A measure of quality of life after abdominal surgery

Objectives: To develop a reliable and valid measure of short-term quality of life after abdominal surgery. Summary background data: A major limitation of clinical trials evaluating laparoscopic surgical procedures has been the lack of a measure of short-term quality of life after abdominal surgery. Methods: We used existing health status measures, focus groups, and semi-structured patient interviews to generate a prototype questionnaire of 51 items, which was administered to patients within 2 weeks after an abdominal surgical procedure. We used structural equations modeling to reduce the number of items, retaining the three items with the highest factor loadings on each of the factors that accounted for one or more eigenvalue. Results: We administered the prototype questionnaire to 500 patients (mean age [SD] 53.4 [16.0], 51.4% male, 73.0% inpatient) at a mean 4.1 days after an abdominal surgical procedure. Item reduction yielded an 18-item measure with 6 sub-scales. The final instrument demonstrated good model fit in relation to our hypothesized factors (root mean square error of approximation 0.085, goodness-of-fit index 0.89). Conclusions: We developed a reliable and valid 18-item, 6-subscale measure of health-related quality of life after abdominal surgery, for use as an outcome measure in studies comparing laparoscopic and conventional abdominal surgery.