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AMBULATORY ANESTHESIOLOGY

Psychometric Testing of the Chinese Quality of Recovery Score

Matthew T. V. Chan, MBBS, FANZCA^*, Charlotte C. K. Lo, MBChB, BMedSc, FANZCA^*, Candy K. W. Lok, MPH, MSc^*, Tak Wing Chan, DPhil(Oxon), Kai C. Choi, PhD, and Tony Gin, MD, FRCA, FANZCA^*

From the *Department of Anaesthesia and Intensive Care, and Centre for Epidemiology and Biostatistics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; and Department of Scoiology, The University of Oxford, Oxford, UK.

Address correspondence to Matthew Chan, MBBS, FANZCA, Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. Address e-mail to mtvchan{at}cuhk.edu.hk.

Abstract

BACKGROUND: We evaluated a Chinese translation of the quality of recovery (QoR) score for measuring health status in patients after surgery and anesthesia.

METHODS: The Chinese QoR score was developed by a panel of linguistic experts using a series of forward and backward translations. We then compared the psychometric performance of the Chinese QoR score with the original English version in bilingual Chinese patients undergoing a variety of surgeries. Using a crossover design, 210 patients were randomly assigned to complete both versions of the QoR score, 1 h apart, in the morning after surgery according to one of the two sequences: Chinese followed by the English QoR score or the reverse order. Test-retest and interrater reliabilities were calculated by comparing scores administered 6–8 h later and those completed by the patients and duty nurses, respectively.

RESULTS: Patient responses to the Chinese QoR score agreed well with the English version (weighted kappa statistic, _w = 0.92). Both QoR scores correlated with patient satisfaction scores (Chinese version, = 0.82; English version, = 0.79) confirming convergent validity. There was also significant negative correlation between the QoR scores and female gender, duration of hospital stay, or magnitude of surgery (discriminant construct validity). We found the Chinese QoR score has good internal consistency (Cronbach’s = 0.91), interobserver (_w = 0.77), and test-retest reliability (_w = 0.83). These values were similar to those of the original English version (Cronbach’s = 0.89, interobserver _w = 0.84, test-retest reliability _w = 0.88).

CONCLUSION: The Chinese QoR score is conceptually, semantically, and operationally equivalent to the English version. Both scales provide valid, reliable, and responsive assessment of the QoR after surgery and anesthesia.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999