The conceptual validity and appropriateness of using health-related quality of life measures with minority ethnic groups.

Health-related quality of life measures have become increasingly used in the evaluation of health care to provide a measure of patients' subjective health status. Although studies often include ethnically heterogeneous samples, it is not clear to what extent the use of quality of life measures in this context is valid, because culture can affect the perception and interpretation of health and illness and so may affect the responses to items in a questionnaire. Such use also assumes the appropriateness of using a questionnaire format with individuals from different cultural backgrounds. This paper questions the assumptions of universality of concept and method, and presents the findings of a study which explored the conceptual validity and appropriateness of using the one health-related quality of life measure, the Short Form-36 with a group of Indian cardiac patients. The study identified some differences between a matched control group and Indian patients. The implications of these results and the importance of considering culture in the measurement of health-related quality of life are discussed.