Cross-cultural adaptation and validation of the Falls Efficacy Scale International in Spanish postmenopausal women

Objective: Falls are a serious public health problem and one of the most important concerns for older people. The risk of falling is dramatically increased in osteoporotic postmenopausal women. The Falls Efficacy Scale International (FES-I) is a reliable and validated questionnaire that can assess the fear of falling. Our objective is to develop the FES-I cross-cultural adaptation to the Spanish postmenopausal population. Methods: FES-I was translated into Spanish language. One hundred postmenopausal women (50-65 years old) completed the FES-I and the 36-item Short-Form Health Survey (SF-36) questionnaire. Content validity was determined by a group of experts and participants. FES-I internal consistency and test-retest reliability were analyzed. Exploratory factor analysis was used to assess construct validity. Criterion validity has been evaluated using the Spearman correlation coefficient with the 36-item Short-Form Health Survey. Results: FES-I has an excellent test-retest reliability (intraclass correlation coefficient, 0.972; P < 0.001) and good internal consistency (Cronbach alpha = 0.940). Factor analysis showed one unifactorial structure with two underlying dimensions related to less or more demanding physical activities. FES-I global score showed a negative correlation with the two SF-36 summary measures (P < 0.001). Conclusions: The Spanish version of FES-I showed high reliability and validity in the adaptation for the Spanish postmenopausal population. Future studies are required to assess the sensitivity to change and to predict the risk of future falling.