title: How well are we measuring postoperative "recovery" after abdominal surgery?
abstract: OBJECTIVE
  The content validity of patient-reported outcomes (PROs) commonly used to measure postoperative recovery is unknown. The objective of this study was to develop a conceptual framework for recovery after abdominal surgery and to analyze the content of PRO instruments against this conceptual framework.
  
  
  METHODS
  Qualitative methods were used to develop a conceptual framework for recovery. Patients undergoing abdominal surgery and healthcare professionals were interviewed. Recovery-related concepts were identified using a thematic analysis, and concepts were then linked to the International Classification of Functioning, Disability and Health (ICF). The contents of eight PRO instruments that have been used to measure recovery were then examined using this conceptual framework.
  
  
  RESULTS
  A total of 17 patients and 15 healthcare professionals were interviewed. A total of 22 important recovery-related concepts were identified and linked to the ICF. The four most important concepts were "Energy level," "Sensation of pain," "General physical endurance," and "Carrying out daily routine." The number of important recovery-related concepts covered by each instrument ranged from 1 to 22 (mean 7.3 concepts). The SF36 (n = 22), European Organization for the Treatment and Research of Cancer Quality-of-Life Questionnaire-C30 (n = 20), and the Gastrointestinal Quality-of-Life Index (n = 19) covered the greatest number of important recovery concepts. No instrument covered all of the important concepts.
  
  
  CONCLUSIONS
  The comparison of the contents of PRO instruments commonly used to measure postoperative recovery after abdominal surgery demonstrated major gaps in the representation of concepts that are important to patients and healthcare professionals.
authors.affiliation: Department of Surgery, Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave, E19-125, Montreal, QC, H3G 1A4, Canada. larry.lee@mail.mcgill.ca.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lee
authors.affiliation: Department of Surgery, Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave, E19-125, Montreal, QC, H3G 1A4, Canada.
authors.forename: Teodora
authors.initials: T
authors.lastname: Dumitra
authors.affiliation: Department of Surgery, Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave, E19-125, Montreal, QC, H3G 1A4, Canada.|Division of Clinical Epidemiology, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.
authors.forename: Julio F
authors.initials: JF
authors.lastname: Fiore
authors.affiliation: Division of Clinical Epidemiology, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Mayo
authors.affiliation: Department of Surgery, Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Ave, E19-125, Montreal, QC, H3G 1A4, Canada.
authors.forename: Liane S
authors.initials: LS
authors.lastname: Feldman
mesh_terms: D034841:Abdominal Cavity / Q000601:surgery*; D000203:Activities of Daily Living; D003289:Convalescence / Q000523:psychology*; D006233:Persons with Disabilities / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000534:rehabilitation* / Q000601:surgery*; D011184:Postoperative Period; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Content validity; Function; ICF; Quality of life; Recovery