Thorsell Cederberg Jenny, Zetterqvist Vendela, Wicksell Rikard K, Goubert Liesbet, Bartels Sara Laureen
Department of Psychology, Uppsala University, Uppsala, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
World Neurosurg. 2025 Mar;195:123744. doi: 10.1016/j.wneu.2025.123744. Epub 2025 Feb 28.
About 1 in 5 adolescents undergoing major surgery develops chronic postsurgical pain. Various risk and resilience factors for recovery and chronic postsurgical pain have been identified, including parental characteristics. However, research commonly relies on nomothetic data, whereas psychometric properties of diaries assessing pediatric postsurgical recovery in everyday life are understudied. This study aimed to evaluate preliminary reliability, validity, and variability of diary data in adolescents and their parents after spinal fusion surgery.
Adolescents with idiopathic scoliosis undergoing spinal fusion surgery and their parents were asked to complete daily diaries for 7 consecutive days at 5 time points: before surgery and 3 weeks, 6 weeks, 6 months, and 12 months after surgery. Diaries were developed based on validated questionnaires measuring relevant constructs of pediatric postsurgical recovery. Internal consistency; test-retest reliability; convergent, divergent, and concurrent criterion validity; and variability were examined.
The sample comprised 95 adolescents and 95 parents. Overall compliance rate was approximately 80% in both adolescents and parents, with a total of 5282 diary entries analyzed. Internal consistency for multi-item variables ranged from good to excellent (α = 0.82-0.93) for adolescent data and acceptable to excellent (α = 0.74-0.93) for parent data. All test-retest correlations were significant-large (ρ = 0.60-0.76) for adolescent data and medium to large for parent data (ρ = 0.57-0.80). Regarding validity, all but 3 correlations between diary variables were significant. Diary variables generally correlated significantly with corresponding questionnaire data. Variability was low in some variables.
These results provide evidence for psychometric properties regarding reliability, validity, and variability of diaries monitoring processes of postsurgical recovery in everyday life in adolescents undergoing spinal fusion surgery. Replication is suggested for refinement and further validation, with particular attention to variability and evaluation of sensitivity to change.
约五分之一接受大手术的青少年会出现慢性术后疼痛。已经确定了各种影响恢复和慢性术后疼痛的风险及恢复力因素，包括父母的特征。然而，研究通常依赖于规范数据，而评估儿童日常生活中术后恢复情况的日记的心理测量特性尚未得到充分研究。本研究旨在评估脊柱融合手术后青少年及其父母日记数据的初步可靠性、有效性和变异性。
患有特发性脊柱侧弯并接受脊柱融合手术的青少年及其父母被要求在5个时间点连续7天完成每日日记：手术前以及手术后3周、6周、6个月和12个月。日记是基于经过验证的问卷编制的，这些问卷测量了儿童术后恢复的相关结构。检查了内部一致性、重测信度、收敛效度、区分效度和同时效度以及变异性。
样本包括95名青少年和95名父母。青少年和父母的总体依从率约为80%，共分析了5282条日记记录。多项目变量的内部一致性对于青少年数据从良好到优秀（α = 0.82 - 0.93），对于父母数据从可接受到优秀（α = 0.74 - 0.93）。所有重测相关性对于青少年数据为显著大（ρ = 0.60 - 0.76），对于父母数据为中等至大（ρ = 0.57 - 0.80）。关于效度，除3个日记变量之间的相关性外，其他所有相关性均显著。日记变量通常与相应的问卷数据显著相关。一些变量的变异性较低。
这些结果为监测脊柱融合手术青少年日常生活中术后恢复过程的日记的可靠性、有效性和变异性的心理测量特性提供了证据。建议进行重复研究以完善和进一步验证，特别关注变异性以及对变化的敏感性评估。
