The Development And Evaluation Of The Perioperative Recovery Scale For The Integrated Traditional And Western Medicine

BackgroundIn recent years, the quality of life as a new clinical efficacy evaluation system, are more and more attention in surgical areas, more and more surgeons evaluate the quality of life as one of the indicators in the report the results of their treatment. Surgery removes the tumor, but also brings different levels of pain and physiological and psychological changes, such as postoperative pain, postoperative fatigue, gastrointestinal dysfunction, and so on. Western medicine treatment is often limited, this is the advantages of Chinese medicine. Therefore, it may improve the therapeutic effect better to take of integrated traditional Chinese and western medicine treatment in perioperative. And there is a high degree of consistency between the traditional Chinese medicine theory and clinical treatment systems and the assessment of quality of life. Therefore, the Clinical Evaluation of integrative medicine system after surgery will get much attention, it has important practical significance to develop the Perioperative Recovery Scale for Integrated Traditional and Western Medicine.ObjectivesTo select the formed item pool of the perioperative recovery scale with the clinical characteristics of integrative traditional and western medicine, and the formation of scale through the preliminary evaluation. and to prepare for the assessment of this scale and the formation of final scale. An objective, comprehensive and generic instrument used to measure the patient-reported outcome (PRO) in perioperative recovery will be developed subsequently. MethodsAccording to the development program of the international scale, this research mainly adopts expert consultation and patient scene investigation method.1.Experts consultationThis study were conducted twice consulting experts, including surgery, gynecology, orthopedics, clinical epidemiology and statistics experts. The first expert consultation mainly in the chief doctors to complete the preliminary selection for the scale items, the second consultation in clinical doctors to select again for the items which have been selected initially. Research team analyzed the results of two consultations, and have the analysis of the response scales for the answers to the items, forming a scale version of the preliminary investigation.2. The patient scene investigationWe investigated the guangdong hospital of traditional Chinese medicine for surgery, gynecology, orthopaedic patients in strict accordance with the diagnostic criteria, inclusion and exclusion standard, and analyzed the survey data to complete the selection of items and the scale evaluation. the selection methods include discrete trends, correlation coefficient, principal component and factor analysis and stepwise multiple regression, etc, mainly for the evaluation scale reliability and validity of the evaluationresultAfter the first round of expert consultation, to select the forming 122 items, the remaining 42 items. The second round of expert consultation is formed 42 entries on the selection again and finally formed 25 items, Including physical function, mental function, activity, pain and the general health perceptions of a total of five dimensions, which 13 items were grouped under the dimensions of physical function,5 under the mental function,2 under the activity,2 under the pain,3 under the general health perceptions. After the analysis of response scales, we selected 20 descriptors including capacity, frequency, intensity, and evaluation, which are suitable for the scale. We investigated 50 patients in orthopedics, surgery and gynecology,21 patients had been repeated measurements and the time is 24 to 48 hours (mostly within 24 hours), at last we collected 71 cases.we delected 2 items and remained 23 items after the analysis of the selection items. After the initial evaluation scale, test-retest reliability was 0.727, split-half reliability was 0.739, Cronbach coefficient scale factor of 0.821, greater than 0.8 to prove the reliability is good,It has good content validity in validity evaluation, The results of construct validity have some differences with the clinical reality.ConclusionThe results show that the results met the study anticipated targets, the Scale Evaluation shows that the reliability and content validity are relatively good, the results of construct validity have some differences with the clinical reality, needing large sample study for validation, and quite different part of the data may be related that survey sample was smaller, or the patient's severity of disease, or the size of surgery and so on.