Abstract
The aim of the present study was to develop a pictorial questionnaire for the assessment of health-related quality of life (PictoQOL) and to examine its content validity and usability across three exemplary population groups of different origin residing in Germany (non-migrants, Turkish migrants and Arabic-speaking migrants). A mixed-methods design combining qualitative and quantitative methods was used, comprising 6 focus group discussions with a total of 17 participants, 37 cognitive interviews and a quantitative pretest with 15 individuals. The PictoQOL consists of a pictorial representation of a total of 15 different situations. Using a visual Likert scale, respondents indicate how much each situation applies to them. Some representations proved to be culturally sensitive and were adapted. Respondents found the use of an additional graphic layer in the form of symbols in addition to pictures helpful for interpretation. The PictoQOL is considered to allow a more accessible assessment and better comparability of HRQOL across different population groups regardless of their literacy level. It is therefore considered to be superior to existing instruments for routine use in health research and practice. Future studies need to examine its convergent and factorial validity.
Highlights
Health-related quality of life (HRQOL) is a frequently studied patient-reported outcome in health research [1]
The aim of the present study was to develop such a pictorial questionnaire for the assessment of healthrelated quality of life (PictoQOL) and to examine its content validity and usability in three selected population groups residing in Germany
We identified several key aspects that guided the development of the images and the questionnaire
Summary
Health-related quality of life (HRQOL) is a frequently studied patient-reported outcome in health research [1]. Identifying disparities in HRQOL between population groups can help to inform healthcare strategies aiming to reduce deficits in the health system and to ensure patient-centered healthcare [1]. For this purpose, HRQOL needs to be measured with high validity and reliability. HRQOL is usually assessed by means of standardized self- or interviewer-administered questionnaires, e.g., from the SF-36, EuroQol or WHOQOL family [2,3]. These questionnaires have been translated and adapted for a large number of populations and, in part, may differ in their underlying psychometric measurement models [2]. Since migrants may have a limited proficiency in the language
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
