Validation of MENTOR Tool to Describe Bowel Dysfunction in Inpatient Rehabilitation Setting

People living with spinal cord injury (SCI) rate neurogenic bowel dysfunction (NBD) as one of the biggest daily challenges. Currently, no validated clinical decision-making tool exists to guide NBD management during the acute/subacute period following SCI, a time highlighted by frequent complications and rapid clinical changes. Previously, the Monitoring Efficacy of NBD Treatment On Response (MENTOR) tool was developed to facilitate shared decision-making between the clinician and the person living with chronic SCI in bowel management.

To assess MENTOR tool validity in an acute/subacute setting.

Prior to discharge from inpatient rehabilitation, the MENTOR tool was completed by a study member via interview, followed immediately by a clinical evaluation by a study clinician who was masked to the MENTOR results. Concordance between the MENTOR tool and the clinical evaluation was assessed using percent agreement calculations.

Two hundred forty participants were enrolled. Significant differences were observed in relation to demographic and clinical factors between various SCI categories and clinical sites. Overall concordance between MENTOR and clinical recommendations was 40.6%. Regardless of factors such as satisfaction score, presence of special attention symptoms, or MENTOR results, "no change" was the most common clinician evaluation.

Similar concordance for using the MENTOR tool as a clinical decision-making tool in the acute/subacute population as compared to the chronic population was not demonstrated. However, the MENTOR tool may be useful as a screening tool to determine whether a clinician assessment is required.