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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.

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.