Development and Psychometric Evaluation of a Postoperative Quality of Recovery Score

Abstract Background: Quality of recovery (QoR) after anesthesia is an important measure of the early postoperative health status of patients. The aim was to develop a short-form postoperative QoR score, and test its validity, reliability, responsiveness, and clinical acceptability and feasibility. Methods: Based on extensive clinical and research experience with the 40-item QoR-40, the strongest psychometrically performing items from each of the five dimensions of the QoR-40 were selected to create a short-form version, the QoR-15. This was then evaluated in 127 adult patients after general anesthesia and surgery. Results: There was good convergent validity between the QoR-15 and a global QoR visual analog scale (r = 0.68, P < 0.0005). Construct validity was supported by a negative correlation with duration of surgery (r = −0.49, P < 0.0005), time spent in the postanesthesia care unit (r = −0.41, P < 0.0005), and duration of hospital stay (r = −0.53, P < 0.0005). There was also excellent internal consistency (0.85), split-half reliability (0.78), and test–retest reliability (ri = 0.99), all P < 0.0005. Responsiveness was excellent with an effect size of 1.35 and a standardized response mean of 1.04. The mean ± SD time to complete the QoR-15 was 2.4 ± 0.8min. Conclusions: The QoR-15 provides a valid, extensive, and yet efficient evaluation of postoperative QoR.