title: Self-reported post-operative recovery in children: development of an instrument.
abstract: OBJECTIVE
  According to the United Nations (1989), children have the right to be heard and to have their opinions respected. Since post-operative recovery is an individual and subjective experience and patient-reported outcome measures are considered important, our aim was to develop and test an instrument to measure self-reported quality of recovery in children after surgical procedures.
  
  
  METHODS
  Development of the instrument Postoperative Recovery in Children (PRiC) was influenced by the Quality of Recovery-24, for use in adults. Eighteen children and nine professionals validated the items with respect to content and language. A photo questionnaire was developed to determine whether the children's participation would increase compared with the text questionnaire. The final instrument was distributed consecutively to 390 children, ages 4-12 years, who underwent tonsil surgery at four hospitals in Sweden.
  
  
  RESULTS
  A total of 238 children with a mean age of 6.5 years participated. According to the parents, 23% circled the answers themselves and 59% participated to a significant degree. However, there was no significant difference in participation between those who received a photo versus a text questionnaire. Psychometric tests of the instrument showed that Cronbach's alpha for the total instrument was 0.83 and the item-total correlations for 22 of the items were ≥0.20.
  
  
  CONCLUSIONS
  Our results support use of the PRiC instrument to assess and follow-up on children's self-reported post-operative recovery after tonsil operation, both in clinical praxis as well in research.
authors.affiliation: Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.|Skane University Hospital, Malmö, Sweden.
authors.forename: Ann-Cathrine
authors.initials: AC
authors.lastname: Bramhagen
authors.affiliation: Faculty of Medicine and Health, School of Health and Medical Science, Örebro University, Örebro, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Eriksson
authors.affiliation: Faculty of Medicine and Health, School of Health and Medical Science, Örebro University, Örebro, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Ericsson
authors.affiliation: Faculty of Medicine and Health, School of Health and Medical Science, Örebro University, Örebro, Sweden.
authors.forename: Ulrica
authors.initials: U
authors.lastname: Nilsson
authors.affiliation: Skane University Hospital, Malmö, Sweden.
authors.forename: Sue
authors.initials: S
authors.lastname: Harden
authors.affiliation: Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.|Skane University Hospital, Malmö, Sweden.
authors.forename: Ewa
authors.initials: E
authors.lastname: Idvall
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D063868:Patient Outcome Assessment; D011183:Postoperative Complications / Q000453:epidemiology*; D011184:Postoperative Period; D011594:Psychometrics; D057566:Self Report; D011795:Surveys and Questionnaires / Q000592:standards*; D013548:Sweden; D014068:Tonsillectomy / Q000009:adverse effects
keywords: children; instrument; post-operative recovery; self-report