Validation of the Nepalese Version of the Quality of Recovery-15 Questionnaire in Patients Undergoing Elective Surgery

TL;DR

This study validates a Nepalese version of a questionnaire used to assess recovery after surgery, showing it is reliable and suitable for use in Nepal.

Contribution

The study provides a culturally adapted and validated Nepalese version of the Quality of Recovery-15 questionnaire for postoperative use.

Findings

The Nepalese version of the questionnaire showed high reliability with a Cronbach’s alpha of 0.890.

It demonstrated good responsiveness with a Cohen’s effect size of 1.4.

The questionnaire was feasible to use with a 100% recruitment rate and 94.33% completion rate.

Abstract

The 15-item Quality of Recovery scale is a widely used tool for assessing postoperative recovery. It has been translated and validated in various languages and cultural settings. However, a validated Nepalese version is currently unavailable.

A cross-sectional study was conducted among 216 patients undergoing elective surgery under general anesthesia, following ethical approval (Ref. No. 21-081/082). The 15 items of the Quality of Recovery scale were translated into Nepalese and modified as needed, resulting in the final version: Quality of Recovery scale-N. Patients were interviewed preoperatively (the day before surgery) and on the first postoperative day using the QoR-N. Reliability, validity, responsiveness, and feasibility of the QoR-N were then evaluated.

The Quality of Recovery scale-N showed acceptable reliability, with a Cronbach’s alpha of 0.890, mean inter-item correlation of 0.413, split-half reliability of 0.94, and standard error of measurement of 2.79. Responsiveness was supported by a Cohen’s effect size of 1.4 and standardized response mean of 1.39. QoR-N scores did not correlate with age or surgery duration, and showed no significant difference between ASA physical status I and II, or across minor, intermediate, and major surgeries. However, scores were significantly higher in males than females, and in patients with good overall recovery (per visual analogue scale) compared to those with poor recovery. The recruitment rate was 100%, and completion rate was 94.33%.

The Quality of Recovery scale-N demonstrated acceptable validity, reliability, responsiveness, and clinical feasibility, and is suitable for use in Nepalese patients undergoing elective surgery.

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