Validation of the Turkish Version of the “Quality of Recovery 15 (QoR-15)” Questionnaire

Validation of the Turkish Version of the “Quality of Recovery 15 (QoR-15)” Questionnaire | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Validation of the Turkish Version of the “Quality of Recovery 15 (QoR-15)” Questionnaire Kaan Sunter, Kadir Yagiz Turker, Can Ates, Mehmet Ali Koc, Yusuf Sevim, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4625303/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Aim The aim of this study was to perform a cross-cultural adaptation and psychometric evaluation of the Quality of Recovery 15 questionnaire in Turkey. Methods The QoR-15 was translated into Turkish through a rigorous process involving independent translations, consensus, back-translation, and review. The questionnaire was administered to patients undergoing elective major gastrointestinal surgery preoperatively and on postoperative days 1, 7, and 30. Reliability was assessed using Cronbach's α and intra-class correlation coefficient. Construct validity was evaluated through confirmatory factor analysis, and responsiveness was analyzed using Cohen's effect size and standardized response mean. Results A total of 510 patients participated in the study. The Turkish version of QoR-15 (QoR-15T) demonstrated good internal consistency with Cronbach's α of 0.896 and 0.888 for preoperative and postoperative administrations, respectively. Intra-class correlation coefficient values indicated good reliability. Confirmatory factor analysis confirmed the construct validity of QoR-15T. QoR-15T showed responsiveness to changes in health status, with Cohen's effect size and standardize response mean indicating its ability to detect clinically important changes. Conclusion The Turkish version of QoR-15 (QoR-15T) is a reliable, valid, and responsive questionnaire for assessing the quality of recovery in patients undergoing major abdominal surgery. Its ability to capture patients' perspectives and multidimensional aspects of recovery makes it a valuable tool for clinical and research purposes. Health sciences/Health care Health sciences/Medical research major abdominal surgery patient-reported outcome QoR-15 quality of recovery validation Figures Figure 1 Figure 2 Figure 3 Introduction The concept of recovery after surgical operations emerges as an important phenomenon. Although there is no perfect definition of recovery, the general consensus is the return to daily life after surgery according to the patient's baseline or social norms [ 1 , 2 ]. In addition to quantitative outcomes such as morbidity, mortality, and readmission, the patient's ability to return normal daily activities after surgery is a valuable qualitative measure of recovery. Therefore, the recovery for the postoperative period should include not only the patients' physical condition, but also psychological and social wellbeing, and these essential components should be considered when assessing the recovery process. Many tools which meet these requirements have been developed to measure postoperative recovery. The most commonly used one is QoR-40, which was developed by Myles et al. in 2000 to evaluate the early postoperative period [ 3 ]. QoR-40, a patient reported outcome measure, and which consists of 40 items and 5 sub-dimensions was used by anesthesiologists as well as by surgeons operating in different fields such as neurosurgery, cardiovascular and orthopedic [ 4 – 7 ]. Stark et al. developed and validated a short form questionnaire from QoR-40 which is called QoR-15 and apparently consist of 15 items [ 8 ]. And a systematic review reported that QoR-15 and QoR-40 are equivalent in terms of psychometric properties, but of course, QoR-15 is more feasible [ 9 ]. QoR-15 has been translated and validated for French-speaking, Korean, Portuguese, Danish and German populations [ 9 – 13 ]. The aim of this study is to perform a cross-cultural adaptation and a psychometric evaluation of the Quality of Recovery 15 (QoR-15) in Turkey. Methods The QoR-15 Instrument Two co-authors (MAK, MAK) independently translated the original English version of the QoR-15 into Turkish. Another co-author (İCE) evaluated these two preliminary translated versions and made a final consensus form. Final form was retranslated into English by a fourth translator (YS) and compared with the original form. All 4 translators have at least advanced proficiency in English language. Lastly, the clarity of the final form was discussed by the authors and a consensus was made (Suppl 1. Original form). QoR-15 has 2 parts to evaluate physical (questions 1–10), and mental (questions 11–15) well-being. Every question has an answer on a Likert scale 0 to 10, therefore, total score is presented as a value between 0–150. Patients After the approval of the Ankara University Medical School Ethics Committee (i5-208-19) and registration on clinical trials.gov (NCT06456918) patients were informed about the study and written informed consents for participation were obtained. All methods were performed in accordance with the relevant guidelines and regulations. Patients who were admitted to 5 different center's general surgery departments for preoperative examinations associated with a scheduled elective surgery in general surgery, from September 2019 to September 2022, were evaluated for the study. 535 patients who met the inclusion criteria of being over age of 18 and had a planned elective major gastrointestinal surgery were included in the study. However, 25 of these 535 patients were excluded from the evaluation due to the lack of data and their decision to leave the study. Those under 18 years of age, as well as those who had an alcohol or substance addiction problem, refused to participate in the study, had a previous major abdominal surgery, or were non-cooperative were excluded from the study. Design To validate the QoR-15, the survey was conducted on the day before the surgery (Pre), and on postoperative days 1 (P1), 7 (P7), and 30 (P30). The patient characteristics including age, sex, height, weight, American Society of Anesthesiologists (ASA) score, morbidity, and operation type were also recorded. QoR-15 form was given to the patients and they were requested to answer the questions by themselves. While the patients were answering the questionnaire, a health professional accompanied them in the room in case of the need for assistance. Statistical Analysis Descriptive statistics are summarized as counts and percentages for categorical variables; mean and standard deviations for continuous variables; median (interquartile range) for ordinal and non-normally distributed variables. Mann-Whitney U test was used to test the difference between two groups in terms of ordinal or non-normally distributed continuous variables. Difference among three or more groups for non-normally distributed or ordinal variables was evaluated by Kruskal Wallis analysis of variance. When the p-value from the Kruskal-Wallis test statistics is statistically significant, Dunn test was used to know which groups differ from which others. Degree of association between variables were calculated by Spearman's correlation coefficient. P value less than 0.05 was considered significant. Reliability Reliability of the QoR-15 was tested by internal consistency, which is an estimate of the degree to which its constituent items are interrelated, and is assessed by Cronbach’s α coefficient [ 14 , 15 ]. Usually, a reliability of 0.70 is required for analysis at the group level, and values of 0.85 and higher for individual use [ 16 ]. In addition, the intra-class correlation coefficient (ICC) was calculated. Validity Construct validity was assessed through confirmatory factor analysis (CFA) in order to evaluate model fit. Number of factor was determined by using number of dimension of original questionnaire. Maximum likelihood estimation was used to calculate factor loadings. Multiple indices in CFA as the chi-square statistic (χ2), the degree of freedom, root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI) and Akaike information criterion were considered for the model’s goodness of fit. The Tucker Lewis Index (TLI > 0.90 acceptable, > 0.95 excellent), the Comparative Fit Index (CFI > 0.90 acceptable, > 0.95 excellent), the Root Mean Square Error of Approximation (RMSEA < 0.08 acceptable, < 0.05 excellent), and the chi-square statistic divided by the degree of freedom (< 3 acceptable) were used as goodness-of-fit statistics [ 17 ]. Items with factor loadings below 0.40 were eliminated [ 18 ]. Error items were correlated only if they were in the same construct. If correlation between error terms was greater than 1, one of the two redundant items was deleted. Responsiveness Responsiveness describes an instrument’s ability to detect clinically important change. Cohen’s effect size was calculated for the responsiveness of QoR15 as the average change scores (from pre-test to post-test) divided by the SD at baseline. Cohen effect sizes of 0.2, 0.5 and ≥ 0.8 correspond to small, medium and large changes in quality of recovery scores. Standardized response mean (SRM) was also calculated as the change scores divided by the SD of the change scores. Sample Size Guidelines for the respondent‑to‑item ratio ranged from 5:1 (i.e., fifty respondents for a 10‑item questionnaire) to 30:1 [ 19 – 21 ]. In this study, respondent‑to‑item ratio was 34:1, so it can be considered as very good. Results 510 patients completed the survey, 231 (45.3%) of the respondents were female, 279 (54.7%) were male. 63.5% of the responders were less than 65 years old, 26.3% were between 65–74 years old and 6.3% were between 75–84 years old, and 2% were greater than 84 years old. Clinical characteristics of patients were given in Table 1 . Mean scores (SD) of QoR-15 was 127.2 (22.9) ranging from 4 to 150. Box-plots of QoR-15 scores at each time point were presented in Fig. 1 . The percentage of patients achieving the highest possible QoR-15 score at the different time points were: preoperative (12.9%, n = 66), post-operative 24 h (0.6%, n = 3). It is seen in Fig. 2 that there is no problem in terms of floor and ceiling effects. For these effects are considered to be present if more than 15% of the patients achieved the lowest or highest possible score, respectively [ 22 ]. The mean time taken to complete the postoperative 24 h QoR-15 score in a subset of patients (n = 15) was 2.7 (1–7) min. Table 1 Clinical characteristics of patients for categorical variables n(%) Groups Colorectal 246(50.72) Hepatopancreaticobiliary 89(18.35) Upper GI 83(17.11) Bariatric surgery 63(12.99) Gender Male 279(54.71) Female 231(45.29) Age 85 10(1.96) ASA 1 177(36.72) 2 218(45.23) 3 85(17.63) 4 2(0.41) The distribution of our patients in terms of categorical variables is also summarized in Table 1 . The comparison results of QoR15 scores for all time points in terms of patient clinical parameters are given in