Conducting quality of life research in people with coronary artery disease in non-English-speaking countries: conceptual and operationalization issues.

Background: Health-related quality of life is an important clinical outcome to measure in patients with cardiovascular disease. International nurse researchers with limited English skills and novice cardiovascular nurse researchers face numerous challenges when conducting quality of life research because of the conceptual ambiguity of the construct and subsequent operationalization issues as well as difficulty identifying conceptual models to guide their quality of life research.

Purpose: The overall purpose of this article was to provide guidance to cardiovascular nurse researchers (using Thailand as an example) who are interested in examining quality of life in their native country but lack access to quality of life conceptual models and instruments because of language barriers. This article will examine definitions of health-related quality of life, selection of a conceptual model to guide quality of life research, use of the conceptual model to guide selection and measurement of variables, and translation of instruments when reliable and valid instruments are not available in the native language.

Conclusions: Ferrans' definition of quality of life and the Wilson and Cleary Revised Model of Patient Outcomes were selected to guide the research. Selection of variables/instruments flowed directly from the conceptualization of constructs identified in this model. Our study, "Examining HRQOL in Thai People With Coronary Artery Disease Following Percutaneous Coronary Intervention," serves as an exemplar to illustrate the conceptual and operational challenges associated with conducting quality of life research in Thailand.

Clinical Implications: The ultimate goal of cardiovascular nursing is to help patients achieve their optimal quality of life. Thai clinicians implementing quality of life assessment in clinical practice face similar conceptual and operationalization issues, especially when using instruments that are not well established or easily interpreted. Although quality of life assessment in clinical practice improves communication between patients and healthcare providers, clear guidelines for making changes to treatment strategies based on changes in quality of life must be established.