The impact of motivational therapy in the management of enuretic children

Ferrara, Pietro; Amodeo, Maria Elisa; Sbordone, Annamaria; Ianniello, Francesca; Verrotti, Alberto; Petitti, Tommasangelo; Ruggiero, Antonio

doi:10.5152/tud.2018.50329

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…Saarikovsky et al reported an improvement after voiding school (60% of children with daytime incontinence, and 50% of children with enuresis showed > 50% decrease in wetting episodes, and 22% children became completely dry) [20]. In contrast, Ferrara et al found that the effect of motivational therapy associated with Desmopressin on wet nights were enhanced, but not statistically significant [21]. Less promising results of voiding school in current literature might be explained by: different programs of voiding schools, different selection of patients, not recognizing enuresis as a problem, i.e.…”

Section: Discussionmentioning

confidence: 98%

Low compliance contribute to insufficient Desmopressin response of primary monosymptomatic nocturnal enuresis and the role of voiding school

et al. 2021

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Aims To evaluate the impact of compliance on the therapeutic effects of Desmopressin, as well as the importance of establishing the voiding school for low-compliance children in primary monosymptomatic enuresis treatment. Methods Eighty-nine patients with primary monosymptomatic enuresis treated with Desmopressin were observed during the 2017–2020 at University Children’s Hospital Belgrade, Serbia. The average patients age was 7.7 ± 2.4 years; 65 (73%) were boys and 24 (27%) % were girls. After the 3 months of Desmopressin treatment, the effect of therapy was evaluated according to the compliance. After the treatment, low-compliance patients and their parents were suggested to visit a voiding school. Results A significant decrease in the median enuresis frequency was noticed during the Desmopressin treatment (25.0 (20.0–26.0) vs 10.0 (2.0–17.0) per month, before vs after treatment, respectively) (p < 0.001). Patients with low compliance had a poorer response to Desmopressin (p < 0.001). An median enuresis reduction in the good compliance group was 92.3% (86.7 -95%), while in the low compliance group was 28.6% (16.7–43.3%). After attending voiding school, there was a significant increase in compliance (p < 0.001), associated with an median percent decrease in enuresis of 84.0% (75.0–95.5%) (p < 0.001). Conclusion Compliance considerably influences the beneficial effects of Desmopressin. Patients with poor therapeutic effects should be evaluated for compliance and introduced to voiding school.

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Section: Discussionmentioning

confidence: 98%

Low compliance contribute to insufficient Desmopressin response of primary monosymptomatic nocturnal enuresis and the role of voiding school

et al. 2021

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“…In addition, several recent studies have also focused on investigating the therapeutic aspects of the enuresis. For example, Ferrara et al have recently investigated the impact of a motivational therapy on the outcomes for individuals diagnosed with nocturnal enuresis (50). The authors showed that motivational therapy could help positive effects on compliance to treatment and adherence to pharmacological therapy.…”

Section: Discussionmentioning

confidence: 99%

Parental Stress and Parental Ratings of Behavioral Problems of Enuretic Children

Roccella

Smirni

et al. 2019

Front. Neurol.

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Background: Primary monosymptomatic nocturnal enuresis (PMNE) may have a stressful impact on the everyday life of children and parents, and it may represent a cumulative stress factor increasing feelings of “learned helplessness.”Methods: The current study investigated parental stress in a group of parents (n = 330) of children affected by PMNE, compared to a group of parents (n = 330) of typical developing children (TDC). In addition, the study evaluated whether parents of PMNE children experience more emotional, social, and behavioral problems in their children, compared to parents of TDC. Finally, the study correlated frequency of enuresis with stress values and Child Behavior Checklist (CBCL) subscales and total stress with CBCL. Both groups were given The Parental Stress Inventory-Short Form (PSI-SF) and the Child Behavior Checklist (CBCL).Results: Parents of PMNE children showed significantly higher stress level than parents of TDC. Nocturnal enuresis, as a demanding clinical condition difficult to control, represents a relevant stress factor. Mothers appeared as more vulnerable to stress than fathers. Parents of PMNE children reported higher behavioral and emotional problems, compared to reports of parents of TDC. PMNE children appeared to their parents as having lower competency in social activities, school performance, and social relationships than TDC. Moreover, they were rated as more withdrawn, anxious-depressed, more aggressive, inattentive, and with more somatic complaints than healthy children. It was always the mother who rated a significantly higher number of emotional, social, and behavioral problems compared to fathers. Correlational analysis showed that the higher the frequency of enuresis, the greater the parental stress level, the lower the social activities, school performance and relational competencies and the higher the emotional, social and behavioral problems in children, according to the parents' evaluations. The greater the parental stress level, the lower the competencies rated and the higher the behavioral problems detected by parents.Conclusion: The physicians who deal with PMNE children have taken into account the stressful role and emotional dimensions of this clinical condition, both for children and mothers, in order to improve clinical management. Psychological support is needed for parents, and mothers especially, for a more functional stress management related to the PMNE.

