3)* | 0.86 | 25.4 (21.2–29.7)* | 1.60 |
RP | 12.0 (4.1–19.9)* | 0.33 | 23.9 (14.0–33.9)* | 0.61 | 1.2 (−8.5 to 10.8) | 0.03 | 16.3 (8.4–24.3)* | 0.43 | 35.8 (28.5–43.1)* | 1.14 |
BP | 16.1 (10.1–22.2)* | 0.56 | 22.1 (14.4–29.7)* | 0.75 | 1.4 (−6.1 to 8.9) | 0.05 | 14.9 (8.8–21.0)* | 0.53 | 36.3 (31.0–41.5)* | 1.67 |
GH | 9.6 (5.2–14.0)* | 0.43 | 22.4 (17.1–27.7)* | 1.06 | 0.5 (−5.0 to 5.9) | 0.02 | 14.9 (10.6–19.2)* | 0.73 | 26.7 (23.0–30.5)* | 1.55 |
VT | 12.3 (8.1–16.4)* | 0.61 | 13.0 (7.6–18.4)* | 0.60 | 1.1 (−4.1 to 6.3) | 0.05 | 12.1 (7.9–16.3)* | 0.60 | 19.9 (15.9–23.8)* | 1.05 |
SF | 11.2 (6.1–16.3)* | 0.46 | 20.4 (14.0–26.7)* | 0.83 | 4.2 (−2.1 to 10.5) | 0.16 | 11.7 (6.5–16.8)* | 0.47 | 22.8 (18.0–27.5)* | 1.15 |
RE | 13.3 (5.8–20.9)* | 0.39 | 24.2 (14.7–33.6)* | 0.68 | 4.8 (−4.4 to 14.1) | 0.12 | 14.0 (6.5–21.6)* | 0.41 | 30.2 (23.0–37.4)* | 1.02 |
MH | 10.1 (6.1–14.1)* | 0.53 | 7.2 (1.9–12.4)* | 0.34 | 2.3 (−2.7 to 7.3) | 0.11 | 7.1 (3.0–11.2)* | 0.36 | 17.6 (13.8–21.4)* | 1.05 |
Moroccan sample (n = 377) | ||||||||||
PF | 4.7 (0.7–8.6)* | 0.28 | 13.6 (8.4–18.9)* | 0.72 | −3.6 (−8.4 to 1.2) | −0.18 | 8.7 (4.8–12.6)* | 0.51 | 16.6 (12.5–20.6)* | 1.17 |
RP | 8.5 (1.1–16.0)* | 0.25 | 6.5 (−3.7–16.8) | 0.18 | −5.7 (−14.8 to 3.4) | −0.15 | 2.5 (−5.1–10.1) | 0.07 | 33.3 (25.7–40.8)* | 1.14 |
BP | 8.1 (2.2–14.1)* | 0.29 | 12.9 (4.8–21.0)* | 0.44 | −4.4 (−11.7 to 2.9) | −0.15 | 11.5 (5.5–17.4)* | 0.42 | 31.4 (25.6–37.2)* | 1.32 |
GH | 4.1 (−0.5–8.7) | 0.18 | 16.7 (10.6–22.8)* | 0.75 | −6.9 (−12.4 to −1.3)*! | −0.31 | 13.1 (8.6–17.5)* | 0.61 | 22.7 (18.1–27.2)* | 1.12 |
VT | 7.4 (3.7–11.1)* | 0.40 | 6.3 (1.2–11.4)* | 0.34 | −5.5 (−10.0 to −1.0)*! | −0.31 | 6.5 (2.7–10.2)* | 0.35 | 15.6 (11.8–19.5)* | 0.88 |
SF | 6.7 (2.0–11.4)* | 0.31 | 10.9 (4.5–17.2)* | 0.47 | −0.5 (−6.2 to 5.2) | −0.02 | 6.0 (1.3–10.7)* | 0.26 | 18.5 (13.7–23.4)* | 0.94 |
RE | 7.0 (−0.2–14.2) | 0.22 | −0.2 (−10.1–9.6) | −0.01 | 6.5 (−2.2 to 15.1) | 0.19 | 2.4 (−4.8–9.7) | 0.07 | 25.0 (17.5–32.6)* | 0.89 |
MH | 5.5 (1.5–9.5)* | 0.28 | 6.4 (0.9–11.9)* | 0.32 | 2.5 (−2.4 to 7.3) | 0.13 | 4.0 (−0.1–8.1) | 0.20 | 15.7 (11.5–19.9)* | 0.89 |
Dutch sample (n = 9,620) | ||||||||||
PF | 4.8 (4.0–5.7)* | 0.24 | 13.5 (12.7–14.4)* | 0.89 | 2.7 (1.7–3.6)* | 0.13 | 16.9 (15.7–18.1)* | 0.88 | 20.1 (19.3–21.0)* | 1.47 |
RP | 7.6 (6.2–9.0)* | 0.23 | 3.4 (2.0–4.8)* | 0.10 | 2.4 (0.9–3.9)* | 0.07 | 8.4 (6.4–10.4)* | 0.24 | 23.3 (21.9–24.7)* | 0.83 |
BP | 7.1 (6.1–8.1)* | 0.31 | 5.0 (4.0–5.9)* | 0.21 | 1.6 (0.6–2.7)* | 0.07 | 7.4 (6.0–8.8) * | 0.31 | 20.6 (19.6–21.5)* | 1.05 |
GH | 2.2 (1.4–3.0)* | 0.11 | 10.0 (9.2–10.8)* | 0.53 | 1.5 (0.6–2.3)* | 0.07 | 11.1 (10.0–12.2)* | 0.56 | 19.1 (18.3–19.8)* | 1.20 |
VT | 6.2 (5.4–6.9)* | 0.34 | 0.2 (–0.6–0.9) | 0.01 | 3.8 (3.1–4.6)* | 0.20 | 6.0 (5.0–7.1) * | 0.33 | 12.3 (11.5–13.0)* | 0.75 |
