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Identifying and Classifying Quality of Life Tools for Assessing Neurogenic Bowel Dysfunction After Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2019 · DOI: 10.1310/sci18-00019 · Published: August 7, 2018

Spinal Cord InjuryParticipationGastroenterology

Simple Explanation

This research identifies and classifies tools used to measure the impact of neurogenic bowel dysfunction (NBD) on the quality of life (QoL) for individuals with spinal cord injury (SCI). It categorizes these tools as either objective (societal viewpoint) or subjective (personal viewpoint) based on Dijkers’ theoretical QoL framework. The study found 13 tools that assess the influence of NBD on QoL in SCI patients. The Health Utility Index (HUI-III) was identified as the only tool providing data on “QoL as utility,” while the validated NBD score was the only condition-specific tool assessing QoL as “subjective well-being.” The review emphasizes the importance of selecting appropriate QoL tools to accurately measure individual progress and treatment effects on QoL, which can inform practice and policy related to resource allocation for bowel care post SCI.

Study Duration
Not specified
Participants
Systematic review of 35 studies
Evidence Level
Systematic Review

Key Findings

  • 1
    Thirteen QoL outcome tools were identified, five objective and eight subjective, used in studies assessing the influence of NBD on QoL in SCI.
  • 2
    The Health Utility Index (HUI-III) was the only identified tool that provided data on “QoL as utility” regarding the impact of NBD.
  • 3
    The NBD score was identified as the only condition-specific tool to assess QoL as “subjective well-being.”

Research Summary

This systematic review aimed to identify and classify outcome measures assessing the influence of neurogenic bowel dysfunction (NBD) on quality of life (QoL) and related constructs after spinal cord injury (SCI). The review identified 13 QoL outcome tools (5 objective, 8 subjective) and classified them according to Dijkers’s framework, summarizing their psychometric properties and sensitivity to NBD. The study highlights the need for researchers and clinicians to use both objective and subjective QoL tools to comprehensively assess the impact of NBD on QoL in SCI and inform clinical practice and resource allocation.

Practical Implications

Informed Practice

Clinicians can use the identified and classified QoL tools to assess the impact of NBD on QoL in patients with SCI, guiding treatment decisions.

Resource Allocation

The objective QoL measures, especially the HUI-III, can inform decision-makers on how to allocate funds and resources for various interventions related to bowel care post-SCI.

Treatment Advancements

Advancing treatments for bowel management after SCI have the potential to improve participation and QoL, and the use of condition-specific validated outcome tools is essential for measuring individual progress and treatment effects.

Study Limitations

  • 1
    Samples with <50% of individuals with SCI were excluded, which may introduce bias in the results.
  • 2
    Further, information on cross-cultural applications were not available.
  • 3
    It is also possible that we did not identify all relevant articles for inclusion.

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