Culture and the measurement of health-related quality of life

One of the justifications for translating a health related quality of life (HRQL) instrument from one language to another is the claim that existing measures are ''culture free''. This paper challenges such a notion. Through a review of the rationales, and research methods, used in the development of nine generic measures, it is proposed that HRQL measures are ''culture full'', reflecting in particular the beliefs and values of the researchers who contributed to their construction. It is also argued that implicit and explicit claims of universal dimensions of HRQL cannot be made at present as research methods have not been sufficiently sensitive to identify any such domains.