Table 2 . No difference was observed in gender distribution of the patients. However, there were difference regarding the ASA score and the type of surgery. Table 2 Clinical characteristics of patients regarding QoR15T scores QoR-pre QoR-P1 QoR-P7 QoR-P30 Groups Colorectal 127,27 ± 22,74 b 99,47 ± 27,56 a 125,8 ± 19,32 a 135,72 ± 14,98 a Hepatopancreaticobiliary 131,15 ± 17 bc 99,25 ± 21,19 a 122,14 ± 19,57 a 133,42 ± 17,66 a Upper GI 119,06 ± 29,71 a 93,04 ± 27,61 a 122,35 ± 20,23 a 133,09 ± 19,61 a Bariatric Surgery 136,79 ± 14,02 c 114,83 ± 17,87 b 137,29 ± 9,99 b 144,61 ± 7,12 b P < 0,001 < 0,001 < 0,001 < 0,001 Gender Male 127,07 ± 25,31 99,51 ± 27,67 125,3 ± 20,64 137,05 ± 15,81 Female 127,28 ± 19,69 100,63 ± 23,82 126,44 ± 17,27 134,65 ± 17,43 P 0,979 0,843 0,705 0,181 ASA 1 128,65 ± 22,24 a 103,47 ± 25,39 a 128,77 ± 17,03 a 138,84 ± 12,95 a 2 130,67 ± 19 a 102,01 ± 24,45 a 126,93 ± 19,64 a 135,92 ± 16,51 ab 3 118,67 ± 29,78 ab 88,29 ± 28,51 b 117,71 ± 20,28 b 131,79 ± 19,94 b 4 99 ± 50,91 b 86 ± NA 106 ± NA NA P < 0,001 < 0,001 < 0,001 0,014 Age < 65 127,42 ± 22,11 99,74 ± 26,15 127,33 ± 17,42 a 136,64 ± 16,62 a 65–74 127,9 ± 23,52 102,39 ± 24,51 124,84 ± 21,34 a 135,48 ± 14,78 a 75–84 124,97 ± 26,61 96,93 ± 28,4 117,93 ± 21,23 ab 134,96 ± 18,58 a > 85 115,6 ± 29,08 85,5 ± 29,79 110,67 ± 29,26 b 117 ± 27,86 b P 0,390 0,261 0,004 0,020 a,b,c and ab ; The means shown with the same index are statistically the same with each other, while the others are statistically different (p < 0.005). Spearman's correlation coefficient was used to examine the relationships of variables such as age, height, weight, ASA score, operation time, and length of stay with the QoR15 score (Table 3 ). Table 3 Relationships of variables versus to QoR Age Groups Surgery Duration Postop Lenght of Stay ASA Size Kilo TS_QoR_0 r -0,016 0,036 -0,157 -0,080 0,084 0,222 p 0,724 0,483 0,002 0,078 0,066 < 0,001 n 510 377 402 482 481 481 TS_QoR_1 r 0,004 -0,064 -0,16 -0,153 0,012 0,17 * p 0,933 0,221 0,001 0,001 0,804 < 0,001 n 494 366 391 468 467 466 TS_QoR_2 r -0,105 -0,116 -0,254 -0,179 0,063 0,187 p 0,019 0,025 < 0,001 < 0,001 0,170 < 0,001 n 502 375 400 476 475 474 TS_QoR_3 r -0,091 -0,171 -0,245 -0,102 0,071 0,255 p 0,061 0,003 < 0,001 0,042 0,162 < 0,001 n 419 297 321 396 393 392 A negative correlation was found with postoperative length of stay and ASA scores. Although statistically significant, this relationship was expressed with a small correlation coefficient. Similarly, a low but significant correlation was calculated between weight and QoR scores. Figure 1 shows the change in QoR15 scores taken at 4 different time points. Accordingly, the change over time was found to be significant and Post-hoc multiple comparison tests showed that; the difference between all possible paired time point comparisons is statistically significant (p < 0.001). Also, it was clearly seen that the median score of the postoperative 1st day was lower than all the others. The Cronbach’s α coefficient of the pre-operative QoR-15 and post-operative QoR-15 were 0.896 and 0.888, respectively. Corrected item-total correlation coefficients were changing from 0.46 to 0.75 for pre-operative QoR-15 and from 0.171 to 0.895 for post-operative QoR-15. Inter-dimension and item-to-total dimension correlation coefficients at pre-operative time point were given in Table 4 . Table 4 Interitem Correlation Matrix for the QoR-15 QoR15 Item Number Total QoR15 Score 1 2 3 4 5 6 7 8 9 10 11 12 13 14 1 0.47 - 2 0.65 0.35 - 3 0.74 0.42 0.57 - 4 0.69 0.37 0.50 0.69 - 5 0.47 0.34 0.36 0.35 0.29 - 6 0.47 0.35 0.33 0.32 0.28 0.59 - 7 0.45 0.37 0.33 0.36 0.31 0.54 0.61 - 8 0.57 0.39 0.42 0.43 0.36 0.63 0.50 0.47 - 9 0.71 0.41 0.56 0.61 0.50 0.46 0.44 0.43 0.57 - 10 0.75 0.43 0.59 0.62 0.48 0.43 0.40 0.41 0.52 0.81 - 11 0.56 0.17 0.29 0.30 0.23 0.30 0.29 0.26 0.31 0.34 0.36 - 12 0.64 0.29 0.34 0.41 0.36 0.37 0.36 0.35 0.37 0.42 0.41 0.67 - 13 0.60 0.23 0.36 0.33 0.30 0.29 0.30 0.25 0.33 0.38 0.43 0.46 0.61 - 14 0.65 0.18 0.28 0.36 0.34 0.21 0.24 0.24 0.25 0.29 0.37 0.32 0.38 0.35 - 15 0.71 0.21 0.33 0.43 0.37 0.24 0.25 0.28 0.31 0.39 0.46 0.36 0.43 0.38 0.78 Quality of recovery (QoR)-15 items. 1 : able to breathe easily; 2 : been able to enjoy food; 3 : feeling rested; 4 : have had a good sleep; 5 : able to look after personal toilet and hygiene unaided; 6 : able to communicate with family or friends; 7 : getting support from hospital doctors and nurses; 8 : able to return to work or usual home activities; 9 : feeling comfortable and in control; 10 : having a feeling of general well-being; 11 : moderate pain; 12 : severe pain; 13 : nausea or vomiting; 14 : feeling worried or anxious; 15 : feeling sad or depressed. Cohen’s effect size and standardized response means (SRM) were calculated to measure degree of responsiveness for pre and post-operative time points (Table 5 ). In this population, the total QoR-15 score had a Cohen effect size of 1.22 at pre-operative time point. Standardized response means of the total QoR-15 score were 1.18 at pre-operative time point. Also changes in health status and responsiveness are summarized in Table 5 . Table 5 Cohen’s effect size and standardized response means Preop Mean Score Post op Mean Score Mean change %Change Cohens Effectsize SRM Q1 8.88 ± 1.82 7.25 ± 2.69 -1.63 (-1.88 to -1.4) 18.33 0.89 0.60 Q2 8.22 ± 2.56 4.3 ± 3.71 -3.92 (-4.23 to -3.39) 47.72 1.53 0.90 Q3 8.16 ± 2.38 6.32 ± 2.93 -1.85 (-2.16 to -1.58) 22.64 0.78 0.57 Q4 7.93 ± 2.5 6.23 ± 3.03 -1.7 (-2.03 to -1.41) 21.44 0.68 0.49 Q5 9.36 ± 1.78 5.31 ± 3.39 -4.05 (-4.39 to -3.75) 43.27 2.28 1.13 Q6 9.33 ± 1.71 8.63 ± 2.35 -0.7 (-0.94 to -0.51) 7.54 0.41 0.29 Q7 9.62 ± 0.99 9.17 ± 1.56 -0.45 (-0.58 to -0.34) 4.69 0.46 0.33 Q8 9.05 ± 1.93 4.63 ± 3.31 -4.42 (-4.78 to -4.11) 48.81 2.29 1.19 Q9 8.52 ± 2.16 6.61 ± 2.63 -1.9 (-2.18 to -1.65) 22.33 0.88 0.64 Q10 8.54 ± 2.08 6.85 ± 2.64 -1.69 (-1.96 to -1.45) 19.81 0.81 0.59 Q11 7.99 ± 2.95 6.33 ± 2.82 -1.67 (-2 to -1.33) 20.86 0.57 0.44 Q12 8.54 ± 3.06 7.48 ± 3.06 -1.05 (-1.37 to -0.72) 12.31 0.34 0.28 Q13 8.22 ± 3.09 7.41 ± 3.17 -0.81 (-1.15 to -0.43) 9.82 0.26 0.20 Q14 7.35 ± 2.87 7.4 ± 2.84 0.05 (-0.24 to 0.36) 0.63 0.02 0.02 Q15 7.45 ± 2.91 7.48 ± 2.95 0.04 (-0.27 to 0.34) 0.52 0.01 0.01 Total 127.17 ± 22.91 100.02 ± 25.96 27.15 (-29.2to -25.1) 21.34 1.22 1.18 The CFA run on the model with 2 factors and 15 items demonstrated acceptable CFI, TLI, RMSEA and met criteria for goodness fit, after applying modifications suggested by CFA (Fig. 3 ). All factor loadings for each item and each model were presented in Table 6 . Model 3 was significantly improved with acceptable CFI, TLI, RMSEA and AIC (Table 7 ). Table 6 Maximum Likelihood Estimates and Factor Loadings Estimate S.E. p Factor Loadings QoR-15-1 Physical well being 1.000 0.596 QoR-15-2 Physical well being 1.474 0.124 < 0.001 0.626 QoR-15-3 Physical well being 1.592 0.120 < 0.001 0.726 QoR-15-4 Physical well being 1.335 0.119 < 0.001 0.580 QoR-15-5 Physical well being 0.896 0.083 < 0.001 0.556 QoR-15-6 Physical well being 0.717 0.078 < 0.001 0.455 QoR-15-7 Physical well being 0.513 0.047 < 0.001 0.567 QoR-15-8 Physical well being 1.156 0.096 < 0.001 0.651 QoR-15-9 Physical well being 1.778 0.118 < 0.001 0.892 QoR-15-10 Physical well being 1.767 0.116 < 0.001 0.921 QoR-15-11 Mental well being 1.000 0.753 QoR-15-12 Mental well being 1.231 0.066 < 0.001 0.894 QoR-15-13 Mental well being 1.034 0.063 < 0.001 0.745 QoR-15-14 Mental well being 0.619 0.060 < 0.001 0.481 QoR-15-15 Mental well being 0.725 0.060 < 0.001 0.553 Table 7 Confirmatory Factor Analysis: Goodness of Fit of the QR-15 N of items χ 2 /df p CFI TLI RMSEA AIC QR-15 15 3.003 < 0.001 0.962 0.950 0.063 321.266 Discussion Recovery after surgery is a complex process including not only physical well-being but also psychosocial status. Traditionally, postoperative success has been evaluated based on hospital stay, complication rates, and survival [ 23 ]. However, this approach overlooks the patient's perspective, resulting in limited information for researchers and medical professionals. Therefore, a multidimensional recovery questionnaire, such as the QoR-15, has been developed and is now considered to have higher clinical value. The QoR-15 is a questionnaire that provides a more comprehensive assessment of the quality of the recovery period for postoperative patients. It focuses on five different areas that are crucial to a successful recovery: pain, physical comfort, physical independence, psychological support, and emotional state. By questioning patients in each of these areas, the QoR-15 provides a more complete picture of their recovery experience. So, unlike traditional methods, its most significant strength lies in offering a multifaceted integration instead of evaluating the patient based on a limited set of outcomes [ 24 ]. By incorporating this questionnaire into clinical studies, researchers and medical professionals can gain a deeper understanding of the factors that contribute to a successful recovery and use this information to improve patient care. This study was conducted to assess the Turkish version of the QoR15 questionnaire. We found that QoR15T has good levels of validity, reliability, responsiveness and feasibility. CFA showed a great goodness of fit and construct validity of QoR15T. The ability of QoR15T to discriminate the known determinants such as negative correlation with ASA score and length of stay, and positive correlation with weight supported the construct validity [ 8 ]. In addition, the significant difference between type of surgeries, which means the QoR15T scores altered regarding the extent of surgery, also confirmed the validity [ 8 , 13 ]. The Cronbach’s α coefficient of the pre-operative and post-operative QoR-15T were good and similar to the published literature [ 8 , 10 – 13 ]. Internal consistency reliability was calculated not only using Cronbach α but also with interitem correlation. Preoperative and postoperative item-total correlation coefficients showed that questions are relevant. Responsiveness and Cohen’s effect size findings were excellent, and demonstrated that QoR15T can assess even small clinical alterations. To the best of our knowledge, there is only one other questionnaire (QoR40) which measures quality of recovery except the QoR15, and this is the main questionnaire which QoR15 is derived from. Cross-cultural adaptation and validation for both are achieved in several countries, and these studies reported that both are reliable, valid, and feasible [ 8 , 10 – 13 , 25 , 26 ]. In addition, QoR15 is reported as a valuable tool to measure recovery regarding its ability to detect smallest changes in clinical trials [ 9 ]. In this section, we deem it appropriate to provide an elucidation in comparison to the article authored by "Selvi O, et al." and published in 2022 [ 27 ]. We contend that there exist significant disparities between their publication and our own study. Firstly, our study