Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Anaesth Crit Care Pain Med. 2024 Jun;43(3):101380. doi: 10.1016/j.accpm.2024.101380. Epub 2024 Mar 16.
To date, there is no instrument to adequately assess self-reported quality of recovery (QoR) in the post-anesthesia care unit (PACU). We previously developed the QoR-PACU, a 13-item questionnaire specifically applicable to the PACU. The feasibility, acceptance, and validity of the QoR-PACU were promising. However, measures of reliability were slightly lower than expected.
We modified the QoR-PACU and evaluated its psychometric properties in a cohort of adult patients scheduled for non-cardiac surgery with general anesthesia. The modified QoR-PACU (termed QoR-PACU) was administered before surgery and postoperatively in the PACU at the time of the decision to discharge.
A total of 307 patients were included in the final analysis. Postoperative QoR-PACU sum scores differed across categories of sex, perioperative and surgical risk, and modes of airway management. The duration of anesthesia and surgery, maximum pain intensity and analgesic requirement in the PACU, and length of PACU stay were all inversely correlated with QoR in the PACU. Cronbach's alpha was 0.70 (95%CI: 0.66-0.75). The intra-class correlation coefficient was 0.86 (95%CI: 0.70-0.94, p < 0.001) for intra-rater reliability (n = 24) and 0.94 (95%CI 0.90 to 0.97, p < 0.001) for inter-rater reliability (n = 31). Cohen's effect size was 0.68 and the standardized response mean was 0.57.
The QoR-PACU assesses self-reported QoR after surgery in the PACU. Measures of feasibility, validity, and reliability were consistently high. Measures of responsiveness were moderate, which might be attributable to the heterogeneity of the study population. Future studies should include aspects of ethnicity and cross-cultural applicability.
迄今为止，尚无仪器可充分评估麻醉后护理单元（PACU）中的自我报告的康复质量（QoR）。我们之前开发了 QoR-PACU，这是一种专门适用于 PACU 的 13 项问卷。QoR-PACU 的可行性、可接受性和有效性很有希望。但是，可靠性的衡量标准略低于预期。
我们修改了 QoR-PACU，并在接受全身麻醉的非心脏手术的成年患者队列中评估了其心理测量特性。修改后的 QoR-PACU（称为 QoR-PACU）在手术前和 PACU 中术后在决定出院时进行。
共有 307 例患者纳入最终分析。术后 QoR-PACU 总分在性别、围手术期和手术风险以及气道管理方式的类别之间存在差异。麻醉和手术时间、PACU 中最大疼痛强度和镇痛需求以及 PACU 停留时间均与 PACU 中的 QoR 呈负相关。Cronbach 的 alpha 为 0.70（95％CI：0.66-0.75）。对于组内可靠性（n=24），内类相关系数为 0.86（95％CI：0.70-0.94，p<0.001），对于组间可靠性（n=31），内类相关系数为 0.94（95％CI：0.90 至 0.97，p<0.001）。Cohen 的效应量为 0.68，标准化反应均值为 0.57。
QoR-PACU 可评估 PACU 手术后的自我报告 QoR。可行性、有效性和可靠性的衡量标准始终很高。响应性的衡量标准适中，这可能归因于研究人群的异质性。未来的研究应包括种族和跨文化适用性的各个方面。
