Validation of a Revised Mandarin Chinese Language Version of the Postoperative Quality of Recovery Scale

Abstract

The aim of the study was to validate a revised Mandarin version of the Postoperative Quality of Recovery Scale (PostopQRS) and to apply the revised version in a Chinese population. In a prospective design, bilingual volunteers completed the scale at baseline, day one, day seven, and day 14 in both languages, with the order of language and parallel forms randomised. In addition, lung cancer patients undergoing open or video-assisted thoracoscopic surgery (VATS) completed the Mandarin version prior to surgery, day one, day three, day seven, day 14, one month, and three months postoperatively. Sixty-eight volunteers participated in the validation part of the study and in the clinical application, 93 lung cancer patients were included. The scores in the Mandarin version were equal to the English version in all domains at all timepoints including the word generation task, when the Mandarin morpheme was included in any part of the Mandarin word. However, Mandarin scores were lower in the word generation task if the morpheme was only included in the first part of the word. In addition, the Mandarin version was able to identify lower rates of overall recovery (P <0.01), nociceptive (P <0.01), emotive (P <0.01), and activities of daily living recovery (P=0.02) after open surgery compared to after VATS. The revised Mandarin version is equivalent to the English version for the cognitive domain, if morpheme substitution for the word generation task is allowed as any part of the word, and it is able to discriminate quality of recovery in Chinese patients.

The validation of a Japanese language version of the postoperative quality of recovery scale: a prospective observational study

“…This study shows that the English and Japanese versions of the PostopQRS are similar, and that the Japanese version was also able to discriminate recovery profiles between ENT and orthopedic patients. Feasibility and In previous studies, the PostopQRS has been successfully translated into other languages and validated in each of the countries [2,[8][9][10]. The cognitive domain is of great importance in the validation of the translation form.…”

“…In the Chinese version, substitution of a morpheme at the start of a word produced lower score values than the English version. However, this was corrected when the morpheme could be used as any part of the word [8]. In the Japanese language, there is cursive syllabary called "Hiragana" which has similarities to the English alphabet.…”

“…Our sample size was based on only one of the tests in the cognitive battery which has data that is closest to continuous rather than categorical data, which may not be the best approach for all of the tests. Further, the definition of 10% difference to define a clinically meaningful difference is subjective but was based on prior language validation studies [8], and we kept that definition to improve consistency across language validations. However, other differences such as a 0.5-point difference may have been a better metric across the full battery of tests.…”

“…The PostopQRS has been translated into Spanish, French, Portuguese, German, Mandarin, Arabic, Japanese, and is in the process of undergoing translation into Malay, Korean, Greek, Swedish, Yugoslavian, and Russian. Validation studies have been separately published for the Chinese [8], Arabic [9], and Portuguese [10] versions. A Japanese version has been previously translated and published as a pilot study but had not considered the differences in the language styles within the word generation task of the cognitive domain in detail [11].…”