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.

Postoperative recovery in children: Turkish cross‐cultural adaptation

“…17 In the original development study of PRiC, Cronbach's alpha value of the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were moderate. 8 In particular, the internal consistency coefficient for the emotional state dimension that was found in this study was higher than that in the original development study of PRiC.…”

“…In this study, Cronbach's alpha coefficient for the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were high. Based on these values, it may be stated that PRiC had “high reliability.” 17 In the original development study of PRiC, Cronbach's alpha value of the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were moderate 8 . In particular, the internal consistency coefficient for the emotional state dimension that was found in this study was higher than that in the original development study of PRiC.…”

“…Items that do not meet this criterion are removed, and the reliability of the scale is recalculated based on the remaining items 16 . Bramhagen et al 8 reported in the original scale development study of PRiC that the item‐total score correlation coefficients of all items were greater than 0.20. In this study, the values of these coefficients were higher.…”

“…The children who could answer the scale questions themselves were older. Additionally, the fact that the scale also has a visual form will make it easier for it to be used in younger children 8,13 . Finally, the inclusion of all complications that may occur after surgery, including pain, expands the usage area of PRiC 8 …”

Postoperative recovery in children: Turkish cross‐cultural adaptation

“…17 In the original development study of PRiC, Cronbach's alpha value of the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were moderate. 8 In particular, the internal consistency coefficient for the emotional state dimension that was found in this study was higher than that in the original development study of PRiC.…”

“…In this study, Cronbach's alpha coefficient for the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were high. Based on these values, it may be stated that PRiC had “high reliability.” 17 In the original development study of PRiC, Cronbach's alpha value of the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were moderate 8 . In particular, the internal consistency coefficient for the emotional state dimension that was found in this study was higher than that in the original development study of PRiC.…”

“…Items that do not meet this criterion are removed, and the reliability of the scale is recalculated based on the remaining items 16 . Bramhagen et al 8 reported in the original scale development study of PRiC that the item‐total score correlation coefficients of all items were greater than 0.20. In this study, the values of these coefficients were higher.…”

“…The children who could answer the scale questions themselves were older. Additionally, the fact that the scale also has a visual form will make it easier for it to be used in younger children 8,13 . Finally, the inclusion of all complications that may occur after surgery, including pain, expands the usage area of PRiC 8 …”

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.…”

Postoperative recovery in children: Turkish cross‐cultural adaptation

“…17 In the original development study of PRiC, Cronbach's alpha value of the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were moderate. 8 In particular, the internal consistency coefficient for the emotional state dimension that was found in this study was higher than that in the original development study of PRiC.…”

“…In this study, Cronbach's alpha coefficient for the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were high. Based on these values, it may be stated that PRiC had “high reliability.” 17 In the original development study of PRiC, Cronbach's alpha value of the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were moderate 8 . In particular, the internal consistency coefficient for the emotional state dimension that was found in this study was higher than that in the original development study of PRiC.…”

“…Items that do not meet this criterion are removed, and the reliability of the scale is recalculated based on the remaining items 16 . Bramhagen et al 8 reported in the original scale development study of PRiC that the item‐total score correlation coefficients of all items were greater than 0.20. In this study, the values of these coefficients were higher.…”

“…The children who could answer the scale questions themselves were older. Additionally, the fact that the scale also has a visual form will make it easier for it to be used in younger children 8,13 . Finally, the inclusion of all complications that may occur after surgery, including pain, expands the usage area of PRiC 8 …”

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.…”

Postoperative recovery in children: Turkish cross‐cultural adaptation

“…17 In the original development study of PRiC, Cronbach's alpha value of the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were moderate. 8 In particular, the internal consistency coefficient for the emotional state dimension that was found in this study was higher than that in the original development study of PRiC.…”

“…In this study, Cronbach's alpha coefficient for the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were high. Based on these values, it may be stated that PRiC had “high reliability.” 17 In the original development study of PRiC, Cronbach's alpha value of the overall scale and the scale dimensions of physical comfort, physical independence, and emotional state were moderate 8 . In particular, the internal consistency coefficient for the emotional state dimension that was found in this study was higher than that in the original development study of PRiC.…”

“…Items that do not meet this criterion are removed, and the reliability of the scale is recalculated based on the remaining items 16 . Bramhagen et al 8 reported in the original scale development study of PRiC that the item‐total score correlation coefficients of all items were greater than 0.20. In this study, the values of these coefficients were higher.…”

“…The children who could answer the scale questions themselves were older. Additionally, the fact that the scale also has a visual form will make it easier for it to be used in younger children 8,13 . Finally, the inclusion of all complications that may occur after surgery, including pain, expands the usage area of PRiC 8 …”

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.…”