SF | 5.8 (4.9–6.6)* | 0.30 | 2.0 (1.2–2.9)* | 0.10 | 4.1 (3.2–5.0)* | 0.20 | 5.8 (4.6–7.0)* | 0.28 | 12.6 (11.8–13.5)* | 0.75 |
RE | 4.2 (3.1–5.3)* | 0.18 | –0.8 (−1.8–0.3) | −0.03 | 3.7 (2.6–4.9)* | 0.15 | 1.8 (0.3–3.3)* | 0.07 | 8.9 (7.8–10.0)* | 0.41 |
MH | 5.3 (4.7–6.0)* | 0.37 | 1.3 (0.7–1.9)* | 0.09 | 5.4 (4.7–6.1)* | 0.37 | 6.3 (5.4–7.2)* | 0.42 | 7.5 (6.9–8.2)* | 0.55 |
DIF analyses
Turkish N = 409 | Moroccan N = 377 | |||
---|---|---|---|---|
OR |
P-value | OR |
P-value | |
PF scale | ||||
PF1 |
2.56 (1.92–3.41)**
| 0.000 |
1.98 (1.49–2.61) | 0.000** |
PF2 | 1.07 (0.78–1.48)** | 0.669 | 0.64 (0.46–0.89) | 0.008 |
PF3 | 0.80 (0.60–1.07) | 0.132 | 0.89 (0.66–1.22) | 0.478 |
PF4 | 0.74 (0.54–1.02) | 0.066 | 0.79 (0.56–1.13) | 0.194 |
PF5 | 1.01 (0.68–1.50) | 0.950 | 0.82 (0.51–1.30) | 0.395 |
PF6 | 1.70 (1.25–2.32) | 0.001 | 1.02 (0.75–1.40) | 0.894 |
PF7 |
0.38 (0.28–0.51) | 0.000 | 0.55 (0.39–0.79) | 0.001 |
PF8 |
0.50 (0.34–0.73) | 0.000 | 0.55 (0.35–0.88) | 0.013 |
PF9 | 0.68 (0.43–1.08) | 0.101 |
0.46 (0.25–0.83) | 0.010 |
PF10 | 0.62 (0.39–0.99) | 0.045 | 0.74 (0.38–1.43) | 0.364 |
RP scale | ||||
RP1 |
2.96 (1.74–5.03) | 0.000 | 1.47 (0.82–2.64) | 0.197 |
RP2 |
0.38 (0.22–0.64) | 0.000 | 0.62 (0.35–1.09) | 0.095 |
RP3 | 1.29 (0.65–2.56) | 0.468 | 0.94 (0.47–1.90) | 0.871 |
RP4 | 0.58 (0.34–0.99) | 0.045 | 0.75 (0.42–1.34) | 0.326 |
BP scale | ||||
BP1 | 1.17 (0.83–1.67) | 0.372 | 1.28 (0.88–1.85) | 0.193 |
BP2 | 1.09 (0.80–1.50) | 0.581 | 1.16 (0.83–1.63) | 0.391 |
GH scale | ||||
GH1 | 0.81 (0.65–1.00)** | 0.050 | 0.89 (0.71–1.11) | 0.295** |
GH2 | 0.56 (0.46–0.68) | 0.000 | 0.67 (0.54–0.82) | 0.000 |
GH3 | 1.85 (1.52–2.26) | 0.000 | 1.83 (1.49–2.25) | 0.000 |
GH4 | 0.93 (0.77–1.12) | 0.448 | 0.85 (0.70–1.03) | 0.103 |
GH5 | 1.22 (0.98–1.53) | 0.079 | 1.31 (1.04–1.66) | 0.023 |
VT scale | ||||
VT1 | 0.64 (0.53–0.77)** | 0.000 |
0.38 (0.31–0.47) | 0.000 |
VT2 | 1.22 (1.00–1.50) | 0.051 | 0.93 (0.75–1.14) | 0.478 |
VT3 | 1.05 (0.86–1.28) | 0.623 |
2.54 (2.06–3.14) | 0.000 |
VT4 |
2.04 (1.67–2.50) | 0.000 |
2.12 (1.72–2.61) | 0.000 |
SF scale | ||||
SF1 | 1.28 (0.97–1.70) | 0.079 | 1.76 (1.30–2.38) | 0.000 |
SF2 | 0.78 (0.60–1.02) | 0.074 | 0.57 (0.43–0.74) | 0.000 |
RE scale | ||||
RE1 |
2.07 (1.00–4.27) | 0.050 |
4.32 (1.75–10.67) | 0.002 |
RE2 | 0.86 (0.44–1.71) | 0.674 | 0.70 (0.31–1.56) | 0.381 |
RE3 | 0.63 (0.37–1.06) | 0.084 | 0.78 (0.42–1.48) | 0.453 |
MH scale | ||||
MH1 | 1.46 (1.19–1.78) | 0.000 |
1.96 (1.59–2.42) | 0.000 |
MH2 | 0.56 (0.45–0.69) | 0.000 | 0.71 (0.56–0.89) | 0.003 |
MH3 | 1.34 (1.09–1.64)** | 0.005 | 0.70 (0.57–0.86) | 0.001** |
MH4 | 0.70 (0.57–0.86) | 0.001 | 1.42 (1.14–1.77) | 0.002 |
MH5 | 1.69 (1.39–2.07)** | 0.000 | 0.98 (0.80–1.20) | 0.864 |