sample exclusively comprises patients undergoing elective major gastrointestinal surgery, and we conducted four distinct measurements (preoperative 1 and postoperative 3 times) for each individual within this cohort. Most notably, our research incorporates a rigorous statistical approach that encompasses confirmatory factor analysis (CFA), which enabled the evaluation of factor loadings, inter-item relationships, and fit statistics. Concerning construct validity, we employed the maximum likelihood estimator for the calculation of factor loadings, thereby ensuring a robust and widely accepted estimation methodology. Additionally, our study presents an extensive examination of model fit through the provision of critical indices, namely CFA, RMSEA (Root Mean Square Error of Approximation), CFI (Comparative Fit Index), TFI (Tucker-Lewis Index), and Akaike Information Criterion (AIC). These indices collectively serve to gauge the extent to which our proposed measurement model aligns with the observed data. One of the limitations of this study is the selection of the patients only with the elective major abdominal surgeries. There were no patients underwent minor surgery or any operation from another specialty except general surgery included in the study. Although the sample size is more than enough, the low variability due to our selection should be considered. Another limitation is also there were no patients underwent emergency surgery. Therefore, there is a need for assessment of the QoR15T on several patient populations and in different settings. On the other hand, this was a multicentric study involving numerous hospitals in several cities around Turkey, which can be an indication of generalizability. In conclusion, measurement of the quality of a patient’s recovery period is an important and current subject. QoR15T, which is a unique tool and designed exactly for this measurement, is a reliable, valid, reproducible, and feasible questionnaire for the assessment of recovery, especially in major abdominal surgery patients. Declarations Conflict of Interest: All outhors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. Author Contributions: Conception: Kaan Sunter, Kadir Yagiz Turker, Onur Ilkay Dincer, Burak Yavuz, Burak Kutlu. Design of the work: Mehmet Ali Koc, Yusuf Sevim, Cemal Ensari, Ismail Cem Eray, Timucin Erol, Siyar Ersoz, Mehmet Ayhan Kuzu. Acquisition, analysis: Can Ates, Kaan Sunter, Kadir Yagiz Turker, Onur Ilkay Dincer, Burak Yavuz, Burak Kutlu. Interpretation of data: Can Ates, Kaan Sunter, Kadir Yagiz Turker, Onur Ilkay Dincer, Burak Yavuz, Burak Kutlu. Wrote the main manuscript text: Mehmet Ali Koc, Yusuf Sevim, Cemal Ensari, Ismail Cem Eray, Timucin Erol, Siyar Ersoz, Mehmet Ayhan Kuzu, Can Ates, Kaan Sunter, Kadir Yagiz Turker, Onur Ilkay Dincer, Burak Yavuz, Burak Kutlu. Prepared figures and tables: Kaan Sunter, Kadir Yagiz Turker, Onur Ilkay Dincer, Burak Yavuz, Burak Kutlu. Have drafted the work or substantively revised it: Mehmet Ali Koc, Yusuf Sevim, Cemal Ensari, Ismail Cem Eray, Timucin Erol, Siyar Ersoz, Mehmet Ayhan Kuzu. All authors reviewed the manuscript. Human Ethics and Consent to Participate Declaration: This study was approved by Ankara University Medical School Ethics Committee (i5-208-19) Data Availability Declaration: The datasets generated and/or analysed during the current study are not publicly available due confidentiality of patient data but are available from the corresponding author on reasonable request. Funding Declaration: None. References Rajabiyazdi F, Alam R, Pal A, Montanez J, Law S, Pecorelli N, et al. Understanding the meaning of recovery to patients undergoing abdominal surgery. JAMA Surg. 2021 Aug 1;156(8):758-765. doi: 10.1001/jamasurg.2021.1557. Lee L, Tran T, Mayo NE, Carli F, Feldman LS. What does it really mean to “recover” from an operation? Surgery. 2014 Feb;155(2):211-6. doi: 10.1016/j.surg.2013.10.002. Myles PS, Weitkamp B, Jones K, Melick J, Hensen S. Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth. 2000 Jan;84(1):11-5. doi: 10.1093/oxfordjournals.bja.a013366. Bost JE, Williams BA, Bottegal MT, Dang Q, Rubio DM. The 8-item short-form health survey and the physical comfort composite score of the quality of recovery 40-item scale provide the most responsive assessments of pain, physical function, and mental function during the first 4 days after ambulatory knee surgery with regional anesthesia. Anesth Analg. 2007 Dec;105(6):1693-700. doi: 10.1213/01.ane.0000287659.14893.65. Buchanan FF, Myles PS, Cicuttini F. Effect of patient sex on general anaesthesia and recovery. Br J Anaesth. 2011 Jun;106(6):832-9. doi: 10.1093/bja/aer094. Leslie K, Troedel S, Irwin K, Pearce F, Ugoni A, Gillies R, et al. Quality of recovery from anesthesia in neurosurgical patients. Anesthesiology. 2003 Nov;99(5):1158-65. doi: 10.1097/00000542-200311000-00024. Myles PS, Hunt JO, Fletcher H, Solly R, Woodward D, Kelly S. Relation between quality of recovery in hospital and quality of life at 3 months after cardiac surgery. Anesthesiology. 2001 Oct;95(4):862-7. doi: 10.1097/00000542-200110000-00013. Stark PA, Myles PS, Burke JA. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology. 2013 Jun; 118(6):1332-40. doi: 10.1097/ALN.0b013e318289b84b. Kleif J, Waage J, Christensen KB, Gögenur I. Systematic review of the QoR-15 score, a patient-reported outcome measure measuring quality of recovery after surgery and anaesthesia. Br J Anaseth. 2018 Jan;120(1):28-36. doi: 10.1016/j.bja.2017.11.013. Kim D, Kim JK, Yeo J. Translation and validation of the Korean version of the postoperative quality of recovery score QoR-15. Biomed Res Int. 2020 Oct 9:2020:3456234. doi: 10.1155/2020/3456234. Demumieux F, Ludes PO, Diemunsch P, Bennett-Guerrero E, Lujic M, Lefebvre F, et al. Validation of the translated quality of recovery-15 questionnaire in a French-speaking population. Br J Anaesth. 2020 Jun;124(6):761-767. doi: 10.1016/j.bja.2020.03.011. Kleif J, Edwards HM, Sort R, Vilandt J, Gögenur I. Translation and validation of the Danish version of the postoperative quality of recovery score QoR-15. Acta Anaesthesiol Scand. 2015 Aug; 59(7):912-20. doi:10.1111/aas.12525. Kahl U, Gebhardt N, Brodersen K, Kainz E, Schirren L, Yu Y, et al. Validation of a translated quality of recovery-15 questionnaire in German patients undergoing elective noncardiac surgery. Br J Anaesth. 2021 Nov;127(5):e161-e163. doi: 10.1016/j.bja.2021.07.026. Travakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011 Jun 27;2:53-55. doi: 10.5116/ijme.4dfb.8dfb. Bland JM, Altman DG. Cronbach’s alpha. BMJ. 1997 Feb 22;314(7080):572. doi: 10.1136/bmj.314.7080.572. Streiner DL, Norman GR. Health measurement scales: a practical guide to their development and use. Oxford University Press; 2008. doi: 10.1093/acprof:oso/9790199231881.001.0001. Xia Y, Yang Y. RMSEA, CFI, and TLI in structural modeling with ordered categorical data: the story they tell depends on the estimation methods. Behav Res Methods. 2019 Feb;51(1):409-428. doi: 10.3758/s13428-018-1055-2. Rose M, Bjorner JB, Becker J, Fries JF, Ware JE. Evaluation of a preliminary physical function item bank supported the expected advantages of the patient-reported outcomes measurement information system (PROMIS). J Clin Epidemiol. 2008 Jan;61(1):17-33. doi:10.1016/j.jclinepi.2006.06.025. Pedhazur EJ. Multipl regression in behavioral research: an explanation and prediction. New York: Holt, Rinehart & Winston; 1997. Gorsuch RL. Factor Analysis. ‘nd ed. Hillsdale, NJ: Lawrance Erlbaum Associates; 1983. Nunnally JC. Psychometric Theory. 2 nd ed. New York: McGraw-Hill; 1978. Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007 Jan;60(1):34-42. doi: 10.1016/j.jclinepi.2006.03.012. Myles PS, Shulman MA, Reilly J, Kasza J, Romero L. Measurement of quality of recovery after surgery using the 15-item quality of recovery scale: a systematic review and meta-analysis. Br J Anaesth. 2022 Jun 1;128(6):1029-1039. doi: 10.1016/j.bja.2022.03.009. Myles PS. More than just morbidity and mortality – quality of recovery and long-term functional recovery after surgery. Anaesthesia. 2020 Jan;75 Suppl 1:e143-e150. doi: 10.1111/anae.14786. Sá AC, Sousa G, Santos A, Santos C, Abelha FJ. Quality of recovery after anesthesia: validation of the Portuguese version of the “Quality of recovery 15” questionnaire. Acta Med Port. 2015 Sep-Oct;28(5):567-574. doi:10.20344/amp.6129. Karaman S, Arici S, Dogru S, Karaman T, Tapar H, Kaya Z, et al. Validation of the Turkish version of the quality of recovery-40 questionnaire. Health Qual Life Outcomes. 2014 Jan15;12:8. doi: 10.1186/1477-7525-12-8. Selvi O, Azizoglu M, Temel G, Tulgar S, Chitneni A, Cinar EN, et al. Translation and validation of the Turkish version of the quality of postoperative recovery score QoR-15: a multi-centred cohort study. Turkish J Anaesthesiol Reanim. 2022 Dec 1;50(6):443-448. doi: 10.5152/TJAR.2022.21417. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4625303","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":328784405,"identity":"dc27e675-f159-45fa-a670-cfa94992a36b","order_by":0,"name":"Kaan Sunter","email":"","orcid":"","institution":"Ankara University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Kaan","middleName":"","lastName":"Sunter","suffix":""},{"id":328784406,"identity":"638336d2-a44d-48ff-90ba-de0ebe466103","order_by":1,"name":"Kadir Yagiz Turker","email":"","orcid":"","institution":"Ankara University School of 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University School of Medicine","correspondingAuthor":true,"prefix":"","firstName":"Mehmet","middleName":"Ayhan","lastName":"Kuzu","suffix":""}],"badges":[],"createdAt":"2024-06-23 12:59:59","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4625303/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4625303/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":60708068,"identity":"06bd1ace-ada3-44a2-8fad-eee3215ea24f","added_by":"auto","created_at":"2024-07-19 19:39:50","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":25454,"visible":true,"origin":"","legend":"\u003cp\u003eBoxplots for each time point of QoR Scores.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4625303/v1/f32bfba033c561c700d54a6b.png"},{"id":60707229,"identity":"50c41ae3-7ffd-40fe-b723-f55376645d02","added_by":"auto","created_at":"2024-07-19 19:31:50","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":42344,"visible":true,"origin":"","legend":"\u003cp\u003eScale characteristics of the quality of recovery score Pre and Post op QoR15, illustrating spread of scores and lack of a ceiling effect. A normal distribution curve is interposed.