title: Validity and reliability of the Iranian version of the quality of recovery-40 questionnaire.
abstract: BACKGROUND
  Recovery after anesthesia and surgery is a complex process and depends on many factors such as patient, anesthesia and surgery conditions as well pre-existing comorbidities.
  
  
  OBJECTIVE
  The aims of this study were to translate the 40-item quality of recovery score (QoR-40) into Persian and evaluate its psychometric properties in Iranian patients.
  
  
  METHODS
  We enrolled patients candidate for elective general surgery undergoing general anesthesia from July 2013 to December 2013 at Shahid Rajaee Hospital, Qazvin, Iran. Translation was performed based on Beaton's and Bullinger's recommendations. Estimates of internal consistency, test-retest reliability, concurrent validity, predictive validity and clinical validity were performed.
  
  
  RESULTS
  All estimates of internal consistency were high (Cronbach's alpha = 0.89 for global estimates, subscales between 0.89 and 0.93). All test-retest scores and subscales were between 0.71 and 0.88.The correlation with a recovery visual analogue scale was 0.51, and all subscales correlated significantly with comparable subscales of the SF-36. An exploratory factor analysis found five-components and explained 52% of the variance. A confirmatory factor analysis based on the five-components, yielded good fit statistics (CFI = 0.93).
  
  
  CONCLUSIONS
  Overall, the Persian version of the QoR-40 was both conceptually and linguistically equivalent to the original English QoR-40. This study revealed that the Persian version of the QoR-40 is a valid and reliable instrument to assess the recovery quality in Iranian patients after surgery.
authors.affiliation: Department of Anesthesiology, Qazvin University of Medical Science, Qazvin, Iran.
authors.forename: Siamak
authors.initials: S
authors.lastname: Yaghoobi
authors.affiliation: Department of Anesthesiology, Qazvin University of Medical Science, Qazvin, Iran.
authors.forename: Monadi
authors.initials: M
authors.lastname: Hamidfar
authors.affiliation: Faculty of Medicine, Medical Education Research Centre, University of Calgary, Calgary, Canada.
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Lawson
authors.affiliation: School of Health Sciences, Jonkoping University, Jonkoping, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Fridlund
authors.affiliation: Department of Anaesthesia and Perioperative Medicine, Alfred Hospital, Monash University, Melbourne, Victoria, Australia.
authors.forename: Paul Stewart
authors.initials: PS
authors.lastname: Myles
authors.affiliation: Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran ; Department of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Pakpour
keywords: Anesthesia; Medicine; Surgery