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Cultural adaptation and validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) in a Mexican population
Authors:Esperanza Ramírez Pérez  Patricia Clark  Niels H. Wacher  Mario H. Cardiel  Ma. del Pilar Diez García
Affiliation:(1) División de Investigación, Depto. Epidemiología Sociomédica, Instituto Nacional de Rehabilitación, Av. México Xochimilco 289, Col. Arenal Guadalupe, Delegación Tlalpan, Distrito Federal, C.P. 14889 México, DF, Mexico;(2) Clínica de Osteoporosis, Instituto Nacional de Rehabilitación, México, DF, Mexico;(3) Unidad de Investigación en Epidemiología Clínica, Hospital de Especialidades, Centro Médico Siglo XXI, Instituto Mexicano del Seguro Social, Facultad de Medicina, UNAM, México, DF, Mexico;(4) Depto. de Inmunología y Reumatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, DF, Mexico
Abstract:
Measuring quality of life (QOL) is important, but to date, questionnaires to measure QOL in Mexican patients with osteoporosis (OP) have not been validated. A study was carried out to culturally adapt and validate the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) in a Mexican population. Interviews were performed with 160 women, 80 patients with at least one vertebral fracture, and 80 patients with OP as determined by the World Health Organization criteria. Several cultural modifications were made to the Spanish version of the QUALEFFO. Content validity was assessed by a group of experts, and a pilot study was undertaken. At the same time, the Spanish version of the Short Form 36 (Medical Outcomes Study) was applied. The mean age of patients was 71.9 ± 11.1. The QOL questionnaire showed a test–retest reproducibility (R i = 0.94) and internal consistency (α = 0.92), while social function scored low (α = 0.46). Concurrent validity was significant (r = −0.837, p < 0.001). Significant differences were found between the two groups for pain (p < 0.05), physical function (p < 0.01), social function (p < 0.01), mental function (p < 0.05), and number of fractures (p < 0.001). Discriminatory characteristics between the groups were significant for physical (p < 0.001), social (p < 0.001), and mental (p < 0.02) function. The cultural adaptation of the QUALEFFO was consistent, homogenous, and discriminative. It also showed deterioration in the QOL group of Mexicans with vertebral fractures. The QUALEFFO can be used in a Mexican population to measure the QOL in patients with vertebral fractures after some cultural modifications to take into account local sensibilities.
Keywords:Cultural adaptation  Mexican population  Osteoporosis  Quality of life  Validation  Vertebral fractures
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