Development and Psychometric Evaluation of a Postoperative Quality of Recovery Score

TLDR

Quality of recovery after anesthesia is a key early postoperative health metric. The study aimed to develop a concise postoperative QoR score and assess its validity, reliability, responsiveness, and feasibility. The authors derived the QoR‑15 by selecting the best‑performing items from each of the five dimensions of the QoR‑40 and tested it in 127 adult patients undergoing general anesthesia and surgery. The QoR‑15 demonstrated strong convergent validity (r = 0.68), construct validity with negative correlations to surgery duration, PACU time, and hospital stay, excellent internal consistency (α = 0.85), split‑half (0.78) and test‑retest (r = 0.99) reliability, and high responsiveness (ES = 1.35, SRM = 1.04), all while taking only 2.4 min to complete.

Abstract

Abstract Background: Quality of recovery (QoR) after anesthesia is an important measure of the early postoperative health status of patients. The aim was to develop a short-form postoperative QoR score, and test its validity, reliability, responsiveness, and clinical acceptability and feasibility. Methods: Based on extensive clinical and research experience with the 40-item QoR-40, the strongest psychometrically performing items from each of the five dimensions of the QoR-40 were selected to create a short-form version, the QoR-15. This was then evaluated in 127 adult patients after general anesthesia and surgery. Results: There was good convergent validity between the QoR-15 and a global QoR visual analog scale (r = 0.68, P < 0.0005). Construct validity was supported by a negative correlation with duration of surgery (r = −0.49, P < 0.0005), time spent in the postanesthesia care unit (r = −0.41, P < 0.0005), and duration of hospital stay (r = −0.53, P < 0.0005). There was also excellent internal consistency (0.85), split-half reliability (0.78), and test–retest reliability (ri = 0.99), all P < 0.0005. Responsiveness was excellent with an effect size of 1.35 and a standardized response mean of 1.04. The mean ± SD time to complete the QoR-15 was 2.4 ± 0.8min. Conclusions: The QoR-15 provides a valid, extensive, and yet efficient evaluation of postoperative QoR.