Development of a questionnaire to measure patient‐reported postoperative recovery: content validity and intra‐patient reliability

Abstract

Aims and objectives In this study we describe the development of a short, easy-to-use questionnaire to measure postoperative recovery and evaluate its content validity and intra-patient reliability. The questionnaire is designed to evaluate the progress of postoperative recovery and the long-term follow-up of possible effects of interventions during recovery. Methods The study involved four steps. (1) A conceptualization and item definitions were based on a theoretical framework and a description of patients' postoperative recovery from the perspective of patients, registered nurses and surgeons; (2) Content validity of items was tested through expert judgements; (3) A test run of the questionnaire was performed to confirm its feasibility and workload requirement; and (4) The stability of the questionnaire was evaluated through intra-patient reliability assessment. Results As a result of the operationalization process of the concept postoperative recovery, five dimensions (physical symptoms, physical functions, psychological, social, activity) and 19 items were identified. Each item was formulated as a statement in the questionnaire. Content validity was judged to be high. After the pre-test of the questionnaire a revision with refinements in the layout was made. The vast majority of items showed a high level of intra-patient reliability. Conclusion Based on a theoretical framework and empirical data, we developed a short and easy-to-use tentative questionnaire to measure patient-reported postoperative recovery. Initial support for content validity was established. The vast majority of items showed a high level of test-retest reliability.

Early Unpleasant Postoperative Symptoms for Patients Undergoing Primary Hip versus Primary Knee Replacement: Patient Perception

“…The majority of items showed a high level of intra-patient reliability [22] .The 2011 KSS is a reliable, internal consistent, construct validity and responsive questionnaire, with 96% response rate and 43% completion rate. Reliability and internal consistency showed excellent result about ≥0.79 with ICCs and ≥0.76 with Cronbach's alpha for all subscales [23] .…”

Recuperação cirúrgica retardada: análise do conceito

“…Attribute 1 -change in the surgical recovery process: it is related to complications that change this process (1)(2)14) . The surgical recovery process is complex, dynamic and starts when the anesthetic-surgical procedure ends, continuing for a variable time span.…”

“…Attribute 3 -Impairment of the psychological functions: comprises the psychological functions domains: impaired psychosocial working, poor emotional status and cognitivebehavioral impairment, manifested by signs and symptoms and that interfere on the patients' lives (1,15) . The impairment of psychological functions may involve manifestations of anxiety, changes of humor, confusion, difficulties to concentrate, depression, sleeping disorders, concerns and low self-esteem (2)(3)14,16) . Attribute 4 -Reduced level of energy (strength): high demand in comparison to the patient's reserve of energy, exceeding their personal resources, hindering the recovery of integrity and leading to the need for resting (sleeping) during the day to recover energy (3,(20)(21) .…”

“…In addition, those employed at the time of the surgery reported to have lost 58 weeks of work on average in postoperative, whereas 43% of caregivers lost on average 1.2 weeks of work to take care of the patients (26) . Consequent 4 -Reduced quality of life: comprises physiological and/or psychological problems that interfere with daily living and welfare conditions (clinical manifestations, difficulties in resuming usual daily activities, loss of labor and wage) reducing the quality of life of surgical patients (1,14) . A study points out that patients with alterations in the surgical recovery process and functional limitations reported lower levels of quality of life six months after surgery.…”

Patient-reported recovery after enhanced colorectal cancer surgery: a longitudinal six-month follow-up study

“…Postoperative recovery was measured by the Postoperative Recovery Profile (PRP), a Swedish questionnaire developed for the self-assessment of general postoperative recovery [18]. The questionnaire consists of 19 items formulated as statements (e.g., "Right now I experience pain that is…").…”