Neurogenic bowel dysfunction score in spinal cord-injured patients: translation and validation of the Dutch-language NBD score.

Abstract

This is a prospective validation study. The neurogenic bowel dysfunction (NBD) score is a widely used symptom-based questionnaire evaluating bowel dysfunction and its impact on quality of life (QoL) in spinal cord-injured patients. This study aimed to translate and validate a Dutch-language NBD score in patientswith SCI. Patientswith SCI visiting the urology department or general practitioner (GP) in Rotterdam, the Netherlands. Standardized guidelines were followed for the translation and validation process of the NBD score. Adult patientswith SCI visiting our urology department were asked to participate by filling in a set of questionnaires: the NBD score, the Fecal Incontinence Quality of Life scale (FIQL), the Fecal Incontinence Severity Index (FISI), and the European Quality of life 5-Dimension 3-Level questionnaire (EQ-5D-3L) at baseline and 1-2 weeks afterward. A control group recruited at a GP office completed the questionnaires once. The following measurement properties were evaluated: content validity, internal consistency, reproducibility, criterion-, and construct validity. Fifty-eight patients and 50 references were included. Content validity was adequate, internal consistency was moderate (Cronbach's alpha 0.56 and 0.30) and reproducibility was adequate (ICC 0.87). Criterion validity was confirmed; NBD score correlated significantly with the FIQL, FISI, and EQ-5D-3L. NBD scores in the patient group were significantly higher than in references, demonstrating good construct validity. The Dutch-language version of the NBD score showed moderate to good measurement properties, and therefore is a reliable tool to measure bowel dysfunction in patientswith SCI. We recommend standardized usage of this questionnaire for clinical evaluation and research purposes.