Development and Validation of the Chinese Version of the Quality of Recovery-40 Questionnaire

Figures & data

Table 1 Participant Characteristics (n = 200)

Characteristics	Values
Gender
Male	75 (37.5%)
Female	125 (62.5%)
Age (years)	45 (16–79)
Weight (kg)	59.6± 10.5
Height (cm)	161.6 ± 8.0
BMI (kg/m^2)	22.8 ± 3.5
Education
Primary or below	38 (19.0%)
Secondary	49 (24.5%)
High	44 (22.0%)
University	69 (34.5%)
Marital status
Married	154 (77.0%)
Divorced/widowed	8/4 (6.0%)
Single	34 (17.0%)
ASA
I	19 (9.5%)
II	156 (78%)
III	24 (12.0%)
VI	1 (0.5%)
Surgery type
General	119 (59.5%)
Otorhinolaryngologic	50 (25.0%)
Orthopedic	31 (15.5%)
Surgical time (min)	146.4 ± 87.1
Duration of hospital stay (day)	5.1 ± 5.9

Table 2 Cronbach’s α of the QoR‑40 at Different Assessment Time Points

Variables	Baseline	POD3	POD30
Emotional state	0.843	0.846	0.803
Physical comfort	0.806	0.798	0.781
Psychological support	0.826	0.858	0.851
Physical independence	0.859	0.863	0.844
Pain	0.891	0.741	0.787
QoR40	0.911	0.907	0.907

Abbreviations: QoR40, Quality of Recovery‑40; Baseline, the day before operation; POD, postoperative day.

Table 3 The Spearman Correlation Between QoR-40C and Subscales

Variables	QoR-40C	Emotional State	Physical Comfort	Psychological Support	Physical Independence	Pain
Emotional state	0.787
Physical comfort	0.859	0.756
Psychological support	0.614	0.313	0.355
Physical independence	0.518	0.202	0.263	0.324
Pain	0.673	0.468	0.553	0.267	0.278

Note: All correlation comparisons showed a significance level of P < 0.001.

Abbreviation: QoR-40C, Chinese version of Quality of Recovery-40 questionnaire.

Table 4 QoR-40C Factor Analysis

Variables	Mean ± SD	Factor Loading
Emotional state
Feeling comfortable	3.76 ±1.00	0.751
General feeling of well-being	3.87±0.93	0.789
Feeling in control	4.08±0.83	0.571
Bad dreams	4.37±0.67	0.486
Feeling anxious	4.12±0.76	0.602
Feeling angry	4.46±0.65	0.660
Feeling depressed	4.41±0.73	0.583
Feeling alone	4.53±0.70	0.559
Difficulty falling asleep	3.92±0.92	0.629
Physical comfort
Able to breathe easy	4.56±0.74	0.423
Have a good sleep	3.59±1.14	0.708
Able to enjoy food	3.90±1.04	0.608
Feeling rested	3.68±1.01	0.719
Nausea	4.58±0.59	0.504
Vomiting	4.82±0.42	0.650
Dry retching	4.76±0.48	0.597
Feeling restless	4.43±0.68	0.567
Shaking	4.81±0.51	0.639
Shivering	4.78±0.53	0.605
Feeling cold	4.67±0.58	0.518
Feeling dizzy	4.43±0.67	0.472
Psychologic support
Able to communicate with hospital staff	4.30±0.96	0.750
Able to communicate with family	4.51±0.78	0.755
Able to communicate with doctors	4.33±0.88	0.839
Able to communicate with nurses	4.37±0.84	0.835
Having support from family	4.58±0.70	0.780
Able to understand instructions	4.46±0.76	0.794
Feeling confused	4.29±0.80	0.427
Physical independence
Able to go to the lavatory by yourself	4.56±1.02	0.909
Able to write	4.64±0.85	0.572
Have normal speech	4.80±0.63	0.439
Wash, brush teeth, shave	4.61±0.91	0.933
Able to look after appearance	4.62±0.91	0.880
Pain
Moderate pain	4.03±0.75	0.594
Severe pain	4.64±0.62	0.518
Headache	4.57±0.62	0.734
Muscle pain	4.52±0.68	0.765
Backache	4.33±0.69	0.640
Sore throat	4.46±0.70	0.568
Sore mouth	4.70±0.60	0.673

Abbreviation: QoR-40C, Chinese version of Quality of Recovery-40.

Table 5 Spearman Correlation Between QoR-40C and SF-36 Scores

Variables	PF	RP	BP	GH	VT	SF	RE	MH	HT	SF-36
Emotional state	0.157	0.156	0.239	0.467	0.516	0.303	0.258	0.536	0.180	0.411
Physical comfort	0.309	0.268	0.363	0.503	0.578	0.377	0.369	0.478	0.244	0.538
Psychological support	0.200	0.205	0.260	0.330	0.362	0.265	0.297	0.295	0.046	0.349
Physical independence	0.386	0.353	0.350	0.194	0.301	0.279	0.218	0.204	0.078	0.396
Pain	0.384	0.347	0.451	0.310	0.402	0.323	0.229	0.271	0.072	0.448
QoR-40C	0.343	0.327	0.426	0.505	0.602	0.412	0.385	0.505	0.189	0.575

Note: All correlation comparisons showed a significance level of P < 0.001.

Abbreviations: PF, physical functioning; RP, role-physical; BP, bodily pain; GH, general health; VT, vitality; SF, social functioning; RE, role emotional; MH, mental health; HT, report health transition; SF-36, Short Form Health Survey; QoR-40C, Chinese version of Quality of Recovery-40.

Table 6 Change in the QoR-40C of Patients’ Baseline and POD3

Scale	Max Score	Baseline (Mean ±SD)	POD3 (Mean ±SD)	Mean Change (95% CI)	t value	P	SRM
QoR-40C	200	177.30 ± 15.02	170.91 ± 15.02	6.39±12.59	7.18	< 0.001	0.51
Emotional state	45	37.30 ± 5.20	36.64 ± 4.74	0.66±4.22	2.21	0.028	0.16
Physical comfort	60	53.74 ± 5.17	51.42 ± 4.99	2.32±4.82	6.79	< 0.001	0.48
Psychological support	35	30.77 ± 4.16	30.43 ± 4.38	0.35±2.82	1.72	0.086	0.12
Physical independence	25	24.00 ± 2.77	22.19 ± 4.23	1.81±3.83	6.69	< 0.001	0.47
Pain	35	31.50 ±4.07	30.24 ± 3.04	1.26±3.27	5.45	< 0.001	0.39

Abbreviations: QoR-40C, Chinese version of Quality of Recovery-40; CI, confidence interval; SRM, standardised response mean.

Figure 1 Changes (Mean ±SD) in QoR‑40 subscale scores at different assessment time points.