Personal hygiene, environmental conditions, and toilet use of children in primary schools: A cohort study

Shkalim Zemer, Vered; Cohen, Herman Avner; Richenberg, Yael; Gerstein, Maya; Atias, Ifat; Gur, Shmuel; Laks, Yoseph; Levinsky, Yoel; Dvir, Or; Brown, Iris; Cohen, Moriya; Ben Meir, David

doi:10.1016/j.jpurol.2023.06.004

Cited by 4 publications

(2 citation statements)

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“…Both Vernon and Lundblad saw holding behaviours increase with increasing grade level, and holding behaviours decrease when students had access to a bathroom in their class 16,19 . Lack of basic hygiene, including unclean accommodations, a lack of toilet seats, toilet paper, paper towels, and hand soap have been reported in multiple studies as well which leads to further avoidance of toileting at school 8,10,11,13,16,19–21 . These studies were conducted worldwide which shows that despite school systems being highly variant, globally paediatric patients with LUTD have similar issues with the school environment.…”

Section: Discussionmentioning

confidence: 98%

“…Existing studies have shown that school systems do not promote LUT health, and teachers and school nurses need improved education regarding LUTD and first‐line treatment options 7–22 . Ko et al surveyed elementary school teachers about their understanding of LUT health, activities that promote LUT health, and classroom rules around toileting.…”

Section: Discussionmentioning

confidence: 99%

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Parental perception of paediatric lower urinary tract dysfunction during the COVID‐19 shutdown

Leroy,

Hutchison,

Kern

2023

Int J of Uro Nursing

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We aimed to investigate how staying at home and stress from the pandemic shutdown impacts lower urinary tract symptoms in paediatric patients. The COVID‐19 pandemic shut down most of the world in March 2020. In the state of Virginia, a mandatory Stay‐at‐Home order was issued requiring students to participate in school from home. Paediatric patients often have difficulty complying with standard urotherapy while at school, with timed voiding being particularly hard to maintain. To our knowledge, only one other study investigated lower urinary tract dysfunction (LUTD) in children during the COVID‐19 shutdown. This study compared lower urinary tract symptoms (LUTS) in paediatric patients seen in their bladder dysfunction clinic for their initial 6 months of treatment during the shutdown to patients treated before the shutdown. Of the studies available that examine how the school environment effects lower urinary tract symptoms, all show a lack of education among teachers and school nurses, classroom rules that oppose adherence to standard urotherapy, and facilities that are often inadequate and unhygienic. Stress is known to have a bidirectional effect on LUTD, so we also investigated the effect of parental stress from the shutdown on LUTD. Parents of patients followed in our bladder dysfunction clinic were given a survey to evaluate the use of a timed voiding regimen, improvement in LUTS and perceived parental stress during the COVID shut down of 2020. Spearman's rank correlation coefficient (rho) was calculated to measure the correlation of the survey responses. We received 42 responses from 202 surveys administered (20.8%). Only 21.4% of respondents maintained timed voiding while at home, despite 78.6% indicating improved bathroom access. A small number (4.8%) indicated total resolution of voiding symptoms. Half of the respondents (50%) indicated some degree of improvement in LUTS, though almost the entire remaining population saw no change in their symptoms (42.9%). Only a very small number indicated slightly worse LUTS (7.1%) and none indicated that symptoms were much worse. There was no correlation between dysfunctional voiding scoring system (DVSS) scores and improvement in bathroom access. There was a moderate correlation between perceived parental stress and their child's DVSS score, Rho = 0.54 p = 0.0002. Additionally, DVSS scores were weakly, negatively correlated with improvement in LUTS, Rho = −0.3 p = 0.047. Despite the majority of parents perceiving increased access to bathrooms during the Stay‐at‐Home order, a minority of patients were maintained on timed voiding regimens while at home. About half of parents still indicated some degree of improvement in their child's LUTS. There was a correlation between parental stress and their child's dysfunctional voiding score. This survey highlights that the relationship between timed voiding, bathroom access, and severity of LUTS is complex and compliance with timed voiding remains a challenge to adhere to.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%