Validity and reliability of the Korean version of the Quality of Recovery-40 questionnaire

Abstract

BackgroundThe Quality of Recovery-40 (QoR-40) is a widely-used, self-rated, and self-completed questionnaire for postoperative patients. The questionnaire is intended to elicit information from each patient regarding the quality of recovery during the postoperative period. It is noteworthy, however, that an official Korean version of the QoR-40 (QoR-40K) has not been established. The purpose of this study was to develop the QoR-40K by translation and cultural adaptation process and to evaluate the validity and reliability of the QoR-40K.MethodsAfter pre-authorization from the original author of the QoR-40, the translation procedure was established and carried out based upon Beaton’s recommendation to create a QoR-40K model comparable to the original English QoR-40. Two hundred surgical patients were enrolled, and each completed the questionnaire during the preoperative period, on the third day, and 1 month after surgery. The QoR-40K was compared with the visual analogue scale (VAS) and another health-related questionnaire, the Short-form Health Survery-36 (SF-36). The method of validation for QoR-40K included test-retest reliability, internal consistency, and level of responsiveness.ResultsSpearman’s correlation coefficient for test-retest reliability was 0.895 (P < 0.001), and Cronbach’s alpha of the global QoR-40K on the third day after surgery was 0.956. A positive correlation was obtained between the QoR-40K and the mental component summary of SF-36 (ρ = 0.474, P < 0.001), and a negative correlation was observed between QoR-40K and VAS (ρ = −0.341, P < 0.001). The standardized responsive mean of the total QoR-40K was 0.71.ConclusionsThe QoR-40K was found to be as acceptable and reliable as the original English QoR-40 for Korean patients after surgery, despite the apparent differences in the respective patients’ cultural backgrounds.

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“…For instance, the QoR-40 is a widely-used, patient-centered, self-rated questionnaire for assessing a patient's health status postoperatively, and several versions of this questionnaire in different languages have been validated [15,[19][20][21]. QoR-40K, especially, has recently been demonstrated to be a valid, reliable and feasible tool that is used to evaluate Korean surgical patients [14]. QoR-40 is composed of 40-items of five di- Fig.…”

“…The quality of postoperative recovery was assessed using a validated Korean version of Quality of Recovery-40 (QoR-40K) questionnaire [14]. QoR-40K is composed of 40-items of five dimensions including emotional state, physical comfort, psychological support, physical independence and pain [14,15]. Each item is rated on a 5-point Likert scale (1 = none of the time, 2 = some of the time, 3 = usually, 4 = most of the time, 5 = all of the time), and the global score ranges from 40 to 200.…”

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“…Individual scores are then summed, with the minimum and maximum scores being 40 and 200 points, respectively. The QoR-40 has also been validated in east Asian countries for evaluating the quality of recovery after surgery and the quality of anesthesia methods, (9,10). Patients in our study completed the questionnaire the day before operation (baseline), on POD1, on POD3, and on the day of discharge.…”

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“…It is a self-rated questionnaire scored along the following sub-dimensions: physical comfort, emotional state, physical independence, psychological support and pain (14). The QoR-40K, which is the Korean version of the QoR-40, has been shown to have acceptable validity, reliability and feasibility (15). Furthermore, many studies have suggested the importance of early ambulation for preventing postoperative complications (16−20).…”