Cross‐cultural adaptation and validation of Spanish version of The Foot and Ankle Ability Measures (FAAM‐Sp)

Abstract

BackgroundThe Foot and Ankle Ability Measure (FAAM) is a Patient Reported Outcome (PRO) commonly used to determine the effectiveness of therapeutic interventions for patients with foot and ankle pathologies and associated impairments of body function and structure, activity limitations, and participation restrictions. The aim of this study was to cross-culturally adapt the FAAM into Spanish.MethodsCross-cultural adaptation was performed according to the international guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Cronbach’s alpha, test re-test reliability, and item-total and inter-item correlations were analyzed. Confirmatory factor analysis (CFA) was carried out to test construct validity. Pearson correlations were calculated to assess the convergent validity between FAAM and EuroQol-5.ResultsSpanish data set comprised 194 patients, with a mean age of 38.45 (16.04) and 130 (67.1%) were female, seeing a podiatrist with a wide variety of foot and ankle related disorders. CFA was carried out to test structure matrix (which has three factors). The test–retest reliability was high with global ICC of 0.95 (95% CI: 0.93 to 0.98). A 15 items version of the FAAM-Sp Activities of Daily Living (ADL) obtained the best fit: relative chi-square (x 2/df) of 2.46, GFI 0.90 CFI 0.95, NFI 0.93, and RMSEA 0.08 (90% CI 0.04 to 0.09). For exploratory factor analysis for the FAAM-Sp Sport, a one factor solution was obtained, which explained 76.70% of total variance. CFA corroborated this model with an excellent goodness of fit:: relative chi-square (x 2/df) of 0.80, GFI 0.99 CFI 1.00, NFI 0.99, and RMSEA 0.00 (90% CI 0.00 to 0.75).ConclusionsThis study validated a new 15-item FAAM-Sp ADL and FAAM-Sp Sport subscales, which can be used as a self-reported outcome measure in clinical practice and research for patients resident in Spain whose main language is Spanish.

Structural and Construct Validity of the Foot and Ankle Ability Measure (FAAM) With an Emphasis on Pain and Functionality After Foot Surgery: A Multicenter Study

“…The FAAM and its subscales demonstrated good internal consistency. The results were similar to those reported by previous validation studies of the FAAM, such as Spanish (ADL and Sport: 0.95) (11), Turkish (ADL: 0.95, Sports: 0.91) (6), German (ADL and Sports: 0.97) (5), and Persian (ADL: 0.97, Sports: 0.94) (10). Conversely, high (> 0.90) alpha values may suggest redundancy among the test items, as the items may be too similar (15).…”

“…The skewed distribution of subscale scores in the ADL subscale could have influenced the EFA, which could therefore have resulted in the Finnish version having different factor structure compared with the original FAAM. Previously, the Spanish version of the FAAM identified a 3-factor structure with a heterogeneous patient population (11). Further, we were unable to retrieve enough follow-up questionnaires from the patients, and thus we were unable to obtain the test-retest responsiveness for the FAAM in this sample.…”

“…The FAAM is a 29-item questionnaire consisting of 21-item ADL and 8-item sport subscales (Sports). Translations and cross-cultural validations of the FAAM are available for several languages, such as Dutch, Turkish, French, Japan, Chinese, Persian, and Spanish (5)(6)(7)(8)(9)(10)(11). The Finnish version of the FAAM has also been established and validated (12).…”

Uso de cuestionarios reportados por pacientes en cirugía de pie y tobillo en Chile

“…11 Es importante mencionar que, para utilizar un PROM en clínica o investigación, este debe contar con un proceso de validación cultural para el medio en el que será utilizado; esto permite asegurar que la herramienta es capaz de medir lo que se espera evaluar. Un total de 12 cuestionarios aplicables en cirugía de tobillo y pie han sido traducidos al español [12][13][14][15][16][17][18][19][20][21][22] y, de estos, sólo el EuroQol 5 Dimensions (EQ-5D), el SF-12, el FAOS, y el Victorian Institute of Sport Assessment-Achilles Questionnaire (VISA-A) cuentan con una adaptación cultural que permite utilizarlos de manera segura en Chile. 16,19,23 La traducción, adaptación transcultural y validación pueden ser procesos largos, difíciles o costosos; sin embargo, son imprescindibles al momento de utilizar un PROM en la práctica clínica.…”

Measures of Foot Pain, Foot Function, and General Foot Health

“…The FAAM has been translated and culturally adapted into Brazilian Portuguese , Chinese , German , Italian , Japanese , Spanish , and Turkish . Translation without cultural adaptation has been performed for Dutch , French , Persian , and Thai .…”