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4625303/v1/58dad8d66a1a6c751895622c.png"},{"id":60707231,"identity":"1609ac91-0219-4aff-9b83-fe59869b44f8","added_by":"auto","created_at":"2024-07-19 19:31:50","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":121118,"visible":true,"origin":"","legend":"\u003cp\u003eConfirmatory factor analysis\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4625303/v1/97e89a341f6cf4106d654afa.png"},{"id":73256337,"identity":"783a6353-ad9b-497d-b2fa-4b27b67b31a4","added_by":"auto","created_at":"2025-01-08 08:39:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1178194,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4625303/v1/91519d79-d4b9-4f81-8abb-36d9b5fb5305.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Validation of the Turkish Version of the “Quality of Recovery 15 (QoR-15)” Questionnaire","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe concept of recovery after surgical operations emerges as an important phenomenon. Although there is no perfect definition of recovery, the general consensus is the return to daily life after surgery according to the patient's baseline or social norms [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In addition to quantitative outcomes such as morbidity, mortality, and readmission, the patient's ability to return normal daily activities after surgery is a valuable qualitative measure of recovery. Therefore, the recovery for the postoperative period should include not only the patients' physical condition, but also psychological and social wellbeing, and these essential components should be considered when assessing the recovery process.\u003c/p\u003e \u003cp\u003eMany tools which meet these requirements have been developed to measure postoperative recovery. The most commonly used one is QoR-40, which was developed by Myles et al. in 2000 to evaluate the early postoperative period [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. QoR-40, a patient reported outcome measure, and which consists of 40 items and 5 sub-dimensions was used by anesthesiologists as well as by surgeons operating in different fields such as neurosurgery, cardiovascular and orthopedic [\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Stark et al. developed and validated a short form questionnaire from QoR-40 which is called QoR-15 and apparently consist of 15 items [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. And a systematic review reported that QoR-15 and QoR-40 are equivalent in terms of psychometric properties, but of course, QoR-15 is more feasible [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eQoR-15 has been translated and validated for French-speaking, Korean, Portuguese, Danish and German populations [\u003cspan additionalcitationids=\"CR10 CR11 CR12\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The aim of this study is to perform a cross-cultural adaptation and a psychometric evaluation of the Quality of Recovery 15 (QoR-15) in Turkey.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eThe QoR-15 Instrument\u003c/h2\u003e \u003cp\u003eTwo co-authors (MAK, MAK) independently translated the original English version of the QoR-15 into Turkish. Another co-author (İCE) evaluated these two preliminary translated versions and made a final consensus form. Final form was retranslated into English by a fourth translator (YS) and compared with the original form. All 4 translators have at least advanced proficiency in English language. Lastly, the clarity of the final form was discussed by the authors and a consensus was made (Suppl 1. Original form).\u003c/p\u003e \u003cp\u003eQoR-15 has 2 parts to evaluate physical (questions 1\u0026ndash;10), and mental (questions 11\u0026ndash;15) well-being. Every question has an answer on a Likert scale 0 to 10, therefore, total score is presented as a value between 0\u0026ndash;150.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003ePatients\u003c/h2\u003e \u003cp\u003e After the approval of the Ankara University Medical School Ethics Committee (i5-208-19) and registration on clinical trials.gov (NCT06456918) patients were informed about the study and written informed consents for participation were obtained. All methods were performed in accordance with the relevant guidelines and regulations. Patients who were admitted to 5 different center's general surgery departments for preoperative examinations associated with a scheduled elective surgery in general surgery, from September 2019 to September 2022, were evaluated for the study. 535 patients who met the inclusion criteria of being over age of 18 and had a planned elective major gastrointestinal surgery were included in the study. However, 25 of these 535 patients were excluded from the evaluation due to the lack of data and their decision to leave the study. Those under 18 years of age, as well as those who had an alcohol or substance addiction problem, refused to participate in the study, had a previous major abdominal surgery, or were non-cooperative were excluded from the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eDesign\u003c/h2\u003e \u003cp\u003eTo validate the QoR-15, the survey was conducted on the day before the surgery (Pre), and on postoperative days 1 (P1), 7 (P7), and 30 (P30). The patient characteristics including age, sex, height, weight, American Society of Anesthesiologists (ASA) score, morbidity, and operation type were also recorded. QoR-15 form was given to the patients and they were requested to answer the questions by themselves. While the patients were answering the questionnaire, a health professional accompanied them in the room in case of the need for assistance.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eDescriptive statistics are summarized as counts and percentages for categorical variables; mean and standard deviations for continuous variables; median (interquartile range) for ordinal and non-normally distributed variables. Mann-Whitney U test was used to test the difference between two groups in terms of ordinal or non-normally distributed continuous variables. Difference among three or more groups for non-normally distributed or ordinal variables was evaluated by Kruskal Wallis analysis of variance. When the p-value from the Kruskal-Wallis test statistics is statistically significant, Dunn test was used to know which groups differ from which others. Degree of association between variables were calculated by Spearman's correlation coefficient. P value less than 0.05 was considered significant.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eReliability\u003c/h2\u003e \u003cp\u003eReliability of the QoR-15 was tested by internal consistency, which is an estimate of the degree to which its constituent items are interrelated, and is assessed by Cronbach\u0026rsquo;s α coefficient [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Usually, a reliability of 0.70 is required for analysis at the group level, and values of 0.85 and higher for individual use [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In addition, the intra-class correlation coefficient (ICC) was calculated.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eValidity\u003c/h2\u003e \u003cp\u003eConstruct validity was assessed through confirmatory factor analysis (CFA) in order to evaluate model fit. Number of factor was determined by using number of dimension of original questionnaire. Maximum likelihood estimation was used to calculate factor loadings. Multiple indices in CFA as the chi-square statistic (χ2), the degree of freedom, root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI) and Akaike information criterion were considered for the model\u0026rsquo;s goodness of fit. The Tucker Lewis Index (TLI\u0026thinsp;\u0026gt;\u0026thinsp;0.90 acceptable, \u0026gt;\u0026thinsp;0.95 excellent), the Comparative Fit Index (CFI\u0026thinsp;\u0026gt;\u0026thinsp;0.90 acceptable, \u0026gt;\u0026thinsp;0.95 excellent), the Root Mean Square Error of Approximation (RMSEA\u0026thinsp;\u0026lt;\u0026thinsp;0.08 acceptable, \u0026lt;\u0026thinsp;0.05 excellent), and the chi-square statistic divided by the degree of freedom (\u0026lt;\u0026thinsp;3 acceptable) were used as goodness-of-fit statistics [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Items with factor loadings below 0.40 were eliminated [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Error items were correlated only if they were in the same construct. If correlation between error terms was greater than 1, one of the two redundant items was deleted.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eResponsiveness\u003c/h2\u003e \u003cp\u003eResponsiveness describes an instrument\u0026rsquo;s ability to detect clinically important change. Cohen\u0026rsquo;s effect size was calculated for the responsiveness of QoR15 as the average change scores (from pre-test to post-test) divided by the SD at baseline. Cohen effect sizes of 0.2, 0.5 and \u0026ge;\u0026thinsp;0.8 correspond to small, medium and large changes in quality of recovery scores. Standardized response mean (SRM) was also calculated as the change scores divided by the SD of the change scores.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eSample Size\u003c/h2\u003e \u003cp\u003eGuidelines for the respondent‑to‑item ratio ranged from 5:1 (i.e., fifty respondents for a 10‑item questionnaire) to 30:1 [\u003cspan additionalcitationids=\"CR20\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. In this study, respondent‑to‑item ratio was 34:1, so it can be considered as very good.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e510 patients completed the survey, 231 (45.3%) of the respondents were female, 279 (54.7%) were male. 63.5% of the responders were less than 65 years old, 26.3% were between 65\u0026ndash;74 years old and 6.3% were between 75\u0026ndash;84 years old, and 2% were greater than 84 years old. Clinical characteristics of patients were given in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Mean scores (SD) of QoR-15 was 127.2 (22.9) ranging from 4 to 150. Box-plots of QoR-15 scores at each time point were presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The percentage of patients achieving the highest possible QoR-15 score at the different time points were: preoperative (12.9%, n\u0026thinsp;=\u0026thinsp;66), post-operative 24 h (0.6%, n\u0026thinsp;=\u0026thinsp;3). It is seen in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e that there is no problem in terms of floor and ceiling effects. For these effects are considered to be present if more than 15% of the patients achieved the lowest or highest possible score, respectively [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The mean time taken to complete the postoperative 24 h QoR-15 score in a subset of patients (n\u0026thinsp;=\u0026thinsp;15) was 2.7 (1\u0026ndash;7) min.