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Validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis-31 in Spanish postmenopausal women

González Matarín, Pedro José MHS1; Martínez-Amat, Antonio PhD1,2; Lomas-Vega, Rafael PhD1; Mendoza Ladrón de Guevara, Nicolás MD3; Díaz-Mohedo, Esther PhD4; Martínez López, Emilio PhD5; García, Ana Belén Padial BS6; Hita-Contreras, Fidel MD1,2

doi: 10.1097/GME.0b013e3182a6cc64
Original Articles

Objective: The Quality of Life Questionnaire of the European Foundation for Osteoporosis-31 (QUALEFFO-31) is a reliable and validated questionnaire that assesses quality of life in osteoporotic women. Our objective was to analyze the reliability and validity of the Spanish version of QUALEFFO-31 and its ability to discriminate between women with osteoporosis and women without osteoporosis in a Spanish postmenopausal population.

Methods: One hundred eighteen women (aged 50-65 y) completed the Spanish version of QUALEFFO-31. Bone mineral density was measured by dual-energy x-ray densitometry. Internal consistency and test-retest reliability were analyzed. Concurrent validity of QUALEFFO-31 was evaluated using Spearman’s rank correlation coefficient with the 36-item Short-Form Health Survey (SF-36). To determined responsiveness, we analyzed mean differences between osteoporotic and nonosteoporotic women and performed receiver operating characteristic curve analysis.

Results: The Spanish version of QUALEFFO-31 has shown excellent test-retest reliability with a high intraclass correlation coefficient for all its domains, especially for the total score (0.988; P < 0.001), and good internal consistency with optimal Cronbach α values in all scales (0.70-0.90). In concurrent validity analysis, QUALEFFO-31 total score showed a high and negative correlation with several scales of the SF-36 (P < 0.001). In responsiveness analysis, significant differences in the pain (P = 0.002) and QUALEFFO-31 total score (P = 0.004) scales were found between osteoporotic and nonosteoporotic women. No differences in areas under the receiver operating characteristic curve were found between the QUALEFFO-31 and the SF-36 scales.

Conclusions: The Spanish version of QUALEFFO-31 has good internal consistency, concurrent validity, and test-retest reliability, with satisfactory general psychometric properties, and is a valid tool for discriminating between osteoporotic and nonosteoporotic postmenopausal women aged 50 to 65 years.

Author Information

From the 1Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain; 2Institute of Biopathology and Regenerative Medicine (IBIMER), Department of Human Anatomy and Embryology, and 3Department of Obstetrics and Gynecology, Faculty of Medicine, University of Granada, Granada, Spain; 4Faculty of Nursing, Physiotherapy, Podology, and Occupational Therapy, University of Málaga, Málaga, Spain; 5Department of Music, Plastical Expression, and Body Language, University of Jaén, Jaén, Spain; and 6Department of Personality, Evaluation, and Psychological Treatment, University of Granada, Granada, Spain.

Received June 19, 2013; revised and accepted July 23, 2013.

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Fidel Hita-Contreras, MD, Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén E-23071, Spain. E-mail:

© 2014 by The North American Menopause Society.