The McGill Quality of Life Questionnaire-Expanded (MQOL-E) and the Quality of Life in Life-Threatening Illness-Family Carer (QOLLTI-F) instruments are designed to evaluate the quality of life of patients nearing the end of life and their family caregivers, and can be used together as companion tools. Current validity frameworks highlight the importance of understanding response processes—the cognitive and emotional engagement of participants when completing questionnaires—which may be influenced by cultural adaptation and translation. This study aimed to translate MQOL-E and QOLLTI-F version 2 into Swedish and assess their content validity and response processes in a Swedish healthcare context. The study was conducted in two phases: (1) translation and cultural adaptation of the instruments, and (2) evaluation of content validity and response processes using cognitive interviews with 15 patients and 9 family caregivers. Participants were recruited from hemodialysis, cardiology, pulmonology, and specialized palliative care services within a Swedish county hospital. Eligible patients had life-limiting illnesses including advanced cancer, end-stage kidney disease, chronic obstructive pulmonary disease, or advanced heart failure, and were receiving outpatient, inpatient, or home-based care. Participants reported that the questionnaires addressed relevant and important aspects of quality of life. Although a few items required additional reflection, the instruments were largely clear and comprehensible. Minor revisions were implemented to resolve translation ambiguities. Respondents valued the reflective nature of completing the questionnaires, perceiving it as an opportunity to articulate feelings and experiences related to their situation. The Swedish versions of MQOL-E and QOLLTI-F v2 demonstrate content validity, linguistic fidelity, and cultural relevance. They may also serve as tools to facilitate meaningful discussions about quality of life between patients, family caregivers, and healthcare providers. Further investigation of the psychometric properties of these translations is recommended.