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical characteristics of patients for categorical variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eGroups\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eColorectal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e246(50.72)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHepatopancreaticobiliary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e89(18.35)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUpper GI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83(17.11)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBariatric surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e63(12.99)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e279(54.71)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e231(45.29)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e335(65.69)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65\u0026ndash;74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e134(26.27)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75\u0026ndash;84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31(6.08)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10(1.96)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eASA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e177(36.72)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e218(45.23)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e85(17.63)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2(0.41)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe distribution of our patients in terms of categorical variables is also summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The comparison results of QoR15 scores for all time points in terms of patient clinical parameters are given in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. No difference was observed in gender distribution of the patients. However, there were difference regarding the ASA score and the type of surgery.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical characteristics of patients regarding QoR15T scores\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eQoR-pre\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eQoR-P1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eQoR-P7\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eQoR-P30\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eGroups\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eColorectal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e127,27\u0026thinsp;\u0026plusmn;\u0026thinsp;22,74\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e99,47\u0026thinsp;\u0026plusmn;\u0026thinsp;27,56\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e125,8\u0026thinsp;\u0026plusmn;\u0026thinsp;19,32\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e135,72\u0026thinsp;\u0026plusmn;\u0026thinsp;14,98\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eHepatopancreaticobiliary\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e131,15\u0026thinsp;\u0026plusmn;\u0026thinsp;17\u003csup\u003e\u003cb\u003ebc\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e99,25\u0026thinsp;\u0026plusmn;\u0026thinsp;21,19\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e122,14\u0026thinsp;\u0026plusmn;\u0026thinsp;19,57\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e133,42\u0026thinsp;\u0026plusmn;\u0026thinsp;17,66\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eUpper GI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e119,06\u0026thinsp;\u0026plusmn;\u0026thinsp;29,71\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93,04\u0026thinsp;\u0026plusmn;\u0026thinsp;27,61\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e122,35\u0026thinsp;\u0026plusmn;\u0026thinsp;20,23\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e133,09\u0026thinsp;\u0026plusmn;\u0026thinsp;19,61\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eBariatric Surgery\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e136,79\u0026thinsp;\u0026plusmn;\u0026thinsp;14,02\u003csup\u003e\u003cb\u003ec\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e114,83\u0026thinsp;\u0026plusmn;\u0026thinsp;17,87\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e137,29\u0026thinsp;\u0026plusmn;\u0026thinsp;9,99\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e144,61\u0026thinsp;\u0026plusmn;\u0026thinsp;7,12\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eMale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e127,07\u0026thinsp;\u0026plusmn;\u0026thinsp;25,31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e99,51\u0026thinsp;\u0026plusmn;\u0026thinsp;27,67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e125,3\u0026thinsp;\u0026plusmn;\u0026thinsp;20,64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e137,05\u0026thinsp;\u0026plusmn;\u0026thinsp;15,81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eFemale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e127,28\u0026thinsp;\u0026plusmn;\u0026thinsp;19,69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100,63\u0026thinsp;\u0026plusmn;\u0026thinsp;23,82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e126,44\u0026thinsp;\u0026plusmn;\u0026thinsp;17,27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e134,65\u0026thinsp;\u0026plusmn;\u0026thinsp;17,43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,979\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,843\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,705\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,181\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eASA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e128,65\u0026thinsp;\u0026plusmn;\u0026thinsp;22,24\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e103,47\u0026thinsp;\u0026plusmn;\u0026thinsp;25,39\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e128,77\u0026thinsp;\u0026plusmn;\u0026thinsp;17,03\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e138,84\u0026thinsp;\u0026plusmn;\u0026thinsp;12,95\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e130,67\u0026thinsp;\u0026plusmn;\u0026thinsp;19\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e102,01\u0026thinsp;\u0026plusmn;\u0026thinsp;24,45\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e126,93\u0026thinsp;\u0026plusmn;\u0026thinsp;19,64\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e135,92\u0026thinsp;\u0026plusmn;\u0026thinsp;16,51\u003csup\u003e\u003cb\u003eab\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118,67\u0026thinsp;\u0026plusmn;\u0026thinsp;29,78\u003csup\u003e\u003cb\u003eab\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88,29\u0026thinsp;\u0026plusmn;\u0026thinsp;28,51\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e117,71\u0026thinsp;\u0026plusmn;\u0026thinsp;20,28\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e131,79\u0026thinsp;\u0026plusmn;\u0026thinsp;19,94\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99\u0026thinsp;\u0026plusmn;\u0026thinsp;50,91\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e86\u0026thinsp;\u0026plusmn;\u0026thinsp;NA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e106\u0026thinsp;\u0026plusmn;\u0026thinsp;NA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,014\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;65\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e127,42\u0026thinsp;\u0026plusmn;\u0026thinsp;22,11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e99,74\u0026thinsp;\u0026plusmn;\u0026thinsp;26,15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e127,33\u0026thinsp;\u0026plusmn;\u0026thinsp;17,42\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e136,64\u0026thinsp;\u0026plusmn;\u0026thinsp;16,62\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e65\u0026ndash;74\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e127,9\u0026thinsp;\u0026plusmn;\u0026thinsp;23,52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e102,39\u0026thinsp;\u0026plusmn;\u0026thinsp;24,51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e124,84\u0026thinsp;\u0026plusmn;\u0026thinsp;21,34\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e135,48\u0026thinsp;\u0026plusmn;\u0026thinsp;14,78\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e75\u0026ndash;84\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e124,97\u0026thinsp;\u0026plusmn;\u0026thinsp;26,61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e96,93\u0026thinsp;\u0026plusmn;\u0026thinsp;28,4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e117,93\u0026thinsp;\u0026plusmn;\u0026thinsp;21,23\u003csup\u003e\u003cb\u003eab\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e134,96\u0026thinsp;\u0026plusmn;\u0026thinsp;18,58\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e\u0026gt;\u0026thinsp;85\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e115,6\u0026thinsp;\u0026plusmn;\u0026thinsp;29,08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85,5\u0026thinsp;\u0026plusmn;\u0026thinsp;29,79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e110,67\u0026thinsp;\u0026plusmn;\u0026thinsp;29,26\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e117\u0026thinsp;\u0026plusmn;\u0026thinsp;27,86\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,390\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,261\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0,004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,020\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003csup\u003e\u003cb\u003ea,b,c and ab\u003c/b\u003e\u003c/sup\u003e; The means shown with the same index are statistically the same with each other, while the others are statistically different (p\u0026thinsp;\u0026lt;\u0026thinsp;0.005).