• Anesthesiology · Mar 2009

    Multicenter Study Comparative Study

    Development of the functional recovery index for ambulatory surgery and anesthesia.

    • Jean Wong, Doris Tong, Yoshani De Silva, Amir Abrishami, and Frances Chung.
    • Department of Anesthesia, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. jean.wong@uhn.on.ca
    • Anesthesiology. 2009 Mar 1;110(3):596-602.

    BackgroundIt is increasingly important to evaluate patients' recovery after ambulatory surgery. The authors developed the Functional Recovery Index (FRI) to assess postdischarge functional recovery for ambulatory surgical patients.MethodsThe scale development involved four phases: item generation, item selection, reliability, and validity testing. A draft questionnaire was tested and revised. Items were selected through testing endorsement frequency, factor analysis, and testing internal consistency. The interrater reliability was calculated. Construct validity was tested by multiple hypotheses on convergent validity, extreme groups, and discriminant validity. Responsiveness was assessed by measuring the FRI postoperatively and comparing minor versus more extensive surgery. The rate of response and the time for completion of the questionnaire were recorded.ResultsThe final questionnaire had 14 items grouped under 3 factors. Each item was scored from 0 to 10, with 0 = no difficulty and 10 = extreme difficulty with the activity. The 3 factors were summated for a total score. Internal consistency for the 3 factors (pain and social activity, lower limb activity, and general physical activity) was as follows: Cronbach alpha = 0.90, 0.89, and 0.86, respectively. Interrater reliability was 0.99. Convergent validity for FRI versus verbal rating scale pain score was 0.76. Discriminant validity testing showed that the type of surgery was significant and that intermediate (beta = 0.138) and major surgery (beta = 0.337) were associated with higher FRI scores than minor surgery. The time to complete the questionnaires ranged between 4 min 10 s and 4 min 35 s.ConclusionsThe FRI had excellent reliability, good validity, responsiveness, and acceptability, indicating that this questionnaire will be a good instrument for assessing functional recovery of ambulatory surgical patients.

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    This article appears in the collection: Quality of recovery after anaesthesia.


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