الفهرس 
Anatomy& Physiology of urinary bladderOnly 14 pages are availabe for public view
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Abstract
Nocturnal enuresis, or bedwetting, is a common problem
of childhood. It is not a serious medical disorder, but it can be
very difficult to live with. Wetting the bed may interfere with
child’s socialization and it can lead to significant stress within the
family (Bachmann et al., 2010). Bedwetting is the cause of
significant psychosocial stress especially in older children
(Elbahnasawy & Elnagar., 2015).
The aim of the study was to assess QOL for children suffering
from enuresis.
Study Question
1. What is the effect of enuresis on quality of life of children?
2. What are the factors affecting the quality of life of such
children?
3. Is there relation between care givers level of knowledge
about enuresis and quality of life of their children?
Research Design:
A descriptive design was utilized for conducting the study
Research Setting:
This study was conducted at the Out Patient Clinic of
Institute of Psychiatry affiliated to Ain Shams University
Hospitals at special days for child clinic ( Saturday & Tuesday)
over 6 month’s period. Research Subject:
A purposive sample composed of (80) children (48 male
& 32 female)and their caregivers (mothers) suffering from
enuresis, involving children from both gender, aged (6<12)
years. In addition to their caregivers (80) regardless their
characteristics.
Tools of data collection:
Data were collected through using of the following tools:
1) A predesigned interviewing questionnaire (Appendix I): It
was developed by the researcher after reviewing the relevant
literature and it was written in Arabic Language to suit level
of understanding of the studied sample to collect data
regarding the following:
a) Demographic characteristics about children:
(Child’s age, sex, level of education and rank in the
family)
b) Demographic characteristics about care givers:
(Care giver’s age, sex, level of education, occupation,
marital status)
c) characteristics of housing condition & environment of
the child and their school achievement.
d) Medical history of children and care givers about: Type of enuresis, number of bed wetting per a week or
month, age of child in beginning urination.
e) Level of knowledge of the care givers & their enuretic
children about enuresis such as: [Definition, etiology,
clinical manifestations, management, prevention and care
of child with enuresis].
f) Caregivers practice toward their children with enuresis.
Details of toilet training & parent’s reaction toward
enuresis
g) Possible psychological problem caused by enuresis for
the child and factors affecting QOL.
Questions were in the form of multiple choices. Each
question was completed individually.
Scoring system for knowledge:
The total scoring for the questionnaire was ”100” marks.
According to answer. A complete correct answer was scored 2
and incomplete answer was 1 and incorrect answer was scored
zero for each area of knowledge, the scores of the items was
summed-up.
The children answers were categorized into:
· Score < 60 referred to unsatisfactory knowledge.
· Score 60 – 100 referred to satisfactory knowledge. Quality of life scale (Appendix II):
It was adopted from Varni et al., (2008) and used to
assess quality of life for children suffering from enuresis by
measuring the essential life spheres which includes: physical,
emotional, social, and scholastic functioning as well as general
well being. The score ranged from (0-2) with zero has always
the problem, 1 has sometimes the problem, 2 has never the
problem. The scale was formed of 31 statements that were
grouped to four domains:
1-Physical domain (8 items)
2-Emotional domains (7 items)
3-Social domains (9 items)
4-School domains (7 items)
Scoring system:
The total score for the QOL scale was ”62” marks.
The children answers were categorized in to:
· Score < 50% referred to poor QOL
· Score 50% – 75% referred to average QOL
· Score 75% – 100% referred to good QOL
Content validity and reliability Operational Design:
Preparatory Phase
In this phase the researcher reviewed the current available
related literature using available book, articles, and periodicals
magazines to develop the study tools and to get acquainted with
the various aspects of the research problem.
Exploratory phase:
A pilot study was carried out, involving 10% of the
expected study sample which total number (80) to test the
feasibility of the study in terms of its setting, tools, time
needed. The necessary modifications were done as revealed
from the pilot study by adding or omitting some items, and
then the children and accompanying caregivers who were
involved in the pilot study were excluded later from the study
subject.
Field Work:
The actual field work over 6 month’s period stated at the
beginning of July (2014) and was completed by the end of
December (2014). The researcher was available twice weekly
(Tuesday and Saturday) during morning shift from (9am to 12
md) using the previously mentioned study tools at the Out
Patient Clinic of Institute of Psychiatry. The researcher started
by introducing herself to the children and their caregiver and giving the brief idea about the aim of the study, explaining the
purpose of the study. Then verbal consent was obtained from the
children’s caregiver to participate in the study. The researcher
interviewed with each child and his care giver individually at
available time within 25-30 minutes to complete the
questionnaire sheet.
Result:
The most important findings obtained from the present study can
be summarized as the following:
· Three fifth (60.0%) of the studied children were males,
around half of enuretic children (52.5%) were in the age
group 10-12 years.
· The most of them 40.0% were in preparatory level of
education. And nearly half (47.5%) of them ranked as the
first child.
· The majority 85.0% of studied children were diagnosed
as primary enuresis, and more than half of them (57.5%)
belonging to big family size as their number of family
member ranged from 5-7 member.
· The majorities of the studied children were irregular in their
school attendance and reported poor scholastic achievement
about (70.0%) were fail in school due to enuresis..
· Around Three fifth (65.5%) of caregiver of enuretic
children were in the age group 30 < 40 years and nearly half (45.0%) of them were read & write in their educational
level, more than three quarter (82.5%) not working. About
third of them had family troubles as being divorced.
· The majority of the studied sample (97.0%) were lived in
shared house, (78.0%) were had separated bathroom, while
more than three quarters (82.5%) were had adequate lighting
in bathroom, also were running water& sewage.
· More than half of them (57.5%) were had nocturnal
enuresis, while about quarter of them (25.0%) were had
Diurnal enuresis, and only (17.5%) were had both.
· Regarding the possible complication of enuresis on child,
around half of them had sleep disturbances, nearly half of
them had emotional disturbances and more than half of
children had social disturbances.
· More than half of caregivers (55.0%) were physically punish
their children for their bedwetting, (20.0%) punish both
(physically & psychologically).
· Regarding the reaction & practice of the family toward
bedwetting of their children and receiving medication for
enuretic children the present study showed that, (42.0%) of
families used the herbal therapy, (77%) using beating
&intensity, while (45%) ask doctor advice.
· Regarding the child’s self concept, satisfying, self- esteem it
was clear from the present study that the great majority of There was no statistical significant relation (P= > 0.05)
between the child’s gender, the education of their caregivers
and the school functioning domain of quality of life.
· There was no statistical significant relation (P= > 0.05)
between the child’s gender and the social domain of quality
of life.
· There was statistical significant relation(P= < 0.050)
between the child’s age, gender and total quality of life,
while There was highly statistical significant relation
between the child’s diagnosis and total quality of
life(P=< 0.001).
· There was no statistical significant relation (P= > 0.05)
between caregiver’s work and their total knowledge about
enuresis.
· There was statistical significant relation (P= < 0.050)
between knowledge of the studied sample and their total
quality of life.
· There was highly significant relation between Total QOL
of children and Practice of caregivers with positive
correlation (P=< 0.001).
· There was no statistical significant relation (P= > 0.05)
between family size of the studied sample and their total
quality of life.