<![CDATA[Health-Related Quality of Life (HRQoL) is a broad concept that includes physical, mental, emotional, and social aspects of well-being. Because different generations often view health in distinct ways, this study compared HRQoL among Generations X, Y, and Z in Medan using a quantitative, cross-sectional design. The main goal was to test and validate the factor structure of the SF-36 questionnaire and examine whether it measures HRQoL consistently across these groups through Multi-Group Confirmatory Factor Analysis (MG-CFA). The initial analysis supported a reliable four-factor model with 12 items covering Physical Functioning, Role Limitations due to Physical Health, Emotional Well-being, and Role Limitations due to Emotional Health. This model showed strong convergent validity. However, further testing revealed that the SF-36 does not maintain structural equivalence across the three generations, indicating that people interpret its items differently depending on their generational cohort. This finding highlights a key methodological issue: direct comparisons of HRQoL scores across generations are statistically invalid without adjustments. As a result, researchers must apply partial invariance techniques or refine the model before making meaningful cross-generational comparisons.]]>
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