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSpearman's correlation coefficient was used to examine the relationships of variables such as age, height, weight, ASA score, operation time, and length of stay with the QoR15 score (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRelationships of variables versus to QoR\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003cp\u003eGroups\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSurgery\u003c/p\u003e \u003cp\u003eDuration\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePostop\u003c/p\u003e \u003cp\u003eLenght of Stay\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eASA \u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSize\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eKilo\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eTS_QoR_0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003er\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0,016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0,157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0,080\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0,222\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,483\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0,002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,078\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e510\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e377\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e402\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e482\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e481\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e481\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eTS_QoR_1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003er\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0,064\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0,16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0,153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0,17\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,933\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,804\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e494\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e366\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e391\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e468\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e467\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e466\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eTS_QoR_2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003er\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0,105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0,116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0,254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0,179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0,187\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0,019\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0,025\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e502\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e375\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e476\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e475\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e474\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eTS_QoR_3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003er\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0,091\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0,171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0,245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0,102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0,255\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0,003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,042\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e419\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e321\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e396\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e393\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e392\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eA negative correlation was found with postoperative length of stay and ASA scores. Although statistically significant, this relationship was expressed with a small correlation coefficient. Similarly, a low but significant correlation was calculated between weight and QoR scores.\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the change in QoR15 scores taken at 4 different time points. Accordingly, the change over time was found to be significant and Post-hoc multiple comparison tests showed that; the difference between all possible paired time point comparisons is statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Also, it was clearly seen that the median score of the postoperative 1st day was lower than all the others.\u003c/p\u003e \u003cp\u003eThe Cronbach\u0026rsquo;s α coefficient of the pre-operative QoR-15 and post-operative QoR-15 were 0.896 and 0.888, respectively. Corrected item-total correlation coefficients were changing from 0.46 to 0.75 for pre-operative QoR-15 and from 0.171 to 0.895 for post-operative QoR-15. Inter-dimension and item-to-total dimension correlation coefficients at pre-operative time point were given in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInteritem Correlation Matrix for the QoR-15\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"16\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQoR15 \u003c/p\u003e \u003cp\u003eItem\u003c/p\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal \u003c/p\u003e \u003cp\u003eQoR15 \u003c/p\u003e \u003cp\u003eScore\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c15\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c16\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e 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\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e12\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e13\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e14\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e15\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"16\"\u003eQuality of recovery (QoR)-15 items.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"16\"\u003e\u003cb\u003e1\u003c/b\u003e : able to breathe easily; \u003cb\u003e2\u003c/b\u003e : been able to enjoy food; \u003cb\u003e3\u003c/b\u003e : feeling rested; \u003cb\u003e4\u003c/b\u003e : have had a good sleep; \u003cb\u003e5\u003c/b\u003e : able to look after personal toilet and hygiene unaided; \u003cb\u003e6\u003c/b\u003e : able to communicate with family or friends; \u003cb\u003e7\u003c/b\u003e : getting support from hospital doctors and nurses; \u003cb\u003e8\u003c/b\u003e : able to return to work or usual home activities; \u003cb\u003e9\u003c/b\u003e : feeling comfortable and in control; \u003cb\u003e10\u003c/b\u003e : having a feeling of general well-being; \u003cb\u003e11\u003c/b\u003e : moderate pain; \u003cb\u003e12\u003c/b\u003e : severe pain; \u003cb\u003e13\u003c/b\u003e : nausea or vomiting; \u003cb\u003e14\u003c/b\u003e : feeling worried or anxious; \u003cb\u003e15\u003c/b\u003e : feeling sad or depressed.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eCohen\u0026rsquo;s effect size and standardized response means (SRM) were calculated to measure degree of responsiveness for pre and post-operative time points (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). In this population, the total QoR-15 score had a Cohen effect size of 1.22 at pre-operative time point. Standardized response means of the total QoR-15 score were 1.18 at pre-operative time point. Also changes in health status and responsiveness are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCohen\u0026rsquo;s effect size and standardized response means\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePreop\u003c/p\u003e \u003cp\u003eMean Score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePost op\u003c/p\u003e \u003cp\u003eMean Score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean change\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%Change\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCohens\u003c/p\u003e \u003cp\u003eEffectsize\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSRM\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.88\u0026thinsp;\u0026plusmn;\u0026thinsp;1.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.25\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.63 (-1.88 to -1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.22\u0026thinsp;\u0026plusmn;\u0026thinsp;2.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;3.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-3.92 (-4.23 to -3.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.16\u0026thinsp;\u0026plusmn;\u0026thinsp;2.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.32\u0026thinsp;\u0026plusmn;\u0026thinsp;2.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.85 (-2.16 to -1.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.93\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.23\u0026thinsp;\u0026plusmn;\u0026thinsp;3.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.7 (-2.03 to -1.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ5\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.36\u0026thinsp;\u0026plusmn;\u0026thinsp;1.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.31\u0026thinsp;\u0026plusmn;\u0026thinsp;3.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-4.05 (-4.39 to -3.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e43.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ6\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.33\u0026thinsp;\u0026plusmn;\u0026thinsp;1.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.63\u0026thinsp;\u0026plusmn;\u0026thinsp;2.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.7 (-0.94 to -0.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ7\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.17\u0026thinsp;\u0026plusmn;\u0026thinsp;1.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.45 (-0.58 to -0.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ8\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.05\u0026thinsp;\u0026plusmn;\u0026thinsp;1.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.63\u0026thinsp;\u0026plusmn;\u0026thinsp;3.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-4.42 (-4.78 to -4.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ9\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.52\u0026thinsp;\u0026plusmn;\u0026thinsp;2.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.61\u0026thinsp;\u0026plusmn;\u0026thinsp;2.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.9 (-2.18 to -1.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ10\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.54\u0026thinsp;\u0026plusmn;\u0026thinsp;2.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.85\u0026thinsp;\u0026plusmn;\u0026thinsp;2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.69 (-1.96 to -1.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ11\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.99\u0026thinsp;\u0026plusmn;\u0026thinsp;2.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.33\u0026thinsp;\u0026plusmn;\u0026thinsp;2.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.67 (-2 to -1.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ12\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.54\u0026thinsp;\u0026plusmn;\u0026thinsp;3.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.48\u0026thinsp;\u0026plusmn;\u0026thinsp;3.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.05 (-1.37 to -0.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ13\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.22\u0026thinsp;\u0026plusmn;\u0026thinsp;3.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.41\u0026thinsp;\u0026plusmn;\u0026thinsp;3.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.81 (-1.15 to -0.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ14\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.35\u0026thinsp;\u0026plusmn;\u0026thinsp;2.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.05 (-0.24 to 0.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ15\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.45\u0026thinsp;\u0026plusmn;\u0026thinsp;2.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.48\u0026thinsp;\u0026plusmn;\u0026thinsp;2.