title: 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.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, University of Tartu, Puusepa 6, Tartu, 51014, Estonia. marika.tammaru@kliinikum.ee
authors.forename: Marika
authors.initials: M
authors.lastname: Tammaru
authors.forename: Judit
authors.initials: J
authors.lastname: Strömpl
authors.forename: Kadri
authors.initials: K
authors.lastname: Maimets
authors.forename: Ele
authors.initials: E
authors.lastname: Hanson
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000523:psychology*; D004957:Estonia; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000295:instrumentation*; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D020377:Self Efficacy; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016896:Treatment Outcome