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“…Motivational therapy differs for each patient; it is a style of therapeutic intervention that can be given as treatment together with pharmacological therapy [10].…”

Section: Introductionmentioning

confidence: 99%

“…In particular, the main therapeutic effect of desmopressin is its antidiuretic activity. Desmopressin rapidly reduces the number of wet nights per week compared with placebo and with homotoxicological remedies [10].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Enuresis among Children in Diyala Governorate

Salahaldeen¹,

Noaman²,

Al-Zuheiry³

2021

DJM

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Background: Nocturnal enuresis, is intermittent involuntary voiding in a child aged five years or more. One time a month for three months is required for the diagnosis. It is a common problem in children. It is the cause of stress for them and for their families. Enuresis can be classified into two types to understand its causes and treatment. These types are primary and secondary enuresis, monosymptomatic and polysymptomatic. Primary enuresis always associated with a familial history of delayed control of the urinary bladder. Secondary enuresis may cause by urinary tract or neurogenic causes like the spinal cord and urinary tract infection. Most of the cases were of the primary type. Objective: To evaluate the associated factor of nocturnal enuresis, study the various types of nocturnal enuresis, and evaluate the associated factors that affect the types of nocturnal enuresis. Patients and Methods: A cross-sectional study conducted in outpatient clinic of Albatool hospital in Diyala province, Iraq, 150 children was eligible in the study, which started from 1st Febreuary to 30th June 2020. Collection of the data was done by interview parents’ or the children's caregiver by a questionnaire that was used before for study enuresis. Analysis was carried out using statistical package for social sciences SPSS version 24. Results: The present study included 150 patients with enuresis, their mean age was 7.51±1.34 years (range:= 5-10 years), there were (59.3%) males and (40.7%) females. Most of the patients (61.3%) had 2-3 sibling, second in their birth order (52%), reside in the urban area (56%), a majority of the mothers 38% had primary school as their highest educational attainment, a majority of the fathers (32.7%) had secondary school as their highest educational attainment, most of the mothers 62.7% were housewives and 57.3% of fathers were employees. Regarding clinical features of the patients, 32% had a family history of enuresis, 52% had a history of fluid consumption other than water, 7.3% had a history of punishment, 8% had history of constipation, 27.3% had a history of emotional stress, 5.3% had a history of DM, 30.7% had a history of drug intake, 61.3% reveal UTI in their urinalysis, 78% reveal abnormal US findings. Secondary enuresis was found in 65.3% of the patients, while primary enuresis found in 34.7% of the patients, 7.3% of the patients complaining of diurnal enuresis. All studied factors not significantly associated with types of enuresis except constipation was found more in patients with secondary enuresis 91.7%. Conclusion: According to the previous study many risk factors were associated with nocturnal enuresis, in the current study these risk factors, except constipation which was associated with secondary enuresis, were not associated with nocturnal enuresis.

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The impact of motivational therapy in the management of enuretic children

Cited by 3 publications

References 17 publications

Low compliance contribute to insufficient Desmopressin response of primary monosymptomatic nocturnal enuresis and the role of voiding school

Low compliance contribute to insufficient Desmopressin response of primary monosymptomatic nocturnal enuresis and the role of voiding school

Parental Stress and Parental Ratings of Behavioral Problems of Enuretic Children

Epidemiology of Enuresis among Children in Diyala Governorate

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