title: Quality of life in patients with osteoporosis fractures: cultural adaptation, reliability and validity of the Osteoporosis Assessment Questionnaire.
abstract: OBJECTIVE
  The purpose of this study was to translate into Brazilian-Portuguese the Osteoporosis Assessment Questionnaire (OPAQ), and to evaluate its reliability and validity.
  
  
  METHODS
  The OPAQ was translated into Brazilian-Portuguese. This version was then back-translated into an English version which was compared to the original version, and a second Brazilian-Portuguese version was generated. This draft version of the Brazilian-Portuguese OPAQ was administered to 30 patients with lumbar osteoporosis and no fractures. The non-applicable questions were modified and, after being administered again, this Brazilian-Portuguese version of the OPAQ was accepted as definitive. Its reliability was tested in 30 osteoporotic out-patients, and was administered three times to the patients to check the intra/interobserver reliability. The patients were also clinically evaluated using HAQ, FIQ and a numerical rating scale for pain. For all patients the number of fractures and the bone mineral density at the spine were determined.
  
  
  RESULTS
  The mean age of the patients was 69 years (54 to 89 years) and the mean number of fractures was 2.72. Twenty-one patients (70%) had had more than one vertebral fracture. All of the questionnaire components, except for mood (c16), presented statistically significant coefficients for intra/interobserver reliability. The highest score was observed for "the fear of falling" (6.70). Correlations between the OPAQ components and the number of fractures, bone density and Z-score were not statistically significant.
  
  
  CONCLUSIONS
  This Brazilian-Portuguese version of the OPAQ is a reliable and valid instrument. Other aspects than bone mineral density and the number of fractures have an important influence on the quality of life in patients with osteoporosis and fractures.
authors.affiliation: Division of Rheumatology, UNIFESP/EPM, São Paolo, Brazil.
authors.forename: F B
authors.initials: FB
authors.lastname: Cantarelli
authors.forename: V L
authors.initials: VL
authors.lastname: Szejnfeld
authors.forename: L M
authors.initials: LM
authors.lastname: Oliveira
authors.forename: R M
authors.initials: RM
authors.lastname: Ciconelli
authors.forename: M B
authors.initials: MB
authors.lastname: Ferraz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D003431:Cross-Cultural Comparison; D003469:Culture; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000523:psychology*; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D014175:Translating