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.04 (-0.27 to 0.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e127.17\u0026thinsp;\u0026plusmn;\u0026thinsp;22.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.02\u0026thinsp;\u0026plusmn;\u0026thinsp;25.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.15 (-29.2to -25.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe CFA run on the model with 2 factors and 15 items demonstrated acceptable CFI, TLI, RMSEA and met criteria for goodness fit, after applying modifications suggested by CFA (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). All factor loadings for each item and each model were presented in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e. Model 3 was significantly improved with acceptable CFI, TLI, RMSEA and AIC (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMaximum Likelihood Estimates and Factor Loadings\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEstimate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eS.E.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFactor Loadings\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysical well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.596\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysical well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.474\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.626\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysical well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.592\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.726\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysical well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.335\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.580\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysical well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.896\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.556\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysical well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.717\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.078\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.455\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysical well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.513\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.047\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.567\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysical well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.096\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.651\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysical well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.778\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.892\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysical well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.767\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.921\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMental well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.753\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMental well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.894\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMental well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.034\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.745\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMental well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.619\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.481\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eQoR-15-15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMental well being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.725\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.553\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eConfirmatory Factor Analysis: Goodness of Fit of the QR-15\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN of items\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e/df\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCFI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eTLI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRMSEA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAIC\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQR-15\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.962\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.950\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e321.266\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eRecovery after surgery is a complex process including not only physical well-being but also psychosocial status. Traditionally, postoperative success has been evaluated based on hospital stay, complication rates, and survival [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. However, this approach overlooks the patient's perspective, resulting in limited information for researchers and medical professionals. Therefore, a multidimensional recovery questionnaire, such as the QoR-15, has been developed and is now considered to have higher clinical value.\u003c/p\u003e \u003cp\u003eThe QoR-15 is a questionnaire that provides a more comprehensive assessment of the quality of the recovery period for postoperative patients. It focuses on five different areas that are crucial to a successful recovery: pain, physical comfort, physical independence, psychological support, and emotional state. By questioning patients in each of these areas, the QoR-15 provides a more complete picture of their recovery experience. So, unlike traditional methods, its most significant strength lies in offering a multifaceted integration instead of evaluating the patient based on a limited set of outcomes [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. By incorporating this questionnaire into clinical studies, researchers and medical professionals can gain a deeper understanding of the factors that contribute to a successful recovery and use this information to improve patient care.\u003c/p\u003e \u003cp\u003eThis study was conducted to assess the Turkish version of the QoR15 questionnaire. We found that QoR15T has good levels of validity, reliability, responsiveness and feasibility.\u003c/p\u003e \u003cp\u003eCFA showed a great goodness of fit and construct validity of QoR15T. The ability of QoR15T to discriminate the known determinants such as negative correlation with ASA score and length of stay, and positive correlation with weight supported the construct validity [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In addition, the significant difference between type of surgeries, which means the QoR15T scores altered regarding the extent of surgery, also confirmed the validity [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe Cronbach\u0026rsquo;s α coefficient of the pre-operative and post-operative QoR-15T were good and similar to the published literature [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR11 CR12\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Internal consistency reliability was calculated not only using Cronbach α but also with interitem correlation. Preoperative and postoperative item-total correlation coefficients showed that questions are relevant.\u003c/p\u003e \u003cp\u003eResponsiveness and Cohen\u0026rsquo;s effect size findings were excellent, and demonstrated that QoR15T can assess even small clinical alterations.\u003c/p\u003e \u003cp\u003eTo the best of our knowledge, there is only one other questionnaire (QoR40) which measures quality of recovery except the QoR15, and this is the main questionnaire which QoR15 is derived from. Cross-cultural adaptation and validation for both are achieved in several countries, and these studies reported that both are reliable, valid, and feasible [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR11 CR12\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. In addition, QoR15 is reported as a valuable tool to measure recovery regarding its ability to detect smallest changes in clinical trials [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn this section, we deem it appropriate to provide an elucidation in comparison to the article authored by \"Selvi O, et al.\" and published in 2022 [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. We contend that there exist significant disparities between their publication and our own study. Firstly, our study sample exclusively comprises patients undergoing elective major gastrointestinal surgery, and we conducted four distinct measurements (preoperative 1 and postoperative 3 times) for each individual within this cohort. Most notably, our research incorporates a rigorous statistical approach that encompasses confirmatory factor analysis (CFA), which enabled the evaluation of factor loadings, inter-item relationships, and fit statistics.\u003c/p\u003e \u003cp\u003eConcerning construct validity, we employed the maximum likelihood estimator for the calculation of factor loadings, thereby ensuring a robust and widely accepted estimation methodology. Additionally, our study presents an extensive examination of model fit through the provision of critical indices, namely CFA, RMSEA (Root Mean Square Error of Approximation), CFI (Comparative Fit Index), TFI (Tucker-Lewis Index), and Akaike Information Criterion (AIC). These indices collectively serve to gauge the extent to which our proposed measurement model aligns with the observed data.\u003c/p\u003e \u003cp\u003eOne of the limitations of this study is the selection of the patients only with the elective major abdominal surgeries. There were no patients underwent minor surgery or any operation from another specialty except general surgery included in the study. Although the sample size is more than enough, the low variability due to our selection should be considered. Another limitation is also there were no patients underwent emergency surgery. Therefore, there is a need for assessment of the QoR15T on several patient populations and in different settings. On the other hand, this was a multicentric study involving numerous hospitals in several cities around Turkey, which can be an indication of generalizability.\u003c/p\u003e \u003cp\u003eIn conclusion, measurement of the quality of a patient\u0026rsquo;s recovery period is an important and current subject. QoR15T, which is a unique tool and designed exactly for this measurement, is a reliable, valid, reproducible, and feasible questionnaire for the assessment of recovery, especially in major abdominal surgery patients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll outhors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConception:\u0026nbsp;\u003c/strong\u003eKaan Sunter, Kadir Yagiz Turker, Onur Ilkay Dincer, Burak Yavuz, Burak Kutlu.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDesign of the work:\u0026nbsp;\u003c/strong\u003eMehmet Ali Koc, Yusuf Sevim, Cemal Ensari, Ismail Cem Eray, Timucin Erol, Siyar Ersoz, Mehmet Ayhan Kuzu.