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Development of a questionnaire to measure patient-reported postoperative recovery: content validity and intra-patient reliability
Örebro University, Department of Clinical Medicine.
Örebro University, Department of Nursing and Caring Sciences.
Örebro University, Department of Clinical Medicine.
Örebro University, Swedish Business School at Örebro University.ORCID iD: 0000-0001-7210-1925
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2009 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 15, no 3, 411-419 p.Article in journal (Refereed) Published
Abstract [en]

Aims and objectives. In this study we describe the development of a short, easy-to-use questionnaire to measure postoperative recovery and evaluate its content validity and intra-patient reliability.   The questionnaire is designed to evaluate the progress of postoperative recovery and the long-term follow-up of possible effects of interventions during recovery.

Method. The study involved four steps. 1) A conceptualisation and item definitions were based on a theoretical framework and a description of patients´ postoperative recovery from the perspective of patients, registered nurses and surgeons. 2) Content validity of items was tested through expert judgements. 3) A test run of the questionnaire was performed to confirm its feasibility and workload requirement. 4) The stability of the questionnaire was evaluated through intra-patient reliability assessment.

Results. As a result of the operationalisation process of the concept postoperative recovery, five dimensions (physical symptoms, physical functions, psychological, social, activity) and 19 items were identified. Each item was formulated as a statement in the questionnaire. Content validity was judged to be high. After the pre-test of the questionnaire a revision with refinements in the layout was made. The vast majority of items showed a high level of intra-patient reliability.

Conclusion. Based on a theoretical framework and empirical data, we developed a short and easy-to-use tentative questionnaire to measure patient-reported postoperative recovery. Initial support for content validity was established. The vast majority of items showed a high level of test-retest reliability.

Place, publisher, year, edition, pages
Oxford: Blackwell Publishing Ltd , 2009. Vol. 15, no 3, 411-419 p.
National Category
Surgery Medical and Health Sciences
Research subject
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-8081DOI: 10.1111/j.1365-2753.2008.01027.xISI: 000266425900002OAI: oai:DiVA.org:oru-8081DiVA: diva2:241636
Note
Part of thesis: http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-7731Available from: 2009-10-05 Created: 2009-10-05 Last updated: 2015-01-19Bibliographically approved
In thesis
1. Postoperative recovery: development of a multi-dimensional questionnaire for assessment of Recovery
Open this publication in new window or tab >>Postoperative recovery: development of a multi-dimensional questionnaire for assessment of Recovery
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis aims to present a multi-dimensional instrument for self-assessment of progress in postoperative recovery. The author employs different research paradigms and methodologies to achieve this aim.

Walker and Avant’s approach to concept analysis was used to examine the basic elements of postoperative recovery (Study I). The analysis identified different recovery dimensions and developed a theoretical definition showing postoperative recovery to be an energy-requiring process of returning to normality and wholeness, defined by comparative standards.

Fourteen patients and 28 staff members participated in individual and focus group interviews aimed at describing patient and staff experiences of patient recovery (Study II). The essence of the postoperative recovery process was described as a desire to decrease unpleasant physical symptoms, reach a level of emotional wellbeing, regain functions, and re-establish activities.

In Study III, 5 dimensions and 19 items were identified as a part of the operationalization process of the concept postoperative recovery. Fifteen staff members and 16 patients participated in the evaluation of content validity. On average, 85% of the participants considered the items as essential to the recovery process. In a test run of the questionnaire, 14 of 15 patients considered the questionnaire to be easy to understand and easy to complete. Twenty-five patients participated in the evaluation of intra-patient reliability. Percentage agreement (PA), systematic disagreement (RP, RC), and individual variability (RV) between the two assessments were calculated. PA measures ranged from 72% to 100%. The observed disagreement could be explained mainly by systematic disagreement.

In total, 158 patients participated in the evaluation of construct validity, the ability to discriminate between groups, and the investigation of important item variables (Study IV). A rank-based statistical method for evaluation of paired, ordered categorical data from rating scales was used to evaluate consistency between the assessments of the Postoperative Recovery Profile (PRP) questionnaire and a global recovery scale. The number of months needed by participants to be regarded as fully recovered was studied by means of recovery profiles displayed by the cumulative proportion of recovered participants over time. A ranking list based on the participant’s appraisal of the five most important item variables in the PRP questionnaire was compiled to illustrate the rank ordering of the items. In comparing the assessments from the PRP questionnaire and the global recovery scale, 7.6% of all possible pairs were disordered. Twelve months after discharge 73% in the orthopaedic group were regarded as fully recovered, compared to 51% of the participants in the abdominal group (95% CI: 6% to 40%). The pain variable appeared among the top five most important items on eight measurement occasions, of eight possible, in both study groups.

In conclusion, the PRP questionnaire was developed and support was given for validity and reliability. The questionnaire enables one to evaluate progress in postoperative recovery.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2009. 73 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 32
Keyword
Concept analysis, experiences, postoperative recovery, questionnaire, recovery profile, reliability, validity
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-7731 (URN)978-91-7668-678-2 (ISBN)
Public defence
2009-09-25, Wilandersalen, Universitetssjukhuset, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2009-08-25 Created: 2009-08-25 Last updated: 2011-05-03Bibliographically approved

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Allvin, RenéeEhnfors, MargaretaRawal, NarinderSvensson, Elisabeth
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