Acta clinica Croatica, Vol. 62. No. 3, 2023.
Original scientific paper
https://doi.org/10.20471/acc.2023.62.03.4
Validation of the Quality of Recovery-40 Questionnaire Adapted for Croatian Population
Nina Sulen
orcid.org/0000-0002-2012-8090
; Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Zadar General Hospital, Zadar, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Health Studies, University of Zadar, Zadar, Croatia
Tatjana Šimurina
orcid.org/0000-0002-2657-5537
; Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Zadar General Hospital, Zadar, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Health Studies, University of Zadar, Zadar, Croatia
*
Milan Milošević
orcid.org/0000-0001-9008-7645
; Department of Environmental Health, Occupational and Sports Medicine, Andrija Štampar School of Public Health, WHO Collaborative Center for Occupational Health, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Miroslav Župčić
orcid.org/0000-0002-1989-7255
; Department of Anesthesiology and Intensive Care Medicine, Rijeka University Hospital Center, Rijeka, Croatia; Department of Physiology and Immunology, School of Medicine, University of Rijeka, Rijeka, Croatia
Boris Mraović
orcid.org/0000-0003-4019-4084
; Department of Anesthesiology and Perioperative Medicine, School of Medicine, University of Missouri, Columbia, MO, USA
* Corresponding author.
Abstract
Quality of recovery after anesthesia is an important indicator of patient postoperative
outcomes. Quality of Recovery-40 (QoR-40) is a validated and widely used multidimensional
40-item questionnaire that measures postoperative quality of recovery. The aim of this
study was to perform translation and psychometric validation of the Croatian version of QoR-40,
which included validity, reliability, responsiveness, and clinical acceptability. The QoR-40 and Short
Form-36 (SF-36) questionnaires were administered to patients undergoing general anesthesia for
elective surgery on the day before surgery and on postoperative day 3. The quality of recovery was
also assessed with visual analog scale (VAS) 0-100. Of 192 enrolled patients, 162 completed the
study protocol. Convergent validity assessed by Pearson correlation (r) between the QoR-40 and
VAS scores was 0.68 (p<0.001). There were moderate correlations of QoR-40 with SF-36 Physical
component scale (r=0.521; p<0.001) and with SF-36 Mental component scale (r=0.580; p<0.001).
Construct validity was supported by negative correlation with the length of hospital stay (r=-0.21;
p=0.007) and significant difference in total postoperative QoR-40 scores between patients with
and without postoperative complications (p<0.001). Internal consistency of the global QoR-40
was high (Cronbach’s α=0.93) and of the QoR-40 dimensions it was moderate to high (≥0.714).
Split-half coefficient was 0.87, Cohen’s effect size was 0.81, and standardized response mean was
0.762. Our translated QoR-40 is a valid, reliable and comprehensive questionnaire for measuring
quality of postoperative recovery across surgery spectrum in Croatian population with psychometric
properties similar to the original version.
Keywords
Patient reported outcome measures; Quality of recovery; Validation study; Perioperative medicine
Hrčak ID:
314859
URI
Publication date:
1.11.2023.
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