Development and validation of a postoperative nausea and vomiting intensity scale
- 1 February 2010
- journal article
- research article
- Published by Elsevier BV in British Journal of Anaesthesia
- Vol. 104 (2), 158-166
- https://doi.org/10.1093/bja/aep370
Abstract
Postoperative nausea and vomiting (PONV) is common and of concern to patients and clinicians. The effect of PONV can range from trivial and transient to major clinical importance, and it is unclear which of its characteristics lead to discomfort and distress.We first enrolled 180 participants (patients, family members, nurses, doctors) to identify the characteristics of clinically important PONV, and from these data developed a measurement scale. We then evaluated the scale in a further 163 patients reporting PONV. Validity, reliability, and responsiveness of the PONV Intensity Scale were tested using psychometric techniques.Most participants agreed that three or more vomits, and greater nausea severity and duration, were key factors in defining clinically important PONV. These data were used to derive a PONV Intensity Scale and a score to define clinically important PONV. The scale identified 29 patients (18%) as having clinically important PONV. Patients with clinically important PONV had a poorer quality of recovery (P<0.0005) and needed twice as much antiemetic treatment (P<0.0005). The scale was strongly associated with PONV consequences and complications, with odds ratios ranging from 6.0 to 31 (all P<0.0005). The scale had excellent reproducibility (intraclass correlation 0.99, P<0.0005). The scale could reliably reflect a clinically important change in health status (effect size 0.82, P<0.0005).The PONV Intensity Scale is a valid, reliable, and responsive measure of clinically important PONV.Keywords
This publication has 31 references indexed in Scilit:
- Postoperative nausea and vomiting following inpatient surgeries in a teaching hospital: a retrospective database analysisCurrent Medical Research and Opinion, 2006
- Postoperative Nausea and Vomiting in Regional AnesthesiaAnesthesiology, 2003
- Massive Subcutaneous Emphysema and Sudden Airway Compromise After Postoperative VomitingAnesthesia & Analgesia, 1999
- Which Clinical Anesthesia Outcomes Are Important to Avoid? The Perspective of PatientsAnesthesia & Analgesia, 1999
- Development and Psychometric Testing of a Quality of Recovery Score After General Anesthesia and Surgery in AdultsAnesthesia & Analgesia, 1999
- Antiemetic efficacy of ondansetron with patient-controlled analgesiaAnaesthesia, 1996
- Differences in nausea, vomiting, and retching between younger and older outpatients receiving cancer chemotherapyCancer Nursing, 1996
- Measuring change over time: Assessing the usefulness of evaluative instrumentsJournal of Chronic Diseases, 1987
- The Hospital Anxiety and Depression ScaleActa Psychiatrica Scandinavica, 1983
- Coefficient alpha and the internal structure of testsPsychometrika, 1951