Quality of Life, Spirituality, and Indigenous Epistemologies in Ecuador

This study validates the McGill Quality of Life Questionnaire-Revised (MQOL-R) in Ecuadorian patients with non-communicable chronic diseases (NCDs), recognizing that quality of life (QoL)—particularly in the context of advanced illness—constitutes a culturally situated experience shaped by spiritual, relational, and contextual factors. Through a rigorous process of linguistic and cultural adaptation, the four-dimensional structure of the questionnaire (physical, psychological, existential, and social) was confirmed by exploratory and confirmatory factor analyses, with the exclusion of one existential item due to low factor loading. The instrument demonstrated satisfactory internal consistency (α = 0.81) and adequate temporal stability in the test–retest analysis. Additionally, a statistically significant gender difference was identified in the psychological dimension (p = 0.039), while no significant differences emerged in the remaining dimensions. Beyond its psychometric validation, this research underscores the importance of integrating local epistemological frameworks into QoL assessment, where spirituality, community ties, and ancestral knowledge inform how individuals experience, cope with, and assign meaning to illness. The Ecuadorian version of the MQOL-R thus constitutes not only a valid and reliable instrument but also a methodological articulation between contemporary clinical models and culturally grounded understandings of well-being in the Andean context.