The value of the qualitative method for adaptation of a disease-specific quality of life assessment instrument: the case of the Rheumatoid Arthritis Quality of Life Scale (RAQoL) in Estonia

BACKGROUND: Due to differences in current socio-economical situation and historically shaped values, different societies have their own concepts of high-quality life. This diversity of concepts interferes with quality of life (Qol) research in health sciences. Before deciding to apply a Qol assessment tool designed in and for another society, a researcher should answer the question: how will this instrument work under the specific circumstances of my research. Our study represents an example of the utilization of qualitative research methods to investigate the appropriateness of the Rheumatoid Arthritis Quality of Life Scale (RAQol) for the assessment of Qol in Estonian patients. METHODS: Semi-structured interviews were conducted with the rheumatoid arthritis (RA) patients of Tartu University Hospital and these were analyzed using the principles of the grounded theory. RESULTS: We described the significance of the questionnaire's items for our patients and also identified topics that were important for the Qol of Estonian RA patients, but that were not assessed by the RAQol. We concluded that the RAQol can be successfully adapted for Estonia; the aspects of Qol not captured by the questionnaire but revealed during our study should be taken into account in future research. CONCLUSIONS: Our results show that qualitative research can successfully be used for pre-adaptation assessment of a Qol instrument's appropriateness.