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcquisition, analysis:\u0026nbsp;\u003c/strong\u003eCan Ates, Kaan Sunter, Kadir Yagiz Turker, Onur Ilkay Dincer, Burak Yavuz, Burak Kutlu.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInterpretation of data:\u0026nbsp;\u003c/strong\u003eCan Ates, Kaan Sunter, Kadir Yagiz Turker, Onur Ilkay Dincer, Burak Yavuz, Burak Kutlu.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWrote the main manuscript text:\u0026nbsp;\u003c/strong\u003eMehmet Ali Koc, Yusuf Sevim, Cemal Ensari, Ismail Cem Eray, Timucin Erol, Siyar Ersoz, Mehmet Ayhan Kuzu, Can Ates, Kaan Sunter, Kadir Yagiz Turker, Onur Ilkay Dincer, Burak Yavuz, Burak Kutlu.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePrepared figures and tables:\u0026nbsp;\u003c/strong\u003eKaan Sunter, Kadir Yagiz Turker, Onur Ilkay Dincer, Burak Yavuz, Burak Kutlu.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHave drafted the work or substantively revised it:\u0026nbsp;\u003c/strong\u003eMehmet Ali Koc, Yusuf Sevim, Cemal Ensari, Ismail Cem Eray, Timucin Erol, Siyar Ersoz, Mehmet Ayhan Kuzu.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAll authors reviewed the manuscript.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate Declaration:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by Ankara University Medical School Ethics Committee (i5-208-19)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Declaration:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analysed during the current study are not publicly available due confidentiality of patient data but are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Declaration:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eRajabiyazdi F, Alam R, Pal A, Montanez J, Law S, Pecorelli N, et al. Understanding the meaning of recovery to patients undergoing abdominal surgery. JAMA Surg. 2021 Aug 1;156(8):758-765. doi: 10.1001/jamasurg.2021.1557.\u003c/li\u003e\n \u003cli\u003eLee L, Tran T, Mayo NE, Carli F, Feldman LS. What does it really mean to \u0026ldquo;recover\u0026rdquo; from an operation? Surgery. 2014 Feb;155(2):211-6. doi: 10.1016/j.surg.2013.10.002.\u003c/li\u003e\n \u003cli\u003eMyles PS, Weitkamp B, Jones K, Melick J, Hensen S. Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth. 2000 Jan;84(1):11-5. doi: 10.1093/oxfordjournals.bja.a013366.\u003c/li\u003e\n \u003cli\u003eBost JE, Williams BA, Bottegal MT, Dang Q, Rubio DM. The 8-item short-form health survey and the physical comfort composite score of the quality of recovery 40-item scale provide the most responsive assessments of pain, physical function, and mental function during the first 4 days after ambulatory knee surgery with regional anesthesia. Anesth Analg. 2007 Dec;105(6):1693-700. doi: 10.1213/01.ane.0000287659.14893.65.\u003c/li\u003e\n \u003cli\u003eBuchanan FF, Myles PS, Cicuttini F. Effect of patient sex on general anaesthesia and recovery. Br J Anaesth. 2011 Jun;106(6):832-9. doi: 10.1093/bja/aer094.\u003c/li\u003e\n \u003cli\u003eLeslie K, Troedel S, Irwin K, Pearce F, Ugoni A, Gillies R, et al. Quality of recovery from anesthesia in neurosurgical patients. Anesthesiology. 2003 Nov;99(5):1158-65. doi: 10.1097/00000542-200311000-00024.\u003c/li\u003e\n \u003cli\u003eMyles PS, Hunt JO, Fletcher H, Solly R, Woodward D, Kelly S. Relation between quality of recovery in hospital and quality of life at 3 months after cardiac surgery. Anesthesiology. 2001 Oct;95(4):862-7. doi: 10.1097/00000542-200110000-00013.\u003c/li\u003e\n \u003cli\u003eStark PA, Myles PS, Burke JA. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology. 2013 Jun; 118(6):1332-40. doi: 10.1097/ALN.0b013e318289b84b.\u003c/li\u003e\n \u003cli\u003eKleif J, Waage J, Christensen KB, G\u0026ouml;genur I. Systematic review of the QoR-15 score, a patient-reported outcome measure measuring quality of recovery after surgery and anaesthesia. Br J Anaseth. 2018 Jan;120(1):28-36. doi: 10.1016/j.bja.2017.11.013.\u003c/li\u003e\n \u003cli\u003eKim D, Kim JK, Yeo J. Translation and validation of the Korean version of the postoperative quality of recovery score QoR-15. Biomed Res Int. 2020 Oct 9:2020:3456234. doi: 10.1155/2020/3456234.\u003c/li\u003e\n \u003cli\u003eDemumieux F, Ludes PO, Diemunsch P, Bennett-Guerrero E, Lujic M, Lefebvre F, et al. Validation of the translated quality of recovery-15 questionnaire in a French-speaking population. Br J Anaesth. 2020 Jun;124(6):761-767. doi: 10.1016/j.bja.2020.03.011.\u003c/li\u003e\n \u003cli\u003eKleif J, Edwards HM, Sort R, Vilandt J, G\u0026ouml;genur I. Translation and validation of the Danish version of the postoperative quality of recovery score QoR-15. Acta Anaesthesiol Scand. 2015 Aug; 59(7):912-20. doi:10.1111/aas.12525.\u003c/li\u003e\n \u003cli\u003eKahl U, Gebhardt N, Brodersen K, Kainz E, Schirren L, Yu Y, et al. Validation of a translated quality of recovery-15 questionnaire in German patients undergoing elective noncardiac surgery. Br J Anaesth. 2021 Nov;127(5):e161-e163. doi: 10.1016/j.bja.2021.07.026.\u003c/li\u003e\n \u003cli\u003eTravakol M, Dennick R. Making sense of Cronbach\u0026rsquo;s alpha. Int J Med Educ. 2011 Jun 27;2:53-55. doi: 10.5116/ijme.4dfb.8dfb.\u003c/li\u003e\n \u003cli\u003eBland JM, Altman DG. Cronbach\u0026rsquo;s alpha. BMJ. 1997 Feb 22;314(7080):572. doi: 10.1136/bmj.314.7080.572.\u003c/li\u003e\n \u003cli\u003eStreiner DL, Norman GR. Health measurement scales: a practical guide to their development and use. Oxford University Press; 2008. doi: 10.1093/acprof:oso/9790199231881.001.0001.\u003c/li\u003e\n \u003cli\u003eXia Y, Yang Y. RMSEA, CFI, and TLI in structural modeling with ordered categorical data: the story they tell depends on the estimation methods. Behav Res Methods. 2019 Feb;51(1):409-428. doi: 10.3758/s13428-018-1055-2.\u003c/li\u003e\n \u003cli\u003eRose M, Bjorner JB, Becker J, Fries JF, Ware JE. Evaluation of a preliminary physical function item bank supported the expected advantages of the patient-reported outcomes measurement information system (PROMIS). J Clin Epidemiol. 2008 Jan;61(1):17-33. doi:10.1016/j.jclinepi.2006.06.025.\u003c/li\u003e\n \u003cli\u003ePedhazur EJ. Multipl regression in behavioral research: an explanation and prediction. New York: Holt, Rinehart \u0026amp; Winston; 1997.\u003c/li\u003e\n \u003cli\u003eGorsuch RL. Factor Analysis. \u0026lsquo;nd ed. Hillsdale, NJ: Lawrance Erlbaum Associates; 1983.\u003c/li\u003e\n \u003cli\u003eNunnally JC. Psychometric Theory. 2\u003csup\u003end\u003c/sup\u003e ed. New York: McGraw-Hill; 1978.\u003c/li\u003e\n \u003cli\u003eTerwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007 Jan;60(1):34-42. doi: 10.1016/j.jclinepi.2006.03.012.\u003c/li\u003e\n \u003cli\u003eMyles PS, Shulman MA, Reilly J, Kasza J, Romero L. Measurement of quality of recovery after surgery using the 15-item quality of recovery scale: a systematic review and meta-analysis. Br J Anaesth. 2022 Jun 1;128(6):1029-1039. doi: 10.1016/j.bja.2022.03.009.\u003c/li\u003e\n \u003cli\u003eMyles PS. More than just morbidity and mortality \u0026ndash; quality of recovery and long-term functional recovery after surgery. Anaesthesia. 2020 Jan;75 Suppl 1:e143-e150. doi: 10.1111/anae.14786.\u003c/li\u003e\n \u003cli\u003eS\u0026aacute; AC, Sousa G, Santos A, Santos C, Abelha FJ. Quality of recovery after anesthesia: validation of the Portuguese version of the \u0026ldquo;Quality of recovery 15\u0026rdquo; questionnaire. Acta Med Port. 2015 Sep-Oct;28(5):567-574. doi:10.20344/amp.6129.\u003c/li\u003e\n \u003cli\u003eKaraman S, Arici S, Dogru S, Karaman T, Tapar H, Kaya Z, et al. Validation of the Turkish version of the quality of recovery-40 questionnaire. Health Qual Life Outcomes. 2014 Jan15;12:8. doi: 10.1186/1477-7525-12-8.\u003c/li\u003e\n \u003cli\u003eSelvi O, Azizoglu M, Temel G, Tulgar S, Chitneni A, Cinar EN, et al. Translation and validation of the Turkish version of the quality of postoperative recovery score QoR-15: a multi-centred cohort study. Turkish J Anaesthesiol Reanim. 2022 Dec 1;50(6):443-448. doi: 10.5152/TJAR.2022.21417.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"major abdominal surgery, patient-reported outcome, QoR-15, quality of recovery, validation","lastPublishedDoi":"10.21203/rs.3.rs-4625303/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4625303/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eAim\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe aim of this study was to perform a cross-cultural adaptation and psychometric evaluation of the Quality of Recovery 15 questionnaire in Turkey.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe QoR-15 was translated into Turkish through a rigorous process involving independent translations, consensus, back-translation, and review. The questionnaire was administered to patients undergoing elective major gastrointestinal surgery preoperatively and on postoperative days 1, 7, and 30. Reliability was assessed using Cronbach's α and intra-class correlation coefficient. Construct validity was evaluated through confirmatory factor analysis, and responsiveness was analyzed using Cohen's effect size and standardized response mean.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA total of 510 patients participated in the study. The Turkish version of QoR-15 (QoR-15T) demonstrated good internal consistency with Cronbach's α of 0.896 and 0.888 for preoperative and postoperative administrations, respectively. Intra-class correlation coefficient values indicated good reliability. Confirmatory factor analysis confirmed the construct validity of QoR-15T. QoR-15T showed responsiveness to changes in health status, with Cohen's effect size and standardize response mean indicating its ability to detect clinically important changes.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe Turkish version of QoR-15 (QoR-15T) is a reliable, valid, and responsive questionnaire for assessing the quality of recovery in patients undergoing major abdominal surgery. Its ability to capture patients' perspectives and multidimensional aspects of recovery makes it a valuable tool for clinical and research purposes.\u003c/p\u003e","manuscriptTitle":"Validation of the Turkish Version of the “Quality of Recovery 15 (QoR-15)” Questionnaire","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-19 19:31:45","doi":"10.21203/rs.3.rs-4625303/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e91c6cd8-f57b-4df9-865c-5853fc1a5b2f","owner":[],"postedDate":"July 19th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":34803824,"name":"Health sciences/Health care"},{"id":34803825,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2025-01-08T08:38:51+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-19 19:31:45","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4625303","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4625303","identity":"rs-4625303","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}