Self‐reported post‐operative recovery in children: development of an instrument

Abstract

Rationale, aims, and objectives: According the United Nations (1989), children have the right to be heard and to have their opinions respected. Since postoperative recovery is an individual and subjective experience and patient-reported outcome measures are considered important, our aim was to develop and test an instrument to measure self-reported quality of recovery in children after surgical procedures.Methods: Development of the instrument Postoperative Recovery in Children (PRiC) was influenced by Quality of Recovery-24, for use in adults. Eighteen children and nine professionals validated the items with respect to content and language. A photo questionnaire was developed to determine whether the children's participation would increase compared to the text questionnaire. The final instrument was distributed consecutively to 390 children, ages 4-12 years, who underwent tonsil surgery at four hospitals in Sweden.Results: A total of 238 children with a mean age of 6.5 years participated. According to the parents, 23% circled the answers themselves and 59% participated to a significant degree.However, there was no significant difference in participation between those who received a photo versus a text questionnaire. Psychometric tests of the instrument showed that Cronbach's alpha for the total instrument was 0.83 and the item-total correlations for 21 of the items were >0.20. Conclusion:Our results support use of the PRiC instrument to assess and follow up on children's self-reported postoperative recovery after tonsil operation, both in clinical praxis as well in research.

Evaluation of the quality of acute pain management in a pediatric surgical setting: Validation of a parent proxy modified version of the revised American Pain Society Patient Outcome Questionnaire

“…In contrast to other studies that targeted parental satisfaction, PRiC is a patient‐reported instrument that was developed to evaluate the quality of recovery from a child's perspective. The response rate for PRiC, however, was about 61%, and 76% of the children did not answer the survey themselves . The modified APS‐POQ‐R in this study was intended for parents because a child's willingness to participate in a survey may be influenced by the feeling of lethargy, hunger, and pain.…”

“…The outcome measures that constitute the success of postoperative care form an important research question that is relevant to our anesthetic practice. Focusing on pediatric patients, Bramhagen et al developed and validated an instrument, the Postoperative Recovery in Children (PRiC), that was influenced by the modified Quality of Recovery‐40 used for the adults . Compared to the questionnaire in our study, the PRiC focused on the different aspects of recovery from anesthesia, specifically for tonsil surgery in children.…”

Child participation in health care (ChiPaC)—Development and psychometric evaluation of a self‐report instrument for children's participation in health care

“…Some efforts have been made to develop measures for children's participation, but the available questionnaires and instruments are neither based on the child perspective on participation nor adapted to general health care. The available instruments are instead specifically designed for use in a school setting (Davies, Soon, Young, & Clausen‐Yamaki, ; Simeonsson, Carlson, Huntington, McMillen, & Brent, ), in the community (Washington, Wilson, Engel, & Jensen, ), mixed contexts (Bedell & Dumas, ; Chien, Rodger, & Copley, ; Coster et al, ; Khetani, Graham, Davies, Law, & Simeonsson, ; Kramer et al, ; Michelsen et al, ) or a very specific circumstance, such as having a disability (Chien et al, ; Michelsen et al, ; Noreau et al, ; Timmons & Wagner, ; Washington et al, ) or postoperative care (Bramhagen et al, ). The questions used in these instruments focus on everyday tasks (Coster et al, , ; King et al, ; Mishra & Rangasayee, ; Noreau et al, ), symptoms and pain (Bramhagen et al, ; File S1).…”

Impact of changing positively worded items to negatively worded items in the Swedish web‐version of the Quality of Recovery (SwQoR) questionnaire

“…It is adapted to be inserted in a mobile app called Recovery Assessment by Phone Points . The initial version of SwQoR developed in 2014 included 31 items inspired by different instruments measuring postoperative recovery . A flow chart of SwQoR development is given in Figure .…”

“…[10][11][12] The initial version of SwQoR developed in 2014 included 31 items 10 inspired by different instruments measuring postoperative recovery. [13][14][15][16][17][18] A flow chart of SwQoR development is given in Figure 1. SwQoR includes both positive items (n = 13) such as having a general feeling of well-being and negative items (n = 18) such as postoperative pain; the positive items are presented first, followed by the negative items.…”