Psychometric testing of the Chinese quality of recovery score

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, 1h 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, K-w = 0.92). Both QoR scores correlated with patient satisfaction scores (Chinese version, rho = 0.82; English version, rho = 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 rho = 0.91), interobserver (K-w = 0.77), and test-retest reliability (K-w = 0.83). These values were similar to those of the original English version (Cronbach's rho = 0.89, interobserver K-w = 0.84, test-retest reliability K-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.